🚨 Pulmonary embolism
Pulmonary embolism is often called the ‘great masquerader’ of emergency medicine. It can mimic pneumonia, acute coronary syndrome, heart failure, COPD exacerbation, anxiety, or even syncope. The key to diagnosis is applying the right test to the right patient using validated clinical prediction tools, here’s the brief & concise notes about PE.
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Doctor ....Last night I took a shower and went straight to bed, and when I woke up in the morning my finger was like this, I'm waiting for it to get better but it's not improving, do you know what causes this ??
A 22 year-old male was brought to a clinic for evaluation of intermittent abdominal pain and watery diarrhea of 12 years’ duration. Over the previous 2 months, his symptoms had included vomiting and weight loss. The patient had numerous hyperpigmented macules on his lips, buccal mucosa, fingers, and toes. Computed tomography (CT) and ultrasonography showed duodenojejunal intussusception. Upper gastrointestinal (GI) endoscopy revealed multiple polyps.
What’s your diagnosis?
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Chest percussion is simple, but powerful.
Don’t just listen for a note — compare both sides and connect it with breath sounds, vocal resonance, chest expansion, and tracheal position.
The sound gives the clue.
The pattern gives the diagnosis.
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🌀 7 CAUSES OF VERTIGO
Vertigo is a symptom, not a diagnosis.
When a patient complains of “dizziness,” the key question is:
❓ Is this true vertigo (a false sensation of movement) or something else?
Correctly distinguishing peripheral from central causes is essential, as some causes are benign, while others may represent a neurological emergency.
🔑 Common Causes of Vertigo
1️⃣ BPPV (Benign Paroxysmal Positional Vertigo)
• Most common cause
• Brief episodes triggered by head movement
• No hearing loss
• Positive Dix-Hallpike test
• Treated with the Epley manoeuvre
2️⃣ Vestibular Neuritis
• Acute severe vertigo lasting days
• Often follows a viral illness
• Nausea and vomiting common
• No hearing loss
3️⃣ Ménière Disease
• Recurrent episodes of vertigo
• Fluctuating hearing loss
• Tinnitus and aural fullness
• Usually unilateral
4️⃣ Vestibular Migraine
• Vertigo associated with migraine features
• Photophobia, phonophobia, aura
• May occur without headache
5️⃣ Labyrinthitis
• Vertigo + hearing loss
• Often post-viral
• Auditory and vestibular symptoms occur together
6️⃣ Acoustic Neuroma (Vestibular Schwannoma)
• Progressive unilateral hearing loss
• Tinnitus
• Gradual onset imbalance or vertigo
7️⃣ Central Causes 🚨
• Stroke
• Multiple sclerosis
• Cerebellar tumours
• Brainstem lesions
⚠️ Red Flags Suggesting a Central Cause
🚨 Diplopia
🚨 Dysarthria
🚨 Limb weakness
🚨 Severe ataxia
🚨 New headache
🚨 Persistent neurological deficits
🩺 Clinical Approach
✔️ Take a careful history
✔️ Examine for nystagmus
✔️ Perform the HINTS examination when appropriate
✔️ Assess hearing
✔️ Look for focal neurological signs
💡 High-Yield Pearl
Peripheral vertigo is common, but never miss a central cause.
Remember:
🧠 Acute vertigo + neurological signs = Stroke until proven otherwise.
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#Vertigo #Neurology #BPPV #MeniereDisease #vestibularneuritis