Answer index - Cambridge University...

$: Answer index - Cambridge University Pressassets.cambridge.org/97805217/19643/index/9780521719643_index.pdf · 470 Answer index 64. Open both bone forearm fracture 65. Jones fracture$
Answer index

I. HEENT (Head, Eyes, Ears, Nose and Throat)1. Acute epiglottitis2. Endophthalmitis and orbital cellulitis3. Retinal detachment4. Temporal arteritis5. Endophthalmitis with hypopyon

II. Cardiology/Cardiovascular Surgery6. Idiopathic fascicular ventricular tachycardia (IFVT)7. Cocaine-associated chest pain8. New-onset atrial fibrillation9. Cardiac tamponade from a pericardial effusion

10. Type B aortic dissection11. Acute pericarditis12. Supraventricular tachycardia (SVT)13. Inferior ST-segment elevation myocardial infarction

(STEMI) with complete heart block14. Cardiac tamponade due to hemopericardium15. Ventricular tachycardia (VT)16. Takotsubo syndrome17. Type II second-degree atrioventricular block18. Type A aortic dissection19. VT converting to third-degree heart block20. Acute anterior STEMI21. Painless type A aortic dissection22. Third-degree heart block23. Descending thoracic aortic hematoma

III. Pulmonology24. Right-sided pneumothorax complicated by re-expansion

pulmonary edema25. Massive pulmonary embolism treated with

thrombolytics26. Ventriculoatrial shunt causing septic emboli and

recurrent pneumonias27. Bacterial infection of a cavitary lesion from previous

coccidioidomycosis infection28. Community-acquired pneumonia (CAP)

IV. Gastroenterology29. Ruptured appendicitis with abscess30. Spontaneous splenic laceration from infectious

mononucleosis

31. Midgut malrotation32. Perforated Meckel’s diverticulitis33. Perforated cecal volvulus34. Foreign body in the rectum35. Gangrenous cholecystitis36. Acute mesenteric ischemia37. Ruptured abdominal aortic aneurysm (AAA)38. Colonic intussusception

V. Genitourinary and Gynecology39. Right ovarian torsion due to a dermoid cyst40. Right obstructing ureteral stone with urosepsis41. Ruptured ectopic pregnancy42. Penile incarceration from a constricting penile ring43. Uterine arteriovenous malformation (AVM)44. Bilateral necrotizing epididymo-orchitis

VI. Neurology/Neurosurgery45. Right middle cerebral artery (MCA) thrombus with

acute cerebrovascular accident (CVA)46. Spontaneous subarachnoid hemorrhage (SAH)47. Spinal epidural abscess (SEA)48. Vertebral artery dissection resulting in acute CVA49. Cauda equina syndrome (CES)50. Cerebral venous sinus thrombosis51. Status epilepticus and traumatic SAH52. Brainstem stroke from “top of the basilar” syndrome

VII. Trauma53. Splenic laceration54. Penetrating abdominal stab wound with herniated bowel

and early small bowel obstruction (SBO)55. Acute compartment syndrome of the thigh56. Clay-shoveler’s fracture of the C7 vertebral process57. Traumatic arrest from penetrating chest trauma58. Rectus sheath hematoma59. Traumatic SAH60. Type II odontoid fracture of the neck61. C5-C6 subluxation of the neck

VIII. Orthopedics62. Type II lateral condyle fracture of the elbow63. Lisfranc fracture-dislocation and compartment

syndrome of the foot

469

© Cambridge University Press www.cambridge.org

Cambridge University Press978-0-521-71964-3 - Clinical Emergency Medicine CasebookJoel T. Levis and Gus M. GarmelIndexMore information

http://www.cambridge.org/9780521719643

http://www.cambridge.org


470 Answer index

64. Open both bone forearm fracture65. Jones fracture (base of the 5th metatarsal)66. Occult radial head fracture with associated fat pad

signs67. Open Monteggia fracture-dislocation of the left

forearm68. Depressed tibial plateau fracture69. Septic arthritis of the hip70. Closed femur fracture

IX. Hand71. Subungual abscess of the thumb72. High-pressure injection injury to the hand73. Felon of the distal phalanx of the finger74. Extensor tendon laceration of the finger75. Infected cat bite to the finger

X. Pediatrics76. Paroxysmal supraventricular tachycardia (PSVT)77. Dilated cardiomyopathy78. Subdural hematoma79. Colocutaneous fistula from PEG tube placement80. Respiratory syncytial virus (RSV) bronchiolitis with

concomitant bacterial pneumonia81. Hydrocephalus from a posterior fossa brain tumor82. Esophageal coin83. Ileocolic intussusception84. Hemolytic uremic syndrome (HUS)85. Moyamoya disease86. Third-degree heart block from Lyme carditis87. Intracranial hemorrhage from an arteriovenous

malformation (AVM)

XI. Infectious Disease88. Vertebral osteomyelitis89. Plasmodium vivax malaria90. Purpura fulminans from S. pneumoniae sepsis91. Sepsis from a liver abscess92. Psoas muscle abscess with vertebral osteomyelitis93. Miliary tuberculosis

XII. Toxicology/Environmental94. Jimson weed poisoning95. Hypothermia with ECG changes96. Intentional acetaminophen overdose97. Scombroid fish poisoning98. Rhabdomyolysis and acute renal failure from

methamphetamine abuse99. Pit viper (rattlesnake) envenomation

100. Angioedema101. Intentional alkali ingestion with caustic esophageal

injury102. Digoxin toxicity

XIII. Miscellaneous103. Nephrotic syndrome104. Thrombotic thrombocytopenic purpura (TTP)105. Morbilliform drug eruption106. Acute myelogenous leukemia (AML) with blast crisis

and leukostasis107. Diabetic ketoacidosis (DKA)108. Right leg deep vein thrombosis (DVT)109. Sweet’s syndrome110. Panhypopituitarism from a pituitary adenoma111. Left internal jugular vein DVT






Subject index

AAA (abdominal aortic aneurysm), ruptured, 155–157AAD (acute aortic dissection). See aortic dissectionABCDEFG (airway, breathing, circulation, disability, exposure, Foley

and gastric tube), 231ABCs (Airway, Breathing, Circulation)

acetaminophen overdose, 404acute myelogenous leukemia (AML), 447alkali ingestion, 426angioedema (AE), 422heart block, 89intracranial hemorrhage (ICH), 364snakebite, 418status epilepticus, 215–216STEMI, 51–52stroke, 191, 221subarachnoid hemorrhage (SAH), 195supraventricular tachycardia (SVT), 318traumatic brain injury (TBI), 249

abdominal aortic aneurysm (AAA), ruptured, 155–157abdominal injuries

blunt, 225–228penetrating, 229–233

abdominal painacetaminophen overdose, 403alkali ingestion, 425appendicitis, 123–124cecal volvulus, 139diabetic ketoacidosis (DKA), 452ectopic pregnancy, 173–174in elderly patients, 149foreign body, 143gangrenous cholecystitis, 147hepatic abscess, 383intestinal intussusception, 159, 345–346Meckel’s diverticulitis, 135, 138mesenteric ischemia, 151midgut malrotation, 131rectus sheath hematoma (RSH), 245splenic laceration, 127–128, 225ureteral colic, 169

abdominal radiographyaortic aneurysm, 156–157aortic intramural hematoma (IMH), 92appendicitis, 125cecal volvulus, 139–140cholecystitis, 147, 149esophageal foreign body, 341–342hepatic abscess, 384intestinal intussusception, 159–160, 345–347Meckel’s diverticulitis, 135–138mesenteric ischemia, 153midgut malrotation, 131–133

ovarian torsion, 165–166PEG tube complication, 329–331psoas muscle abscess, 387rectal foreign body, 143–144rectus sheath hematoma (RSH), 245–246splenic laceration, 127–128, 225–228stab wounds, 229–231ureteral colic, 169–171

