ACMT Toxicology Visual Pearl – Apricot Kernels: Eat or pass?
What toxin is found in bitter apricot kernels? Cardiac glycoside Cyanogenic glycoside Dinitrophenol Lysergic Acid [+]
Maureen Nsofor, MD
Atrium Health’s Carolinas Medical Center
Latest posts by Maureen Nsofor, MD (see all)
SAEM Clinical Images Series: More Than Skin Deep
A 57-year-old female college counselor living in the northeastern United States with no PMH presented for evaluation of rash, joint pain, and dyspnea for the past three weeks. The patient first noticed the rash on her upper back, describing it as being itchy. The rash then spread to her face, scalp, and thighs. Two weeks ago, she noticed swelling in her hands and had a gradual onset of dyspnea on exertion. The patient has pain in her hands and when moving her fingers. She denied fever, cough, chills, chest pain, headache, vision changes, focal weakness, [+]
SAEM Clinical Images Series: Man with a Recurrent Rash
A 33-year-old male presented to the emergency department with a diffuse pruritic rash that appeared several days after starting Trimethoprim/Sulfamethoxazole (TMP-SMX) for a dental infection. Initially beginning on the torso and low back, the rash spread to the palms, soles, and genitalia. Progression stopped after discontinuing TMP-SMX. He conveyed a remote history of a similar rash following use of an unknown medication, and noted that several of the current lesions arose at the same location as previous. Skin: Widely distributed violaceous, non-blanching patches with a dusky center. Lesions ranged from 3 [+]
ACMT Toxicology Visual Pearl: Making Rash Decisions
Which of the following best describes the pictured rash occurring 4 weeks after starting minocycline? Anaphylaxis Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome Erythema multiforme Serum sickness Stevens-Johnson Syndrome (SJS)/Toxic Epidermal Necrolysis (TEN) [+]
Destiny D. Folk, MD
Carolinas Medical Center
SAEM Clinical Images Series: Wolf in Sheep’s Clothing
A 55-year-old female with a history of hyperlipidemia presents after a syncopal episode. She had mild nausea and diarrhea on the morning of presentation but otherwise had no prodromal symptoms before suddenly losing consciousness in a grocery store. Of note, she recalls a similar syncopal episode in the remote past, also preceded by gastrointestinal symptoms at that time. At present, she is symptom-free. Vitals: BP 135/71; HR 52; Temp 98°F; RR 18; SpO2 100% on room air General: Tired appearing CV: 2+ peripheral pulses. Regular rate and rhythm, no murmurs, rubs, or [+]
ALiEM AIR Series | Trauma 2023 Module
Welcome to the AIR Trauma Module! After carefully reviewing all relevant posts in the past 12 months from the top 50 sites of the Digital Impact Factor [1], the ALiEM AIR Team is proud to present the highest quality online content related to related to trauma in the Emergency Department. 8 blog posts met our standard of online excellence and were approved for residency training by the AIR Series Board. More specifically, we identified 3 AIR and 5 Honorable Mentions. We recommend programs give 4 hours of III credit for this module. AIR Stamp of Approval and Honorable Mentions [+]
ACMT Toxicology Visual Pearl: Who Doesn’t Like a Nice Rosé?
What clinical presentation and medication is associated with this urinary discoloration? Critical illness requiring intubation and propofol sedation Cyanide toxicity requiring sodium thiosulfate Iron toxicity treated with deferoxamine Refractory vasoplegic shock treated with methylene blue Septic shock treated with vancomycin and cefepime [+]
Allison Frazure, MD
Carolinas Medical Center
Coaching for Faculty: The Secret to Unlocking Professional Success
Dr. Garcia is a freshly minted faculty member at Big Name University Medical Center. She's excited to have finally finished residency and dive into her career as a full time (and fully paid) attending. After spending her first year acclimating to the new department and achieving board certification, Dr. Garcia finds herself at a bit of a crossroad. She likes teaching, but are not sure residency or medical student education leadership is for her. The same goes for clinical operations and research – interesting, but there hasn’t been any “a ha” moment to illuminate her calling. She heard that [+]
SAEM Clinical Images Series: Intracranial Abnormality
A 26-year-old male with no significant past medical history presented to the ED after slipping on wet pavement and hitting his head on the ground three hours prior. He endorsed a constant, achy 7/10 headache accompanied by nausea and photophobia. He denied vomiting, dizziness, diplopia, loss of consciousness, or seizures. Nothing made it better or worse. Vitals: BP 101/63; HR 76; RR 14; T 36.7°C General: Alert and oriented, no acute distress HEENT: Normocephalic, atraumatic, tenderness elicited over right occipital bone, PERRLA, + photophobia Neurologic: WNL with no focal motor or [+]
IDEA Series: Specialised Lectures in Emergency Medicine (SLEM) – A virtual conference to strengthen EM education in the developing world
The Problem: Emergency Medicine (EM) in Pakistan has moved from developing to developed stage in the last decade [1]. As the specialty evolves in Pakistan and other countries, there is a need to improve and assimilate novel learning methods to elevate education standards. The COVID-19 pandemic catalyzed the routine use of video-conference platforms such as Zoom. Virtual educational programming offers the opportunity to leverage educational resources across space and time, foster collaborations, and improve knowledge, clinical and evidence-based practice globally. The Innovation Specialised Lectures in Emergency Medicine (SLEM) is a virtual program for learning, collaboration and social engagement. The [+]