Red, Hot, Legs: Thrombophlebitis of the Superficial Veins of the Lower Extremity

A 34-year-old female with medical history notable for varicose veins presents with complaint of left medial thigh pain. The patient states the pain started 3 days ago. She denies any fevers. She states the area is very painful to the touch. No antecedent trauma or injury. She has been taking Tylenol with minimal relief. She has a remote history of varicose vein ablation to her left leg..

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“Gotta Go Right Now”: Use of Whole Bowel Irrigation in the Treatment of Lithium Toxicity

A 30-year-old female with a history of bipolar disorder presented after intentional lithium overdose. The patient reported feeling increasingly depressed for several weeks with intermittent suicidal thoughts. She reported getting into a verbal altercation with family while drinking alcohol and subsequently ingested a nearly full bottle of lithium (approximately 40 tablets, each with a concentration of 300 mg). She reported mild blurred vision and anxiety, but otherwise denied any other subjective complaints…

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Island Med: Challenges of Remote Healthcare

A 60-year-old man with a history of hypertension and smoking presents to the medical center with chest pain. Over the weekend, he developed chest pain while cleaning out his gutters that resolved with rest. This morning, he was working at his computer when he developed chest pain radiating to his left arm. It has since resolved, but he presents to the clinic for evaluation. An EKG obtained on arrival is unremarkable, but he soon develops chest pain again…

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Fall on Thinners: Management of Traumatic ICH in the ED

An 86-year-old female with past medical history of atrial fibrillation and coronary artery disease on apixaban and clopidogrel presents as a trauma activation after a mechanical fall from standing at her nursing facility. She does not remember the fall, but her nurse reports she tripped over her walker, fell and struck her head. She did not lose consciousness…

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