101 Clinical Cases in Emergency Room Badar M Zaheer
INDEX
Page numbers followed by b refer to box, f refer to figure, fc refer to flowchart, and t refer to table
A
Abdomen 31, 119
examination 202
Abortion, septic 271
Abscess 314
epidural 155
peritonsillar 318f
retropharyngeal 317, 319f
tubo-ovarian 270
Absolute neutrophil count 323
Acamprosate 179
Accommodation 202
Acetazolamide 377
Acetycholinesterase 168
Acetylsalicylic acid 67, 74
Aching 78
Acidic urine 325
Acidosis 206
metabolic 325
Acquired immunodeficiency syndrome 274, 358
Acromioclavicular joint
anatomy of 148f
injury 148
features of 148
separation 148, 149f, 149fc
Activated partial thromboplastin time 70
Acute coronary syndrome 39, 64, 65, 72, 74, 77
management of 67
Acute respiratory distress syndrome 39, 61, 63f, 134, 252
Berlin definition of 62t
Addison disease 33
Addisonian crisis 211
Adenopathy 34, 273
Adjuvant therapy 70
Adrenal crisis 211
signs in 214f
symptom in 214f
Adrenal function 365
Adrenal insufficiency, acute 91
Advanced trauma life support 92t, 195
Aggression 16
Agitation 249, 265
Agoraphobia 216
Air sacs 5
Airway 100, 101, 331
breathing, circulation 3, 16, 25, 26, 44, 48, 105
deformity 21
disability, and exposure 52, 238
management 227
obstruction, location of 291f
Alanine
aminotransferase 130
transaminase 165
Albumin 93
Alcohol 33, 184, 222, 358
consumption, heavy 120
Alcoholism 1, 175
Aldosterone 212
Alkaline
burn 265, 267f
phosphatase 165
Allergic alveolitis, extrinsic 39
Allergic reaction 220, 241
Allergy 239
Allopurinol 326
Alprazolam 217
Alteplase 44
Ambisome 354
Amenorrhea 308
American Association for Emergency Psychiatry 218
American College of Emergency Physicians 159
Aminoglycoside 125, 168
Amnesia 16
post-traumatic 26
retrograde 26
Amoxicillin 128
Amphetamines 180f, 197
abuse 258
overdose 258
adverse effects of 259f
Amphocin 354
Ampicillin 318
Amylase 126
Anal sphincter tone, absent 156
Analgesia 134, 278
Anaphylaxis, cutaneous 241
Androgen hormones 212
Anemia 165
Aneurysm
aortic 89
ruptures, prevention of 14f
Angina 239
Anginal symptoms, severe 79
Angiocath 48f
Angioedema 225, 234f
Angiogram, selective pulmonary 42f
Angiography 72, 86f, 95, 338
pulmonary 41
Angioplasty 67, 187f
Angiotensin receptor blockers 369
Angiotensin-converting enzyme 76, 110, 224, 233, 234f, 369
inhibitor 71, 234f, 241
Angle-closure glaucoma, acute 376
Animal antiserum 222
Animal bites 220
Anorectic agents 34
Anorexia 128
nervosa 358
Anterior dislocation, reduction of 152f
Antiacetylcholine receptor 166
Antianxiety medications 217
Antibiotics 128, 166, 278
Antibody, antinuclear 32
Anticholinesterase drugs 167
Anticoagulant
current use of 185
therapy 1
Antiepileptics 167
Antigen, prostate-specific 162
Antihistamines 227
Anti-PD-1-monoclonal antibodies 168
Antiplatelet therapy 70, 186
Antistreptolysin O titer 95
Antithrombin therapy 70
Anxiety 73, 177, 249, 265
disorders 39
Aorta
abdominal 84f
enlarged abdominal 83f
scan 86
Aortic aneurysm
abdominal 82, 82f, 83, 84f, 85f, 88, 155
dissecting 71, 75
Aortic arch anomalies 59
Aortic dissection 70, 94
Aortic stenosis 33, 39, 71, 75, 91, 94
Apnea, central 39
Appendicitis 83, 127, 275
Appendix diameter 278
Arachnoid cysts 1
Arrhythmia 177
Arterial occlusions, meningococcemia-induced 343f
Arterial oxygen, partial pressure of 62
Arteritis, temporal 376
Artery
anterior segmental 41f
enlarged central pulmonary 32f
femoral 57f
Arthritis 127
Aspartate aminotransferase 130
Aspartate transaminase 165
Aspirin 69, 71, 186, 241
Asthma 53, 59, 60, 239, 240
exacerbation 33, 240
Astrocytoma 23f
Ataxia 209
Atherosclerosis 310
Atrioventricular block 33, 67
Atropine 228, 248f
Automated external defibrillator 99, 102f
Universal sign for 99f
Automobile accidents 15
Azathioprine 109, 167
B
Back pain 39
assessment of 156
low 154
mechanical low 161
Bacteremia 193, 295
Bacteremic origin 144
Bacteriuria 127
Balloon-catheter removal 316
Barbiturates 33
Barium enema study 289f
Cough, barking 294
Bartter-Schwartz criteria 210
Basal metabolic
profile 3
panel 83, 165, 353
Basilar artery
occlusion 170
thrombosis 185
Basilar skull fracture 15
Bath salts 180f
Bee sting 238
Bell's palsy 190, 191f
Benzodiazepines 33, 178, 196, 217, 260
Benztropine mesylate 219
Beta-blockers 33, 71, 167, 168, 203, 204, 233
Beta-human chorionic gonadotropin 307
Bicarbonate 209
Bile acid sequestrants 204
Bilirubin 165
Biopsy, endomyocardial 95
Bird's beak 289
Biting flies 243
Bladder 251
distended 197
incontinence 156
Bleeding
active 70
control 338f
diathesis 70
external 91
gastrointestinal 260
identifying source of 91
vaginal 270, 308
