Blog

A 47-year-old woman with known Graves disease presents to the emergency department with acute agitation, vomiting, profuse diarrhea, and fever. Vital signs reveal a temperature of 105.8°F (41°C), heart rate 156 bpm, blood pressure 82/46 mmHg, and oxygen saturation 93% on room air. She is confused and diaphoretic. ECG shows atrial fibrillation with rapid ventricular response.Which feature most strongly supports thyroid storm rather than uncomplicated hyperthyroidism?

A 55-year-old female patient with a history of choledocholithiasis presents to the emergency department with fever, jaundice, and right upper quadrant abdominal pain. Laboratory tests reveal elevated white blood cell count, bilirubin, and liver enzyme levels. Imaging studies demonstrate biliary tract dilation and evidence of obstruction. Based on the clinical presentation and diagnostic findings, which of the following conditions is most likely responsible for the patient’s symptoms?

A 65-year-old male patient presents to the emergency department with severe abdominal pain and tenderness in the right upper quadrant. He has a history of cardiovascular disease and recently underwent major surgery for aortic valve replacement. Laboratory tests show elevated white blood cell count and liver enzyme levels. Imaging studies reveal a distended gallbladder with thickened walls and no evidence of gallstones. Which of the following conditions is most likely causing the patient’s symptoms?

A 58-year-old man presents to the emergency department with melena and epigastric pain. He is tachycardic on arrival but becomes hemodynamically stable after intravenous fluid resuscitation. Laboratory studies are pending. Upper gastrointestinal bleeding from a peptic ulcer is strongly suspected, and endoscopic evaluation is planned.Which intervention should be initiated prior to endoscopy to optimize visualization and diagnostic accuracy while avoiding unnecessary delays in care?

In a patient presenting with suspected gastrointestinal bleeding, which laboratory finding supports upper gastrointestinal bleeding as the likely source?

A 66-year-old man presents to the emergency department with profuse hematemesis and melena. On arrival, he is hypotensive (BP 78/42 mmHg), tachycardic (HR 136 bpm), and confused. Laboratory studies reveal hemoglobin of 6.9 g/dL, INR 2.4, and platelet count of 48,000/µL. An upper gastrointestinal bleeding is suspected.Which action is most appropriate prior to performing endoscopic evaluation?

A 34 y/o female is complaining of increased irritability, weight loss despite eating, and diarrhea. She always feels exhausted, but can’t seem to sleep. She states she “feels like she could jump out of her skin”.   If excess thyroid hormone is the cause of her symptoms, which of the following might be noted?

A 48-year-old male with a history of hypertension refractory to multiple antihypertensive medications presents to the ED with sudden-onset episodic headaches, palpitations, and diaphoresis. His blood pressure is 210/115 mmHg, and his heart rate is 120 bpm. On exam, he appears anxious but has no focal neurological deficits.Which of the following is the most appropriate initial diagnostic test?

A 30-year-old man presents to the emergency department with 24 hours of fever, anorexia, and progressively worsening abdominal pain. He initially noted vague periumbilical discomfort that has since localized to the right lower quadrant. Physical examination reveals right lower quadrant tenderness without guarding or rebound. Laboratory evaluation shows leukocytosis with a left shift.Which diagnosis best explains this presentation?

A 30-year-old man presents to the emergency department with 24 hours of fever, anorexia, and progressively worsening abdominal pain. He initially noted vague periumbilical discomfort that has since localized to the right lower quadrant. Physical examination reveals right lower quadrant tenderness without guarding or rebound. Laboratory evaluation shows leukocytosis with a left shift.Which diagnosis best explains this presentation?