ABG. See arterial blood gas analysisABS (apical ballooning syndrome), 63abscess

felon, 303–305hepatic, 383–386psoas muscle, 387–389scrotal, 183–185spinal epidural (SEA), 197–199subungual, 297–298

accidents. See falls; motor vehicle accidents; traumaACE inhibitors, angioedema induced by, 422Acetadote. See N-acetylcysteine (NAC)acetaminophen

for bronchiolitis, 333for cholecystitis, 149for intracranial hemorrhage, 365for malaria, 373overdose, 403–406for pneumonia, 117for vertebral osteomyelitis, 369

acetyl-para-aminophenol (APAP). See acetaminophenacidemia, diabetic ketoacidosis (DKA), 451acid ingestion, 426ACLS (advanced cardiac life support) guidelines, 59ACP (Antivenin Crotalidae Polyvalent), 418ACTH (adrenocorticotrophic hormone) deficiency,

463–464activated charcoal

for acetaminophen overdose, 404contraindications, 426for digoxin toxicity, 431for Jimson weed poisoning, 398

activated protein C, 381, 384acute abdomen. See abdominal painacute aortic dissection (AAD). See aortic dissectionacute febrile neutrophilic dermatosis. See Sweet’s syndromeacute ischemic stroke (AIS). See strokeacute lymphoblastic leukemia (ALL), 447acute myelogenous leukemia (AML), 445–447acute myocardial infarction (AMI). See myocardial infarctionacute renal failure. See renal failureacute respiratory distress syndrome (ARDS), 381acute tubular necrosis (ATN), 413acyclovir, 459

471






472 Subject index

ADAMTS-13, 438adenosine, 46–48, 58, 319adenosine triphosphate (ATP), 413adnexal torsion, 165–167adrenal insufficiency, 385adrenergic agents, 408. See also specific drugadrenocorticotrophic hormone (ACTH) deficiency, 463–464advanced cardiac life support (ACLS) guidelines, 59Advanced Trauma Life Support (ATLS), 231adverse drug reactions, dermal hypersensitivity, 441–443AE (angioedema), 421–423agitation, Jimson weed poisoning, 396airway management. See also ABCs (Airway, Breathing,

Circulation)epiglottitis, 4traumatic brain injury (TBI), 249

AIS (acute ischemic stroke). See strokealanine aminotransferase (ALT), 404–406, 457, 459albuterol

for bronchiolitis, 333for pneumonia, 109, 118, 451for respiratory distress, 321

alcohol ingestion, acetaminophen overdose and, 404alkali ingestion, intentional, 425–427alkalinization, for rhabdomyolysis, 413ALL (acute lymphoblastic leukemia), 447allergic angioedema, 422ALT (alanine aminotransferase), 404–406, 457, 459alteplase. See tissue plasminogen activatoraltered consciousness

cerebral venous thrombosis (CVT), 210diabetic ketoacidosis (DKA), 452intestinal intussusception, 346ischemic stroke, 219subarachnoid hemorrhage (SAH), 194

amenorrhea, ectopic pregnancy, 173–174AMI (acute myocardial infarction). See myocardial infarctionamiodarone, 58, 59, 319, 431AML (acute myelogenous leukemia), 445–447ammonia ingestion, 426amoxicillin, 334, 361amoxicillin/clavulanate, 119, 304, 308, 311amphotericin B, 114ampicillin, 114amylase, 153, 232analgesics. See also specific drug

for cervical spine subluxation, 256for femoral fracture, 292for rectus sheath hematoma (RSH), 246

anal wink reflex, 207anaphylactoid reactions, N-acetylcysteine (NAC), 405anemia

acute myelogenous leukemia (AML), 445–447microangiopathic hemolytic, 438normochromic, normocytic, 13–15Sweet’s syndrome, 459

aneurysmabdominal aortic, 155–157intracranial, 194

angioedema (AE), 421–423angiography

aortic dissection, 38–40, 85–86aortic intramural hematoma (IMH), 92brain arteriovenous malformation (AVM), 364–365cerebral venous thrombosis (CVT), 211deep vein thrombosis (DVT), 466mesenteric ischemia, 153

middle cerebral artery (MCA) thrombus, 190Moyamoya disease (MMD), 353–355myocardial infarction (MI), 51pericarditis, 41pulmonary embolism (PE), 103, 105–106stroke, 202–203, 220–221subarachnoid hemorrhage (SAH), 194–195, 215Takotsubo cardiomyopathy, 61, 63

animal bitescat, 311–313snake, 415–419

Anopheles mosquito, 375anorexia

appendicitis, 124mesenteric ischemia, 151

anterior compartment syndrome (CS), 235–237anterior humeral line, 262–263, 276antiarrhythmic drugs. See also specific drug

for atrial fibrillation, 30–31digoxin interactions with, 431for supraventricular tachycardia (SVT), 47

antibiotics. See also specific drugfor alkali ingestion, 426, 427for appendicitis, 124for biliary disease, 150for bite wounds, 312–313for bronchiolitis, 335for coccidioidomycosis, 114digoxin interactions with, 431for endophthalmitis, 6–7, 18for epididymo-orchitis, 184–185for epiglottitis, 4gastrointestinal side effects of, 149for hepatic abscess, 384–385for high-pressure injection hand injury, 300for ileocecal intussusception, 160intravitreal injection of, 18for Lyme disease, 361for mesenteric ischemia, 153morbilliform drug eruption caused by, 442for open fractures, 270for orbital cellulitis, 6–7for PEG tube complication, 331for pneumococcal sepsis, 381for pneumonia, 109, 111, 119, 334–335, 451for psoas muscle abscess, 388–389for septic arthritis, 288–289for spinal epidural abscess, 198for subungual abscess, 298for vertebral osteomyelitis, 369–371

anticholinergic toxidrome, Jimson weed poisoning, 396–399anticoagulation. See also specific drug

for acute ischemic stroke, 191before cardioversion, 31for cerebellar stroke, 203for cerebral venous thrombosis (CVT), 210contraindications, 71, 106for deep venous thrombosis, 455, 466for pulmonary embolism (PE), 106reversal of, 55

anticonvulsants. See also specific drugDRESS syndrome caused by, 442for status epilepticus, 215–216for traumatic brain injury (TBI), 249

antiemetics. See also specific drugfor midgut malrotation, 131for subarachnoid hemorrhage (SAH), 216






Subject index 473

antihistamines. See also specific drugfor angioedema (AE), 422for morbilliform drug eruption, 441–442for scombroid fish poisoning, 408

antihypertensive agents. See also specific drugfor aortic dissection, 40for subarachnoid hemorrhage (SAH), 216

antimalarial drugs, 375–376antiplatelet agents. See also specific drug

for acute ischemic stroke, 191for cerebellar stroke, 203

antithrombotic agents. See thrombolysisantitubercular drugs, 392–393Antivenin Crotalidae Polyvalent (ACP), 418antiviral agents, DRESS syndrome caused by, 442anuria, hemolytic uremic syndrome (HUS), 349–250aortic aneurysm, abdominal, 155–157aortic dissection

classification of, 39, 70, 85intramural hematoma (IMH) leading to, 92type A, 39, 40, 69–72

painless, 83–86type B, 37–40, 70–72, 86

aortic intramural hematoma (IMH), 91–93aortography, 71APAP (acetyl-para-aminophenol). See acetaminophenapical ballooning syndrome (ABS), 63appendectomy, 124appendiceal perforation, 123–126appendicitis

versus Meckel’s diverticulitis, 138ruptured, 124–125

ARDS (acute respiratory distress syndrome), 381Arixtra. See fondaparinuxarms. See also fingers; hands

deep vein thrombosis (DVT), 465–467pain, 261, 269, 279swelling, 465trauma, 261–263, 269–271, 270, 275–277, 279–282weakness, 209, 255, 353