Blind spots 10
Blood 5, 189
cultures 95
disorders 56
gases, arterial 36, 45, 62, 254, 367
glucose 133
levels 208
loss of 90
pressure 82, 107, 196, 211, 233, 266, 302, 333
control 213
dropping 239
high 10
low 264
maintain 8
systolic 10, 11
tests 198
transfusion of 93, 122f
type 308
urea nitrogen 165, 304
Body mass index 135
Body temperature 90
Bone 5
cysts, aneurysmal 161
Borrelia burgdorferi 244f
Botulinum toxin 168
Botulism 165, 170
diagnosis of 172
Bowel 156
ischemic 83
obstruction, large 83
Bradyarrhythmia 91
Bradycardia 7, 33, 166, 197, 198, 246
persistent profound 43
Bradypnea 7
Brain 5, 69, 215
abscess 258, 324
astrocytomas 22
frequency of 23f
injury 197
chronic traumatic 29
matter 189
neoplasms 24
tumor 23f
Brainstem infection 170
Braunwald classification 79t
Breathing 100, 101, 331
shortness of 39, 82, 216, 239
Bronchial lesions 59
Bronchitis 239
Bronchoconstriction 240
Bronchorrhea 246
Bronchospasm 246
Brugada syndrome 111
types of 112fc
Bundle branch block 69
Bunny ear 36
Burns 90, 282, 331
C
Calcium 100, 372
channel blocker 36, 167
containing stones 349
levels 325
phosphate stones 349
stones 351
Calf swelling 58
Campylobacter jejuni 174
Canabanoid hyperemesis syndrome 262
Canadian C-spine rule 20f
Cancer, active 58
Cannabis abuse 260
Carbamazepine 209
Carbon monoxide 253
poisoning 253, 254t
Carbonic anhydrase inhibitor 377
Carboxyhemoglobin 253
Carcinoid syndrome 197
Carcinoma, esophageal 320
Cardiac arrest 99, 100f, 101f, 103b
acute 102f
outside hospital 104
Cardiac biomarkers 69, 75
elevated 76
Cardiac death, sudden 39, 111
Cardiac enzymes, elevated 94
Cardiac monitoring 69, 227
Cardiomyopathy 39, 91, 260
Cardiovascular system 94, 126, 177
Catecholamine surge 259
Catheter
directed therapy 43
insertion 49f
C-collar 50
Ceftriaxone 278
Celebrex 354
Cement burns 267f
Centers for Disease Control and Prevention 243, 248, 281
Central nervous system 31, 249, 304, 324
tumors 11
Central pulmonary veins, extrinsic compression of 34
Central retinal artery occlusion 376, 378
Central venous catheter site 324
Cephalosporin, third-generation 125
Cerebral
abscess 184
angiography 10
contusion 29
edema, reduce 8
salt wasting 364
spinal fluid 158
vascular disease 165
venous thrombosis 158, 159
Cerebrospinal fluid 12f, 172, 304, 332
Cerebrovascular accident 158
Cerebyx 354
Cervical
arthritis 331
motion tenderness 306
spine
anatomy of 19f
injury 17, 20f
Cervix 144
Chest 31
computed tomography 45
discomfort 216
imaging 62
pain 65, 82, 216, 223
causes of 66fc
symptom of 259
radiograph 95, 177, 210
tube 49f
wall 294
X-ray 32, 34, 39, 44, 52, 53, 60, 61, 66, 77, 83, 95, 323, 330
Chlamydia 308
trachomatis 270
Chlordiazepoxide 178
Chloroquine 168
Cholangiopancreatography, endoscopic retrograde 131
Cholangitis 136
primary sclerosing 127
Cholecystectomy 136
laparoscopic 136, 137f
Cholecystitis 271
acute 135, 136, 136f
Cholecystostomy 136
Cholelithisasis 83
Cholinesterase enzyme permitting 247
Chronic obstructive pulmonary disease 33, 39, 45, 67, 85
Ciprofloxacin 278
Circulation 331
Citrus fruits 326
Clammy sweat 90
Clavulanic acid 128
Clindamycin 168
Clonazepam 217
Clonidine 354
C-loop, widening of 131
Clopidogrel 70, 71, 186
Coagulation 223
abnormalities 146
Coagulopathy 1, 310
Cocaine 197
Codeine 241
Coffee
bean sign 289f
ground emesis 120
Cold 90
agglutinin titer 95
stimulus 158
Collagen vascular disease 34
Colloid 93
Colon cut-off sign 131
Colonoscopy 120
Colovaginal fistulae 129
Coma 16, 249, 254, 264
Compartment syndrome 339, 340f
Complete blood count 1, 45, 55, 83, 91, 94, 100, 114, 126, 130, 135, 162, 165, 192, 218, 233, 256, 275, 288, 308, 341, 353, 367
Comprehensive metabolic panel 126, 233, 256, 353
Compression 100
external 158
fracture, contralateral anteroposterior 335f
lateral 335f
ultrasound 40
Computed tomography 1, 6, 9, 13, 16, 21, 22, 26, 41f, 53, 61, 63f, 66, 83, 84f, 92f, 96, 114, 123, 124f, 127, 129, 130, 156, 158, 165, 166, 170, 177, 182, 192, 195, 210, 235, 275, 277, 314, 317, 330, 333, 346
severity index 133t
Concussion 25, 27, 29
symptom of 29
syndrome 29
Condylomata acuminata 273f
Condylomata lata 273
Confusion 249, 254, 325
Conjunctivitis 375f, 377
Connective tissue disorders 10
Consciousness 294
level of 182
loss of 26, 157
Conservative method 8
Constipation 264
Constriction 91
Continuous positive airway pressure 62, 107
Contusion, pulmonary 44, 46f
Convulsions 325
Cor pulmonale 39
Corneal abrasion 375f
Coronary angioplasty, percutaneous transluminal 75f, 76
Coronary artery
bypass
graft 67, 75f, 76
surgery 71
disease 74, 78, 82, 95, 108, 177
vasospasm 94
Corticosteroids 109, 227, 228
