Crossword Puzzles:
Antidotes Used In Toxicology

Orthopedics

August 2005 Radiology Quiz

This patient is a 24 year old female who presents to the ED with the chief complaint of fever, dysuria and right sided abdominal/ back pain. The following CT scan is shown.

Questions:

1. Describe what you see? Hydronephrosis of the right kidney with stranding.

  Diagnosis: Acute pyelonephritis

2. What are the typical sign and symptoms for the above diagnosis?

· Fever
· Rigors
· Chills
· Flank pain
· Dysuria
· Polyuria
· Hematuria
· Toxic feeling and appearance
· Nausea and vomiting
· Headache
· Diarrhea

· Physical examination:

• Costovertebral angle tenderness
• Exquisite flank pain

3. What is your differential for the above diagnosis?

· Nephrolithiasis
· Appendicitis
· Ovarian cyst torsion or rupture
· Acute glomerulonephritis
· PID
· Endometritis
· Other causes of acute abdomen
· Perinephric abscess
· Hydronephrosis

4. How would you treat this patient?

• IV hydration (IV fluids are indicated for those unable to take adequate amounts of liquids.)
• Antipyretics
• Antibiotic therapy should be initiated after cultures are obtained and guided by the results of culture and sensitivity testing.
• Consider hospitalization for:
• Toxic patients
• Complicated infections
• Diabetes
• Suspected bacteremia

Trivia: Neil Young had cheesed off Lynyrd Skynyrd by writing a less than complimentary song about the south. Young's song gets a mention in "Sweet Home Alabama". What is the name of Neil's song?

   Answer: Southern Man

 Bonus: What famous hotel gets a mention in “Sweet Home Alabama“?

   Answer: Watergate hotel

 

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