arrhythmias. See also palpitations; specific arrhythmiadigitalis-induced, 431with hypothermia, 402

arterial blood gas (ABG) analysisacute myelogenous leukemia (AML), 445diabetic ketoacidosis (DKA), 451pneumococcal sepsis, 381pulmonary embolism (PE), 101–105septic shock, 384stab wounds, 232status epilepticus, 215

arteriovenous malformation (AVM)brain, 363–365uterine, 179–181

arteritis, temporal, 13–15arthralgias

Lyme disease, 357, 359Sweet’s syndrome, 459

arthritisrheumatoid, 288septic, 287–289

aspartate aminotransferase (AST), 153, 404–406aspiration, diagnostic peritoneal (DPA), 231aspirin

for cocaine-induced chest pain, 26for coronary artery disease, 51, 81for dilated cardiomyopathy (DCM), 322

for myocardial infarction (MI), 49, 51for pericarditis, 41for stroke, 202for Takotsubo cardiomyopathy, 61, 63for uterine arteriovenous malformation (AVM), 191

assault, stab wounds, 229–233AST (aspartate aminotransferase), 153, 404–406atenolol, 30, 429, 431Ativan. See lorazepamatlantoaxial complex, 252ATLS (Advanced Trauma Life Support), 231ATN (acute tubular necrosis), 413atovaquone, 375–376ATP (adenosine triphosphate), 413atrial collapse, cardiac tamponade, 35atrial fibrillation, 59, 402, 431

new-onset, 29–31atrial impulse, nonconducted, 67atrial tachycardia, digitalis-induced, 431atrioventricular (AV) block, 47, 58

first-degree, 67, 75, 359, 463second-degree, 65–67, 75third-degree (See complete heart block (CHB))

atrioventricular (AV) conduction delay, with hypothermia,402

atrioventricular node re-entry tachycardia (AVNRT), 318atropine, 49, 51, 52, 89, 398, 429, 431Augmentin, 298AV block. See atrioventricular (AV) blockAVM (arteriovenous malformation)

brain, 363–365uterine, 179–181

AVNRT (atrioventricular node re-entry tachycardia), 318azithromycin, 119, 184, 334

bacitracin, 304back pain

abdominal aortic aneurysm (AAA), 155aortic dissection, 37, 71, 85aortic intramural hematoma (IMH), 91cauda equina syndrome (CES), 205–206physical examination for, 206psoas muscle abscess, 388spinal epidural abscess, 198vertebral osteomyelitis, 369

bacteremia, 109–112, 199bacterial arthritis, 287–289bacterial infection. See also specific infection

bite wounds, 312felon, 303–305hepatic, 383–386pulmonary, 117–120, 333–336purpura fulminans (PF), 379–382vertebral osteomyelitis, 369–371

Bado classification, 281bag-valve-mask (BVM) ventilation, 241barbiturates. See also specific drug

for status epilepticus, 216for traumatic brain injury (TBI), 249

barium contrast enema, for intestinal intussusception, 346–347barium enteroclysis, Meckel’s diverticulitis, 137–138basilar artery (BA) occlusion, stroke secondary to, 219–222batteries, button, ingestion of, 343Benadryl, 422, 442benzodiazepines. See also specific drug

for cocaine intoxication, 26for status epilepticus, 215–216






474 Subject index

beta-adrenergic blockers. See also specific drugfor aortic dissection, 40, 71, 86for atrial fibrillation, 31contraindications, 26, 52for supraventricular tachycardia (SVT), 47, 319

Betadine, 304beta-human chorionic gonadotropin (β-hCG), 174–175,

179Bezold-Jarisch reflex, 52bicycle injuries, 225–228bifascicular blocks, 75biliary disease, 149–150bilirubin, 437–438biofilms, 111biopsy

bone marrow, 445renal, 436skin, 441–442, 459temporal artery, 13–14

bitescat, 311–313snake, 415–419

blast crisis, 445–447bleach (sodium hypochlorite) ingestion, 426bleeding. See also hemorrhage

acute myelogenous leukemia (AML), 445–447finger laceration, 307head laceration, 247stab wounds, 231urinary tract, 169, 171vaginal (See vaginal bleeding)

bloodin emesis, 241in stool, 346, 350

blood culturesbacteremia, 109malaria, 373, 375pneumococcal sepsis, 381pneumonia, 119psoas muscle abscess, 388septic arthritis, 289vertebral osteomyelitis, 370

blood glucose, diabetic ketoacidosis (DKA), 451–452blood transfusion

abdominal aortic aneurysm (AAA), 156–157acute myelogenous leukemia (AML),

445cardiac tamponade, 55hemolytic uremic syndrome (HUS), 350septic shock, 384thrombotic thrombocytopenic purpura (TTP), 437–438

blood urea nitrogen (BUN), 413, 451blunt injuries

abdominal, 225–228head, 213, 216, 247–249, 325–327

bone fracture. See fracturesbone marrow biopsy, acute myelogenous leukemia (AML),

445bone scans, vertebral osteomyelitis, 370Borrelia burgdorferi, 359–361boutonniere deformity, 308bowel obstruction, with cecal volvulus, 139–141bradycardia

atrioventricular (AV) block, 65–67digoxin toxicity, 429hypothermia, 401

bradykinin, 422brain arteriovenous malformation (AVM), 363–365

brain injury, traumatic, 248–249brainstem stroke, 219–222brain tumor, posterior fossa, 337–340broken heart syndrome. See Takotsubo cardiomyopathybronchiolitis, 333–336bronchoalveolar lavage, 393bronchodilators. See also specific drug

for bronchiolitis, 335for respiratory distress, 321

bronchoscopy, 393bruising, thrombotic thrombocytopenic purpura (TTP), 437bulbocavernosus reflex, 207BUN (blood urea nitrogen), 413, 451bupivacaine, 298, 304burns, alkali ingestion, 425–427button batteries, ingestion of, 343buttonhole deformity, 308BVM (bag-valve-mask) ventilation, 241

CAD (cervical artery dissection), 201–204calcium-channel blockers. See also specific drug

for atrial fibrillation, 30–31contraindications, 319for subarachnoid hemorrhage (SAH), 216for supraventricular tachycardia (SVT), 47, 58, 319

“calcium sign,” 39camel-hump sign, 402CAP (community-acquired pneumonia), 117–120, 334captopril, 322cardiac arrest, traumatic, 241–244cardiac catheterization, 51, 81cardiac glycosides, 431. See also specific drugcardiac ischemia, cocaine-associated, 25–27cardiac tamponade, 43, 85

from hemopericardium, 53–56from pericardial effusion, 33–36

cardiology consultationaortic dissection, 85aortic intramural hematoma (IMH), 92complete heart block, 67, 75, 89dilated cardiomyopathy (DCM), 322–323Lyme carditis, 359myocardial infarction (MI), 51supraventricular tachycardia (SVT), 318–319

cardiomyopathydilated (DCM), 321–323Takotsubo, 61–64

cardiopulmonary resuscitation (CPR), 241–242cardioversion

atrial fibrillation, 30–31supraventricular tachycardia (SVT), 47, 48, 318–319ventricular tachycardia, 58–59

cardioverter-defibrillator, implantable (ICD), 58, 59, 75carotid artery dissection, 203cat bite, 311–313catecholamine release, stress-induced, 63cauda equina syndrome (CES), 205–208caustic alkali ingestion, 425–427cavitary lesions, coccidioidal, 113–115CBC. See complete blood countcecal volvulus, 139–141cefazolin

for elbow trauma, 270, 281for orbital cellulitis, 6for stab wounds, 229for subungual abscess, 297

