Guest pac4hire Posted July 2, 2006 Share Posted July 2, 2006 1. a non narcotic OD. lol Quote Link to comment Share on other sites More sharing options...
JenGintheED Posted July 2, 2006 Share Posted July 2, 2006 because it is a separation of the joint the sh1 doesn't actually involve any cracks in the epiphysis or metaphysis it doesn't actually cause a disturbance in the growth plate where the cells are active. Good job, jennie!! A: The line of cleavage runs through the hypertrophic zone of the physis, with the growing cells remaining on the epiphysis, in continuity with the blood supply. Perron AD, Miller MD, Brady WJ. Orthopedic pitfalls in the ED: pediatric growth plate injuries. Am J Emerg Med. January 2002;20:50-54. (LLSA 2004) Quote Link to comment Share on other sites More sharing options...
UGoLong Posted July 2, 2006 Share Posted July 2, 2006 and 2. a cocaine OD? Quote Link to comment Share on other sites More sharing options...
ajnelson Posted July 3, 2006 Share Posted July 3, 2006 All I could come up with was a non-narcotic OD too - but the answers are: Chest wall rigidity Side effects of normeperidine (metabolite of meperidine) If someone is able to explain the chest wall rigitdity - please explain...I've spent 3 days trying to find an explanation! Quote Link to comment Share on other sites More sharing options...
amanquee Posted July 4, 2006 Share Posted July 4, 2006 Is this referring to reports of fentanyl causing chest wall rigidity?? As in the Narcan would reverse too much fentanyl but not the complication of chest wall rigidity that could be caused by the fentanyl? I don't know I could be way off :rolleyes: amanda Quote Link to comment Share on other sites More sharing options...
Marlene G Posted July 5, 2006 Share Posted July 5, 2006 And of course narcan doesn't do a thing for PCP. I saw a lot of that in the jail and it was worthless to try Narcan or Ativan. It was a matter of cuff them to the gurney and let them ride it out while watching for any complications. Quote Link to comment Share on other sites More sharing options...
arion45 Posted July 20, 2006 Share Posted July 20, 2006 What causes the lateral one third of the eye browns to be lost Quote Link to comment Share on other sites More sharing options...
JenGintheED Posted July 20, 2006 Share Posted July 20, 2006 What causes the lateral one third of the eye browns to be lost hypothyroidism :) Quote Link to comment Share on other sites More sharing options...
ajnelson Posted August 2, 2006 Share Posted August 2, 2006 I think this is a pretty easy one, but it was my question of the day from open-er.com: (and it's relavent to the heat wave taking over the country!) What is the difference between heat exhaustion and heat stroke? Quote Link to comment Share on other sites More sharing options...
Guest jennie783 Posted August 2, 2006 Share Posted August 2, 2006 heat exhaustion occurs when the body has been exposed to prolonged periods of heat and its cooling mechanism begins to break down due to excessive loss of fluids and salts. Meanwhile, heat stroke occurs when the body is unable to regulate its core tempture and as a result the core temp rises quickly. unlike heat exhaustion, heat stroke often occurs in people who already have difficulty regulating body temperature to to age or illness. thus, in heat exhaustion the body is still fighting to keep te core temp from rising while in heat stroke the body is no longer trying (a life threatening emegency). heat stroke also differs because it can be accompanied by muscle breakdown due to exhertion- which can cause renal failure. heat exhaustion sx Heavy sweating Intense thirst Dizziness Loss of coordination Nausea and/or vomiting Cool, moist skin Weak and rapid pulse heat stroke sx Body temperature of 105° or higher Red, dry, very hot skin Dilated pupils Strong and rapid pulse Mental status changes Unconsciousness and possibly convulsions Quote Link to comment Share on other sites More sharing options...
ajnelson Posted August 2, 2006 Share Posted August 2, 2006 Great answer jennie! The answer posted at open-er.com: Heat exhaustion and heat stroke are both heat related illnesses along a continuum of symptoms with heat stroke at the more terminal end involving profound central nervous system derangement. Glazer JL. Management of Heatstroke and Heat Exhaustion. Am Fam Physician. 2005 Jun 1;71(11):2133-4 Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted August 3, 2006 Moderator Share Posted August 3, 2006 Great answer jennie!The answer posted at open-er.com: Heat exhaustion and heat stroke are both heat related illnesses along a continuum of symptoms with heat stroke at the more terminal end involving profound central nervous system derangement. Glazer JL. Management of Heatstroke and Heat Exhaustion. Am Fam Physician. 2005 Jun 1;71(11):2133-4 the more basic answer to this is aloc as opposed to the common belief that the difference is sweating vs no longer sweating. if someone is unconscious, hot, and sweating they have heat stroke not heat exhaustion...just saw a great lecture on this topic at aapa in s.f. in may given by eric weiss, md (the guru of wilderness and expedition medicine). Quote Link to comment Share on other sites More sharing options...
