Paucis Verbis card: Knee exam

How accurate is the clinical knee exam?

JAMA published a meta-analysis trying to answer this question. Although they include patients with acute and chronic knee pain, it’s a good general review of the knee anatomy, historical clues, and exam elements.

In the ED, the knee exam is challenging because we see very acute injuries where knee pain and swelling often preclude an accurate exam. For patients with an equivocal exam, be sure to refer for orthopedic follow-up. A repeat exam should be performed once the pain and swelling subside.

This installment of the Paucis Verbis (In a Few Words) e-card series reviews the Knee Exam.

I used to be all confused and had a hard time memorizing all the different maneuvers (especially for the meniscus). It is much easier to remember after doing these knee exams routinely. Particularly, the lateral pivot test and McMurray test can be done with several rounds of simultaneous knee flexion-extension, internal-external rotation, and valgus stressing. Looking at diagrams almost makes things more confusing.

PV Card: Knee Exam

Go to ALiEM (PV) Cards for more resources.

By Michelle Lin, MD|2021-10-19T18:57:31-07:00Mar 19, 2010|ALiEM Cards, Orthopedic|

Paucis Verbis card: Hyperkalemia management

Hyperkalemia is a common presentation in the Emergency Department, especially in the setting of acute renal failure. In one shift, I had 4 patients with hyperkalemia! All had from some form of renal failure.

This installment of the Paucis Verbis (In a Few Words) e-card series reviews the treatment options for hyperkalemia.

PV Card: Hyperkalemia

Adapted from [1]
Go to ALiEM (PV) Cards for more resources.

Reference

Weisberg L. Management of severe hyperkalemia. Crit Care Med. 2008;36(12):3246-3251. [PubMed]

By Michelle Lin, MD|2021-10-19T19:04:37-07:00Mar 12, 2010|ALiEM Cards, Endocrine-Metabolic|

Paucis Verbis card: Aneurysmal subarachnoid hemorrhage

Atraumatic subarachnoid bleeds are most commonly caused by ruptured intracranial aneurysms.

This installment of the Paucis Verbis (In a Few Words) e-card series reviews the current management, knowledge, and challenges in aneurysmal subarachnoid hemorrhage (SAH).

PV Card: Subarachnoid Hemorrhage

Adapted from [1]
Go to ALiEM (PV) Cards for more resources.

Reference

Edlow J, Malek A, Ogilvy C. Aneurysmal subarachnoid hemorrhage: update for emergency physicians. J Emerg Med. 2008;34(3):237-251. [PubMed]

By Michelle Lin, MD|2021-10-19T19:03:54-07:00Mar 5, 2010|ALiEM Cards, Neurology|

Great teaching video: Cell and flare

Using the slit lamp can be a challenge to learn, especially if you haven’t seen pathology before. In checking for anterior uveitis (i.e. iritis), you need to look for “cell and flare”. In theory, you know that you are looking for inflammatory cells and “flare”, which resembles a light beam being filtered through smoke.

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By Michelle Lin, MD|2019-01-30T11:38:44-08:00Mar 2, 2010|Ophthalmology|

Paucis Verbis card: NIH Stroke Scale

Patients present with acute strokes to the Emergency Department. Time is of the essence to obtain a rapid neurologic exam, draw labs, get CT imaging, and consulting a neurologist especially if the patient presents within 3 hours of onset. To help the neurologist determine whether the patient should get thrombolytics, calculating a NIH Stroke Scale score is useful.w

In this installment of the Paucis Verbis (In a Few Words) e-card series, here is the NIHSS scoresheet.

Score 0	No stroke
Score 1-4	Minor stroke
Score 5-15	Moderate stroke
Score 16-20	Moderate-severe stroke
Score 21+	Severe stroke

PV Card: NIH Stroke Scale

Go to ALiEM (PV) Cards for more resources.

By Michelle Lin, MD|2021-10-19T19:07:03-07:00Feb 26, 2010|ALiEM Cards, Neurology|

Paucis Verbis card: Ankle fractures

$Lauge-Hansen Classification of Ankle fractures$ Ankle fractures are a common injury diagnosed in the Emergency Department. Being able to speak Ortho-ese (i.e. the language of orthopedists) is invaluable in consulting the orthopedist over the phone. One ankle fracture classification system that our orthopedists like to use is the Lauge-Hansen system.

PV Card: Lauge-Hansen Classification of Ankle Fractures

Go to ALiEM (PV) Cards for more resources.

By Michelle Lin, MD|2021-10-19T19:08:02-07:00Feb 19, 2010|ALiEM Cards, Orthopedic, Radiology|

Paucis Verbis card: Urinary tract infection

In this installment of the Paucis Verbis (In a Few Words) e-card series, the topic is Urinary Tract Infection. UTIs are one of the most common infections that we treat in the Emergency Department.

PV Card: Urinary Tract Infection

Adapted from [1]
Go to ALiEM (PV) Cards for more resources.

Reference

Norris D, Young J. Urinary tract infections: diagnosis and management in the emergency department. Emerg Med Clin North Am. 2008;26(2):413-30, ix. [PubMed]

By Michelle Lin, MD|2021-10-19T19:10:04-07:00Feb 12, 2010|ALiEM Cards, Genitourinary|