cefotaxime, 384cefotetan, 149






Subject index 475

cefpodoxime proxetil, 4ceftriaxone

for epididymo-orchitis, 184for epiglottitis, 4for hemolytic uremic syndrome (HUS), 349for Lyme disease, 359, 361for orbital cellulitis, 6for pneumococcal sepsis, 381for septic arthritis, 288for Sweet’s syndrome, 459

cellulitisfingers, 304, 311–313orbital, 5–7

central venous catheters (CVC), venous thrombosis with,466

cephalexin, 300cephalosporins, 6–7, 289cerebellar stroke, 201–204cerebral angiography

arteriovenous malformation (AVM), 364Moyamoya disease (MMD), 353–355subarachnoid hemorrhage (SAH), 194–195

cerebral ischemia, Moyamoya disease (MMD), 354cerebral venous thrombosis (CVT), 209–212cerebrospinal fluid (CSF) analysis

cerebral venous thrombosis (CVT), 211subarachnoid hemorrhage (SAH), 195

cerebrospinal fluid shunt infection, 109–112cerebrovascular accident (CVA), 219–222. See also stroke

middle cerebral artery (MCA) thrombus with, 188–191vertebral artery dissection with, 201–204

cervical artery dissection (CAD), 201–204cervical os, open, in ectopic pregnancy, 175cervical spine

fracture, 239–240, 251–253subluxation, 254–257trauma series, 256–257

CES (cauda equina syndrome), 205–208C1-esterase inhibitor (C1-INH) deficiency, 422CHB. See complete heart blockchest decompression, 242–243chest injuries, penetrating, 241–244chest pain

aortic dissection, 39, 69, 71, 85atrioventricular (AV) block, 73, 357cocaine-associated, 25–27myocardial infarction (MI), 50–52, 79pericarditis, 41, 43pleuritic, 97, 118pulmonary embolism (PE), 101, 104supraventricular tachycardia (SVT), 45Takotsubo cardiomyopathy, 61

chest pressureatrioventricular (AV) block, 73cardiac tamponade, 33idiopathic fascicular ventricular tachycardia (IFVT), 21myocardial infarction (MI), 79pulmonary edema, 98Takotsubo cardiomyopathy, 61

chest radiographyacute myelogenous leukemia (AML), 445, 447aortic dissection, 39–40, 69–71, 83–86aortic intramural hematoma (IMH), 91–93bronchiolitis, 333–335cardiac tamponade, 33–36, 53–56coccidioidomycosis, 113–115diabetic ketoacidosis (DKA), 450–451dilated cardiomyopathy (DCM), 321–322

esophageal foreign body in, 341–342gunshot wound (GSW), 242–243heart block, 87–89pericarditis, 41–43pneumococcal sepsis, 379–381pneumonia, 109–110, 117–118pulmonary edema, 97–99pulmonary embolism (PE), 101–105stab wounds, 229–232tuberculosis, 391–393

chest tube thoracostomy, 242–243CHF. See congestive heart failurechildren. See also infants; newborns

acute ischemic stroke, 188–191brain tumors, 337–340dilated cardiomyopathy (DCM), 322elbow fractures, 261–263, 281esophageal foreign body, 340–343foot trauma, 267forearm fractures, 270head trauma, 326–327hemolytic uremic syndrome (HUS), 349–350hemorrhagic stroke, 355, 363–365intestinal intussusception, 345–347intra-abdominal injury (IAI), 225–228Jimson weed poisoning, 396–399lower respiratory tract infection, 334–335Moyamoya disease (MMD), 353–355

chillsmalaria, 373vertebral osteomyelitis, 369

chloroquine, 375–376choking, esophageal foreign body, 340cholecystectomy, 149cholecystitis, gangrenous, 147–150cimetidine, 408C1-INH (C1-esterase inhibitor) deficiency, 422ciprofloxacin, 124, 171, 183, 184, 370, 426CK (creatine kinase), 413clarithromycin, 119, 431clay-shoveler’s fracture, 239–240clindamycin, 385clopidogrel, 63closed reduction of fractures, 270, 274, 281, 292coagulopathy

acetaminophen-induced, 405acute myelogenous leukemia (AML), 445–446snakebite, 418

cocaine-associated chest pain, 25–27coccidioidomycosis, 113–115coins, esophageal, 340–343colchicine, 43colocutaneous fistula, as PEG tube complication, 329–331colonic intussusception, 159–161community-acquired pneumonia (CAP), 117–120, 334compartment pressure, measurement of, 236, 267compartment syndrome (CS)

elbow, 262–263foot, 266–267thigh, 235–237, 292

complete blood count (CBC)acute myelogenous leukemia (AML), 445diabetic ketoacidosis (DKA), 451intra-abdominal injury (IAI), 227mesenteric ischemia, 151, 153pneumonia, 334splenic laceration, 225stab wounds, 232






476 Subject index

complete heart block (CHB), 67, 87–89from Lyme carditis, 357–361STEMI with, 50–52ventricular tachycardia (VT) converting to, 73–77

compression ultrasound, deep vein thrombosis (DVT), 455computed tomography (CT)

abdominal aortic aneurysm (AAA), 156–157acute abdomen, 149appendicitis, 124, 125brain, 13, 247–248brain arteriovenous malformation (AVM), 364–365brain tumor, 338–339cecal volvulus, 140cerebral venous thrombosis (CVT), 209–211cervical spine fracture, 251–253cholecystitis, 147, 149deep vein thrombosis (DVT), 466hepatic abscess, 384–385ileocecal intussusception, 159–160intra-abdominal injury (IAI), 227–228intracerebral hemorrhage (ICH), 363, 446knee trauma, 284Meckel’s diverticulitis, 135–138mesenteric ischemia, 152–153midgut malrotation, 131–133Moyamoya disease (MMD), 354necrotizing epididymo-orchitis, 184orbital cellulitis, 6ovarian torsion, 165–166psoas muscle abscess, 387–389pulmonary infection, 114rectus sheath hematoma (RSH), 245–246septic arthritis, 289spinal epidural abscess, 198splenic laceration, 127–128, 225–227stab wounds, 229–232stroke, 189–190, 201–202, 219–221subarachnoid hemorrhage (SAH), 193–194, 213–216,

247–248subdural hematoma (SDH), 325–327tuberculosis, 392–393ureteral colic, 169–171vertebral osteomyelitis, 370

computed tomography angiography (CTA)aortic dissection, 38–40, 70, 85–86aortic intramural hematoma (IMH), 92middle cerebral artery (MCA) thrombus, 190pericarditis, 41pulmonary embolism (PE), 103, 105–106

computed tomography enteroclysis (CTE), Meckel’s diverticulitis,137–138

conduction abnormalities. See also specific abnormalityintraventricular (IVCA), 75

confusion, Jimson weed poisoning, 396congestive heart failure (CHF), 87–89

pediatric, 318, 322–323consciousness, alterations in. See altered consciousnessconstipation, in elderly patients, 149contrecoup injury, 247–249coronary angiography

myocardial infarction (MI), 51Takotsubo cardiomyopathy, 61, 63

coronary artery disease, 51, 81corticosteroids. See steroids; specific drugcortisol, 463cough. See also hemoptysis

aortic dissection, 83

cardiac tamponade, 33, 35dilated cardiomyopathy (DCM), 321pneumonia, 117–118pulmonary edema, 98respiratory syncytial virus (RSV) infection, 333

Coumadin. See warfarinCPK (creatine phosphokinase), 153, 235, 413CPR (cardiopulmonary resuscitation), 241–242cranial decompression, 249C-reactive protein (CRP)

appendicitis, 125psoas muscle abscess, 387septic arthritis, 287Sweet’s syndrome, 457, 459temporal arteritis, 13–14vertebral osteomyelitis, 369–370

creatine kinase (CK), 413creatine phosphokinase (CPK), 153, 235, 413creatinine, 349–350, 406, 413, 451Crotalidae Polyvalent Immune Fab (CroFab), 417CRP. See C-reactive proteincrystalloids

for rhabdomyolysis, 413for septic shock, 384

CS. See compartment syndromeCSF (cerebrospinal fluid) analysis

cerebral venous thrombosis (CVT), 211subarachnoid hemorrhage (SAH), 195

CT. See computed tomographycubitus varus, 263culdocentesis, 174CURB-65 rule, 120CVA (cerebrovascular accident), 188–191, 219–222