andersenpa Posted September 4, 2006 Share Posted September 4, 2006 OK, I'm lifting this from NEJM but it's such a cool diagnosis- students only- What should you suspect in a patient with recurrent chest pain occuring during menses? Quote Link to comment Share on other sites More sharing options...
Guest lisnek Posted September 4, 2006 Share Posted September 4, 2006 endomteriosis? Quote Link to comment Share on other sites More sharing options...
JenGintheED Posted September 4, 2006 Share Posted September 4, 2006 endomteriosis? i second that.... ectopic endometrial tissue in the chest cavity pms must REALLY be bad :eek: Quote Link to comment Share on other sites More sharing options...
andersenpa Posted September 5, 2006 Share Posted September 5, 2006 you're on the right track, keep going with it. Maybe a DDx of chest pain.... Quote Link to comment Share on other sites More sharing options...
Razorback Posted September 5, 2006 Share Posted September 5, 2006 What 3 structures lye within the carotid sheath? Quote Link to comment Share on other sites More sharing options...
Evan Posted September 5, 2006 Share Posted September 5, 2006 Corotid artery, Internal jugular vein, and the vegas nerve... Evan Quote Link to comment Share on other sites More sharing options...
andersenpa Posted September 5, 2006 Share Posted September 5, 2006 Corotid artery, Internal jugular vein, and the vegas nerve... Evan the vegas nerve, which triggers impulsive gambling.... Quote Link to comment Share on other sites More sharing options...
Evan Posted September 6, 2006 Share Posted September 6, 2006 the vegas nerve, which triggers impulsive gambling.... Whoops!:o I believe I meant to say "Vegus" nerve. Although... there may be something to that gambling thing...:D Evan Quote Link to comment Share on other sites More sharing options...
pahopeful Posted September 6, 2006 Author Share Posted September 6, 2006 you're on the right track, keep going with it. Maybe a DDx of chest pain.... Is this something related to ischemic pain d/t lack of O2 because of lack of hemogloblin because of anemia d/t heavy menses?? Quote Link to comment Share on other sites More sharing options...
andersenpa Posted September 6, 2006 Share Posted September 6, 2006 Whoops!:o I believe I meant to say "Vegus" nerve. Although... there may be something to that gambling thing...:D Evan Actually, "vagus"...or you can take the easy way out and call it Cranial Nerve X.:) Quote Link to comment Share on other sites More sharing options...
andersenpa Posted September 6, 2006 Share Posted September 6, 2006 Is this something related to ischemic pain d/t lack of O2 because of lack of hemogloblin because of anemia d/t heavy menses?? Step back and list your differential for chest pain. Immediately, about 10 things should jump out at you. When dealing with any patient complaint, rely on your anatomy, and think about what lives in that area... Quote Link to comment Share on other sites More sharing options...
Guest Bethp Posted September 8, 2006 Share Posted September 8, 2006 Had to look this one up, but catamenial pneumothorax? http://www.mayoclinicproceedings.com/pdf%2F8005%2F8005cr3.pdf#search=%22recurrent%20chest%20pain%20in%20women%20at%20menses%22 Thoracic endometriosis can also cause chest pain during menses http://www.radiology.vcu.edu/Education/Websites/Pulm_COTW/2004%2008%2013%20cotw.htm Quote Link to comment Share on other sites More sharing options...
doboy Posted September 8, 2006 Share Posted September 8, 2006 Step back and list your differential for chest pain. Immediately, about 10 things should jump out at you. When dealing with any patient complaint, rely on your anatomy, and think about what lives in that area... 1. ami 2. ischemia 3. tension pneumo 4. TAA 5. lung mass okay my mind is toast, thats is all I can think of off the top of my head...:D Quote Link to comment Share on other sites More sharing options...
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