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Hot Seat #223 Denouement

This week’s case highlights the presentation of a 14 yo M with stable asymptomatic hypoxia. Fellows noted that polycythemia on the initial CBC could be secondary to chronic hypoxia. CXR appeared overexpanded with air bronchograms with possible small RLL consolidation and prominent hilum L>R with asymmetric vasculature. Fellows brought up if his pulse ox had […]

Hot Seat #223: You Take My Breath Away

Case by George Nassar MD, Inova PEM Fellow A 14-year-old male, with no significant past medical history is brought by EMS to the ER from an outside urgent care because of hypoxia. He has had low-grade fevers (Tmax 101 F) and a productive cough for 2 days. At the urgent care, he was noted to […]

Hot Seat #222: Denouement

GI consulted and upon further examination found presentation and physical exam findings concerning for cutaneous manifestation of Crohn’s disease. Labs were obtained and the patient was found to have normal CBC, CMP, ESR, CRP, uric acid, and LDH. Negative serum beta hCG. With unremarkable lab work, GI recommended outpatient follow-up and dermatology outpatient for the […]

Hot Seat #222: Just Swell

Case by Nikki Animasaun, CNH PEM Fellow 15 yo previously healthy M presenting with chronic penile and scrotal swelling. Patient has been having swelling without pain for the past few months. The swelling has increased gradually over the past 2-3 months. He went to his PMD today due to having blisters on the scrotum that […]

Hot Seat #221: Making The Breast Choices

Case by Brandon Kappy MD, CNH PEM Fellow A 35-day-old female presents to the ED with what Mom describes as a “right-sided chest rash.” Mom states that she noticed the mild erythema around 2 days ago when she was breastfeeding the infant. Since then, Mom believes that it has become moderately more erythematous, though no […]