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ToxCard: Iron

EMDocs

Antidote : Deferoxamine is a chelating agent derived from Streptomyces pilosus ; binds free iron from plasma and iron inside of cells. Coagulopathy: Parenteral vitamin K and/or fresh frozen plasma (FFP) as clinically indicated. Published 2012 Jul 1. 2012 Aug;39(8):719-24. 2 L/hr in adults. mg of elemental iron.

E-9-1-1 95
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Acute Transverse Myelitis in Children

Pediatric EM Morsels

Tavasoli 2018, Wolf 2012) More common in adults; children comprise 20% of total cases (Pidcock 2007, Wang 2019) Bimodal age distribution (Absoud 2016) Children < 5 years Children > 10 years Symptoms evolve over 2-4 days and peak at 5-6 days (Absoud 2016) ATM may occur alone OR as part of another disorders (e.g. 27,11 (2012): 1426-36.

Plasma 144
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REBEL Core Cast 108.0 – Angioedema

REBEL EM

Bradykinin Mediated Plasma globulins called kininogens release bradykinin and cause vascular permeability. Image: ( Morgan 2010 ) Features Absence of urticaria and pruritus Insidious onset (24-36 hours) ACE Inhibitors Inhibition of ACE hinders the degradation of bradykinin and can lead to idiosyncratic angioedema. Zuraw et al.

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SAEM Clinical Images Series: A Case of Painful Skin Lesions

ALiEM

Necrobiosis Lipoidica – This patient had a previous skin biopsy with histopathologic changes demonstrating a granulomatous dermatitis involving the dermis and subcutaneous tissues with necrobiosis of collagen and inflammatory infiltrates of lymphocytes and plasma cells consistent with a diagnosis of necrobiosis lipoidica.

Plasma 161
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Transfusion Reactions

Core EM

Author: Natalie Bertrand, MD Editor: Naillid Felipe, MD Background: Definition: adverse reaction to blood product administration Incidence: more common in children than adults, except for delayed hemolytic transfusion reactions Allergic (non-anaphylaxis) – Platelets 1-3%; RBCs 0.1-0.3% mg IF requiring IM Epi >3x, switch to IV Epi, 0.05-0.1

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Complex Regional Pain Syndrome

Don't Forget the Bubbles

Pro-inflammatory states may also play a role, as patients with CRPS have significantly higher levels of plasma cytokines and chemokines. in 2012 of 19 children with CRPS treated with CBT and physical therapy showed that 89% eventually had full symptom resolution. Pain Res Manag 2012; 17:386–90 Harden RN, Oaklander AL, Burton AW, et al.

MPD 98
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EM@3AM: Endometritis

EMDocs

Plasma cell endometritis is associated with Chlamydia trachomatis infection. 2012 May;27(5):1368-74. Epub 2012 Mar 14. Chorioamnionitis and endometritis. Infect Dis Clin North Am. 1997 Mar;11(1):203-22. doi: 10.1016/s0891-5520(05)70349-4. PMID: 9067792. Paukku M, Puolakkainen M, Paavonen T, Paavonen J. Am J Clin Pathol.

EMS 83