23-year-old male has persistent wound after crushing finger

23-year-old male has persistent wound after crushing finger

The patient is a 23-year-old healthy male presenting for a “wound check” about four weeks after crushing his left fifth finger in a car door. At that time, x-rays were negative for a fracture. He was placed on cephalexin because of a small avulsion of skin on the distal aspect of the finger. Today, you find that the distal aspect of the dermis of the fifth finger has sloughed off. The underlying tissue is pink, …

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37-year-old diabetic female feeling weak after switching diuretics

37-year-old diabetic female feeling weak after switching diuretics

The patient is a 37-year-old female who presented with a history of longstanding hypertension and diabetes mellitus. She had recently started on a new diuretic, and felt very weak and lightheaded. Her blood pressure was 88/56 mmHg with a pulse of 44 beats per minute. After reviewing the ECG, consider the following questions: 1. Based on this ECG, what type of diuretic is she likely to be taking? 2. How should she be managed?

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16-year-old male experiencing chest and throat pain

16-year-old male experiencing chest and throat pain

The patient is a 16-year-old male who presents with difficulty breathing, pain in his throat, difficulty swallowing, and pleuritic chest pain. He reports that the symptoms began “a couple of hours” earlier. There is no history of trauma, choking, or recent dental procedure. The patient looks well, and is quiet and not toxic. Pulse is 75, O2sat 94; there is no fever. Chest is normal, with bilateral air entry. Assessment is hindered by the patient’s …

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