See also strokeCVC (central venous catheter), venous thrombosis with,

466CVT (cerebral venous thrombosis), 209–212cyst, ovarian, 165–167cytochrome p450 enzyme system, 404

danazol, 422Datura stramonium poisoning, 396–399DCM (dilated cardiomyopathy), 321–323D-dimer tests, 41, 105–106, 454–455DeBakey classification of aortic dissection, 85debridement

high-pressure injection hand injury, 300subungual abscess, 298

Decadron, 4, 198, 206, 381decompression

chest, 242–243cranial, 249

decontamination, for poisoning, 398, 404, 426, 431deep vein thrombosis (DVT)

lower extremity, 103, 105–106, 453–456upper extremity, 465–467

defibrillation, for ventricular tachycardia, 58–59, 75dehydration, panhypopituitarism, 461dermatology consult, 459dermatosis, acute febrile neutrophilic. See Sweet’s syndromedermoid cyst, 165–167descending thoracic aortic hematoma, 91–93Devil’s Trumpet flower poisoning, 396–399dexamethasone, 199, 207, 385diabetic ketoacidosis (DKA), 449–452diagnostic peritoneal aspiration (DPA), 231diagnostic peritoneal lavage (DPL), 231–232






Subject index 477

dialysis, for acute renal failure, 413diarrhea

appendicitis, 124bloody, 350cecal volvulus, 139hemolytic uremic syndrome (HUS), 348hepatic abscess, 383ventriculoatrial shunt infection, 109

diazepam, 215, 216DIC (disseminated intravascular coagulation), 381, 413, 418, 438,

446Digibind. See digoxin-Fab fragmentsdigital felon, 303–305digital injection injuries, 300“digitalis effect,” 431digital rectal examination, 144digoxin, 319, 322

toxicity, 429–432digoxin-Fab fragments, 431–432Dilantin, 350. See phenytoindilated cardiomyopathy (DCM), 321–323Dilaudid, 39, 169, 369diltiazem, 30–31“dinner fork” deformity, 269–271diphenhydramine, 404, 408DIP (distal interphalangeal) joint, 297, 303, 308discectomy, 206–207, 256disc herniation, 206discitis, 387–389dislocation

elbow, 261–263, 270, 279–282foot, 265–268

disseminated intravascular coagulation (DIC), 381, 413, 418, 438,446

distal interphalangeal (DIP) joint, 297, 303, 308diuretics. See also specific drug

for dilated cardiomyopathy (DCM), 323for pulmonary edema, 98for rhabdomyolysis, 413for traumatic brain injury (TBI), 249

diving reflex, cardioversion using, 318–319dizziness

cerebellar stroke, 201diabetic ketoacidosis (DKA), 449intracerebral hemorrhage (ICH), 363vertebrobasilar stroke, 220–221

DKA (diabetic ketoacidosis), 449–452dobutamine, 322, 323, 384dog bites, 312–313dopamine, 103, 323, 381, 413doxycycline, 119, 184, 313, 361DPA (diagnostic peritoneal aspiration), 231DPL (diagnostic peritoneal lavage), 231–232Drano ingestion, 425–427DRESS syndrome, 442drug eruption, morbilliform, 441–443drug interactions, digoxin toxicity, 431drug use. See also specific drug

abdominal pathology and, 149duodenal malrotation, 131–134DVT. See deep vein thrombosisdysarthria, vertebrobasilar stroke, 221dysphagia

alkali ingestion, 425vertebrobasilar stroke, 221

dyspneaacute myelogenous leukemia (AML), 445

aortic dissection, 69, 83atrial fibrillation, 29cardiac tamponade, 33, 35, 55cocaine-associated, 25dilated cardiomyopathy (DCM), 321–322heart block, 87mesenteric ischemia, 151pericarditis, 43pneumonia, 117, 333–335pulmonary edema, 97pulmonary embolism (PE), 101, 104scombroid fish poisoning, 407supraventricular tachycardia (SVT), 45

dysrhythmias. See also palpitations; specific dysrhythmiadigitalis-induced, 431with hypothermia, 402

dysuria, appendicitis, 123

early goal-directed therapy (EGDT), 384EBV (Epstein-Barr virus), 128ECG. See electrocardiographyechocardiography

aortic dissection, 40, 71cardiac tamponade, 33–36, 55–56dilated cardiomyopathy (DCM), 322–323pericarditis, 43pulmonary embolism (PE), 105supraventricular tachycardia (SVT), 47Takotsubo cardiomyopathy, 61, 63ventriculoatrial shunt, 111

ectopic pregnancy, ruptured, 173–175EDAS (encephaloduroarteriosynangiosis), 354–355edema

alkali ingestion, 426arm, 465bite wound, 313, 415cerebral, 194eyelid, 5, 17facial, 421, 435, 442fingers, 297, 303, 311foot, 411, 415forearm, 269hand, 435intracerebral hemorrhage (ICH), 364–365leg, 435, 445, 453nephrotic syndrome, 435–436psoas muscle abscess, 387pulmonary, 97–99scrotal, 183

EDH (epidural hemorrhage), 248ED thoracotomy, 243EEG (electroencephalography), status epilepticus,

215–216EGD (esophagogastroduodenoscopy), 427EGDT (early goal-directed therapy), 384elbow trauma, 261–263, 270, 275–277, 279–282elderly patients

abdominal pain in, 149injuries in, 253, 284septic arthritis in, 289

electrocardiography (ECG)aortic dissection, 69, 71, 83–86aortic intramural hematoma (IMH), 91atrial fibrillation, 29–31atrioventricular (AV) block, 65–67, 73–77, 87–89

Lyme disease, 357–360panhypopituitarism, 463






478 Subject index

electrocardiography (ECG) (cont.)cardiac tamponade, 33–36, 43, 53–56cerebral venous thrombosis (CVT), 209cocaine-associated chest pain, 25–27diabetic ketoacidosis (DKA), 450–452digoxin toxicity, 429–431dilated cardiomyopathy (DCM), 322hypothermia, 401–402idiopathic fascicular ventricular tachycardia (IFVT), 21–23myocardial infarction (MI), 50–52, 79–82pericarditis, 41–44pneumonia, 117pulmonary embolism (PE), 101–105rhabdomyolysis, 411–413supraventricular tachycardia (SVT), 45–48, 58, 317–318Takotsubo cardiomyopathy, 61–63ventricular tachycardia, 57–59

electroencephalography (EEG), status epilepticus, 215–216ELISA, Lyme disease, 359, 361embolectomy, 106, 153embolism

mesenteric, 152–153pulmonary (PE), 101–107, 454, 466

septic, 109–112venous, 103, 105–106, 453–456

embolizationarteriovenous malformation (AVM), 365middle cerebral artery (MCA), 194–195uterine arteries, 180

emesis. See vomitingemotional stress, chest pain following, 61encephaloduroarteriosynangiosis (EDAS), 354–355endocarditis, with cerebrospinal fluid shunts, 111endocrinology consult, 463Endograft, 157endophthalmitis

with hypopyon, 17–18and orbital cellulitis, 5–7

endoscopyalkali ingestion, 426esophageal coin, 342–343

endovaginal ultrasonography (EVUS), uterine arteriovenousmalformation (AVM), 180

endovascular stenting, for aortic dissection, 39, 40, 72enema, barium contrast, intestinal intussusception, 346–347enoxaparin

for cerebral venous thrombosis (CVT), 210for deep vein thrombosis (DVT), 455, 466for middle cerebral artery (MCA) thrombus, 190for pulmonary embolism (PE), 103

enteroenteric intussusception, 160envenomation, snake, 415–419ependymoma, 337–340epididymo-orchitis, necrotizing, 183–185epidural abscess, 197–199epidural hemorrhage (EDH), 248epiglottitis, 3–4epinephrine

for angioedema (AE), 422for gunshot wound (GSW), 241for morbilliform drug eruption, 442for scombroid fish poisoning, 408for subarachnoid hemorrhage (SAH), 247

