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Devin Morris

EM@3AM: ESBL-Producing Organisms and Their Management

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A 62-year-old female patient with a history of recurrent urinary tract infections (UTIs) presents to the emergency department with fever, chills, and dysuria. Her recent urine culture results show growth of Escherichia coli resistant to third-generation cephalosporins but susceptible to carbapenems. When ordering an antibiotic, what type of organism should the physician ensure is covered based on previous cultures?

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EM@3AM: Basilar Artery Occlusion

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A 68-year-old male with a past medical history of hypertension, diabetes mellitus, and CAD with a drug eluting stent placed 2 months ago presents with dizziness and vomiting that began 3 hours ago. He has been having “issues with [his] eyes” today and “not feeling quite right.”  Vital signs include BP 165/83, HR 81, RR 18, SpO2 96%. On exam, you notice he has dysarthric speech, limb ataxia, and vertical gaze palsy, which he reports is new. You perform a NIHSS which scores a 3 for mild dysarthria and ataxia in two limbs.

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EM@3AM: Infectious Mononucleosis

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A 17-year-old male with history of asthma presents to the ED with a chief complaint of sore throat for the past 3 days, associated with decreased oral intake. He denies sick contacts. Vital signs include Temp 100.6F, BP 124/78, HR 92, RR 16, 96% on RA. On exam the patient has swollen, erythematous tonsils with grayish exudate, as well as enlarged, tender anterior and posterior cervical chain lymph nodes. What is the most likely diagnosis?

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