December 12, 2013

The case from this week is from one of the PGY-1 residents at University of Texas Health Science Center at San Antonio (UTHSCSA).  Several of the details of the case have been changed to keep patient information confidential. 53 year old female with a past medical history of hypertension, hyperlipidemia, coronary artery disease, and 3 anterior myocardial infarctions s/p 4-vessel CABG (LIMA-LAD, RIMA-RCA, SVG-D1-OM1 sequentially) 9 months ago who presents with intermittent 10/10 chest pain that radiates to his left arm for the past 6 months. The chest pain is associated with nausea and shortness of breath but denies diaphoresis or syncope. Patient reports that the pain is the same as his index chest pain and is both exertional and non-exertional and will often wake him up from sleep. The pain can last 5-10 minutes and is always relieved by rest. The patient reports good medication compliance (on metoprolol, atorvastatin, enalapril, amlodipine, aspirin). He presented with similar symptoms 3 months ago but left against medical advice before a work-up could be performed. Now he presents with increasing frequency of chest pain. BP 152/105  HR 86 RR 16 O2 sat 99% on RA   Temp 98.0 ECG from triage is shown…

REBEL Review 42: HEART Score

Created December 10, 2013 | Cardiovascular | DOWNLOAD

REBEL Review 40: Infectious Gastroenteritis Part II

Created December 9, 2013 | Abdominal and Gastroinstestinal | DOWNLOAD

REBEL Review 41: Pulmonary Embolism Severity Index (PESI) Score

Created December 9, 2013 | Thoracic and Respiratory | DOWNLOAD

REBEL Review 39: L5, S1, Sciatica, and Peroneal Nerve Injuries

Created December 4, 2013 | Neurology | DOWNLOAD