Lincoln EM 2026 #2

1-800-OMAR

100

Eating inadequately refrigerated fish such as mackerel & Mahi Mahi can lead to this toxidrome. 

Scombroid poisoning / histamine toxicity

200

Opsiclonus is highly specific for this hyperthermic toxidrome.

Serotonin Syndrome

300

 

A man comes in with seizures after eating what he believed to be a true morel mushroom requires benzos and this antidote.

Pyridoxine (B6)

400

This treatment can help a glass etcher presenting with acute chemical burns. 

Calcium gluconate 

(gel &/or intra-arterial)

500

 

This baby develops encephalopathy, prompting sequential treatment with these 2 parenteral agents. 

dimercaprol + CaNa2EDTA 

(succimer is oral, for milder cases)

OB-GYN & Tonic

100

This condition usually presents with dysmenorrhea, dyspareunia, dyschezia, & dysuria, and rarely with catamenial hemoptysis.

Endometriosis

200

This is the 1st-line treatment for vaginitis with copious frothy green vaginal discharge, inflamed vaginal walls, & cervix with punctate hemorrhages.

Metronidazole 

(trichomonas vaginalis)

300

The greatest risk factor for an ectopic pregnancy.

Hx of PID

400

An acceptable empiric IV abx regimen for tubo-ovarian abscess. 

cefotetan/cefoxitin + doxycycline or CTX/doxy/Flagyl

(alt: Clinda/gent or Unasyn/Doxy) 

Polymicrobial infection!

500

This is the first maneuver/position that should be attempted when shoulder dystocia is recognized during delivery.

McRoberts (maternal hip hyperflexion) 

then suprapubic pressure

Lost in the Anterior Triangle

100

In Brown-Séquard syndrome, these functions are affected on the contralateral side of the hemisected spinal cord

loss of pain & temperature sensation 

(ipsilateral loss of motor function, proprioception, & vibratory sensation)

200

This is the most common zone for penetrating neck injuries, but also has the best prognosis due to its accessibility.

Zone 2 (cricoid cartilage to mandible)

300

Patients with this traumatic condition present with decreased strength (and to a lesser degree, decreased pain & temperature sensation) affecting the upper extremities more than the lower extremities

Central Cord Syndrome 

(usually hyperextension mechanism)

400

This test is essential for diagnosis of the autoimmune disease that presents with acute, symmetric, ascending paralysis with decreased/absent DTRs.

Lumbar Puncture

for Guillain-Barré syndrome 

(albuminocytologic dissociation = elevated CSF protein & normal/mild pleocytosis)

500

This condition presents with descending paralysis starting with cranial nerves without any sensory loss or pain and is reportable to the Health Department.

Botulism

Stool Intentions

100

This emergent surgical condition in pediatrics is best diagnosed by corkscrew sign on upper GI series & requires the Ladd procedure for definitive management.

Midgut volvulus 

(bowel fails to rotate counterclockwise during embryonic development)

200

This treatment is indicated for an elderly person presenting with the triad of abdominal pain, distention, & constipation.

Flexible sigmoidoscopy 

(sigmoid volvulus)

300

Preferred treatment for Clostridioides difficile infection.

Oral fidaxomicin or vancomycin 

(fidaxomicin has slight advantage in reducing recurrence)

400

An elderly patient with Pmhx CAD & A-fib p/w with severe abdominal pain but minimal tenderness, prompting you to order this imaging study.

CTA 

(for mesenteric ischemia)

500

The most common etiology of the suspected diagnosis on this XR

Adhesions from previous surgeries 

(>90% of SBOs result from adhesions, neoplasms, & hernias)

rare causes include radiation-induced strictures, IBD, gallstone ileus, intussusception, volvulus, foreign bodies, & congenital abnormalities)

50 Shades of Erythema

100

This diagnosis may also appear as a slightly scaly plaque on the trunk.

Basal cell (most common type of skin CA)

200

The most common bullous autoimmune disease, seen in older patients (formed by autoantibodies to basement membrane proteins)

Bullous pemphigoid w/ (-)Nikolsky  

[contrast with Pemphigus vulgaris: +Nikolsky blisters caused by IgG autoantibodies to desmosomes]

300

This presents acutely in young children, usually within 2 days & without oral mucosal involvement or shock.

Staphylococcal scalded skin syndrome 

(Ritter disease)

400

This pruritic papulosquamous rash often starts on one area of the trunk, then spreads outwardly over a few days before self-resolving over about a month.

Pityriasis rosea 

(herald patch > centrifugal spread in a Christmas tree or fir tree distribution)

500

This clinical Dx presents with GI symptoms, joint pain, rash without oral involvement. Platelet count is WNL.

IgA vasculitis 

(formerly known as Henoch-Schönlein purpura) 

Complications include arthritis, bowel ischemia, intussusception, nephrotic syndrome