Fever is so hot right now… ‘Humanity has but three great enemies: fever, famine and war; of these by far the greatest, by far the most terrible, is fever’ — William Osler1 Fever is one of the cardinal signs of infection and — nearly 120 years after William Osler’s statement in his address to the 47th annual meeting of the American Medical Association on The Study of the … [Read more...] about Fever, Friend or Foe?
aka Metabolic Muddle 008 You are asked to review a pregnant patient (30 weeks gestation) who has been diagnosed with pneumonia. The referring doctor is concerned that she has a metabolic acidosis. She is currently receiving high flow oxygen with an FiO2 of 0.5. This is her arterial blood gas: Questions Q1. Describe and interpret the A-a gradient. [DDET Answer and … [Read more...] about Pregnant and Acidotic
aka Hematology Hoodwinker 004 One of the emergency residents has just taken an ABG on the 44 year-old woman in cubicle 3. Prior to her current presentation she had no known medical problems. This is the arterial blood gas: The patient's pulse oximetry reading is SpO2 98% on air. Questions Q1. What are the possible explanations for the discrepancy between the … [Read more...] about Dissociated Oxygen Saturations
aka Oncology Quandary 002 A 30 year-old woman presents with abdominal pain and paraesthesiae. She was diagnosed with CML 2 months previously, and was treated with chemotherapy a month prior to presentation. These are her blood test results: Describe and interpret the test results. [DDET Answer and interpretation] Description: Mild hyponatremia … [Read more...] about Troubling Lab Strife
aka Pulmonary Puzzle 015 Post coauthor: Chris Nickson A 40 year old man had been in ICU for nearly 2 weeks and was slow to wean off the ventilator due to ARDS (acute respiratory distress syndrome). A percutaneous dilational tracheostomy (PDT) was performed. Following the procedure he developed a requirement for increased respiratory support. He was sufficiently stable … [Read more...] about Puffed Post-Tracheostomy