Corticotropin-releasing hormone 213
Costochondritis 71, 75
Cough 240
Coumadin 354
Cramping, abdominal 246, 265
Cranial nerves 181
Craniofacial disorder 158
Craniotomy 4f
Cranium 158
C-reactive protein, elevated 94
Creatine kinase 215, 360
muscle 69, 75, 215
and brain 75, 94, 165
Creatine phosphokinase 304
Creutzfeldt-Jakob disease 184
Crisis, hypertensive 114fc, 203
Croup
acute 291
mild 294
Crystalloids, infusion of 308
Cullen sign 307f
Cyanosis 294
Cyclobenzaprine 352
Cyclophosphamide 167, 209
Cyclosporine 109, 167
Cystic fibrosis 59, 286
Cystine stones 351
Cytokines 287
Cytomegalovirus 374
D
D-dimer 32, 39, 55, 58
positive 39
test 40
Deep tendon reflexes 55, 90, 165, 182
Deep venous thrombosis 38, 40, 55, 58
Doppler ultrasound of 57f
venograms of 57f
Degenerative disk disease 85f
Dehydration 205
Delirium 209, 249, 264
tremens 174, 175, 373
Delusions 218
Dentition 331
Depression 16, 177
Dermatitis, exfoliative 90
Dexamethasone 204
Dextran 93, 222
Dextrose, intravenous 203
Diabetes 1, 74, 78
mellitus 73
non-insulin-dependent 82
Diaphoresis 73, 79, 177
Diarrhea 166, 251, 260, 346, 367
symptom of 259
Diastolic dysfunction 331
Diazepam 178
Diazoxide 198
Dichlorodiphenyltrichloroethane 249
Diethylstilbestrol 308
Diphtheria 172, 238
Diplopia 168
Dipyridamole 186
Dirty fat 131
Disaster management 380
Disseminated intravascular coagulation 213, 259, 297, 341
Distal ureter 346
Distention, jugular venous 365
Distress
abdominal 216
gastrointestinal 246
Disulfiram 179
Diuretics 107, 328
Diverticular disease 83
Diverticulitis 123, 127, 128, 271
acute 129
complicated 129
severe 124f
Diverticulum, true 128
Dizziness 26, 33, 223, 234, 249
Dobutamine 228
Dopamine 259
Dopaminergic neuron 260
Doppler flow 139
Doppler ultrasound 40
Dorsiflexion 39
Drawing blood 100
Drowsiness 26, 197, 234, 264
Drug abuse 216
Dry drowning 296
Dry mouth 264
Dry oral mucus 202
Dual energy radiographic absorptiometry 162
Dying, fear of 216
Dysarthria 182, 209
Dyspareunia 270
Dysphagia 317, 320
Dyspnea 39, 79, 239, 240, 317
Dysreflexia, autonomic 196
Dysrhythmia 91, 296
cardiac 230, 325
re-entry 331
ventricular 118
Dystrophy, muscular 165
Dysuria 127
E
Ear, nose and throat 126
emergencies 310
Echocardiogram 95
transesophageal 109
Echocardiography 32, 111
Ectopic pregnancy 271, 306, 307f
Eczema, venous 56f
Edema 5, 94
acute pulmonary 203
interstitial 64f
laryngeal 239, 240
origin of 62
peripheral 239
pitting 58
pulmonary 39
submucosal 347
Edrophonium 166
Ejection fraction 71
Electrical injury 229, 232f, 237t
Electrocardiogram 32, 35, 42f, 64, 69, 74, 77f, 82, 94, 96f, 100, 111, 183, 235, 356, 367
Electrocardiography 35, 53, 60, 62, 65f, 198, 215, 353
Electroencephalogram 192
Electroencephalography 193
Electrolyte 100, 165
abnormalities 179
balance 213
Electromyography 166, 172
Emergency eye wash tool 268f
Emergency medical services 22, 61, 208, 262, 333
Emergency room 9, 59, 64, 99, 106, 164, 174, 192, 215, 302, 304, 376
care and disposition 212, 324, 372
management 174
treatment 278
Emesis 120
Emotional liability 26
Emphysema 39, 239
Encephalitis 184, 193, 258, 295, 324
Encephalopathy
hepatic 184
hypertensive 184
Endarterectomy, carotid 186
Endocarditis, bacterial 341
Endocrine 33, 201
Endometriosis 127
Endophthalmitis, traumatic 377
Endothelin receptor antagonists 37
Endotoxin 287
Endovascular therapies 186
Enzymes, cardiac 215, 233
Epididymo-orchitis 138
Epidural compression syndrome 155
Epidural hematoma 3, 3f, 4f, 6, 7f, 8, 29, 188f, 193, 295
neurosurgical exposure of 7f
Epigastric discomfort 120
Epiglottitis 291
Epilepsy 1, 295
type 193
Epinephrine
administration 228
autoinjector 242f
Episode, acute 217
Epistaxis 239, 310
management of 311fc
Erythema migrans 243f
Erythrocyte sedimentation rate 94, 162, 271
Esophageal button battery 321f
Esophageal rupture 94
Esophageal spasm 94
Esophagitis 94
European honey bee 241f
Exercise 59
Extracorporeal membrane oxygenators 109
Extracorporeal shock wave lithotripsy 351
Extremities 31, 126, 170
Eye
contact 249
severe eye pain with redness of 377
Eyelid drooping 10
F
Facet arthropathy, lumbar 161
Facial 29
Fasciculation 166
Fasciotomy procedure 340f
Fat embolism 39
Fatigue 26, 205
generalized 79, 165
Febrile 201
seizures 294
complex 295t
Female reproductive system, anatomy of 271f
Femur fracture 280f
Fever 124f, 127, 145f, 273, 295, 317
high 197
history of 155
neutropenic 323
Fibrillation, atrial 39, 185
Fibrinolysis 70
Fistula formation 129
Fitz-Hugh-Curtis syndrome 271
Flail chest, Computed tomography of 46f
Flank pain 127
Fleas 243
Flesh burns 232f
Fluid 179, 206
