Joe is a 35-year-old male who slipped on some ice while shoveling snow in his driveway. he fell onto his back and felt pain in his lower spine when standing. joe continued to finish the driveway. he took an analgesic and applied a heating pad when he was finished. the next day he was unable to stand upright when he got out of bed, and the pain increased when he moved. joe made an appointment with dr. steinberg. after examination, dr. steinberg diagnosed a possible herniated disk. he recommended conservative treatment but advised joe to return if the pain didn't subside in a few weeks. if the pain continued, he would order an mri and a myelogram. surgery might be an option at that time, and the myelography would aid in the decision whether to perform a laminectomy or a microdiscectomy. what is the difference between a laminectomy and endoscopic microdiscectomy?

The parents of a 9-year-old girl bring their daughter to the ed. for the last 12 hours, the child has suffered severe nausea and vomiting, as well as diarrhoea and abdominal cramps. further discussion with the child indicates that she suffers from blurred vision and headache. the parents originally were worried about bringing the child to the ed because they feared deportation since the family are illegal immigrants employed to pick strawberries on a nearby farm. on direct questionning, the parents admit that the child was assisting with spraying crops with pesticides the previous day. none of the family members was wearing any protecting clothing. her bp is 88/48 mmhg, pulse is 90/min, rr 33/min, temp 38 c. the child appears sweaty and confused. auscultation of the lungs reveals a diffuse wheeze bilaterally. pupils are miotic and the child has diffuse muscle weakness. which of the following interventions is the most appropriate treatment? - atropine- charcoal- glucagon- naloxone- exposure: consider organophosphate poisoning, which inhibits cholinesterase and results in accumulation of ach in both muscarinic and nicotinic sites. pralidoxime activates achatropine competes with ach only at muscarinic receptors, but will not reverse nicotinic effectscharcoal = gastric decontaminationglucagon = reverse beta-blocker overdosenaloxone = reverse effects of opioids