Archives for December 2011

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Clinical case 039: Ectopic ectopic – a Gedankenexperiment

This case starts with a bad gas.  This patient arrived ‘in extremis’.  Suspected ectopic transferred in by plane with the following data: Urinary HCG positive Abdominal pain for a few days No urine output for the last 24 hours Hb in the remote clinic was 130 g/l yesterday A 14 second US in ED showed […]

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Clinical case 038: a AAA eh?

Todays case – 69 yo woman presents to ED with 3 hour history of sharp, severe left abdominal pain. Pain is colicky, radiating down into groin. Urinalysis shows 2+ blood. So if you read the “frolic with colic” post and the wise comments from the readers you will be asking for an ultrasound – not […]

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Introducing Dr Jonathan Ramachenderan

Broome Docs has a new contributing author.  Dr Jonathan Ramachenderan was going to be a Broome doc, unfortunately due to a misalignment in the stars of medical administration he is now on his way to Albany in the far south of WA (if Broome were the eye at the top of WA, Albany would be […]

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Clinical Case 037: finding fevers’ focus

Another case for Sepsis week. 67 yo. male traveller.  Recently been on vacation in Scotland, then spent a week in Singapore, flew into Perth (WA) then up to Broome to sit on the beach.  Spent all his time in metro areas, no farm / rural / jungle exposure. Presents to the ED with a 2 […]

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Clinical Case 036: Silent, sitting sepsis

This case is part of my “Sepsis week” at Broome Docs.  Lets say this case happpens in January, just after the first big rain for the wet season. 58 yo Aboriginal man, presents to triage at ED complaining of “cold sick” [flu] symptoms. Has been feeling hot, sweating and had a non-productive cough intermittently for […]