and electrolytes, loss of 90
loss 93
restriction 210, 328
Flu-like symptoms 79
Fluoroquinolones 168
Focal neurologic signs 159
Forced expiratory volume 36
Fosphenytoin 196
Foul 127
rhinorrhea 316
Fracture 282
long-bone 91
lumbar compression 160
Free ventricular wall 91
Fresh frozen plasma 330
Fungizone 354
G
Gait 177
Gallbladder disease 71, 75
Gastric
dilatation, acute 51
ulcer, deep 121f
Gastritis 83, 94
Gastroesophageal reflux disease 59, 65, 75, 93, 130
Gastrointestinal
abnormalities 273
bleeding management, lower 122fc
system 94
Glasgow Coma
Scale 1, 6, 8, 14, 52
Score 296
Glaucoma, acute 376
Glenohumeral joint dislocation 150
Glenoid rim fractures, anterior 151
Glioblastoma 22, 23f
multiforme 22
Glomerular filtration rate 113, 370
Glucocorticoids 167, 173, 204, 212, 213
intravenous 203
Glucose 100, 165
serum 365
Glyceryl trinitrate 107
intravenous 108
Glycoprotein 68, 70
Gonococcemia 341
Gonorrhea 308
Graves’ disease 203
Greater tuberosity avulsion fracture 151
Guillain-Barré syndrome 169, 170, 173, 173f, 197
clinical stages of 171f
phases of 171f
H
Hallucinations 179, 218
Halo sign, positive 313f
Haloperidol 219
Hantavirus pulmonary syndrome 64f
Head
and neck 1, 202
elevation 328
eyes, ears, nose and throat 126, 158
injury 184, 280f
trauma 158, 197
Headache 5, 26, 52, 67, 90, 145, 157, 158, 197, 249, 273, 377
atypical 22
cluster 158
different types of 24f
frontal 254
miscellaneous 158
tension-type 158
throbbing 254
thunderclap 10
types of 24fc
Heart
disease
atrial 34
valvular 34, 109
ventricular 34
failure
acute right 109
congestive 39, 56, 59, 67, 75, 78, 85, 90, 97, 106, 110fc, 117, 177
pounding 216
rate, accelerated 216
rhythm 103
sounds 202
Heat
emergency 256
stroke 203
Helicobacter pylori 120, 121
Hemangiomas 161
Hemangiomatosis, pulmonary capillary 34
Hematemesis 120, 251
Hematochezia 120
Hematocrit 120, 207, 323
Hematoma 90
postictal subdural 184
septal 314
subdural 1, 3, 3f, 4f, 8, 29, 188f
Hematuria 127
Hemicrania, chronic paroxysmal 158
Hemodialysis 325
Hemodynamics 107
Hemoglobin 120, 121
Hemoperitoneum 89, 90
Hemopneumothorax 50
blood, chest X-ray for 51f
Hemoptysis 40, 239
Hemorrhage 92f, 93
external 90
internal 90
intracranial 3t, 70
ocular 198
subarachnoid 3, 3f, 9, 11f, 15, 158, 159, 184, 188f, 197
subconjunctival 375f
Hemothorax 90, 91
Heparin 185
unfractionated 42, 70
Hepatic necrosis 260
Hepatitis 179, 273
Heroin abuse 262
Herpes simplex 374
Herpes zoster 374
Hiatal hernia 71, 75
High-tension pneumothorax needle 49f
Hinchey classification system 129
Hippocratic technique, modified 152, 152f
Histamine 226
administration 228
Hoarse cry 294
Hoarseness 239
Homan's sign 39
Hormone 56
adrenocorticotropic 211
antidiuretic 208, 364
Human immunodeficiency virus 160, 272, 273, 344
infection 34
Human papilomavirus 273f
Hydration 325
Hydrocarbon, chlorinated 249
Hydrocephalus 5
Hydrochlorothiazide 113, 157, 201, 356, 371
Hydrocortisone 212
Hydromorphone 354
Hydrostatic pressure, minimizing 328
Hydroxychloroquine 168
Hydroxyindoleacetic acid levels 226
Hyperaggression 179
Hyperbaric therapy, indications for 254
Hyperbilirubinemia 146
Hypercholesterolemia 79
Hyperemia, conjunctival 304
Hyperglycemia 72, 145, 184, 206
Hyperkalemia 325, 367, 369f
causes of 367
toxic levels of 367f
treatment of 370fc
Hyperosmolar hyperglycemic nonketotic state 208t
Hyperphosphatemia 325
Hyperplasia
benign prostatic 347
thymic 166
Hyperpyrexia, severe 259
Hypersensitivity reaction 240
Hypertension 7, 64, 78, 79, 113, 177, 352
arterial 33
history of 74
paroxysmal 197
persistent pulmonary 34
portal 34
primary pulmonary 34
pulmonary venous 34
questionable 310
Hypertensive emergency 108, 113, 115f, 203
causes of 115fc
treatment of 115fc
Hyperthermia
malignant 203, 258
severe 179
Hyperthyroidism 216
Hypertrophy, ventricular 35, 35f
Hyperuricemia 325
Hyperventilation 8
Hypervolemia 364
Hypocalcemia 133, 184, 325
symptomatic 326
Hypoglycemia 33, 184, 296
Hypokalemia 171, 356, 357
symptom of 357f
Hypomagnesemia 371
causes of 372fc
Hyponatremia 184, 208210, 259, 361, 362f, 363
causes of 210
correction of 210
degree of 210
types of 363fc
Hypoperfusion 107
Hypophosphatemia 171
Hyporeflexia 209
Hyposmolality 208
Hypotension 107, 145f, 240, 254, 303
arterial 145
orthostatic 33
Hypothalamus-anterior-pituitary-ACTH pathway 213
Hypothermia 145
Hypothyroidism 210
Hypovolemia 331, 364
Hypoxemia 133
arterial 146
I
Idiopathic diseases 374
Iliopsoas compartment 92f
Immunoglobulin 222
serum 172
Immunosuppression 272
Immunosuppressive therapy 167
Impression 127, 166, 170, 203, 240
In vitro fertilization 308
Indinavir stones 351
