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Grand Rounds Recap 5/4
Grand Rounds Ryan LaFollette, MD Grand Rounds Ryan LaFollette, MD

Grand Rounds Recap 5/4

Acetaminophen Toxicity Sim - Drs. LaFollette, Nelson and Toth

Take a read through our Cases If It Bleeds it Leads..., Seeing is Believing..., and Belly Pain Bonanza. Curated commentary to follow

Acetaminophen Toxicity

  • 60,000 poisonings / year
  • ~500 deaths per year, evenly split therapeutic / suicide
  • Mechanism - acetaminophen to NAPQI by P450, overwhelming gluthathione stores
  • Alcohol, phenytoin, isoniazid all induce P450 and may increase NAPQI production. Chronic alcohol use will worsen toxicity when acute ingestion will competitively inhibit and can be preventative at producing the toxic metabolite
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Clinical Concepts in Pelvic Ultrasound
Diagnostics, Intern Radiology Videos Courtney McKee, MD Diagnostics, Intern Radiology Videos Courtney McKee, MD

Clinical Concepts in Pelvic Ultrasound

Your patient is a well appearing, otherwise healthy 22 year old female who presents with lower abdominal pain x3 days.  She is unsure of her LMP, but thinks she had some spotting about a month ago.  Vital signs: Temp 99.3F, HR 92, BP 102/70, RR 20, 98% on RA.  She has a benign, non-gravid abdomen.  Urine pregnancy is positive.  You fire off a quantitative hCG and don’t expect that result to come back for a while.  What do you do next?  

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