Tamingthesru
B Pod Case: Double Vision
78 year old male with past medical history coronary artery disease status post stenting, hypertension, hyperlipidemia, chronic kidney disease presents with a chief complaint of double vision, feeling off balance. Patient states he awoke this morning with double vision. He states this sensation of double vision is worse when he looks side to side, and completely resolves when he closes one of his eyes. He does not wear glasses or contacts and denies any eye pain or trauma. Also, since this morning he has felt somewhat off balance, however denies any focal numbness or weakness of extremities. He noted an episode of slurred speech approximately 1 hour prior to arrival that has since resolved. No other difficulties with word finding or language. Otherwise patient denies headache, head trauma, neck pain, chest pain, or shortness of breath. He has not had symptoms like this in the past.
Right Upper Quadrant Ultrasound
You are talking to your new patient, John. He's a pleasant 30 year old man who, by your estimation appears to be a victim of HGS... Holiday Gluttony Syndrome. John presented to you in the ED with abdominal pain, nausea, and vomiting. He goes on to tell you all this started after he chowed his way through a few too many Buckeyes. You see every Christmas, his mom sends him a far too large tin of Buckeye candies, which John had eagerly eaten and eaten and eaten, until the belly pain hit.