Category: Visual Diagnosis
Posted: 11/17/2014 by Haney Mallemat, MD
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Patient presents with dyspnea & hypoxemia (pulse oximeter is 80%). The "stat" CXR is delayed, but ultrasound is not. What's the diagnosis and what are some differential diagnoses?
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Category: Visual Diagnosis
Posted: 11/10/2014 by Haney Mallemat, MD
(Emailed: 11/11/2014)
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Parasternal long-axis of two different patients. What is the:
Answer:
Take home pearl: when there is fluid behind the heart, the parasternal long-axis view of the heart is helpful to distinguish between a pleural effusion and a pericardial effusion.
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Category: Visual Diagnosis
Posted: 11/4/2014 by Haney Mallemat, MD
(Updated: 11/5/2014)
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A patient presents post-motor vehicle crash with chest pain and dyspnea. The lung ultrasound is shown below. What's the diagnosis?
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Category: Visual Diagnosis
Posted: 10/20/2014 by Haney Mallemat, MD
(Updated: 11/4/2014)
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13 year-old right-hand dominant following assault with blunt object. What’s the diagnosis?
Monteggia Fracture
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Category: Visual Diagnosis
Posted: 10/13/2014 by Haney Mallemat, MD
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A neck ultrasound is performed during endotracheal intubation. What is labeled "A", what is labeled "B" and what's the diagnosis?
Answer:
A: Trachea
B: Esophagus
This is an esophageal intubation! Take out the tube and try again. Check out this podcast for more on the technique from my good friends at the ultrasound podcast
Here's a summary:
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Category: Visual Diagnosis
Posted: 10/6/2014 by Haney Mallemat, MD
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7d old child presents with difficulty feeding,vomiting one time, and now with intermittent apneic episodes. What's the diagnosis? (Careful....this one is tricky!)
Answer: Workup should include an ALTE and sepsis evaluation PLUS evaluation for non-accidental trauma
Non-accidental trauma (NAT)
NAT is most prevalent in children 0-3 months of age.
Classic metaphyseal lesions, rib fractures, and fractures in various stages of healing are most commonly described in children.
How do we know this is not just birth trauma from a shoulder dystocia, large for gestational age, or difficult vaginal delivery?
Subperiosteal new bone formation appears as a:
NAT Work-up:
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Category: Visual Diagnosis
Posted: 9/28/2014 by Haney Mallemat, MD
(Emailed: 9/29/2014)
(Updated: 10/1/2014)
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Person presents with painless vision loss after seeing flashes of light. Ultrasound is below. What's the diagnosis?
Answer: Vitreous hemorrhage with retinal detachment
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Category: Visual Diagnosis
Posted: 9/15/2014 by Haney Mallemat, MD
(Updated: 10/1/2014)
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Football player complains of sudden foot pain after begin tackled. What’s the diagnosis?
Lisfranc fracture-dislocation
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Category: Visual Diagnosis
Posted: 9/8/2014 by Haney Mallemat, MD
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CXR shown below, what's the diagnosis? ...and name 3 differential diagnoses.
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Category: Visual Diagnosis
Posted: 9/1/2014 by Haney Mallemat, MD
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You are scaning the liver with ultrasound and you see this. What's the diagnosis?
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Category: Visual Diagnosis
Posted: 8/25/2014 by Haney Mallemat, MD
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50 year-old female with diabetes complains of pain and discharge from a poorly healing wound. XRay below. What's the diagnosis?
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Category: Visual Diagnosis
Posted: 8/18/2014 by Haney Mallemat, MD
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A critically-ill patient requires fluid resuscitation. Someone hands you a bag of this. What’s the pH of this fluid?
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Category: Visual Diagnosis
Posted: 8/11/2014 by Haney Mallemat, MD
(Updated: 8/12/2014)
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30 year-old female with complains of night sweats and painful lesions on her fingertips. What’s the diagnosis and list some things to have in the differential diagnosis?
Answer: Osler Nodes
Osler notes are painful, palpable, and erythematous lesions secondary to the deposition of immune-complexes within the pads of digits.
Although classically associated with infective endocarditis, some authors claim that it may be seen in only 10-23% of confirmed cases. Therefore the differential diagnosis should also include:
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Category: Visual Diagnosis
Posted: 8/4/2014 by Haney Mallemat, MD
(Updated: 8/12/2014)
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40 year-old female presents with painful lesions and ulcers on lower extremities. She has had this before, but never to this extent. She also has a history of DVT. What’s the diagnosis?
Answer: Livedoid vasculopathy or Livedoid vasculitis (LV)
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Category: Visual Diagnosis
Posted: 7/27/2014 by Haney Mallemat, MD
(Emailed: 7/28/2014)
(Updated: 7/28/2014)
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2-day old baby boy presents with forceful vomiting of entire feeds, bloated belly, and has not passed stools since birth. What's the diagnosis?
Colonic atresia
Colonic Atresia
Small bowel atresia
Meconium plug syndrome
Hirschsprung's disease
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http://emedicine.medscape.com/article/934014-overview
Category: Visual Diagnosis
Posted: 7/21/2014 by Haney Mallemat, MD
(Updated: 7/22/2014)
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45 year-old right-hand dominant patient presents with right hand pain from a prior injury to hand. Patient has also been injecting subcutaneous heroin into hand for relief. What's the diagnosis?
Perilunate dislocation (volar displacement)...and severe hand cellulitis.
Perilunate and Lunate dislocations
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Category: Visual Diagnosis
Posted: 7/14/2014 by Haney Mallemat, MD
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30 year-old presents with cough & fever. CXR shows mild right lower lobe pneumonia. The lung ultrasound of the right lower lobe is shown below. What's the diagnosis?
Answer: Pulmonary abscess
Bottom-line: Not only is ultrasound faster than a CXR in diagnosing pneumonia, unexpected diagnoses may be found that change management
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Category: Visual Diagnosis
Posted: 7/6/2014 by Haney Mallemat, MD
(Emailed: 7/7/2014)
(Updated: 7/7/2014)
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10 year-old male complains of fever and rash (shown below); no other complaints. He went camping 10-days ago. What’s the diagnosis...and what medication(s) should he receive?
Rocky Mountain spotted fever (RMSF)
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Category: Visual Diagnosis
Posted: 6/30/2014 by Haney Mallemat, MD
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49 year-old female on trimethoprim/sulfamethoxazole presents with a rash & lesions on her oral mucus membranes. What's the diagnosis?
Answer: Steven-Johnson Syndrome (SJS)
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Category: Visual Diagnosis
Posted: 6/22/2014 by Haney Mallemat, MD
(Emailed: 6/23/2014)
(Updated: 6/23/2014)
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35 year-old female presents with nausea and vomiting 1 week post-op for an abdominal surgery. Abdominal ultrasound is below; what's the diagnosis?
Small bowel obstruction (SBO)
Ultrasound for Small bowel obstruction (SBO)
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