This patient presents with symptoms consistent with acute seizure, most likely due to _. I considered, but think less likely, secondary etiologies of epileptic seizures to include drug / toxin etiologies (ETOH, stimulants, medication side effects), metabolic disturbances (glucose, Na), acute CNS infections (meningitis, encephalitis, abscess), ICH / tumor / CVA. Presentation not consistent with impact seizure related to head trauma. Patient with no signs of trauma from the seizure. DMV was notified to remove patient's licence_, patient was given strict seizure precautions. Patient to follow up with PMD.
This patient presents with symptoms concerning for acute CVA versus TIA. Other items on the<unk> ial include dissection, AMI, hypoglycemia or other metabolic derangement such as hepatic/uremic encephalopathy, medication side effect, or post-ictal Todd’s paralysis. However, presentation most concerning for a CVA. EKG without evidence of STEMI or ischemia, labs with no hypoglycemia, metabolic derangements, and clinical picture does not suggest other stroke mimic. CT head showed _. CTA head and neck showed _. Per neuro _.
This patient presents with a headache most consistent with benign headache from either tension type headache vs migraine. No headache red flags. Neurologic exam without evidence of meningismus, AMS, focal neurologic findings so doubt meningitis, encephalitis, stroke. Presentation not consistent with acute intracranial bleed to include SAH (lack of risk factors, headache history). No history of trauma so doubt ICH. Given history and physical temporal arteritis unlikely, as is acute angle closure glaucoma. Doubt carotid artery dissection given no focal neuro deficits, no neck trauma or recent neck strain. Patient with no signs of increased intracranial pressure or weight loss and history and physical suggest more benign headache so less likely mass effect in brain from tumor or abscess or idiopathic intracranial hypertension. Pain was controlled with headache cocktail and patient discharged home with PMD follow up.
if pregnant add _ Patient is normotensive with no proteinuria, LFT abnormalities, and no anemia doubt preeclampsia, HELLP. Considered, but think unlikely, CVT given no cranial nerve deficits, blurry vision, diplopia.
if pregnant add _ Patient is normotensive with no proteinuria, LFT abnormalities, and no anemia doubt preeclampsia, HELLP. Considered, but think unlikely, CVT given no cranial nerve deficits, blurry vision, diplopia.
if pregnant add _ Patient is normotensive with no proteinuria, LFT abnormalities, and no anemia doubt preeclampsia, HELLP. Considered, but think unlikely, CVT given no cranial nerve deficits, blurry vision, diplopia.
This patient presents with altered mental status, concerning for _. Labs and exam were inconsistent with toxic metabolic etiologies such as electrolyte disturbances (Na/Ca), hypoglycemia, and uremia; acidosis states, infection (i.e. Sepsis). History and exam make toxidromes of intoxication or withdrawal, hypoxemia or hypercarbia, liver disease or failure causing hepatic encephalopathy, endocrine emergencies (hyper/hypothyroidism, adrenal insufficiency), seizure, trauma, intracranial bleeds or ischemic stroke less likely_.
This patient presents with generalized weakness and fatigue likely secondary to dehydration. Suspect acute kidney injury of prerenal origin. Doubt intrinsic renal dysfunction or obstructive nephropathy. Considered alternate etiologies of the patient’s symptoms including infectious processes, severe metabolic derangements or electrolyte abnormalities, ischemia/ACS, heart failure, and intracranial/central processes but think these are unlikely given the history and physical exam.
MDM for different chief complaints
Critical care documentation
Combative patient
Wilderness preparedness
ACEP clinical policies
Expedited partner therapy
SCVMC:CUSTODY CARE
FALLS protocol