Beyond the Abstract: Systemic Online Academic Resources Review: Renal and Genitourinary

Production and use of free open access medical education resources (FOAM) has had a meteoric rise over the last decade.​1–4​ ALiEM works hard to produce content, disseminate knowledge, and consolidate resources in a democratic and accessible way. However, we recognize that FOAM comes with its own limitations:

  1. Blogs are distinct, individual, and decentralized. How can we search for topic-specific content?
  2. FOAM doesn’t often have peer review. How can we assess quality and accuracy?
  3. FOAM is produced on an as-needed basis. How do we achieve curricular comprehensiveness?

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By |2020-05-20T21:59:24-07:00May 20, 2020|Genitourinary, Renal|

Diagnose on Sight: Scrotal Swelling

pneumoscrotum

Case: A 58-year-old male with no past medical history presents to the emergency department for evaluation of right lower quadrant abdominal pain associated with right scrotal swelling. The patient reports that he had a colonoscopy the day before to remove a 20 mm polyp, which had been seen on an outpatient CT scan. He states that he noticed that his right scrotum appeared slightly swollen immediately away after the procedure, but since then the swelling had increased and he developed mild right lower quadrant abdominal pain. Physical examination reveals mild tenderness to the right lower quadrant and swelling of the right scrotum with palpable crepitus of the right scrotum and inguinal canal.  There is no overlying skin discoloration.  What is the most likely diagnosis?

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SAEM Clinical Image Series: Flu-like symptoms, oral ulcers, and rash

palmar rash erythema multiforme

[Click for larger view]

Chief Complaint: Flu-like symptoms, lip pain/swelling, mouth pain, eye redness, and rash

History of Present Illness: Patient is a 35-year-old transgender male with a history of bipolar disorder (taking seroquel/lamotrigine) who presents with 2 days of:

  • Flu-like symptoms
  • Progressive lip pain/swelling
  • Mouth pain
  • Oral ulcers
  • Eye redness
  • New erythematous rash involving the palms/soles and lower extremities

The patient initially noted myalgias, fever, and malaise 2 days ago. Yesterday, the patient woke up with bilateral eye redness and itching, and he developed lip swelling/discoloration and mouth pain throughout the day. He presented to an outside emergency department (ED) 12 hours prior, where he was told that he had a viral infection, given pain medication, and discharged home. He has not taken any other medications. The patient presents to this ED due to progression of symptoms, including the development of a pruritic rash on his palms, soles, and lower extremities. Upon further questioning, the patient also reports vaginal itching and a fishy odor. He has a history of bacterial vaginosis and states that these symptoms feel similar. The patient denies genital sores, vaginal discharge, and vaginal bleeding. He is currently sexually active with men and women, and does not regularly use barrier protection.

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Algorithm for ED Evaluation and Management of Pediatric UTI

Pediatric UTI - urine sample

When should urinary tract infections (UTI) be included in the differential diagnosis for febrile infants and young children? The EM Committee on Quality Transformation in the American Academy of Pediatrics (AAP) thoughtfully outlines a clinical algorithm to help guide clinicians towards a standardized, evidence-based approach. Thanks to the expert content team (Drs. Shabnam Jain, Anne Stack, Scott Barron, Pradip Chaudhari, and Kathy Shaw) for sharing this clinical algorithm.

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Renal Colic & Pulmonary Embolism CT | Reducing Imaging: ACEP E-QUAL Network Podcast

Computed tomography (CT) is increasingly available across U.S. Emergency Departments and has changed the practice of medicine. However, it is coupled with potential side-effects from radiation and contrast media. Emergency Medicine is beginning to make a concerted effort to identify clinical scenarios in which CT may be unnecessary, producing outcomes research and validated clinical decision rules. Renal colic and pulmonary embolism, in particular, seem amenable to this area of investigation. The ACEP E-QUAL Network podcast, a partnership with ALiEM to promote clinical practice improvements, reviewed this topic with experts Dr. Chris Moore (Emory University) and Dr. Jeffrey Kline (Indiana University). We present highlights from their discussion with Dr. Jason Woods.

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By |2020-04-20T19:38:20-07:00Mar 5, 2018|Genitourinary, Podcasts, Pulmonary, Radiology|

Ultrasound For The Win! Case – 64M with Fever and Scrotal Pain #US4TW

Welcome to another ultrasound-based case, part of the “Ultrasound For The Win!” (#US4TW) Case Series. In this series, we focus on a real clinical case where point-of-care ultrasound changed the management or aided in the diagnosis. In this case, a 64-year-old man presents with acute onset scrotal pain and fever.
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AIR Series: Renal/Genitourinary (2017)

air series renalWelcome to the Renal/GU Module! After carefully reviewing all relevant posts from the top 50 sites of the Social Media Index, the ALiEM AIR Team is proud to present the highest quality Renal/GU content. Below we have listed our selection of the 13 highest quality blog posts within the past 12 months (as of May 2017) related to Renal/GU emergencies, curated and approved for residency training by the AIR Series Board. We identified 3 AIRs and 10 Honorable Mentions. We recommend programs give 4 hours (about 20 minutes per article) of III credit for this module. As of June 2017, over 125 residency programs are using the AIR series – that’s over 1,200 residents completing at least one module in the 2016-2017 academic year!
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