3of4, roofing nail | Figure 1

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3of4, roofing nail

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80+year old male. First visit for finger pain.](https://app.figure1.com/case-detail/4f8ea036-b630-4ac2-89e3-05b8458c98cf)



45 year old man was brought to the clinic. Conscious, oriented to time and place. He was screaming of severe waist pain, back pain, hip pain, left flank pain, and sudden onset inability to walk. He had to be carried into bed. There was no history of trauma, no fall or no injury. He's a taxi driver by profession. He has no known medical conditions. He has not had any surgical procedures done. Not on any medication. He has never experienced this episode of pain and inability to walk. His abdomen was full, non-tender, renal angle tenderness positive on left side. Failed pin prick test and patellar reflex (hyporeflexia). Vitals Blood pressure: 150/108mmHg, pulse: 110bpm, Spo2 - 98%, Respiratory: 22 cpm, Temp-36.5 degree Celsius Administered on arrival. IVF Normal Saline 500mls stat, IV paracetamol 1 g stat, Inj Diclofenac 75 mg stat. Antibiotics started on suspicion of Acute Pyelonephritis to rule out Nephrolithiasis. While, awaiting lab investigations: Urine R/E, FBC, Bf for malaria parasites. Renal function test, Ultrasound and X-ray unavailable. After 30 minutes he still complained of pain hence Inj Morphine 5 mg administered, this relieved his pain. While closely monitoring BP. lab results. FBC:(WBC-12.3, Granulocytes:80.1, Hb:12.1 PLT: 122) Urine R/E:(Amber, Hazy, Leucocytes seen, blood seen (hemolyzed), proteins seen, glucose seen, no Nitrite, no Crystals, epithelial cells 5/10, no bacteria). Due to Glucosuria RBS checked 13 mmol/l. X-ray, CT-scans came back normal, Abd-pelvic USG: no obstruction dilated loops of bowel noted. Patient is no longer in pain, but still cannot walk. What could be the diagnosis?](https://app.figure1.com/case-detail/58c726ec-d97a-4ae3-99a7-27dd603173a0)



50M presenting with anxiety. Mildly diaphoretic after gardening. Mild chest pain, poor historian, only other complaint of “I feel like I’m going to die.”](https://app.figure1.com/case-detail/832a15d6-3dcc-42aa-8807-d8e5b9d9285a)



65 years-old male with chest pain and severe dyspnoea came to the ER, we took this EKG and we quickly sent him to the cath lab.
Any other finding?](https://app.figure1.com/case-detail/9bc3952e-7ee3-4ec6-89de-b906cedd7d4f)



A 52-year-old man presented with a 20-minute history of chest pain radiating to the left shoulder and neck, associated with dyspnea and diaphoresis.\He had a history of hypertension, long-term smoking, and a sedentary lifestyle.\On physical examination, bibasilar crackles were noted on lung auscultation. An electrocardiogram (ECG) was performed in the primary care setting, and the patient was promptly referred to the emergency department.](https://app.figure1.com/case-detail/ae0fe999-6875-4474-94f0-ad823dbb9b3a)



A 28-year-old woman presented with a 3-day history of intense pruritus over the lower back. She reported no recent travel or exposure to new environments. She cares for a small kennel with approximately eight dogs rescued from the streets.\Physical examination revealed multiple small vesicles, some clustered and others scattered, predominantly involving the lumbar region and the left gluteal area.](https://app.figure1.com/case-detail/c271070f-2bc7-4052-9895-635277e1a7d5)



A 4-month-old male infant presented with skin lesions localized to the chin for the past 3 days. Physical examination revealed multiple small pustules with surrounding inflammatory signs on the chin, along with a few scattered papules on the chest.](https://app.figure1.com/case-detail/48f41642-b9db-4089-b120-a94ee52328de)



patient in late teens presenting after a collapse, no chest pain, no previous cardiac history, no history of sudden death in family, are there any features in this ekg that would warrant further work-up or is this just a pediatric ekg?](https://app.figure1.com/case-detail/2af390e1-ace8-40ed-ba1c-98fb2d72f4c5)