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Title Specialty Votes Comments Rating

Where have all the doctors gone?

In our rural hospital, we have been able to attract only 3 categories of physicians for the medical staff in the past 10 years. 1) IMG's, who have done res...		 General Interest 41 44

48 yo female with elevated CPK/aldolase

48 yo female, refereed by mid-level for elevated CPK of 3K. She had had a work up the prior November when she complained of chest pain in setting of elevat...		 Internal Medicine 79 48

Delayed post-op breast hematoma: to drain or not?

76 yo woman with DCIS left breast. Months post stroke. A-fib and on coumadin. Doing well from those problems. Surgery planned carefully, bridged with lov...		 Surgery 30 65

improving infant mortality statewide

My state has done poorly with regard to improving infant mortality over the last several years. Low birth weight, lack of perinatal care/poor access to hea...		 Pediatrics 48 67

2 year 9mo male skull fracture and behavioral changes

I saw this patient today after he fell backwards from a chair 1 week ago and sustatined a linear skull fracture in the right paramidline occipital region co...		 Pediatrics 32 18

Severely Elevated D-Dimer with no obvious thrombosis.

I have a a 77 year old women with chronic RLE edema who I saw for the first time last week. She has a history of colon cancer diagnosed 5 years ago and is curre...		 Hematology 97 45

Hypoxia and multiple lung lesions

38 year old with diabetes and morbid obesity, got a gastric bypass which was uncomplicated. She is now resting comfortable but hypoxic. CT scan for hypoxia sh...		 Radiology 59 24

Sermo Case Conference in ID: 48 yo M with myalgia, confusion

Chief Complaint: Leg pain, weakness and confusion History of present illness: A 48 year-old man presented to the Emergency Department in a large East Co...		 Case Conference 18 34

Sermo Case Conference in Internal Medicine: 82 YO F w/anemia

CC: Fatigue HPI: Long term patient with chronic mild anemia, generally running in the range of hemoglobin 9-10. Today presents with severe fatigue and hemog...		 Internal Medicine 57 41

Sermo Case Conference in Radiology: 85 YO M with abd. pain

CC: 85 year old male with vague abdominal discomfort and loose stools.HPI (including ROS): 85 year old male presents with vague upper abdominal discomfort w...		 Case Conference 87 22

Sermo Case Conference in Psychiatry: 26 YO male with anxiety

CC: "I have anxiety."HPI: Bradley is a 26 y/o married wm who presents for initial psychiatric outpatient consultation after being referred by his PCP. He r...		 Case Conference 6 67

Proceed with surgery without consent?

80 year old man with history of dementia, diabetes, blindness falls and presents for ORIF of a hip fracture. Upon questioning he is a&ox3 and recalls having fa...		 Anesthesiology 54 41

I know having a high HDL is good, but is this too good?

I recently did a lipid panel on a male patient, age 65, and his HDL was 154! I've never seen an HDL this high before. Lab said they rechecked it as well. ...		 Cardiology 22 12

Amiodarone in Complete Heart Block with VFIB.

I apologize if this is simplistic, I often work alone in a small community hospital. During an ER shift I am called to the ICU to code a 78 year old in Ventricu...		 Cardiology 11 52

44 yo male with abdominal pain & leukocytosis

44 Yo caucasian male presents for his 3 ER visit in 3 weeks complaining of LLQ pain, with constipation and occasional blood in the stool. The pain is radia...		 Surgery 86 6

Elevated CRP in Healthy Lady without complaints

A 57y.o. healthy lady whom I follow for hyperlipidemia, but otherwise has no health problems. I checked her CRP initially because of the high cholesterol & was...		 Family Medicine 15 45

As if the 80 hour resident work week weren't bad enough...

There is now talk among members of the ACGME and RRC to limit work hours to 56 hours per week. The data from the 80 hour work week has not shown a decre...		 Surgery 84 46

Is this a first psychotic break or unusual seizure?

28 year old Caucasian female (no previous psych history) who in July 2008 was in Mass with mother. Mom reported patient was covered with ticks but didn't th...		 Neurology 25 45

tietze syndrome

I have a 34 yr old healthy woman with 3 month history of anterior chest wall pain. She has a swelling at the 3rd costochondral junction that is tender to palpat...		 Rheumatology 40 16

cluster of ob-gyn surgical infections

In our 100-bed community hospital, there has been a cluster of 12 surgical infections confined only to Ob-Gyn patients. There were 5 in the first six months of ...		 OBGYN 87 97

Doing EMG studies on unordererd limbs

Frequent dilemma for me, minor one, but has significant financial implications for the patient, myself and the insurance company -I do a lot of EMGs for...		 Physiatry 52 15

18 year old BF with near syncope 18 month pregnancy .

18 year old BF with congenital heart disease and 8 month pregnancy presented to me with dizziness and near syncope daily for a couple of weeks. Her echo sho...		 Cardiology 13 50

What diagnosis is consistent with these findings?

59 year old woman developed dyspnea over about a week. Ultimately found to have b/l effusions and left IJ thrombosis. despite anticoagulation, the thrombo...		 Internal Medicine 19 100

87 yo for colostomy reversal w/ EF of 20%.

although Bob had posted a cardiac "clearance" case today i had this one come up today and thought i'd post it.Pt had Hartman's pouch for ruptured tic 2/08...		 Anesthesiology 44 53

Epipen after simple bites and stings?

During the past year or so there appearsto be an explosion of requests by parents, school nurses and even some allergists to prescribe Epi-Pen for kids to have ...		 Allergy and Immunology 78 50

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