UOTW #34

67 yo nursing home patient presents with altered mental status. Vitals signs are as follows: BP 92/78, HR: 115, RR: 35, O2 sat: 89%. Patient is moaning and uncooperative with the physical exam. On auscultation, you are unable to appreciate any overt lobular rales or wheezing. You think you feel a distended bladder in the suprapubic region. Ultrasound shows the following in the right posterior lung field.  What is the finding and diagnosis?



UOTW #32

The patient is a 39 y/o female with a h/o lupus who is post-op day #7 status-post renal transplant.  The patient complains of abdominal pain with gross hematuria for several days. Upon arrival, the patient’s initial vitals were a BP of 137/59 and a pulse of 91.  Examination showed cold extremities, moderate diffuse abdominal tenderness/distension and a pale tongue.

I-stat hematocrit was noted to be 5, and so the patient was given 4 units of pRBCs and surgery was consulted.  Suddenly the patient becomes unresponsive in front of you, and you are unable to palpate any pulses.  Standard ACLS was followed and the patient obtained ROSC. Repeat abdominal scan showed the following.


UOTW #31

The patient is an 11 year old male who was leaving soccer practice when his family witnessed him suddenly collapse.  He was then noted to have left sided hemiparesis associated with a headache and nausea/vomiting, and was airlifted to your emergency department.  Noncontrast CT of the brain was negative, but CTA revealed a complete proximal right M1 occlusion.  You perform a bedside echocardiogram: