ABSTRACT
BACKGROUND: Nonketotic hyperglycemic hemichorea is a rare complication of diabetes mellitus seen in the emergency department. It is most commonly reported in elderly women, predominantly of Asian race, with poorly controlled diabetes mellitus. Patients present with a triad of nonketotic hyperglycemia, hemichorea, and contralateral basal ganglia abnormality on imaging. Its exact pathophysiology is still not known. However, it has a very good prognosis with early diagnosis and treatment. CASE REPORT: We report a case of hemichorea involving the right upper and lower limbs due to nonketotic hyperglycemia. The patient's symptoms resolved after normalization of blood glucose. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Nonketotic hyperglycemic hemichorea should be included in the differential of a patient presenting with chorea and high blood glucose levels. It has an excellent prognosis with both symptoms and imaging abnormalities typically resolving completely with restoration of normoglycemia.
Subject(s)
Chorea , Diabetes Mellitus , Hyperglycemia , Humans , Male , Female , Aged , Chorea/etiology , Chorea/diagnosis , Blood Glucose , Hyperglycemia/complications , Diagnostic ImagingABSTRACT
Objectives: Clear and specific content for debriefing promotes learning and reflection for the learner. Currently, there is no universal tool for developing the content for debriefing. Methods: We developed a tool for debriefing that can be applied for developing content for debriefing, which can be used for instructor-led and within-team debriefing. These tools include two sets of eight questions, namely, the how and the what questions. Results: We used these tools in our monthly simulation activities and got a favorable response from the residents who used them. Conclusions: The how question deals with human factors, and the what questions deal with educational factors.
Subject(s)
Hemopneumothorax/diagnostic imaging , Chest Pain , Drainage , Hemopneumothorax/pathology , Hemopneumothorax/therapy , Humans , Male , Motorcycles , Ultrasonography , Young AdultABSTRACT
Aortic dissection (AD) is a great imitator, and its diagnosis is quite challenging due to its varied presentations and unreliable clinical findings. Based on the literature search we found, this is the first case report of Stanford-A/DeBakey Type 1 AD reported as a triple mimic, namely stroke, acute limb ischemia, and pericarditis. Here, we describe the case of a 46-year-old male who presented to our emergency department with features suggestive of acute pericarditis, cerebrovascular accident, acute limb ischemia, which could have been attributed to athero-thrombo-embolic disease and AD could have been possibly missed. However, point-of-care ultrasound helped us in the diagnosis of this highly lethal condition.