Infantile spasms 193
Infarction 5, 72
inferior 73
Infections 5, 97, 347
epidural 193, 295
subdural 193, 295
Infectious diseases 341
Infectious Diseases Society of America 243
Inferior vena cava 58, 89
filter 43
Inflammatory bowel syndrome 127
Inguinal hernia 138
Injury
environmental 220
heat related 256t
levels of 18f
mechanism of 8
mild 15
types of 237
Inotropes 107
Inotropic support 43
Inspired oxygen, fraction of 61, 62
Insulin 206
Integrase strand transfer inhibitors 274
Intensive care unit 371
International normalized ratio 58, 121
Intestinal spasms 264
Intra-aortic balloon pump 110
Intracranial disorder, nonvascular 158
Intracranial mass lesion 165
Intracranial pressure 3, 5, 9, 15, 160, 195
Intraosseous line 104
placement 104
Intrauterine device 308
Intravenous Keppra levetiracetam 194
Intussusception 278, 283
computed tomography scan of 285f
management plan of 286fc
operative management of 287f
Iodine 204
Iritis 376
Iron
poisoning 250
tablets 252f
toxicity, stages of 251
Ischemia
accurate test for 182
myocardial 39
recurrent 67
Itching 239
symptoms 240
J
Jelly stools 283
Jolt test, positive 159
K
Kallikrein-kinin systems 223
Kerley B lines 64f
Ketoacidosis
alcoholic 179
diabetic 90, 205, 208t
Ketolides 168
Ketosis 206, 208
Kidney 251
disease, chronic 113
injury 238, 331
stones 348, 349
Kiesselbach's plexus 310
Klonopin 354
L
Lacrimation 246
Lactate dehydrogenase 95, 207
Lactic acidosis 325
Ladd's procedure 290
Lambert-Eaton syndrome 165, 168
Large infarction, large 73
Laryngomalacia 291
Laryngoscopy 320
Laryngotracheitis, acute 291
Laryngotracheobronchitis, acute 292
Left ventricular
assist device 109, 116
ejection fraction 76, 78
Leg pain 85f
unilateral 39
Lethargy 249
Leukemia 325
chronic myelogenous 324
Leukocytosis 128, 145, 165
Leukopenia 145
Lichtenberg figure 236f
Light aerobic exercise 30
Light bulb 154
Lightning injury 235, 237t
Limb paresis, asymmetric 170
Lip, edema of 233
Lipase 126, 130
Lipids 365
Lisinopril 157
Liver
disease 177
enzymes 207
function test 165, 218
Lorazepam 178, 217, 219, 259
Lumbar puncture 158, 170, 177, 198
locations 12f
Lung 39
arteriovenous malformation 39
contusion, right 51
injury, acute 62
Lyme disease 190, 243, 244f, 245
antibody titer 95
M
Macroglossia 331
Maculopapular rash 273
Magnesium 100, 167
Magnetic resonance
angiogram 10
cholangiopancreatography 131
imaging 10, 25, 85, 85f, 96, 156, 158, 162, 182, 198, 210, 332
Malaise 273
Malformation, arteriovenous 158
Malignancy 40, 56, 155
Mallory-Weiss syndrome 120
Mania 177
Marijuana
abuse 260
preparation 261f
Massive pulmonary embolism 43, 43f
Mastoid air cells fractures 5
Maxillary sinus nontender 240
Mean arterial pressure 10, 195
Mecamylamine 198
Meckel's diverticulitis 278
Mediastinitis, fibrosing 34
Medical expulsion therapy 351
Medical gallstone dissolution 136
Melanocyte stimulating hormone 213
Melena 89, 120
Memory 16, 177
Meningeal signs 159
Meningitis 193, 258, 295, 324
Meningococcal disease 343
peripheral complications of 344f
Meningococcemia 341, 342f
Mental disorders
diagnostic manual of 216
statistical manual of 216
Mental status 5, 10, 145, 177, 202, 218, 246
Metabolic disorders 158
Metallic taste 224
Metaphyseal corner fractures 282
Metformin 157, 354
Methicillin-resistant Staphylococcus aureus 303
Methylprednisolone 240
Metronidazole 278, 354
Microstomia 331
Midazolam 259
Midgut volvulus 289
Migraine 158
pulmonary 59
Mild sensory
signs 172
symptoms 172
Mineralocorticoids 212
Miosis 246
Missing sepsis 147
Mitochondrial myopathy 165
Mitral regurgitation 73
murmur 94
Mitral stenosis 39, 91
Mitral valve prolapse 71, 75
Monobactam 125
Morphine 69, 107, 241, 354
Mosquito bites 243
Motor vehicle accident 14, 161, 331, 333
Motor weakness, major 156
Mucosa swollen 240
Mucous membranes 90, 304
Muffled voice 317
Muscle
cramps 325
spasticity 264
weakness, generalized 209
Muscular dystrophy, oculopharyngeal 165
Myalgia 10, 265
Myasthenia 172
gravis 166, 166f, 168b, 172
Myasthenic crisis, acute 167
Mycophenolate 167
Mycoplasma 132
Myelin sheath, destruction of 173f
Myelinolysis, extrapontine 366
Myelitis, transverse 170
Myocardial infarction 39, 53, 65, 78, 83, 88, 94, 108, 215, 296
acute 80f, 113
new classification of 73f
Myocardial perfusion imaging 72
Myocardial stiffness 331
Myocarditis 71, 75, 109
Myoclonus 209
Myopathy 171
Myxoma, atrial 91
N
Naltrexone 179
Nasal
cautery 313f
congestion 197
foreign body 316
removal hook 317f
fracture 314, 315f
vascular anatomy 312f
Nasopharyngeal fragility 331
National Electronic Injury Surveillance System 300
National Institute of Allergy and Infectious Diseases 226
