Factoid: Hypercalcemia Clinical signs and symptoms

The memory aid ‘moans, stones, bones, groans and psychic overtones’ is often used to recall the signs and symptoms of hypercalcemia.

  • Nausea and vomiting
  • Altered mental status, lethargy, confusion
  • Abdominal pain, kidney stones
  • Constipation
  • Weakness
  • Headache
  • Depression
  • Polydipsia, polyuria, nocturia

Factoid: Pneumonia Mimics on CXR

You’ve just seen a previously well 50 year old man with a cough and fever. A chest x-ray shows what you think is a pneumonia. Finally, a straightforward case! You are finishing up his charting and about to write ‘pneumonia’ as your diagnosis when you pause, is there anything else you could be missing?

  • Pulmonary embolism
  • Neoplasm/Cancer
  • Congestive heart failure
  • ARDS
  • Atelectasis/Lobar collapse
  • Pleural effusion
  • Bronchiolitis obliterans organizing pneumonia (BOOP)
  • Tuberculosis
  • Granulomatous disease (Wegner’s granulomatosis, Churg Strauss syndrome)
  • Collegen vascular diseases (Systemic Lupus Erythematosus, Mixed connective tissue disease)
  • Drug induced pulmonary disease (eg Amiodarone lung)
  • Pulmonary fibrosis
  • Eosinophillic pneumonia
  • Allergic/Hypersensitivity pneumonitis
  • Radiation pneumonitis
  • Foreign body obstruction

Factoid: Causes of Acute Vision Loss

A patient arrives in your ED with acute loss of vision. How many potential causes of acute vision loss spring to mind?

  1. Globe rupture
  2. Optic neuritis
  3. Iritis
  4. Uveitis
  5. Endopthalmitis
  6. Glaucoma
  7. Corneal ulceration
  8. Ocular migraine
  9. Ischemic optic neuropathy
  10. Traumatic lens dislocation
  11. Arterial dissection (aortic, carotid or vertebral)

  1. Hyphema
  2. Vitreous haemorrhage
  3. Macular haemorrhage
  4. Retinal detachment
  5. Retinal artery occlusion CRAO
  6. Retinal vein occlusion CRVO
  7. Occipital/PCA cerebrovascular event
  8. Pre-eclampsia
  9. Functional visual loss
  10. Idiopathic intracranial hypertension (could also be painful with headache)

Factoid: Causes of an elevated troponin

  • Myocardial infarction
  • Myocarditis
  • Congestive heart failure
  • Pulmonary embolism
  • Aortic dissection
  •  Sepsis/Shock
  • Arrhythmia
  • Cardiac contusion
  • Intracranial haemorrhage
  • Chronic Renal Failure
  • Takasubo cardiomyopathy
  • Prolonged exercise (marathon running)
  • AECOPD

Factoid: Antidotes Galore!

For each listed substance give the antidote (or the drug or process that must immediately spring to mind for exam purposes), then click to check your answer!

Flumazenil

Naloxone

Octreotide

Glucagon

(High dose insulin)

High dose insulin

Digibind (Digoxin immune Fab)

Oxygen

Hyperbaric oxygen

Methylene Blue

Fomepizole

Ethanol

Folic Acid

Dialysis

Fomepizole

Ethanol

Thiamine

Dialysis

Protamine

Prothrombin complex concentrate

Vitamin K

Fresh frozen plasma

Dialysis

Prothrombin complex concentrate

Deferoxamine

Calcium-Disodium-EDTA

Dimercaprol (BAL)

DMSA

Iodine

Hydroxycobalamin

or

Amyl nitrite

Sodium nitrite

Sodium thiosulfate

Physostigmine

Atropine

Pralidoxime (2-PAM)

Pyridoxine

Intravenous fat emulsion (Intralipid)

N-acetyl-cystine

Dialysis

Sodium bicarbonate

Sodium bicarbonate

Cyproheptadine

Black widow anti-venin

Cro-Fab crotalid antivenin