INSTAGRAM

ALiEM presents ACMT Toxicology Visual Pearl:  Salt, not Shock  What agent would most likely be responsible for these ECG findings?
 1	Cyclobenzaprine
 2	Digoxin
 3	Flecainide
 4	Sotalol
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.
.  Take-Home Points:
đź’Ą  Flecainide causes cardiac Na channel blockade, QRS prolongation, and toxicity can lead to ventricular arrhythmia.
đź’Ą  Treatment of choice for toxicity from cardiac Na channel-blocking agents is Na bicarbonate.
💥. Other therapies to consider in severe toxicity:  lipid emulsion, ECMO  Click link in bio for more info! 📲  https://www.aliem.com/acmt-salt-not-shock/  #FOAMEd #FOAM #EmergencyMedicine #MedicalEducation  #medicalstudent #residentlife #medschool  #Emergency

ALiEM presents ACMT Toxicology Visual Pearl: Salt, not Shock

What agent would most likely be responsible for these ECG findings?
1 Cyclobenzaprine
2 Digoxin
3 Flecainide
4 Sotalol
.
.
.
.

Take-Home Points:
đź’Ą Flecainide causes cardiac Na channel blockade, QRS prolongation, and toxicity can lead to ventricular arrhythmia.
đź’Ą Treatment of choice for toxicity from cardiac Na channel-blocking agents is Na bicarbonate.
đź’Ą. Other therapies to consider in severe toxicity: lipid emulsion, ECMO

Click link in bio for more info! 📲

https://www.aliem.com/acmt-salt-not-shock/

#FOAMEd #FOAM #EmergencyMedicine #MedicalEducation #medicalstudent #residentlife #medschool #Emergency
...

15 0
ALiEM presents SAEM Clinical Images Series:  An Ultrasonographic Rabbit Hole!  An 86yo man with a history of coronary artery disease, hypertension, hyperlipidemia, chronic kidney disease, COPD, choledocholithiasis requiring ERCP and sphincterotomy 2 years ago presented with 5 days of feeling unwell, with intermittent nausea, generalized abdominal pain, subjective fevers, chest pain, and shortness of breath. What do you see on the point-of-care ultrasound?  What is your suspected diagnosis?
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Perforated Gangrenous Cholecystitis!  💥 “Hole signs” with adjacent fluid collection on your gallbladder ultrasounds suggest perforation.
đź’Ą Intraluminal membranes or wall irregularities suggest gangrenous cholecystitis.
💥 Initial treatment:  broad-spectrum antibiotics and cholecystostomy tube decompression.  Click link in bio for more info! 📲  https://www.aliem.com/saem-clinical-images-series-ultrasonographic-rabbit-hole/  #FOAMEd #FOAM #EmergencyMedicine #MedicalEducation  #medicalstudent #residentlife #medschool  #Emergency

ALiEM presents SAEM Clinical Images Series: An Ultrasonographic Rabbit Hole!

An 86yo man with a history of coronary artery disease, hypertension, hyperlipidemia, chronic kidney disease, COPD, choledocholithiasis requiring ERCP and sphincterotomy 2 years ago presented with 5 days of feeling unwell, with intermittent nausea, generalized abdominal pain, subjective fevers, chest pain, and shortness of breath. What do you see on the point-of-care ultrasound? What is your suspected diagnosis?
.
.
.
.
.
Perforated Gangrenous Cholecystitis!

💥 “Hole signs” with adjacent fluid collection on your gallbladder ultrasounds suggest perforation.
đź’Ą Intraluminal membranes or wall irregularities suggest gangrenous cholecystitis.
đź’Ą Initial treatment: broad-spectrum antibiotics and cholecystostomy tube decompression.

Click link in bio for more info! 📲

https://www.aliem.com/saem-clinical-images-series-ultrasonographic-rabbit-hole/

#FOAMEd #FOAM #EmergencyMedicine #MedicalEducation #medicalstudent #residentlife #medschool #Emergency
...

