I: CARDIOVASCULAR
Adapted from: Wang K, Asinger RW, Marriott H. ST-segment elevation in conditions other than acute myocardial infarction. N Eng J Med. 2003;349:2128–2135. CHEST PAIN Approach Obtain & review an ECG…
XIV: PEDIATRICS
APPENDICITIS Definition • Inflammation of the appendix History • Diffuse/periumbilical pain → localizing to RLQ, anorexia, nausea, vomiting, irritability (may be the only sx in age <2), fever Physical Findings…
IX: ENDOCRINE & METABOLIC
• Step 4a: Is there an anion gap? Anion gap acidosis: (Na – (Cl + bicarb)) > 14 (see chart) Note: Needs to be corrected for albumin; a fall in…
XVIII: TRAUMA
HEAD TRAUMA Background • Leading cause of traumatic death in pts <25 • 80% mild (GCS 14–15), 10% mod (GCS 9–13), 10% severe (GCS <9) injuries • CPP = MAP…
XVI: TOXICOLOGY
History • Timing, quantity of ingestion/exposure, access to household chemicals/other meds, coingestions, enteric-coated/extended-release substances Physical Exam • VS, pupils, skin, neuro findings (AMS, nystagmus, myoclonus, tremor), peristalsis, smell Evaluation •…
X: ENVIRONMENTAL
History • Excessive fluid loss (V/D, sweating, polyuria, diuretic/laxatives, bowel regimen), inadequate intake (debilitated, institutionalized, NM d/o, H&N pathology), altered thirst mechanism (intoxication, systemic illness, malignancy, antipsychotic use) Findings •…
V: NEUROLOGY
Delirium Definition • Acute state of temporary or fluctuating disturbance of consciousness (eg, impaired cognition, perception disturbances, reduced attention, hypo- or hyperactivity) that is caused by an organic medical condition…
IV: INFECTIOUS DISEASE
ENDOCARDITIS (Arch Intern Med 2009;169(5):463) History • RFs: IVDU, congenital or acquired valvular dz, prosthetic valves, structural heart dz, HD, indwelling venous catheters, cardiac surgery, bacteremia, chronic alcoholism, previous endocarditis…
III: GASTROINTESTINAL
RIGHT UPPER QUADRANT PAIN Cholelithiasis Presentation • Acute, severe, intermittent RUQ pain, +N/V, a/w fatty meals • In biliary colic, sxs generally resolve completely in b/w episodes • Mild RUQ…
XIII: OTOLARYNGOLOGY/DENTAL/OPHTHALMOLOGY
Otitis Externa (Swimmer’s Ear) Definition • Infection (Pseudomonas, S. aureus) of the outer ear due to breakdown of natural barriers History • Summer, water exposure, cotton swab trauma, hearing aids,…