National Institute of Neurological Disorders and Stroke 193
National Stroke Association 189f
Nausea 5, 10, 166, 197, 216, 251, 346, 367, 377
symptom of 259
Near drowning 296
Neck 158
pain 11
stiffness 10, 317
veins 94
Neisseria gonorrhoeae 143, 270, 341, 342
Neisseria meningitidis 343f
diplococcal bacteria, gram-negative 342f
Neoplasm 33, 97, 310
Neostigmine 167
Nephrolithiasis 83, 346
Nephrolithotomy, percutaneous 351
Nesiritide 107
Neuralgias 158
Neuroleptic malignant syndrome 197, 258
Neuromas, acoustic 190
Neuromuscular blocking agents 168
Neuropathy 177
toxic 171, 172
Neuropsychiatric abnormalities 260
Neuropsychiatric testing, abnormal 254
Neuropsychologic testing 30
Nicotinic effects 246
Nifedipine 198
Nitrates 33, 71
Nitroglycerin 69, 198
paste 68
Nitroprusside 107
Nitrous oxide 36
N-methyl-D-aspartate 175
Noncritical coronary stenosis 72
Non-Hodgkin's lymphoma 323
high-grade 325
Noninvasive positive pressure ventilation 107
Non-nucleoside reverse transcriptase inhibitors 274
Nonsteroidal anti-inflammatory drugs 119, 155, 222, 241, 332, 369
Non-ST-segment elevation myocardial infarction 74
clinical management of 75f
Norepinephrine 108, 259
Novolin 354
Novolog 354
Nutrient artery 128
Nystagmus 177
O
Obesity 56
Obstipation 128
Obstruction
atherosclerotic 72
coronary 72
small-bowel 83
Ohm's law 231f
Oliguria, acute 146
Opioids 167, 222
Oral antibiotics 128
Oral calcium channel blockers 36
Oral injuries 282
Organ dysfunction 146
Organochlorine pesticides 249
Organophosphate 249
poisoning 246
Orthopnea 239
Osmolality, serum 209
Osteoporosis 161
Ovarian cyst 127, 271
ruptured 278
Oxcarbazepine 209
Oxygen 76, 130
saturation 45
maintenance of 107
support 328
P
Packed red blood cells 308
Pain 347
abdominal 79, 124f, 127, 171, 251, 278, 308, 367
chronic 270
control 69
misdiagnosing lower-back 157
musculoskeletal 83
patterns 24f
Pallor 294
Palpitations 216, 239
symptom of 259
Panbronchiolitis, diffuse 59
Pancolonic diverticula 128
Pancreas, normal 133
Pancreatic necrosis 133
Pancreatitis 83, 136, 177, 179
acute 96f, 130
Panic attack 215, 240
Papillary muscle malfunction 73
Paralysis 58
descending 170
extent of 18f
periodic 171
Paralytic ileus 131
Paraneoplastic disease 172
Paranoia 179
Paresis 58
Paresthesia 216, 367
Parkland formula 232f
Paroxysmal nocturnal dyspnea 239
Pelvic fractures 91, 333
classification of 333
lateral compression 333
treatment of 337
Pelvic girdle 91
Pelvic hemorrhage, controlling 337
Pelvic inflammatory disease 127, 270, 278, 307
pyrosalpinx in 272f
Penicillamine 168
Penicillins 239, 241
Peptic ulcer
active 70
disease 71, 75, 83, 94
Percutaneous coronary intervention 68, 69, 76, 109
Perfusion 40
lung scan 32
Periappendiceal fat changes 277f
Pericardial disease 91
Pericardial friction rub 94
Pericardial tamponade 88
Pericardiocentesis 96, 97f
Pericarditis 39, 53, 71, 75, 93
constrictive 96
neoplastic 96
restrictive 96
staging 96
Pericardium 98f
Peripheral nervous system 197
Peritoneal cavity 91
Peritoneal lavage, diagnostic 332
Peritonitis, generalized 128
Pertussis 238
Phencyclidine 179
Phenothiazines 33, 167
Phenoxybenzamine hydrochloride 198
Phenytoin 241
Pheochromocytoma 203
Phlegmon, ill-defined fluid collection of 133
Phonophobia 26
Phosphate 207, 325
deficiencies 372
Photophobia 10
Pinpoint pupils 264
Piperacillin 278
Placenta
previa 304
types of 305f
Plasma
C-reactive protein 145
glucose 145
loss of 90
osmolarity 365
Plasmapheresis 167
Plasminogen activator 183, 187
Platelets 126
Pleural cavity 91
Pleurisy 53
Pleuritis 71, 75
Pneumonia 39, 53, 97, 179, 239
Pneumothorax 33, 39, 47, 48, 50, 53, 71, 75
Poliomyelitis 170, 172
Polycystic kidney disease, history of 10
Polycythemia 56
Polydipsia 205
Polymerase chain reaction 144
Polymorphonuclear neutrophil 275
Polymyositis 170
Polyphagia 205
Polysomnography 36
Polyuria, classical symptoms of 205
Pontine myelinolysis, central 366
Porphyria 171
Porphyrin metabolism, abnormal 172
Positive end-expiratory pressure 47, 62, 63
Positron emission tomography 162
Posterior epistaxis, management of 311fc
Potassium 206, 372
chloride 353
iodide 204
levels 234
serum 212
sparing diuretics 369
Pralidoxime chloride injections 248f
Prednisone 204
Pregnancy 272
Pressure
central venous 257
compression fracture, anterior 334
jugular venous 31
Procainamide 167, 168
Profunda femoris vein 57f
Prominent systolic flow murmur 202
Propranolol 204
Propylthiouracil 204
Prostacyclin
analogs 37
intravenous 36
Protamine 222
Protease inhibitors 274
Pseudodiverticulum 128
Pseudohyperkalemia 368
Pseudohyponatremia 363
Pseudomonas aeruginosa 324
