All the content from the Blood & Clots series can be found here. CanMEDS Roles addressed: Medical Expert Case Description You are seeing a 54F in the emergency department after she sustained a mechanical fall. She struck her head on the pavement and is now confused. Her comorbidities include: hypertension, diabetes mellitus, and atrial fibrillation. She has been taking rivaroxaban 20 mg daily for three years without incident. Her complete blood count (CBC) …
Tiny Tips: “TREADMILLS” Peripheral Neuropathy mnemonic
Peripheral neuropathy is prevalent in up to 2.4% of the general population1. It is often characterized by an asymmetric distribution with sensory symptoms following a dermatomal pattern. Initial investigations include a complete blood count (CBC), metabolic panel (electrolytes, glucose, urea, creatinine), and thyroid stimulating hormone (TSH)2. There are many causes for peripheral neuropathy, so when considering the etiology, think “TREADMILLS.” Toxins Ethanol, Heavy metals, Tetanus, Organophosphates, Diphtheria Renal Failure Endocrine Diabetes, Hypothyroidism Acquired …
Blood and Clots Series: How can I tell whether this patient has a deep vein thrombosis?
All the content from the Blood & Clots series can be found here. CanMEDS Roles addressed: Communicator, Collaborator, Scholar, Professional, Medical expert Case Description A patient with increasing pain and edema in his left leg. In a recent hospital admission he was diagnosed with myeloma. This case reviews pretest probability of deep vein thrombosis, D-dimer and interpretation of compression ultrasound. Main Text Last week when I came onto a day shift I was …
Tiny Tips: “C-3PO’s RIVAL” Acute Unilateral Painless Vision Loss mnemonic
Early diagnosis and treatment of acute, painless vision loss greatly increases the chances of vision restoration. Though treatment for most conditions involves an ophthalmology consult, it is important to consider and evaluate for the possible etiologies. A mnemonic to remember the list of causes for acute unilateral painless vision loss is “C-3PO’s RIVAL”.1 Central Retinal Artery Occlusion (CRAO) Central Retinal Vein Occlusion (CRVO) Cerebral Vascular Accident (CVA) Posterior Vitreous Detachment (PVD) Optic Neuritis …
Spot the Diagnosis! The Case of the Dutch Painter
In 1665, Rembrandt painted an honest portrait of his younger colleague Gerard de Lairesse, unknowingly immortalizing this painter’s unique physical appearance for contemporary speculation. Like Rembrandt, de Lairesse was a celebrated Dutch artist who was widely influential in his time for his French-style paintings. Today, many believe that he shows facial manifestations of this infectious disease. Do you know what disease he may have had? While you’re giving it some thought, please consider taking …
Tide Pod Challenge: Managing caustic laundry pod ingestions
A Case of Laundry Pod Ingestion You are called to the low-acuity side of your department for a two year old child who was triaged three hours ago. The child was witnessed to eat a laundry pod at home, but was stable on arrival so sent to the back. Now, the child is wheezing, seems drowsy, and is tachycardic. When you approach the child, he begins to cry and you note the sound …