EpiPen, 422Epsom salt soaks, 304Epstein-Barr virus (EBV), 128eptifibatide, 51, 61, 81

ertapenem, 370erythema

bite wound, 313eyelid, 5, 17finger, 297, 303, 311purpura fulminans (PF), 379–381snakebite, 415Sweet’s syndrome, 457, 459

erythrocyte sedimentation rate (ESR)psoas muscle abscess, 387septic arthritis, 287spinal epidural abscess, 197–198Sweet’s syndrome, 457, 459temporal arteritis, 13–14vertebral osteomyelitis, 370

erythromycin, 119, 431Escherichia coli O157:H7 infection, 349–350esmolol, 39, 40, 70, 71, 86esophagogastroduodenoscopy (EGD), 427esophagus

alkali injury to, 426foreign body in, 340–343

ESR. See erythrocyte sedimentation rateestrogen, 180ethambutol, 392–393ethanol ingestion, acetaminophen overdose and, 404ethmoid sinusitis, 6evisceration, from stab wounds, 231EVUS (endovaginal ultrasonography), uterine arteriovenous

malformation (AVM), 180exanthematous drug eruption, 441–443extensor tendon laceration of finger, 307–309eye discharge, 5, 17eye examination, 5, 9–10, 17eyelid edema, 5, 17eye pain, 5, 17

facial swelling, 421, 435, 442factor Xa inhibitor, 455falls

abdominal injury, 227anterior compartment syndrome (CS), 235–237arm fractures, 269–271, 465cervical spine fracture, 251–253cervical spine subluxation, 254–257elbow fractures, 261–263, 275–277, 281by elderly patients, 253femoral fracture, 291–293head trauma, 325–327knee fractures, 284

fasciitis, necrotizing, 184–185fasciotomy, 236, 266–267FAST (Focused Assessment with Sonography for Trauma) exam,

173–174, 227, 232, 242–243fatigue

acute myelogenous leukemia (AML), 445atrioventricular (AV) block, 65–67, 87miliary tuberculosis, 391

fat pad sign, 262, 276FDA (Food and Drug Administration), acetaminophen overdose

guidelines, 404–405FDS (flexor digitorum superficialis), 308felon, 303–305femoral fracture, 291–293femoral radiography, anterior compartment syndrome (CS), 235femoral venous thrombosis, 103, 105–106fentanyl, 270






Subject index 479

feveracute myelogenous leukemia (AML), 445appendicitis, 123–124dilated cardiomyopathy (DCM), 321epiglottitis, 3hemolytic uremic syndrome (HUS), 350hepatic abscess, 383malaria, 373Meckel’s diverticulitis, 135miliary tuberculosis, 391pericarditis, 43pneumococcal sepsis, 379pneumonia, 109, 117–118psoas muscle abscess, 388respiratory syncytial virus (RSV) infection, 333sepsis, 384septic arthritis, 288spinal epidural abscess, 198Sweet’s syndrome, 457, 459thrombotic thrombocytopenic purpura (TTP), 437–438vertebral osteomyelitis, 369

fibrinolysiscontraindications, 71, 81for coronary artery disease, 52, 81–82for deep vein thrombosis (DVT), 466for pulmonary embolism (PE), 106

fight bite, 312figure-of-eight assessment, for elbow trauma, 262–263fingers

cat bite, 311–313felon, 303–305high-pressure injection injury, 300laceration, 307–309pain and swelling, 297, 303subungual abscess, 297

fish poisoning, scombroid, 407–409flank pain, ovarian torsion, 165flexion-extension testing

cervical spine injury, 256–257elbow trauma, 262

flexor digitorum superficialis (FDS), 308floaters, visual, 9fluconazole, 114fluid management

alkali ingestion, 426diabetic ketoacidosis (DKA), 451–452hemolytic uremic syndrome (HUS), 350intracerebral hemorrhage (ICH), 365pneumococcal sepsis, 382septic shock, 384

fluocinonide, 441fluoroscopy

ileocolic intussusception, 346PEG tube complication, 329–331

Focused Assessment with Sonography for Trauma (FAST) exam,173–174, 227, 232, 242–243

fondaparinux, 106, 454, 455Food and Drug Administration (FDA), acetaminophen overdose

guidelines, 404–405food-borne disease, scombroid fish poisoning, 407–409foot pain

rhabdomyolysis, 411snakebite, 415trauma, 265–268, 273–274

forearm trauma, 269–271, 279–282foreign body

esophageal, 340–343

penile, 177–178rectal, 143–145

fosphenytoin, 216, 338Fothergill’s sign, 246Fournier’s gangrene, 184–185fractures

cervical spine, 239–240, 251–253compartment syndrome (CS) with, 236elbow, 261–263, 275–277, 279–282in elderly patients, 253femoral, 291–293foot, 265–268, 273–274forearm, 269–271humeral, 261–263, 465odontoid, 251–253open, 269–271, 279–282, 285, 292skull, 248, 326–327tibial plateau, 283–286

free intraperitoneal air, 160, 232free intraperitoneal fluid, 225, 227, 232fresh frozen plasma, 55“frog sign,” 46furosemide, 98, 322, 323, 436

Galeazzi fracture-dislocation, 270gallstones, 144–149gamma knife surgery, 365gangrenous cholecystitis, 147–150Gartland classification system, 263gastroenterology consultation, 342, 426gastrointestinal decontamination, for poisoning, 398, 404, 426, 431gastrostomy tube complication, 329–331gatifloxacin, 18, 119GCA (giant-cell arteritis). See temporal arteritisGCS (Glasgow Coma Scale), 248genital trauma, 177–178giant-cell arteritis (GCA). See temporal arteritisgingivitis, acute myelogenous leukemia (AML), 445Glasgow Coma Scale (GCS), 248glucocorticoids

for angioedema (AE), 422for hypopituitarism, 464for thrombotic thrombocytopenic purpura (TTP), 437–438

glucometry, 451glucose, 431

diabetic ketoacidosis (DKA), 451–452glucose-6-phosphate dehydrogenase (G6PD) deficiency, 376glutathione (GSH), 404–405glycoprotein IIb/IIIa inhibitors, 51, 81–82. See also specific druggonococcal arthritis, 288–289greenstick fractures, 270groin pain, 387–388GSH (glutathione), 404–405gunshot wound (GSW), 231, 241–244Gustilo classification, 270gynecology consultation, 166, 174, 179–180

HAE (hereditary angioedema), 422Haemophilus influenzae (Hib), 4hallucinations, Jimson weed poisoning, 396Hampton’s hump, 105hands. See also fingers

bite wounds, 312paint gun injury, 299–301surgery consultation, 308swelling, 435tendon laceration, 308






480 Subject index

headacheaortic dissection, 69cerebellar stroke, 201, 203cerebral venous thrombosis (CVT), 209–210head trauma, 326–327intracerebral hemorrhage (ICH), 363malaria, 373panhypopituitarism, 461scombroid fish poisoning, 407subarachnoid hemorrhage (SAH), 193, 213, 216,

