Core Cases

C3 – Critical Care Case (September)

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CC: Nausea, vomiting, and abdominal pain

HPI: Acid-Base Workshop: At the beginning of the conference year, multiple faculty members ran a workshop on acid-base abnormalities where we worked on identifying acid-base disturbances, determining primary respiratory or metabolic abnormalities, causes of such disturbances, and if compensation was appropriate. …

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August 2019

CC: 5 days of intermittent fever and 2 weeks of right lower back pain

HPI: 19 yo M with hx of anhydrosis and tetralogy of fallot s/p repair (at 9 mo of age) presenting with 2 weeks of continued right lower back pain and 5 days of intermittent fevers. Patient reports having fevers that have …

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July 2018

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CC: Aphasia and R-sided hemiparesis

HPI: 29yo FTM on testosterone cypionate, no other sig pmh, presents with worsening headache, expressive aphasia, and R sided hemiparesis. Pt had been having moderate L sided headache x 1 week prior to this presentation. No hx of headaches or migraines. …

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May 2018

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CC: Malaise

HPI: 45yo M with obesity, HTN, DM, GERD, EtOH abuse, presents feeling unwell and fatigued. Has mild HA, lightheadedness and for the past few days has been having polyuria with home FS in 300s. Was seen in ED yesterday with elevated …

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April 2018

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CC: AMS

HPI: 62yF with h/o low back pain presents to ED decreased sensation to bilateral upper extremities, R>L. Family reports weight loss and increased muscle cramps for over 1 month. Stroke team activated, GCS 15, NIHSS score 1 (decreased sensation over hands). …

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December 2017

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CC: Chest pain

HPI: 50yM no PMH, active smoker presents by ambulance with chest pain. Six hours ago he developed substernal chest pressure and nausea, no vomiting. Pain was moderate and constant, but he had a presyncopal episode 1hr prior and severe worsening of …

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November 2017

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CC: Shortness of breath and abdominal pain

HPI: 62yM PMH HTN, HLD, DM2, bioprosthetic MVR p/w shortness of breath and diffuse abdominal pain for three days. He c/o generalized malaise, nausea and multiple episodes of non-bloody, non-bilious emesis. He is concerned about elevated readings on his home glucometer. …

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October 2017

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CC: AMS

HPI: 52yM unknown PMH BIBEMS found minimally responsive in the field. The patient is undomiciled-appearing male found on a wet sidewalk in the rain. EMS administered 2 amps D50 IV, 2 mg Narcan IV, and 1L NS without improvement in mental …

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