It’s a typical shift in your community shop when you see a patient on the board that makes you nervous. 2 year old male with syncope. It’s been awhile since you have treated someone born in the 21st century and you know this child’s workup will likely involve an EKG. The closest pediatric hospital is 2 hours away. How comfortable do you feel interpreting the squiggle lines generated by this little heart?Read More
CPC with Dr. Boyer vs. Dr. Steuerwald
16yoF with 4 days of bilateral lower quadrant abdominal pain and diarrhea that was tachy, dry, and with a diffusely tender abdomen and some right-sided discomfort on pelvic exam with a mild leukocytosis.
Dr. Steuerwald's approach to listening to patient presentations: Pick out the main symptoms, get a time course, and listen for any other true "weirdness" then build your own timeline of events.
- Don't forget about the "sexy numbers" in everyone, these include the vitals and also key aspects of a disease process (i.e. the EF in a patient with CHF)
- DDx included appendicitis, PID, TOA, Fitz-Hugh Curtis, Ovarian Torsion, Yersinia enterocolitis
- Dr. Steuerwald correctly identified the need to get a RLQ US to assess for appendicitis!