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Archive for July 2011

Why is there a bag of balls in this man’s left lung?

Came across this interesting X-ray the other day. These are PLOMBAGE balls. From the latin ‘plumbum’, meaning lead. Great if you can make the diagnosis on the X-ray. They are a form of treatment prior to the 1960′s for TB. It was believed at that time, that if an inert substance was placed in the…

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Neck lump in a child

A 2 year old girl is brought into the Emergency Department by her parents. She has recently had some coryzal symptoms. Today when the child was picked up from kindergarten, the parents noticed a lump on the left side of the neck. It had not been there the morning before. The child is febrile at…

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The suprapubic just won’t go in!

Here’s the typical case: “Doctor, I’ve had a suprapubic in for some time and have been having it changed at home. I usually have a size 16, but last time they put in a 14. Today, they couldn’t change it and it’s been out all day. Can you please put a new one in?” The…

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Headache – how not to miss the bad ones

Headache. Still one of those areas that causes concern. Not because we make a mess of it, but more because we often don’t know what we should be considering, so we don’t miss the bad ones. How do we learn this material? Like all other things, I believe in simplicity to make this happen. To…

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The crying infant

“More is missed by not looking than by not knowing” William Osler One of the biggest challenges I find, is being presented with the crying infant. The challenge is there because they are too young to tell us what is wrong. It is up to us to use all the tools in our possession to discover…

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ALTE – apparent life threatening events

Case Scenario:A family bring their 8 month old to the Emergency Department. The child has had a recent respiratory infection with episodes of coughing. Tonight whilst being held, the mother states that the child stopped breathing and went blue and limp, then soon after, made a strange breathing noise and started breathing again. Do any parts of this story concern…

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Hip Relocation

I remember the days when we had to reduce hips in the emergency department and I used to have to jump on the bed. Stand there and pull up on the hip with the knee at right angles. In fact I remember, many years ago, working in a small emergency department with one doctor and…

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