Hematology/Oncology

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Rapid Airway Narrowing Associated with Hodgkin’s Lymphoma

Luke Hoffmann, BS* and Toby Myatt, MD*

DOI: https://doi.org/10.21980/J86D3Q Issue 5:2[mrp_rating_result]
Neck X-ray showed nonspecific significant prevertebral soft tissue swelling at the level of the cervical spine, with associated apparent thickening of the epiglottis (yellow arrow), diffuse soft tissue swelling of the neck (red arrows) and tracheal airway narrowing (light blue arrow). The computed tomography imaging of the neck was significant for multiple conglomerating pathological lymph nodes with a significant mass effect (orange arrows) compressing the right internal jugular vein (green arrow).
Hematology/OncologyRespiratoryVisual EM
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Spontaneous Intracranial Hemorrhage in Severe Hemophilia A: A Rare Cause of Seizure in a Young Child

Sharon Kook Won, MD* and Andrea T Cruz, MD, MPH*

DOI: https://doi.org/10.21980/J8G91D Issue 4:3[mrp_rating_result]
A computed tomography (CT) scan of the head without contrast was obtained out of concern for intracranial pathology due to the patient’s young age and the witnessed focal seizure.  The CT showed a 4.2 x 1.2 x 1.5 cm acute extra-axial intracranial right frontoparietal hemorrhage favoring epidural over subdural hemorrhage given its lenticular shape. There was no underlying fracture, herniation or midline shift identified.
Hematology/OncologyNeurologyVisual EM

Novel Emergency Medicine Curriculum Utilizing Self-Directed Learning and the Flipped Classroom Method: Hematologic/Oncologic Emergencies Small Group Module

Michael G Barrie, MD*, Chad L Mayer, MD*, Colin Kaide, MD*, Emily Kauffman, DO*, Jennifer Mitzman, MD*, Matthew Malone, MD*, Daniel Bachmann, MD*, Ashish Panchal, MD*, Howard Werman, MD*, Benjamin Ostro, MD* and Andrew King, MD*

DOI: https://doi.org/10.21980/J8VW56Issue 4:1[mrp_rating_result]
We aim to teach the presentation and management of psychiatric emergencies through the creation of a flipped classroom design. This unique, innovative curriculum utilizes resources chosen by education faculty and resident learners, study questions, real-life experiences, and small group discussions in place of traditional lectures. In doing so, a goal of the curriculum is to encourage self-directed learning, improve understanding and knowledge retention, and improve the educational experience of our residents.
Hematology/OncologyCurricula
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Warm & Blue: A Case of Methemoglobinemia

Danielle Biggs, MD* and David C Castillo, DO*

DOI: https://doi.org/10.21980/J8591M Issue 4:1[mrp_rating_result]
The patient hadperioral cyanosis, blue coloration around her mouth, but the rest of the skin on her face appeared normal. She also had acrocyanosis to bilateral hands that can be seen in the image. The patient has a tan complexion up to the level of her wrists, but the palms of her hands are pale and cyanotic.
Hematology/OncologyVisual EM
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Acute Hemolytic Transfusion Reaction

Michael Purcell, MD*, Christopher E San Miguel, MD* and Jennifer Yee, DO*

DOI: https://doi.org/10.21980/J88D2Z Issue 3:3[mrp_rating_result]
By the end of this simulation session, the learner will be able to: 1) Recognize the clinical signs and symptoms associated with transfusion reactions. 2) Discuss necessary systems-based management of potential transfusion reactions, such as notifying the blood bank and evaluating to see if another patienta accidentally received a wrong unit of blood. 3) Discuss the management of various transfusion reactions. 4) Appropriately disposition the patient to an intensive care unit (ICU) or stepdown unit. 5) Effectively communicate with team members and nursing staff during the resuscitation of a critically ill patient.
Hematology/OncologySimulation
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Rare Rapidly Growing Thumb Lesion in a 12-Year-Old Male

Alana J Arnold, MD, MBA*

DOI: https://doi.org/10.21980/J8B92J Issue 3:2[mrp_rating_result]
History of present illness: A 12-year-old male presented to the emergency department with right thumb pain and a mass for four months (see images). He denied fevers, chills, change in appetite, or fatigue. He noted that the lesion was growing and “bleeds easily if bumped.” He denied any trauma to the thumb, except “hitting it” months ago while in football
Hematology/OncologyOrthopedicsVisual EM
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Bedside Echocardiography for Rapid Diagnosis of Malignant Cardiac Tamponade

Alaina Brinley, MD, PhD*, Maili Alvarado, MD* and J Christian Fox, MD*

DOI: https://doi.org/10.21980/J82S38Issue 2:1[mrp_rating_result]
The video shows a subxiphoid view of the heart with evidence of a large pericardial effusion with tamponade – note the anechoic stripe in the pericardial sac (see red arrow). This video demonstrates paradoxical right ventricular collapse during diastole and right atrial collapse during systole which is indicative of tamponade.1,2 Figure 1 is from the same patient and shows sonographic pulsus paradoxus. This is an apical 4 chamber view of the heart with the sampling gate of the pulsed wave doppler placed over the mitral valve. The Vpeak max and Vpeak min are indicated. If there is more than a 25% difference with inspiration between these 2 values, this is highly suggestive of tamponade.1 In this case, there is a 32.4% difference between the Vpeak max 69.55 cm/s and Vpeak min 46.99 cm/s.
Cardiology/VascularHematology/OncologyUltrasoundVisual EM

Transfusion Related Emergencies

Megan Boysen Osborn, MD, MHPE* and Min-Ha Tran, DOŦ

DOI: https://doi.org/10.21980/J86P4VIssue 1:2[mrp_rating_result]
At the end of this didactic session, the learner will be able to: 1) list the various transfusion reactions and their approximate incidence; 2) understand the pathophysiology behind each transfusion reaction; 3) describe the management for each type of transfusion reaction; and 4) discuss the plan for prevention of future transfusion reactions.
Hematology/OncologyTeam Based Learning (TBL)