83 yom BIBA, rectal bleeding, on Coumadin, received 5 units | Figure 1

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83 yom BIBA, rectal bleeding, on Coumadin, received 5 units uncrossmatched blood in ER. PT INR 17.7 H&H 5.6 & 17.3

Clinical Cases

Case 1

Elderly female fell out of bed a week ago. Today increased "purple color" and swelling. On Coumadin for multiple cva's. CT reads: 6cm acute subcutaneous active bleeding. Patient is normotensive, non tachycardia with stable h/h. Inr 3.0. Next step..go?

Case 2

Clinical scenario — female in early eighties BMI- 37, has DMII-insulin dependent, kidney stones status post multiple lithotripsy, has several bouts with UTI, including urosepsis, with resulting chronic renal insufficiency, eGFR, unknown, presents with low hemoglobin in the past as low as 7; low platelets; currently only replacement erythropoietin injection q2 months; most recent CBC shows WBC’s-6K, with normal differential; H/H - 8.9/28; MCV-80, and plts-103k.

Case 3

jehovahs witness with #AML. H/H 2.5/5. Treating with continuous infusion of #Hemopure derived from bovine hemoglobin.

Case 4

73 y/o male patient. Can unilateral renal agenesis cause this low H/H?

Case 5

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.

Case 6

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.

Case 7

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.

Case 8

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?