247temporal arteritis, 13thrombotic thrombocytopenic purpura (TTP), 437

head traumablunt, 213, 216, 247–249pediatric, 325–327

heart block. See atrioventricular (AV) blockheart rate, abnormal. See arrhythmias; palpitations; specific

disorderheart sounds

in aortic dissection, 71muffled, with cardiac tamponade, 35–36, 53, 55

hematocritcerebral venous thrombosis (CVT), 209diabetic ketoacidosis (DKA), 451intra-abdominal injury (IAI), 227rectus sheath hematoma (RSH), 246ruptured ectopic pregnancy, 173–174septic shock, 384splenic laceration, 225, 227thrombotic thrombocytopenic purpura (TTP), 437–438uterine arteriovenous malformation (AVM), 179

hematologic tests. See also specific testacetaminophen overdose, 405–406acute myelogenous leukemia (AML), 445–446hemolytic uremic syndrome (HUS), 350malaria, 375rhabdomyolysis, 413snakebite, 418thrombotic thrombocytopenic purpura (TTP), 437–438

hematology consultation, 438hematoma

compartment syndrome (CS) with, 236parenchymal, 364rectus sheath (RSH), 245–246retroperitoneal, 156–157splenic trauma, 228subdural (SDH), 325–327

hematuria, 169, 171hemodialysis, 350hemolytic uremic syndrome (HUS), 348–351hemopericardium, 53–56hemoptysis

coccidioidomycosis, 113, 115pulmonary embolism (PE), 104

hemorrhage. See also bleedingalkali ingestion, 426elbow trauma, 262, 276femoral fracture, 292intracranial (ICH), 363–365, 446–447splenic laceration, 225–227subarachnoid (See subarachnoid hemorrhage

(SAH))traumatic brain injury (TBI), 248

hemorrhagic stroke, 355, 363–365heparin

for cerebral venous thrombosis (CVT), 211

for deep vein thrombosis (DVT), 455, 466for middle cerebral artery (MCA) thrombus, 190for myocardial infarction (MI), 51, 81, 82for pulmonary embolism (PE), 106for stroke, 191, 203for supraventricular tachycardia (SVT), 58for Takotsubo cardiomyopathy, 61

hepatic abscess, 383–386hepatic dysfunction, rhabdomyolysis, 413hepatotoxicity, acetaminophen-induced, 403–406hereditary angioedema (HAE), 422hernia, inguinal, Meckel’s diverticulitis with, 135herniated bowel, abdominal stab wound with, 229–233herniation, disc, 206herniation syndrome, 445high-pressure injection hand injury, 299–301hip arthritis, septic, 287–289, 388His-Purkinje conduction delay, 67, 75histamine, scombroid fish poisoning and, 408histamine-induced angioedema, 422Homan’s sign, 454Horner’s syndrome, 221humeral fracture, 261–263, 465HUS (hemolytic uremic syndrome), 348–351hydrocephalus, obstructive, 337–340hydrocodone, 135hydrocortisone, 385, 463hydronephrosis, 170–171hydroxyzine, 441–442hyoscyamine, 398hyperdense MCA sign, 190hyperglycemia

diabetic ketoacidosis (DKA), 451–452hyperosmolar nonketotic, 451

hyperkalemia, 151, 153, 413diabetic ketoacidosis (DKA), 451–452digoxin toxicity, 431

hyperlipidemia, nephrotic syndrome, 436hyperosmolar nonketotic hyperglycemia, 451hyperphosphatemia, 151, 153hypersensitivity reaction

drug-induced, 441–443food-induced, 421–423

hypertensionaortic dissection, 37, 40, 71, 86hemolytic uremic syndrome (HUS), 350nephrotic syndrome, 435–436subarachnoid hemorrhage (SAH), 216

hyperventilation, for traumatic brain injury (TBI), 249hypoalbuminemia, 436hypocalcemia, 413hypopituitarism, 463hypopyon, 17–18hypotension

abdominal aortic aneurysm (AAA), 156–157aortic dissection, 71cardiac tamponade, 33, 35–36, 43, 54, 55diabetic ketoacidosis (DKA), 449, 451–452mesenteric ischemia, 151penetrating thoracic injury, 243pulmonary embolism (PE), 101, 103, 106septic shock, 383–384

hypothermia, 401–402hypovolemia, ectopic pregnancy, 175hypoxemia, pulmonary embolism (PE), 104hypoxia, pneumonia, 118hysterectomy, 180






Subject index 481

IAI (intra-abdominal injury)blunt, 225–228penetrating, 231

ibuprofen, 43ICD (implantable cardioverter-defibrillator), 58, 59, 75ice packs

for elbow trauma, 275for femoral fracture, 291–292for foot trauma, 265, 274for rectus sheath hematoma (RSH), 246for snakebite, 415for supraventricular tachycardia (SVT), 318–319for tibial plateau fracture, 285

ICH (intracranial hemorrhage)acute myelogenous leukemia (AML), 446–447arteriovenous malformation (AVM), 363–365

ichthyotoxicosis, scombroid, 407–409ICI (intracranial injury), pediatric, 326–327ICP. See intracranial pressureI&D (incision and drainage), of felon, 304idiopathic fascicular ventricular tachycardia (IFVT), 21–23ileocecal intussusception, 159–161ileocecal valve tumor, 160ileocolic intussusception, 345–347IM (infectious mononucleosis), splenic laceration with, 127–129IMH (intramural hematoma), aortic, 91–93immobilization

cervical spine fracture, 251–253cervical spine subluxation, 256–257elbow trauma, 261, 276, 281femoral fracture, 292finger injuries, 298, 308, 312foot fracture, 274tibial plateau fracture, 285

implantable cardioverter-defibrillator (ICD), 58, 59, 75incision and drainage (I&D), of felon, 304indomethacin, 43infants. See also newborns

dilated cardiomyopathy (DCM), 321–323head trauma, 325–327intestinal intussusception, 346PEG tube complications, 329–331pneumonia, 333–336supraventricular tachycardia (SVT), 317–319

infection. See also bacterial infection; specific infectionbite wound, 311–313nail bed, 297–298pulmonary, 113–115, 117–120, 333–336ventriculoatrial shunt, 109–112

infectious mononucleosis (IM), splenic laceration with, 127–129inguinal hernia, Meckel’s diverticulitis with, 135injuries. See trauma; specific injuryinotropic agents, contraindications, 71INR. See international normalized ratioinsulin, 413, 431

for diabetic ketoacidosis (DKA), 451–452Integrilin. See eptifibatideinternal jugular vein thrombosis, 465–467international normalized ratio (INR)

acetaminophen overdose, 403–404acute myelogenous leukemia (AML), 445cardiac tamponade, 53, 55cerebral venous thrombosis (CVT), 211deep vein thrombosis (DVT), 466pulmonary embolism (PE), 106, 454–455

intestinal intussusception, 159–161pediatric, 345–347

intestinal malrotation, 131–134, 139–141intestinal perforation, 160intra-abdominal injury (IAI)

blunt, 225–228penetrating, 231

intracranial hemorrhage (ICH)acute myelogenous leukemia (AML), 446–447arteriovenous malformation (AVM), 363–365

intracranial injury (ICI), pediatric, 326–327intracranial pressure (ICP)

brain tumors, 339intracerebral hemorrhage (ICH), 364–365subarachnoid hemorrhage (SAH), 216traumatic brain injury (TBI), 249

intramedullary nailing, for femoral fracture, 292intramural hematoma (IMH), aortic, 91–93intrauterine device (IUD), 174intraventricular conduction abnormalities (IVCA), 75intussusception, intestinal, 159–161

pediatric, 345–347ischemia

brainstem, 221cardiac, cocaine-associated, 25–27mesenteric, 151–153Moyamoya disease (MMD), 354

ischemic stroke. See strokeisoniazid, 392–393isoproterenol, 89IUD (intrauterine device), 174IVCA (intraventricular conduction abnormalities), 75

jaw claudication, 14–15Jimson weed poisoning, 396–399Jones fracture, 273–274jugular venous distension, cardiac tamponade, 33, 35–36, 43, 53, 55J (Osborn) waves, 402

