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Clinical Question: What is the best treatment for acute dyspepsia?

In Clinical Questions, Medical Concepts by Colin Siu0 Comments

The Case: Tummy Ache? Piece of Cake! A 26-year-old woman presents with epigastric pain after consuming a large piece of cake. She describes that she had previously been diagnosed with heartburn by her family doctor and was on a heartburn medication but stopped taking it when she went on vacation. She denies associated chest pain, shortness of breath, and changes in bowel habits. She describes the pain as a 7/10 sharp stabbing pain. She is otherwise …

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Clinical Question: How useful is the β-HCG discriminatory zone in a suspected ectopic pregnancy?

In Clinical Questions, Medical Concepts by Taft Micks0 Comments

For female patients presenting to the emergency department with a positive serum β-HCG as well as abdominal pain, vaginal bleeding, syncope, or hypotension, the prudent emergency physician must rule out an ectopic pregnancy (EP). This potentially life-threatening entity is estimated to occur in 1.5 to 2% of all pregnancies and ruptured ectopic pregnancies account for 6% of all maternal deaths [cite num=”1″]. Point-of-care ultrasound (either trans-abdominal or trans-vaginal) has become the standard of …

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Boring Question: What is the role of the FAST exam for blunt abdominal trauma?

In Clinical Questions, Medical Concepts by Michael Butler0 Comments

You are working an overnight shift in the emergency department when a 40 year-old male passenger involved in a high-speed motor vehicle collision arrives. His vital signs include a blood pressure of 88/56 mmHg, heart rate of 112, and respiratory rate of 16. His Glasgow coma score is 12 (3E, 4V, 5M). En route, your patient received 2L of normal saline with no change in his blood pressure. On exam, his abdomen is tender …