Wide, Complex and Troublesome

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aka Cardiovascular Curveball 013 A junior colleague asks if he can discuss a case with you. His patient is a 23 year-old man who presents with 2 hours of rapid regular palpitations associated with ‘not feeling quite right’. These symptoms came on while he was running on a treadmill at his local gym. He has [...]

Muscular claustrophobia

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A 27 year-old man sustained an undisplaced midshaft fracture of his left tibia after his girlfriend inadvertently (or so she said…) backed into him in her car, with the rear bumper pinning his leg against the car behind. Following an orthopedic consult, he was put in a long leg cast and sent home…what happened next?

Puzzling out the PERC rule

A patient has chest pain and shortness of breath. Is there a way to rule out pulmonary embolism without further investigation? Can you use the PERC rule?

Forgetting the Unforgettable II

The man did not respond. No amount of verbal persuasion could make him lift his eyelids and the only noises he made were incomprehensible groans. He moved only to push away his loved ones and the hospital staff trying to look after him.

Hyperammonaemia

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You’ve just been handed over a patient who has an altered mental status when the phone rings. It’s the lab – you’re told that your patient has a serum ammonia level of 250 umol/L (reference range, 11-35 umol/L). WTF?

Putting the Wencke back in your life

The impact of audio, visual and kinaesthetic learning modalities within a contextual setting is an effective educational ploy. Have been using this great video from ‘Med 2010 – U of A records’ to demonstrate these education techniques to medical students and residents with great effect….