POCUS PEARLS

UTF-832- Thyroid Ultrasound

50 y F presents with nausea, vomiting and palpitations and elevated blood pressure

Using the US seen to here what is a likely cause of her symptoms

29- Testicular Ultrasound

24 y male presents with acute severe groin pain.

What is on your differential?

Pretty broad

-Kidney Stone

- Trauma

-Infection

- Torsion

30- Transgluteal Sciatic Nerve Block

28- TCD

Pamphlets made by Dr. Carolina Brea, US Fellow at Ohio State University Department of Emergency Medicine, 2024-2025

26- Intussusception

Baby presents with exhausted parents who States they have been unconsolable for 1-2 days and now have dark red stool...

25- RWMA

5 Min Sono Regional WMA

55 Y Female with A history of nausea, heartburn and fatigue Presents...

She has the following ECG:

24- Pyloric Stenosis

Mom brings in A 3 month old male with projectile vomiting!

What risk factors exist for the likely condition? (select all)

A) 2-3 years of life

B) Male

C) Bottle Feeding

D) Trauma

23- Advanced Right Heart Strain

22- Peds Appy

21- Carpal Tunnel Syndrome

20- PENG

Your patient and the arctic burst were not compatible...

They fell and fractured their pelvis!

Unfortunately, they are allergic to all opioids but are in a LOT of pain.

19- Normal Cardiac Variants

Your patient presents with 2 weeks of congestion, unilateral facial pain and subjective fevers.

You proudly percuss their sinuses and diagnose them with sinusitis!

Your patient is less than thrilled with your diagnostics and wants imaging to confirm this diagnosis.

16- Fractures

Your patient is feeling festive an doing some holiday decorations.

They have a "Clark" moment and take a tumble.

They are having excruciating chest wall pain but the XR is negative.

15- Posterior Tibial Nerve Block

Your patient was putting ornaments on the tree and a naughty kitten knocked one off! They, of course, didn't see it and now have a piece of glass stuck in their foot.

14- Gallbladder Mimics

13- Diaphragm Excursion

11- Gastric Ultrasound to Predict Aspiration Risk for RSI

Your patient is on a GLP-1 and has followed the guidelines for holding her medication. She now presents pre-operatively for a major surgery requiring intubation.

Which US makes you more comfortable with not doing an endotracheal intubation?

A. a solid full stomach

B. fluid filled stomach

C. an empty stomach

Below is a video of a very full (750mL of blood) stomach with an NG tube in place

10- Achille's Heel_ Try Ultrasound!

Patient presents with calf pain after jumping out of the way of a scooter

What medication increases the risk of the injury shown in the image?

A. Acetaminophen

B. Ciprofloxacin

C. Ibuprofen

D. Naproxen

9- Serratus Anterior Plane Block

Patient presents with ribs 3-5 fractured after an MVC. Patient is 85 years old with COPD. Family is very nervous about opioids but patient is screaming in pain. What block could help you in this situation?

A. Serratus Anterior

B. Superficial Cervical Plexus

C TAP Block

D. Stellate Ganglia Block

Coverage is shown below. Image from Core Ultrasound

8- US for Flexor Tenosynovitis

Patient has these findings on ultrasound of the finger. What mechanism would you suspect?

A. Hyperextension

B. Hyperflexion

C. Puncture

D. Subluxation

BONUS QUESTION!

Image courtesy of NUEM Blog

7- US for Temporal Arteritis

Patient presents with a headache and vision loss. You see this on ultrasound.

What demographics would you expect for this patient ?

A. 5y boy with premature birth history

B. 20y male with trauma

C. 80 y female joint pain

6- IUP or Not IUP?

What is the first definitive sign of an IUP?

A. Decidual Reaction

B. Fetal Pole

C. Gestational Sac

D. Yolk Sac

Decidual Reaction is the first finding followed by gestational sac.

Gestational Sac or rather pseudo gestational sac has been seen in ectopic

Yolk sac will occur around week 4 and before fetal pole or heart tones and is a reliable finding for IUP

4- Should I Stab That Pt.2

A 45 y male with history of lung cancer, chemo/radiation as well as a recent port placement presents with worsening shortness of breath.

Which image below requires an immediate/emergent procedural intervention?

POCUS Pamphlet 3- Should I Stab That

Patient presents with right groin pain, warmth, redness and swelling.

What do you want to do?

Incision and Drainage
Antibiotics
Call Surgery
Nothing

You then get this ultrasound

Now what do you want to do?

Surgery! this is a pseudoaneurysm

Can be treated with surgery, ultrasound compression, or IR

POCUS Pamphlet 2- Pearls for Renal Ultrasound

Patient presents with right flank pain and hematuria

A renal ultrasound is done and this is found:

What is the next best step based on above?

A. Treat as a kidney stone with hydro

B. Place a foley and irrigate

C. Pursue further testing

D. Consult trauma/surgery for renal injury

This image shows normal renal architecture so further testing is needed to evaluate the symptoms

POCUS Pamphlet 1- Beware the Pelvis

25 y female found down with BP of 70/p HR 120

Unknown history

You obtain this view of the pelvis

What is the next best step?

A. CT scan

B. IV Fluid Bolus

C. Place a Foley

D. OR

5- Superficial Cervical Plexus Block

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