Cases coming soon!

1. A 22-year-old man with a history of ADHD and mood disorder has a seizure at home after taking extra quantities of his antidepressant with the intent to get high. An ECG on ED arrival reveals the following: HR, 150 bpm; QRS, 105 ms; QT, 290 ms; QTc, 375 ms. 2. A 30-year old-man is "found down" with a suspected opioid overdose. A fentanyl screen in the ED is positive and a finger stick glucose reads ‘low.’ 3. ​A 77-year-old man drinks an unknown liquid from a sports drink bottle found in his garage and shortly thereafter experiences intractable vomiting. A point of care test done in the ED reveals the likely diagnosis.

1. A 55-year-old woman presents with persistent nausea, vomiting, and diarrhea after taking a weight loss supplement that she purchased online. She arrives to the ED with the following vital signs: HR 73, BP 135/75, RR 24, SaO2 98% RA. Shortly after, her HR begins to drop into the 40s. 2. A 42-year-old man with a history of pituitary macroadenoma excision complicated by CSF leak returns to the ED five days later with encephalopathy and oliguric renal failure. 3. A 24-year-old man with a history of Crohn’s disease, depression, hypertension, and erectile dysfunction comes to the ED with sweating, tremors, “muscle tightening”, rapid heart rate (130s) starting 1-1/2 h after using a tanning product.

1. A 22-year-old, 32-week pregnant woman presents to the ED after an intentional ingestion of an insecticide called "Sniper." Her initial vital signs are: BP, 126/78 mmHg; HR, 96/min; RR, 26/min; T, 98.9F; O2 Sat, 98% (RA). She has increased salivation per the treating physician. 2. A 16-year-old girl presents with a presumed pseudoephedrine overdose. Her vital signs are HR 137, BP 198/158, RR 30, T 36.7. After an observation period of 5 days she has not improved. 3. A 39-year-old man is transferred from a treatment center to the ED for opioid withdrawal and intractable vomiting Several hours after arrival at the treatment center that morning, he developed worsening opioid withdrawal for which he received methadone (30mg) but immediately vomited and became "shaky." His initial vital signs are: BP, 153/95 mmHg; P, 83/min; RR, 22/min; T, 99 F; Sp02, 96%

1. A 7-day-old boy in the NICU is receiving TPN and dopamine through a left forearm peripheral IV that is noted to have extravasated. This is suspected to have begun two 2 hours earlier. 2. A 30-year-old man is cleaning his saltwater tank when "something" gets in his eye. Four hours later he develops a fever, cough, and shortness of breath. 3. A 38-year-old woman on INH monotherapy for latent TB presents with RUQ abdominal pain. She is noted to have: AST 545, ALT 130, AlkPhos 156, nl bilirubin. A RUQ sonogram is negative.

1. A 56-year-old man with a history of diabetes, hypertension, severe restrictive lung disease secondary to covid pneumonia presents with one day of fatigue, dyspnea on exertion, dry cough, and hypoxia (79% at home pulse oximetry). Patient states the symptoms began acutely, two hours after getting home from work the day prior. He reports that a few other co-workers have similar symptoms as him or they have nausea, abdominal pain, vomiting. He thinks a virus is going around his workplace. 2. A 51-year-old man presents with a diffuse rash over the past 6 days that developed after he ingested a product for sexual stimulation called “royal honey” that he obtained at a local shop. His VS are normal and he is in no distress. 3. A 2-year-old girl is extracted from underneath debris from a structural fire; she was found covered in soot and is pulseless. CPR is initiated and ROSCis achieved within minutes. She arrives to the ED with the following vital signs: BP, 95/58; HR, 130; RR, 28; SaO2, 100% on NRB; T, 98.6F. She is only responsive to pain and is promptly intubated.

1. A 16-year-old girl arrives by EMS after a seizure following an ingestion possibly including “a heart medicine, a depression medicine, and a sleep medicine.” She has an abnormal rhythm on the cardiac monitor. 2. A 25-year-old woman presents with nausea and vomiting after taking an overdose of a supplement roughly 13 hours earlier. Vital signs: BP, 119/81 mmHg; HR, 130/min; RR, 18/min; T, 98.9 F; SaO2 100% RA. 3. A 49-year-old man presents 2 hours after being bit by a black widow spider. Minutes after the bite he began experiencing severe pain to his legs, back and abdomen and complaining of muscle spasms. VS on arrival: BP 207/97, HR 77, Temp 97.9F, SaO2 96% on RA.

1. A 66-year-old woman with sarcoidosis presents with dysphagia 4 days after receiving a medication to relieve her symptoms. 2. A 70-year-old woman with a history of anaplastic large T-cell lymphoma presents with shortness of breath for three days. She has a heart rate of 125/min, is tachypneic, and requires 4L nasal cannula to maintain her oxygen saturation. 3. A 7-year-old girl presents with one day of fever and a diffuse erythematous maculopapular rash sparing the palms and soles. VS: HR 145 bpm, BP 115/79 mm Hg, RR 28 b/min, SaO2 93% on RA, Temp 103.1F.

1. Three workers at a leather tanning facility collapse at work. Two recover upon removal from the room, one is intubated on the scene. Medical toxicology is consulted upon arrival to the emergency department. 2. A 23 month-old girl is found with a tablet of a weight loss supplement. She presents to the ED with vomiting and the following vital signs: BP, 114/86 mmHg; HR, 93/min; RR, 26/min; SaO2, 100% RA. 3. A 30-year-old man presents to the ED with 3 days of weight gain, swelling, and headache after taking a compounded pharmaceutical pill.

1. A 52-year-old man presents to the ED drowsy and diaphoretic after unintentional overdose of a prescription medicine he used to treat a sore throat. 2. A 51-year-old woman presents to the ED after waking up blind after attempting suicide the night before. 3. A 26-year-old woman presents with left hand pain and swelling after an animal bite.