Awesome visual pearls, perils and pitfalls from the University of Maryland Emergency Medicine gurus especially + Haney Mallemat (@criticalcarenow). See also…
Scenario | UMEM Link | Keywords |
|---|---|---|
| 19 year-old male presents with L ankle pain and obvious deformity after jumping out of a window and landing on his inverted foot. What's the diagnosis? | UMEM Pearl 001 | ankle, subtalar, dislocation, limp |
| An alcoholic patient presents with a cough, fever, and very foul smelling breath (worse than usual) | UMEM Pearl 002 | Lung abcess, respiratory, CXR |
| 68 yo man presents with new-onset seizures. What is your differential diagnosis? | UMEM Pearl 003 | CT, head, ring enhancing, lesion |
| 67 yo male presents with burning substernal chest pain; worse with meals and when supine. What's the diagnosis? | UMEM Pearl 004 | hernia, GERD, GORD, HH, hiatus |
| 26 year old male with pain when he extends his 4th finger as well as swelling of that digit. | UMEM Pearl 005 | hand, finger, infection, tenosynovitis |
| 14 year-old male presents with right-sided testicular pain. What's the diagnosis? | UMEM Pearl 006 | testicle, pain, torsion, ultrasound |
| 24 year-old male presents following fall from a scaffolding and complains of wrist pain. Diagnosis? | UMEM Pearl 007 | hand, wrist, scaphoid, lunate, dislocation |
| 35 year old male with sudden onset of abdominal pain. Diagnosis? | UMEM Pearl 008 | pneumonperitoneum, x-ray |
| 28 y.o. male felt his left knee "pop" after landing from a jump while playing basketball. Knee exam revealed limited knee extension. X-ray is shown. Diagnosis? | UMEM Pearl 009 | Patella Alta secondary to Patellar tendon rupture, knee, x-ray |
| 20 year old female complains of ÛÏitchyÛ rash to her foot x 1 week and recently the rash has spread to her other other foot and both hands (shown below). No past medical history, no fever or chills, no mucus membranes involvement, no new medications, no tick bites, no travel. She is also 16 weeks pregnant. WhatÛªs the diagnosis? | UMEM Pearl 010 | STD, infectious disease, dermatology, syphilis |
| 23 year-old male fell off porch while intoxicated. The head CT is shown below. Diagnosis? | UMEM Pearl 011 | pneumocephalus, CT head, fracture, skull |
| 64 year old male with emphysema and stage 4 lung cancer presents in respiratory distress. What's the diagnosis? | UMEM Pearl 012 | Pneumothorax, bullae, CXR, chest, lung ca |
| 60 year old male with 6 months of weight loss and recent epistaxis. Diagnosis? | UMEM Pearl 013 | SVC, obstruction, vascular, obstruction |
| 9 year-old boy with sudden onset of unilateral facial swelling. WhatÛªs the diagnosis? | UMEM Pearl 014 | Parotitis, mumps, bacterial, viral |
| 72 year-old man, one-week post right fem-pop bypass presents with painful blue and black toe. Diagnosis? | UMEM Pearl 015 | Blue-Toe Syndrome, Emboli, Vascular, infective |
| 5 year-old male with developmental delay presents with intractable non-bloody and non-bilious vomiting over 10 days; bowel movements are normal. Four weeks ago he was placed in a hip-spica cast following a motor vehicle crash. Abdominal x-ray is below. Diagnosis? | UMEM Pearl 016 | CAST syndrome, x-ray, Superior Mesenteric Artery Syndrome |
| 50-year-old diabetic female s/p foot burn several weeks ago, now presenting with pain and discharge from a poorly healing wound. Diagnosis? | UMEM Pearl 017 | Osteomyelitis, diabetic foot, x-ray |
| 19 year-old male s/p high-speed MVC with hypotension and diminished breath sounds on left. Diagnosis? | UMEM Pearl 018 | diaphram rupture, trauma, chest x-ray |
