Also known as: Early labor
A 25-year-old woman at 22 weeks gestation presents with vaginal hemorrhaging and goes into preterm labor. Despite attempts to stop contractions with nifedipine, she delivers a 490-gram infant who initially survives but ultimately dies after resuscitation attempts.
Also known as: Premature birth
Infant born at 22 weeks weighing 490 grams (under 500g viability threshold). Initially managed with comfort care per parents' wishes, but later resuscitated at mother's request. Develops bradycardia and ultimately dies despite resuscitation efforts.
Also known as: CSF leak
A 14-year-old homeless girl presents with seizures and is found to have a cockroach in her nasal sinus cavity. CT reveals a cranial fracture causing CSF leak into the nasal cavity, which attracted the insect. The injury resulted from physical abuse by her mother's boyfriend.
Also known as: Seizure
The patient experiences a seizure in the ED, treated with Ativan, which leads to discovery of the underlying cranial fracture and CSF leak.
Also known as: Lung cancer
A renowned cardiac surgeon presents with a tumor on the upper lobe of his right lung that has invaded the superior vena cava, obstructing blood flow to the head and upper extremities. He requests to be awake during his own surgery using epidural anesthesia, creating conflict when he attempts to direct his own operation.
Also known as: Child abuse
The patient's cranial fracture and subsequent complications are revealed to be the result of physical abuse by her mother's boyfriend, which caused her to flee to homelessness.