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Biliary Diseases Biliary Colic- A gallstone DOES NOT GET STUCK, but it slowly rolls out of the gallbladder, through the cystic duct, then the common bile duct and pancreatic duct. This results in several hours of crampy “colicky” pain as the stone passes. Cholecystitis- A gallstone gets stuck IN THE NECK OF THE GALLBLADDER OR […]

Appendicitis History Vague nonspecific abdominal cramping and nausea (Nonspecific Phase) gradually progresses to localized pain (Localized Phase). The pain most commonly localizes in the RIGHT LOWER QUADRANT near McBurney’s Point. Exam Focal tenderness in the right lower quadrant McBurney’s Point: 1/3 the distance traveled from anterior superior iliac spine (ASIS) to the navel. Psoas Sign: […]

EM Clerkship’s 10 Step Patient Presentation Demographics (Age, Gender, Pertinent Medical/Surgical History, Chief Complaint) At Least 4 Descriptors (Location, Quality, Severity, Duration, Timing, Context, Modifying Factors) Red Flags/Pertinent Positives and Negatives Vital Signs Focused Physical Exam of the Complaint Suspected Diagnosis Can’t Miss Diagnosis Testing Plan Treatment Plan (If Asked) Anticipated Disposition Vital Signs “Vitals […]

EM Clerkship’s 10 Step Patient Presentation Demographics (Age, Gender, Pertinent Medical/Surgical History, Chief Complaint) At Least 4 Descriptors (Location, Quality, Severity, Duration, Timing, Context, Modifying Factors) Red Flags/Pertinent Positives and Negatives Vital Signs Focused Physical Exam of the Complaint Suspected Diagnosis Can’t Miss Diagnosis Testing Plan Treatment Plan (If Asked) Anticipated Disposition Demographics (Age, Gender, […]

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Tip #26 Update your attending when the nurse is having difficulty with your patient’s IV or drawing blood. Tip #27 Get the urine sample from your patient (there is no greater delay in patient flow than waiting on urine) Tip #28 Round on your patients and repeat your initial scripting. “It’s Zack the medical student […]