Psychiatric emergencies 215
Psychiatric issues 177
Psychosis 171, 217
Psychotropic drugs 33
Ptosis 168
senile 165
Pubic rami 335f
Pubic ramus fracture 336f
Pulmonary arterial hypertension 34
treatment of 37fc
Pulmonary embolism 33, 3840, 53, 58, 59, 71, 75, 88, 94, 215
colored computed tomography 42f
computed tomography 41
Pulmonary function test 32, 36
Pulmonary hypertension 31, 33, 39, 91
diagnosis of 33
Pulmonary veno-occlusive disease 34
Pulse
rate 73
symmetry of 21
Pump failure 91
Pupillary size 126, 170, 202
Pure calcium phosphate stones 349
Pure matrix stones 351
Pyelogram, intravenous 371
Pyelonephritis 83, 127, 271
Pyoderma gangrenosum 127
Pyridostigmine 167
Pyuria 127
Q
Quinidine 168
Quinine 168
Quinolones 241
Q-wave 76
R
Radioactive albumin 41
Ramsay Hunt syndrome 190
Randomized controlled trials 160, 346
Range of motion 126, 157
Ranson's criteria 133b
Ranson's CT severity index 132
Rapid bolus injection 69
Rectum 144, 197
Red blood cell 91, 158, 246
Red eye 374
diagnosis of 375t
symptom of 375t
Renal dysfunction, preexisting 325
Renal emergencies 346
Renal failure 260
acute 325
post-treatment 325
Renal function 365
Renin angiotensin-aldosterone system 369
Repetitive nerve stimulation 165
Respiration 31, 51, 126, 209
Respiratory 33, 223, 237, 239
equipment 100
failure 254
impending 294
findings 224
rate 90
system 94
Resuscitation, cardiopulmonary 38, 99, 102, 104, 116, 235, 300
Reteplase 69
Retinal detachment 376
Rhabdomyolysis 171, 260
nephrology for 238
Rhesus 308
Rheumatoid arthritis 143
Rh-immunoglobulin 5
Rhinitis 265
Rhino rocket applicator and packing 312f
Rhinorrhea 239
Rib fractures 45, 46f
Richmond agitation-sedation scale 61
Right bundle branch block 35
Right ventricular assistive device 116
Ringer's lactate 227
Road traffic accidents 56
Rocky mountain spotted fever 341
Rotator cuff tears 151
Rule of nine 232f
S
Sacral fracture 336f
Sacroiliac complex 336f
Sacroiliac ligaments, complete disruption of 336f
Saddle anesthesia 156
Saline, normal 61, 174, 302, 303, 371
Salivation 246
Salpingitis 308
Sarcoidosis 34, 172
Schistosomiasis 34
Schizophrenia 218
Sclera icterus 126
Sclerosis, multiple 184
Segmental wall motion abnormalities 95
Seizures 10, 254
complex 33
differential diagnosis of 193, 295
disorders 192, 194
epileptic 184
generalized 209
symptom of 259
Selective serotonin reuptake inhibitor 209
Sensation, loss of 10
Sensory loss, perianal 156
Sensory syndrome 172
Sentinel loop 131
Sepsis 127, 193, 203, 258, 295
diagnostic management of 146f
Septal hypertrophy, asymmetric 33
Septic arthritis 143
X-ray of 144f
Serial electrocardiograms 45
Serotonergic neuron 260
Serotonin
release 259
syndrome 197
Serum glutamic
oxaloacetic transaminase 304
pyruvic transaminase 304
Serum lactate 145
Sexually transmitted
diseases 306
infections 138, 270, 273
Sheehan syndrome 213
Shock 91
anaphylactic 91
cardiogenic 39, 91
distributive 90, 91
hemorrhagic 88, 92t
hypovolemic 90, 92t
neurogenic 90, 91
obstructive 90, 91
septic 91, 203
Shockwave lithotripsy 351
Shoulder
dislocation, types of 151fc
X-ray of 149f, 151f
Sigmoid colon 128
Sigmoid malignancy 127
Simple febrile seizure 295t
Sinus 5, 158
disease 59
node disorders 33
Sinusitis 59, 314
Skeletal injury 237
Skin 90, 126, 249
color changes 197
examination 170
turgor 205
Skull fracture 29, 165
Sleep
apnea, obstructive 36
disturbance 26
study 36
Sodium
bicarbonate 207
continued renal exertion of 210
hydroxide 267
serum 212, 362
Soft-tissue compartments 91
Solitary toxic adenoma 203
Sore throat 239
Spasmodic croup 292
Speech
incoherent 26
slurred 26
Sphincterotomy, endoscopic 136
Spinal cord
compression 170
injuries 197, 296, 332
Spinal stenosis 155
Spiral computed tomography 39, 40
Splenectomy 56
Spondylolisthesis 161
Spondylolysis, lumbar 161
Spontaneous pneumothorax 53, 54
pathophysiology of 54t
presentation of 54t
progression diagnosis of 54t
treatment of 54t
Spontaneous ureteral stone expulsion 348f
Sporadic disorder 34
Sputum 239
Squeezing 65
Staphylococcus aureus 143, 304, 324
Steeple sign 293f
Stiffness 11, 197
Stigmata 177
Stimson's technique 152, 153, 153f
Stones, types of 349, 350fc
Streptokinase 44
contraindications of 70
Stridor 317
Stroke 10, 33, 180
golden hour of acute ischemic 184
ischemic 70
types of 183fc
warning signs of 189f
ST-segment elevation myocardial infarction 64, 67, 77
Stupor 249
Subarachnoid space 13f
Substance abuse 258
Sudden infant death syndrome 111
Sulbactam 318
Superficial veins, collateral 58
Superior iliac spine, anterior 276
Superior vena cava 326
syndrome 39, 326, 327f
Sweating 58, 197, 216, 265