| A 50 year-old patient presents after a self-inflicted eye injury. The patient had taken some type of needle and inserted it into their eye. What is the diagnosis and what complications might result? | UMEM Pearl 019 | eye, penetrating trauma, needle, ocular, endophalmitis |
| 26 year old male presents s/p basketball dunk. Diagnosis? | UMEM Pearl 020 | talar dislocation, ankle, x-ray, trauma |
| Patient presents with right-sided chest and shoulder pain.... What's the diagnosis? | UMEM Pearl 021 | Herpes Zoster, rash, vesicles, shingles |
| 79 y.o. male lung cancer patient with tachypnea, tachycardia, and normal blood pressure. | UMEM Pearl 022 | Right ventricular (RV) dysfunction, ultrasound, submassive pulmonary embolism |
| 13 year-old right-hand dominant male following assault with blunt object. Diagnosis? | UMEM Pearl 023 | Monteggia fracture, x-ray, trauma |
| 34 y.o. male with history of IVDA (intravenous drug abuse) complains of fever, chills and cough. Diagnosis? | UMEM Pearl 024 | IV drug use, lung abscess, CXR, chest x-ray, CT |
| 48 year old male following 15 foot fall onto both feet. What is the diagnosis? Û_and why is it called the ÛÏLoverÛªs FractureÛ? | UMEM Pearl 025 | Calcaneus fracture, trauma, lover's fracture, x-ray, Bohler's angle |
| 49 y.o. female on Trimethoprim/sulfamethoxazole presents with rash and oral mucus membrane lesions. Diagnosis? | UMEM Pearl 026 | Steven-Johnson Syndrome, rash, drug |
| 13 y.o. with shoulder trauma (during basketball game). Arm held in adduction and exquisite scapular tenderness. Diagnosis? | UMEM Pearl 027 | Scapular fracture, x-ray, shoulder, trauma |
| A 20 year-old female presents with bilateral neck pain that occurred at rest. No other complaints. See if you can find the subtle clue on the x-ray... | UMEM Pearl 028 | Pneumomediastinum, subcutaneous emphysema, x-ray, chest |
| 13 y.o. female with ankle pain following fall down escalator. What's the diagnosis? (Hint: Look very closely) | UMEM Pearl 029 | Tri-plane ankle fracture, x-ray, trauma |
| 50 yo female s/p motor vehicle crash. Diagnosis? | UMEM Pearl 030 | PneumomediastinumåÊfrom pneumothorax, chest x-ray |
| 70 yo female from nursing home with fever. RUQ ultrasound is shown below. Diagnosis? | UMEM Pearl 031 | Acalculous Cholecystitis, ultrasound |
| Patient presents with the following X ray after yawning. Diagnosis? | UMEM Pearl 032 | mandibular dislocation, x-ray |
| 60 y/o male transferred from local rehab facility c/o abdominal pain. | UMEM Pearl 033 | Ogilvie's syndrome, x-ray, Acute colonic pseudo-obstruction (ACPO) |
| 25 year old male presents after falling from 10 feet and landing on right shoulder. Diagnosis? | UMEM Pearl 034 | Glenoid Fossa Fracture, shoulder dislocation, scapula, x-ray |
| 65 yo female with breast cancer presents with dyspnea and CXR shown below. Diagnosis? Can anything help clarify the diagnosis? | UMEM Pearl 035 | ung, ultrasound, pneumonia, hepatization, sonogram, air bronchograms |
| 24 yo woman presents with syncope, abdominal pain, and normal menses 4 days prior. Urine HCG(+) and quantitative beta-HCG is 1300 with the transvaginal ultrasound seen below. Diagnosis? | UMEM Pearl 036 | ultrasound, ectopic, free fluid, hypotension, pregnancy |
| 50 year-old s/p fall.....what's the diagnosis? | UMEM Pearl 037 | Luxatio Erecta, shoulder, x-ray, inferior glenohumeral dislocation |
| What's wrong with this picture? (Don't scroll too far down) | UMEM Pearl 038 | boxer's, fracture, orthopedics, hand, brawler's, radiology, xray |
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