Calciphylaxis is a life-threatening vasculopathy that results from the deposition of calcium in the arteriolar vasculature of the deep dermis and subcutaneous adipose tissue, which causes occlusion of the affected blood vessels and overlying tissues and skin…
Read MoreA 41-year-old G1P0 female at 7 weeks gestation presents to the emergency department (ED) with 3 days of mild lower abdominal cramping and intermittent vaginal spotting. Nothing makes the cramps better or worse and the spotting randomly occurs throughout the day. She rates the cramping at a 7/10 and describes it as “bad period cramps.” She has no other symptoms and is nervous that “something is wrong with the baby”…
Read MoreA 68-year-old male presents to the emergency department (ED) with one week of worsening shortness of breath. He has no known cardiac history and has rarely seen a physician. He reports shortness of breath with exertion, mild non-productive cough, and subjective fever. He is not having chest pain. He is a long-time smoker but denies other drugs. Vitals are as follows: heart rate (HR) of 102, blood pressure (BP) of 105/70, afebrile, 89% on room air (RA), respiratory rate of 20. On exam the patient exhibits labored breathing, crackles in bilateral lower lung fields and +1 pitting edema in bilateral lower extremities…
Read MoreA 31 y.o. male presents to the Emergency Department with a chief complaint of swelling of his right leg. He has no past medical history, and his social history is significant for polysubstance use disorder and housing insecurity. He primarily injects opioids and cocaine and has had periods of time where he received medication assisted treatment with buprenorphine. On exam, there is an area of erythema and swelling on the lower right extremity that does not overly the joints. The area is warm and tender to palpation. There is no obvious wound or purulent drainage. The remainder of a 12 point Review of Systems is negative…
Read MoreA 14-year-old female presented to the emergency department (ED) with persistent left upper quadrant (LUQ) pain. She was last seen in the ED one week prior for similar symptoms. Initially, she was diagnosed with a urinary tract infection (UTI), treated with IV ceftriaxone, and discharged home on a course of cefdinir. On re-presentation, she complained of persistent LUQ pain, fevers with a Tmax of 103 F, and one episode of emesis overnight. Physical examination revealed abdominal tenderness in the LUQ, without ipsilateral CVA tenderness…
Read More