Brady Pregerson, MD


A 30-ish-year-old male with no prior surgeries or significant medical history presents to the emergency department for vomiting, generalized abdominal pain and tenesmus. He denies any fever, diarrhea, bleeding, or other complaints. He said that he has had this a few times in the past but never this bad. He was hospitalized for it once, about 3 months ago, and they did not find a cause.

Vital signs are normal except for a pulse of 118 and BP of 153/94. He is afebrile. A physical exam is otherwise normal except for severe apparent distress and retching into a bag. Except for mild epigastric tenderness the abdomen is benign.

: bicarb = 13, lactic = 6.5, glucose =181, potassium = 3.1, acetone level = 56

Articles

Our latest case report from Dr. Brady Pregerson features a man in his 30s presenting with vomiting, generalized abdominal pain, and tenesmus. Can you determine the correct diagnosis?

Case Report: Man in 30s w/ Vomiting, Abdominal Pain, & Tenesmus  

A Caucasian woman in her 30s presents to the emergency department for 10 days of gradually worsening generalized weakness, nausea without vomiting and occasional mid-abdominal pain. She also mentions that she has recently been on a keto-diet and also has had a surprising tan despite it being mid-winter. She denies any diarrhea, fever, missed periods or other complaints.

Vital signs are normal except for a BP of 85/61, which she does not think is normal for her. The pulse is 90 and temperature is 97.7. Physical exam is otherwise normal except for the skin findings and gum findings shown below.

: normal except for a sodium of 131, potassium of 5.3 and glucose of 62

Check out this Emergency Department Minute Quiz from Brady Pregerson, MD. Can you determine the correct diagnosis?

Emergency Department Minute Quiz: Weak and Tan

A 52-year-old female presents to the emergency department for dyspnea and a feeling that she is being choked, especially when she bends her neck forward. She denies fever, sore throat, chest pain, voice change or other complaints.

Vital signs are normal except for pulse of 52. Physical exam is otherwise normal except for that her thyroid gland feels a bit enlarged.

Brady Pregerson, MD

Articles

Case Report: Man in 30s w/ Vomiting, Abdominal Pain, & Tenesmus

Emergency Department Minute Quiz: Weak and Tan

Emergency Department Minute Quiz: 52-Year-Old Female with Throat Tightness