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Elementary school child, completely neurologically normal. Straight A student. 1 month of mild intermittent diplopia.

20years patient MVA 7 days ago , frontal contusion controlled by haloperidol and got improved 3 days after admission coma , temp = 40 RR=50. HR=175 rigidity CPI= 50000 incubated ventilated improving in ICU diagnosis ????

20yo woman brought to ER after high energy car crash from rear. Eupneic breathing pattern, hemodynamically stable, normal neurological examination, neck collar in place. Complains abdominal pain. While receiving 2000 ml of crystaloids is transferred to Radiology for a CT: spleen injury type IV with hemoperitoneum + body of C2 vertebra fracture + right vertebral artery occlusion + 6 left ribs fracture with pulmonary contusion + left pubis fracture + transverse processus fracture in 3 lumbar vertebrae. Haemoglobin 6.9 (Continues in comments)

Open head injury after assault by a Gang

EMS is dispatched to a local prison facility for an inmate with new onset of confusion. Upon arrival to patient side, he has eyes open spontaneously with incomprehensible speech to questioning and does not follow commands. Staff reports pt presented with chest pain 4 days ago but was not sent to the ER for treatment. He returned 2 days ago with severe headache. Staff consulted their physician by phone who said to treat with phenergan, Ativan, and 500ml NS bolus. Pt noted relief. He was found this AM around 0530 with presenting symptoms. Pt is a 56 yom with no past medical history. Cincinnati strike scale positive. Code stroke activated and pt taken emergent transport to nearest stroke facility. BP 148/78 Pulse 78, O2 98% room air, 12-lead showing sinus rhythm without ectopy, 16g IV established. EMS delayed entering and exiting facility due to prison staff slow to open locked gates and doors, and then refusing to allow EMS to leave with pt without shackles despite code stroke activation. Total delay on scene due to these issues approximately 18 minutes. Transport to hospital approx 7 minutes. This is an image of the CT scan obtained at the ER. Pt airlifted to higher level of care at a neuro facility for further workup.

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.

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.

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.

\n 70 yo WF with 20y hx HTN lost 21 lbs on a semaglutide but still BMI over 30, shows drop in BP when standing, stabilizing at 102-116 systolic, 65-75 diastolic. Discontinued all HTN meds x 30 days and no episodes of HTN. Could a small weight loss like this cause a drop to normal BP? Has anyone heard of a side effect of lowering BP?