Question 6 43 year old male with recent ORIF of right tibial fracture. He is 6 weeks post op and the post operative splint has been removed. He was diagnosed 4 days ago with 5cm thrombus in anterior tibial vein on formal ultrasound in the vascular lab. Given the DVT was provoked, the splint was Read more about Question 6 : DVT[…]
Images and text Genevieve Carbonatto A 54 year old man presents to the Emergency Department with abdominal pain and jaundice. He has a distended abdomen. He is known to have alcoholic cirrhosis. A point of care ultrasound was performed. The following demonstrates some of the basic features of cirrhosis with ultrasound. Liver size, increased echogenicity Read more about Alcoholic cirrhosis[…]
Images and text Genevieve Carbonatto A 56 year old man presents to the Emergency Department with chest pain. This is his ECG The ECG shows deep Q waves and ST elevation in his anteroseptal leads These are his vital signs: BP 120/69 mmHg, HR 89/min, Sats 100% on RA, RR16/min This is his ECHO PLAX Read more about LV Aneurysm[…]
Images and text Genevieve Carbonatto An abdominal ultrasound is performed on a young woman for right upper quadrant pain. This is what is seen while scanning through the liver This is a cavernous haemangioma. It looks like a snowball on ultrasound. Characteristics of haemangiomas: Blood filled cavernous space lined with a single layer of flat Read more about Cavernous haemangioma[…]
Images and text Genevieve Carbonatto A 35 year old man presents to the Emergency Department with severe shortness of breath. He is known to have an amphetamine induced cardiomyopathy. His heart rate is 129/min, BP 116/76. He has mild pedal oedema. His JVP is elevated and on auscultation he has crepitations bilaterally. You decide to Read more about Right ventricular thrombus[…]
Images and text Genevieve Carbonatto A 55 year old man with bilateral renal transplants and diabetes presents to the Emergency department with a 6 day history of right upper quadrant pain and severe back pain, fever, diarrhea, nausea and vomiting. On examination his HR is 95/min. He has a systolic BP of 97, and he Read more about Emphysematous kidney[…]
Images and text Genevieve Carbonatto It is a busy Thursday evening in the Emergency Department. There is no place to put patients and assess them. The only bay which may be available is occupied by a lady who refuses to leave the bay because she feels so ill. You call the nurses and together you Read more about Pitfall: Blood clots and ruptured ectopic pregnancy[…]
Images Mark Russel, text Genevieve Carbonatto A 35 year old women presents to the Emergency Department for a review of a possible ectopic pregnancy. She is 7 weeks pregnant by dates. An outpatient scan was performed the day before for painless vaginal bleeding . It did not show an intrauterine gestational sac. A complex left Read more about Pitfall: Painless ruptured ectopic pregnancy[…]
Text and images Genevieve Carbonatto Pericardial effusions are commonplace. A pericardial effusion is not synonomous with pericardial tamponade. Pericardial tamponade is a medical emergency characterised by shock and associated with a number of clinical criteria including Becks triad (hypotension, decreased heart sounds, elevated JVP) pulsus paradoxus ( > 12 mmHg drop in BP on inspiration), Read more about Assessment of Pericardial effusion[…]
Images Ying Ying Lee, text Genevieve Carbonatto A 44 year old man presents with acute right upper quadrant pain. A point of care ultrasound is performed to exclude a biliary cause. While scanning the patient in the supine position, stones are visible in the body of the GB which do not move when the patient Read more about Pitfall – Stones in the gall bladder – Adenomyomatosis[…]