excessive 90
Swelling
cloudy 250
periorbital 242f
Symphysis, slight widening of 335f
Syncope 31, 33, 76, 166, 223, 240, 254, 296
neurogenic 314
Syndrome of inappropriate secretion of antidiuretic hormone 208
Synovial fluid analysis 147f
Syphilis 273, 374
Systemic inflammatory response syndrome 130, 147
Systemic lupus erythematosus 143
T
Tachyarrhythmia 91, 203
Tachycardia 90, 177, 179, 198, 240, 294
supraventricular 33
ventricular 33, 76, 230
Tachydysrhythmia 67
Tachypnea 145, 177
Tamponade 91
Tazobactam 278
Tenecteplase 69
Tension pneumothorax 47, 54, 91
left 51
pathophysiology of 54t
presentation of 54t
progression diagnosis of 54
treatment of 54
Test tubes 12f
Testicle, torsion of 139f
Testicular torsion 138, 140f
treatment of 140fc
types of 139fc
Tetanus 238
Tetany 325
Thoracic-lumbar-sacral orthosis 162
Thoracoscopy, video-assisted 53
Throat, inflammation of 318f
Thrombectomy 43
mechanical 186, 186f
Thrombocytopenia 1, 146, 165
Thrombolysis 43, 79
Thrombolytics 44
benefits 44
therapy 184f
Thrombosis 56, 239
Thymoma 166
Thyroid 202
function 365
stimulating hormone 202
level 218
storm 201, 203
Tick bites 243
Tidal volume 61
Tissue
perfusion variables 146
plasminogen activator 43, 68, 90
Tongue
angioedema affecting 234f
discoloration 264
edema of 233
Tonsillar enlargement 240
Topiramate 179
Toradol 354
Total iron binding capacity 251
Total parenteral nutrition 133, 358
Toxic multinodular goiter 203
Toxic shock syndrome 302, 303b, 304, 304b, 314, 341
typical rash of 303f
Toxicology 220
Toxoplasmosis 374
Traction-counter-traction technique 152, 152f
Tramadol 354
Transcatheter aortic valve implantation 109
Transcranial Doppler ultrasounds 10
Transient ischemic attack 165
Transthoracic echo 96
Trauma 56, 177, 179
focused abdominal sonography for 332
Traumatic brain injury 14, 15, 27f
conta sports-related 16
major causes of 15f
Trazodone 354
Tremors 177, 209
Treponema pallidum 273
Tricyclic antidepressant 33
Troponin 45, 69, 165, 233
Tuberculosis 97, 213, 239, 374
Tubular necrosis, acute 132
Tumor 34, 184
cardiac 91
lysis syndrome 324
testicular 138
T-wave 183, 356
normalization of 96
Tympanic membrane rupture 237
U
Ulcer
corneal 377
perforated 83
Ultrasound 131
Unstable angina 68, 72, 75, 77
Braunwald classification of 79t
Upper airway
anteroposterior radiograph of 293f
normal anteroposterior radiograph of 292f
Upper extremity, right 181
Upper gastrointestinal bleed 119
Upper quadrant, right 130, 284
Uremia 171
Ureteral muscle spasm 347
Ureteral stones, tamsulosin for 346
Ureterolithiasis 346
Ureters 251
Urethra 144
Uretoscopy 351
Uric acid 325
blood levels 350f
crystals 350f
formation of 350f
levels, reduce 326
stones 351
Urinalysis 126, 130, 165, 177, 218, 275
Urinary 5-hydroxyindoleacetic acid 226
Urinary frequency 127
Urinary tract infection 83, 127
Urine
cloudy 127
culture 192
osmolality 209
sodium 365
tests 198
Urokinase 44
Urticaria, acute 241
Uveitis
acute 375f
anterior 376, 377
U-wave 356
V
Vaginal discharge 270
Vague abdominal pain 39
Valproic acid, intravenous 194
Valvular disease 95
obstructive 91
Valvular dysfunction, acute 91
Vancomycin 168, 222
Varicose veins 239
Vascular disorders 158
Vasculitic neuropathies 172
Vasculitis 341
risk of 260
Vasoactive systems 223
Vasodilator 33, 107
challenge, acute 37fc
drugs 91
Vasodilatory test, acute 36
Vasopressin 209, 366, 370
Vasovagal reflex 33
Vein, femoral 57f
Ventilation 32, 40, 101, 331
Ventricles 5, 189
Ventricular assistive device 116
Ventricular septum, rupture of 91
Vertebroplasty, transcutaneous 162f
Vesicle fistulae 129
Vienna Concussion Conference 29
Vinblastine 354
Vincristine 354
Viral infection 286
Vision 16
blurred 197
double 10
halo around 377
loss 10
differential diagnosis of 378fc
Visual disturbances 26
Vital signs 90, 177, 202, 331
Vitamin B12 level 218
Vocal cord dysfunction 59, 291
Volume depletion, absence of clinical evidence of 210
Vomiting 5, 10, 79, 127, 225, 251, 346, 367, 377
symptom of 259
von Willebrand disease 328, 329f
W
Water and electrolyte imbalance 356
Water ice therapy 258
Waterhouse-Friderichsen syndrome 213, 342
Weak pulses 264
Weakness
abdominal 171
extreme 16
Weight
heparin, low-molecular 43, 58
loss 127
low-molecular 223
Well's criteria 40t, 58b
Well's score 58b
Wernicke-Korsakoff syndrome 179, 184
Wheezing 239, 240, 296
White blood cell 123, 126, 135, 143, 271, 275
count 271
White cell casts 127
Willis tower 235f
World Health Organization's Diagnostic Classification of Pulmonary Hypertension 34b
X
Xanthochromia 12f
×
Chapter Notes

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