18 0
ALiEM presents SAEM Clinical Images Series: Retrobulbar Spot Sign!  A 59yo man presented with sudden onset, painless vision loss in his left eye. He was watching TV 2 days prior when he saw a “brightness” in his left eye and then progressive blurriness until his vision faded away, all occurring within the span of a minute. At the time of presentation, he only sees a speck of light from that eye. He denied associated pain, flashes, floaters, jaw claudication, the sensation of a “curtain falling”, prior vision problems, or a history of blood clots. What does the POCUS finding suggest is the diagnosis?
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Central Retinal Artery Occlusion (CRAO)!
đź’Ą An ocular emergency that presents as acute painless monocular vision, caused by ischemia and infarction to the retina via thromboembolic disease to the central retinal artery. 
đź’Ą Requires immediate consultation with ophthalmology as well as neurology as it is considered a stroke equivalent.  Take-Home Points
âś… POCUS can guide us in diagnosing a patient with painless vision loss prior to more time-consuming fundoscopy exam.
âś… Interestingly, RBSS may predict poor response to systemic thrombolysis. 
✅. Stroke workup for CRAO is necessary, and don’t forget about secondary prevention/risk stratification which must be part of the management.  Click link in bio for more info! 📲  https://www.aliem.com/saem-clinical-images-series-retrobulbar-spot-sign/  #FOAMEd #FOAM #EmergencyMedicine #MedicalEducation  #medicalstudent #residentlife #medschool  #Emergency

ALiEM presents SAEM Clinical Images Series: Retrobulbar Spot Sign!

A 59yo man presented with sudden onset, painless vision loss in his left eye. He was watching TV 2 days prior when he saw a “brightness” in his left eye and then progressive blurriness until his vision faded away, all occurring within the span of a minute. At the time of presentation, he only sees a speck of light from that eye. He denied associated pain, flashes, floaters, jaw claudication, the sensation of a “curtain falling”, prior vision problems, or a history of blood clots. What does the POCUS finding suggest is the diagnosis?
.
.
.
Central Retinal Artery Occlusion (CRAO)!
đź’Ą An ocular emergency that presents as acute painless monocular vision, caused by ischemia and infarction to the retina via thromboembolic disease to the central retinal artery.
đź’Ą Requires immediate consultation with ophthalmology as well as neurology as it is considered a stroke equivalent.

Take-Home Points
âś… POCUS can guide us in diagnosing a patient with painless vision loss prior to more time-consuming fundoscopy exam.
âś… Interestingly, RBSS may predict poor response to systemic thrombolysis.
✅. Stroke workup for CRAO is necessary, and don’t forget about secondary prevention/risk stratification which must be part of the management.

Click link in bio for more info! 📲

https://www.aliem.com/saem-clinical-images-series-retrobulbar-spot-sign/

#FOAMEd #FOAM #EmergencyMedicine #MedicalEducation  #medicalstudent #residentlife #medschool  #Emergency
...

24 0
ALiEM presents SAEM Clinical Image Series:  Fever with Rash  A 40yo male, tailor by occupation, was brought to the ED with complaints of high-grade fever for 11 days. His temp was 102°F. The patient also complained of shortness of breath for 1 week and a dry cough, as well as an altered sensorium for 1 day. During his hospital stay, he developed ARDS and was on mechanical ventilation for 20 days. He was then extubated and discharged after 27 days.  What clinical condition is associated with eschars?
Which antibiotic is the treatment?  Watch the video to find out! 👀  Click link in bio for more info! 📲  https://www.aliem.com/saem-clinical-images-series-fever-with-rash/  #FOAMEd #FOAM #EmergencyMedicine #MedicalEducation  #medicalstudent #residentlife #medschool  #Emergency

ALiEM presents SAEM Clinical Image Series: Fever with Rash

A 40yo male, tailor by occupation, was brought to the ED with complaints of high-grade fever for 11 days. His temp was 102°F. The patient also complained of shortness of breath for 1 week and a dry cough, as well as an altered sensorium for 1 day. During his hospital stay, he developed ARDS and was on mechanical ventilation for 20 days. He was then extubated and discharged after 27 days.

What clinical condition is associated with eschars?
Which antibiotic is the treatment?

Watch the video to find out! đź‘€

Click link in bio for more info! 📲

https://www.aliem.com/saem-clinical-images-series-fever-with-rash/

#FOAMEd #FOAM #EmergencyMedicine #MedicalEducation #medicalstudent #residentlife #medschool #Emergency
...

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Also check out the Instagram feed by Dr. Michelle Lin.

Michelle Lin, MD
ALiEM Founder and CEO
Professor and Digital Innovation Lab Director
Department of Emergency Medicine
University of California, San Francisco
Michelle Lin, MD

@M_Lin

Professor of Emerg Med at UCSF-Zuckerberg SF General. ALiEM Founder @aliemteam #PostitPearls at https://t.co/50EapJORCa Bio: https://t.co/7v7cgJqNEn
Michelle Lin, MD