Year: 2020

Case Reports

Renal Papillary Necrosis Case Report

Case Report (Sickle Cell Disease and Rhabdomyolysis vs. Renal Papillary Necrosis)  31 yo M w/ hx of sickle cell disease (SCD) presents to the ED c/o gross hematuria x 12 days. Pt  reports hematuria began shortly after exercising and has remained constant with each episode  of urination. Pt denies experiencing any similar sx’s previously. No abdominal pain, dysuria,  back pain, fever, nausea, vomiting, fatigue, myalgias. Otherwise, pt states he feels perfectly  normal. Pt was sent to ED from clinic for further evaluation.  Vitals stable.

by Mallory Castillo, MD
TJ Tidbits

Nail Trauma

Nail Trauma Brief Anatomy Overview: Topics to discuss:-Acrylic Nail Injury-Subungual Hematoma management -Nail Bed Injuries and management - cosmetic importance, prevent infection, enhance tactile sensation, enhancement of picking up objects, protects digits from mechanical injuries Why Should we care? 1) Acrylic Nail Injury 21 year old female presents to ED with “broken nail.” Patient had acrylic nails placed 2 weeks ago and accidentally slammed her right thumb into car door 2 hours ago, and heard a crack. She noticed bleeding at the sit

by Tejeshwer Jaswal, DO
TJ Tidbits

A note on ARVD

Hey so after some reading just thought I’d share some info on ARVD. This can be tricky to diagnose for many reasons. 1) What does it stand for? Arrhythmogenic Right Ventricular Dysplasia (common to replace Dysplasia with Cardiomyopathy). It’s the second most common death in young people <35yo with males more common than females (up to 20% of SCD in young).  (Bonus points: what’s the most common death in young people?) Interns..? 2) Two types: autosomal dominant (most common we see) and autosomal recessive (Naxos Disease, watch out for people with Itali

by Tejeshwer Jaswal, DO
Sunday Scaries

Angioedema (Sunday Scary)

Now to the Scary -- ANGIOEDEMA Background -- Angioedema is a paroxysmal, non-demarcated swelling of dermal or submucosal layers of skin / mucosa. Swelling is typically asymmetric, non-pitting and nonpruritic but can be associated with allergic features.  isolated uvular angioedema (Quincke's disease) is a rare presentationcauses: trauma, inhalation, general anesthesia, meds (ACEI), infections, hereditary Etiologies  ACE-I (bradykinin) Hereditary Autosomal DominantC1 esterase deficiency --> unregulated bradykinin associated with compli

by Angela Frisby, DO
Sunday Scaries, TJ Tidbits

Ovarian Torsion

So it’s a busy weekday at Coney Island Hospital. You get an upgrade and it’s for a 41 year old woman with severe RLQ abdominal pain. You see she’s writhing in bed, crying and guarding. Vitals are normal but she is slightly tachycardic. What do you do next?  History! History!  The patient is not fully cooperating with your questioning because of the pain but tells you it started 2 hours ago and that the pain is sharp, 10/10 constant and nonradiating. She woke up with this pain and had 2 episodes of vomiting and is still nauseous.  You press on her abdom

by Tejeshwer Jaswal, DO
Sunday Scaries

Breakfast with Boo Boos, the grand reveal!

You're working at an ED in a small hospital, (or Coney on a very very very bad day) consult services take at home call and availability is consistently twenty minutes from arrival. A 20s-40s year old woman comes in, obese body habitus, no known medical history, ill appearing, unable to give a medical history. She mouths something that you think looks like 'baby' before she becomes unresponsive.  Clock starts ticking, good thing you trained at Coney Island Hospital. (copyright) 2020 ACGME accreditation. Welcome to Breakfast with Boo Boos.... TIME ZERO. 

by Brenda Sokup, DO
Sunday Scaries

Gout: Don’t Poo Poo Podagra

Gout: Don't Poo Poo Podagra We spend a lot of time talking about septic joints/arthritis, when/when not to do the joint aspirations, but how about our forgotten mono-arthritic friend GOUT.  Picture yourself on an overnight shift, it's 5:30a and on your board pops up a 50yr Male with Foot Pain. You walk over to the bed and see this foot "Greaaaatttt" you think to yourself, "does this person want a work note? Are they seeking opiates? Do I attempt to do an arthrocentesis? How is this an EM problem?!?!" WHO?: 1-4% of overall population. Think: Old Obese

by Alyssa Cocchiara, DO