EMDutch

Hello everybody, today we have a very interesting case for you (that was send to me by one of my great collegeaus and friends working in the Netherlands!) Sadly the forensic pathologist had to give the diagnosis, which is always a bad sign.

An 80-year old man came to the ED during a nightshift, after falling a few steps from the stairs. He was complaining of neck and back pain, pain in his left elbow and in his  right wrist. It was uncertain if he had fallen on his head, but he had no loss of consciousness. Because he used marcoumar a CT-scan of brain was ordered which showed no traumatic brain injury. The CT-scan of neck, thorax and abdomen showed 2 vertebral fracture from C4 and T2 and 3 ribfractures (#1, 2, 7) on the right side with no pneumo-/hematothorax or vascular injury. In the thorax or abdomen no free fluid was found.  In the extremities there was also a fracture of the left elbow.

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Welcome back to EMDutch and GMEP Friday! At first I have to apologies for 2 things. 1.) Still no post about PE…I know, but I have to work 6 days this week + 1 day with the kids, so the post had to waith. 2.) Their were 2 correct answers in the question from last week, which was:   What does alcoholic ketoacidosis have in common with diabetic ketoacidosis? The correct answers were a Kussmaul respiration, but also a low serum insulin level. This means that 13/14 were correct! Great job!

Now the case + question for this week. First the case. (First take a look and the picture and see if you know what is wrong!)

https://gmep.org/media/13344

Now the question: https://gmep.org/questions/4217

addition to the question:

Apart from the Cotton Wool spots is the fundoscopy norma and he has several painless pigmented lesions on his cheeks and forehead!!!

Good luck and enjoy your weekend!

Egon

It’s friday…..so you know what that means! It’s time for GMEP FUN FRIDAY, here on EMDutch.

And without further ado, here is the case and question.

The case about a patient on steriods with abdominal pain. This case clearly shows that these patiets are very tricky patients! https://gmep.org/media/12157

And here is the question: https://gmep.org/members/exams/5024/questions/1 (to aswers the question log in on GMEP.org or give your answers in our pol below!)

The answer of last week was A: a pneumomediastinum does NOT always need a chest drain!  13/17 were correct!

Hope to see you next week! In the meantime the post “PE not as deadly as we think” is coming. It takes some more time since I am going to post it in a PPT which you all can en may use in your own hospital or for whatever reason you want.

HAVE A GREAT WEEKEND!

Egon

P.s. tell all your collegeaus about GMEP.org! Help build the greatest database out there!