UMEM Educational Pearls - Visual Diagnosis

Title: An alcoholic with fever and cough

Category: Visual Diagnosis

Keywords: fever, cough, alcoholic (PubMed Search)

Posted: 5/7/2012 by Rob Rogers, MD (Updated: 11/24/2024)
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Question

An alcoholic patient presents with a cough, fever, and very foul smelling breath (worse than usual)

What's the diagnosis? And what are the risk factors?

 

 

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Question

50 year-old male with cough and dyspnea. What's the diagnosis?

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Question

23 year-old female presents complaining of progressive right lower quadrant pain after doing "vigorous" pushups. CT abdomen/pelvis below. What’s the diagnosis? (Hint: it’s not appendicitis)

 

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Question

33 y/o M with PMH of ETOH induced pancreatitis presents with epigastic/RUQ pain & N/V after drinking last night, per patient his usual “pancreas pain”. The nurse shows you his blood tubes because they look “milky”. Lipase 1200, Ca 6.8.

 



What lab test would you add?

 

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Pulmonary Embolism 

  • In patients with high pretest probability and abnormal vital signs think about cardiac evaluation for pulmonary embolism. McConnell’s sign is most specific but can also be found in acute RCA infarct. TAPSE < 1.8 cm is also a good identifier of RV strain. Remember that patients with COPD or Pulm Htn may have RV dilation at baseline. You may also want to risk stratify patients with PE with labs as well as lower extremity dvt studies. 
  • Let’s give a shout out to Ashley Pickering who recently took some awesome echo images of a patient with a known saddle embolism. 

 

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