Kayexelate, 413, 431Kehr’s sign, 128, 227ketonemia, diabetic ketoacidosis (DKA), 451ketonuria, 451ketorolac, 165King’s College Criteria, 406kinin-induced angioedema, 422knee trauma, 283–286Kussmaul sign, 55, 452

labetalol, 40, 71laceration

finger, 307–309head, 247splenic, 127–129, 225–228

lactate, 384, 451lactate dehydrogenase (LDH), 153, 437–438Ladd’s bands, 133Ladd’s procedure, 133–134LAFB (left anterior fascicular block), 75laminectomy, 206–207Lasix, 98lateral condyle fracture, 261–263lavage, diagnostic peritoneal (DPL), 231–232LBBB (left bundle branch block), 75, 81LDH (lactate dehydrogenase), 153, 437–438left anterior fascicular block (LAFB), 75left bundle branch block (LBBB), 75, 81left posterior fascicular block (LPFB), 75left ventricular (LV) dysfunction, Takotsubo cardiomyopathy, 61, 63






482 Subject index

legs. See also foot paindeep vein thrombosis (DVT), 103, 105–106, 453–456swelling, 435, 445, 453trauma, 283–286weakness, 37, 197, 353

lethargy, 346, 401. See also fatigueleukemia

acute lymphoblastic (ALL), 447acute myelogenous (AML), 445–447

leukocyte countacute myelogenous leukemia (AML), 445–447alkali ingestion, 425anterior compartment syndrome (CS), 235appendicitis, 123, 125diabetic ketoacidosis (DKA), 451diverticulitis, 135epiglottitis, 3hemolytic uremic syndrome (HUS), 349–350midgut malrotation, 131morbilliform drug eruption, 442necrotizing epididymo-orchitis, 183pneumonia, 117–118sepsis, 384subarachnoid hemorrhage (SAH), 213Sweet’s syndrome, 457, 459urinary tract infection, 169vertebral osteomyelitis, 369

“leukocyte larceny,” 447leukocytosis, Sweet’s syndrome, 457, 459leukostasis, 445–447levocarnitine, 322levofloxacin, 119Levophed, 103Levothroid, 463LFT. See liver function testslidocaine

for blunt head trauma, 247for cholecystitis, 147for digoxin toxicity, 431for heart block, 73, 75for stab wounds, 229

lipase, 232lipohemarthrosis, 284Lisfranc injuries, 265–268liver abscess, 383–386liver function tests (LFT)

acetaminophen overdose, 403–406intra-abdominal injury (IAI), 227stab wounds, 232

LMWH (low-molecular-weight heparin), 106, 455, 466lorazepam, 26, 213, 215, 216, 338, 349, 398low back pain. See back painlow-molecular-weight heparin (LMWH), 106, 455, 466LPFB (left posterior fascicular block), 75lumbar puncture, 195, 210lung infection, 113–115lung-protective ventilation, for septic shock, 384lung sounds, pneumonia, 118LV (left ventricular) dysfunction, Takotsubo cardiomyopathy, 61, 63Lyme carditis, 357–361lymphadenopathy, with drug eruptions, 442lymphangitis, hand, 311–313

Maalox, 147magnesium, for panhypopituitarism, 463magnetic resonance imaging (MRI)

aortic dissection, 40, 71, 86

aortic intramural hematoma (IMH), 93brain arteriovenous malformation (AVM), 364–365brain tumor, 338–339cauda equina syndrome (CES), 206–207cerebral venous thrombosis (CVT), 210–211, 211cervical spine subluxation, 256compartment syndrome (CS), 236deep vein thrombosis (DVT), 466discitis, 388–389ileocecal intussusception, 160knee trauma, 285Moyamoya disease (MMD), 353–354pituitary adenoma, 463septic arthritis, 288–289spinal epidural abscess, 198–199stroke, 190, 202–203, 220–221vertebral osteomyelitis, 370, 388–389

mahi mahi fish, 408malaria, 373–377Malarone. See atovaquone; proguanil chloridemalrotation, intestinal, 131–134, 139–141mammalian bites, 311–313mandatory reporting

scombroid food poisoning, 408tuberculosis, 393

mannitol, 364, 413MCA (middle cerebral artery)

aneurysm, 194occlusion, 190

McBurney’s point, 124MCNS (minimal change nephrotic syndrome), 435–436MCP (metacarpophalangeal) joint, 307mechanical ventilation, for septic shock, 384Meckel’s diverticulitis, perforated, 135–138medullary infarction, 221mefloquine, 376meniscus sign, 347meropenem, 370, 385mesenteric ischemia, acute, 151–153metabolic acidosis, 215, 322, 406

diabetic ketoacidosis (DKA), 451–452metacarpophalangeal (MCP) joint, 307metatarsal fractures, 265–268, 273–274methamphetamine abuse, rhabdomyolysis induced by, 411–414Methergine, 179methicillin-resistant Staphylococcus aureus (MRSA), 381methotrexate, 175methylergonovine maleate, 180methylprednisolone, 385metoprolol, 65, 71, 73, 81, 86metronidazole, 124, 384, 385, 426MI. See myocardial infarctionmicroangiopathic hemolytic anemia, 438midazolam, 215, 216, 270middle cerebral artery (MCA)

aneurysm, 194thrombus, with cerebrovascular accident (CVA), 188–191

midgut malrotation, 131–134Milch classification system, 263miliary tuberculosis (TB), 391–393minimal change nephrotic syndrome (MCNS), 435–436miscarriage, recurrent vaginal bleeding after, 179MMD (Moyamoya disease), 353–355Mobitz I (Wenckebach) block, 67Mobitz II block, 67mononucleosis, splenic laceration with, 127–129Monteggia fracture-dislocation, 270, 279–281






Subject index 483

morbilliform drug eruption, 441–443morphine sulfate

for anterior compartment syndrome (CS), 235for cauda equina syndrome (CES), 205for elbow trauma, 270, 279for femoral fracture, 291for foot trauma, 265for hand injury, 299for intestinal malrotation, 139for intra-abdominal injury (IAI), 225for intracerebral hemorrhage (ICH), 363for knee trauma, 283for Meckel’s diverticulitis, 135for necrotizing epididymo-orchitis, 183for ovarian torsion, 165for penile incarceration, 177for pericarditis, 41, 43for rectal foreign body, 143for rectus sheath hematoma (RSH), 245for septic arthritis, 287for snakebite, 415for splenic laceration, 127for stab wounds, 229for subarachnoid hemorrhage (SAH), 193

mosquitoes, malaria transmitted by, 375motor vehicle accidents

blunt head trauma, 247–249foot trauma, 265forearm trauma, 279–282knee trauma, 283–286

moxifloxacin, 109, 118, 119, 298Moyamoya disease (MMD), 353–355MRI. See magnetic resonance imagingMRSA (methicillin-resistant Staphylococcus aureus), 381MRV (magnetic resonance venography), cerebral venous thrombosis

(CVT), 211Mucomyst. See N-acetylcysteine (NAC)multi-organ failure, pneumococcal sepsis, 379–382myalgia, rhabdomyolysis, 411, 413Mycobacterium tuberculosis, 392myelography, spinal epidural abscess, 198myocardial infarction (MI)

aortic dissection, 71cocaine-associated, 25–27diabetic ketoacidosis (DKA), 452inferior ST-segment elevation (STEMI), 50–52, 79–82

myocarditis, 43myoglobin, 413

N-acetylcysteine (NAC), 404–405N-acetyl-p-benzoquinone imine (NAPQI), 404nafcillin, 198nail bed infection, 297–298NAPQI (N-acetyl-p-benzoquinone imine), 404Narcan, 219nasopharyngeal swab, RSV infection, 334–335nasopharyngoscopy, 4nausea

abdominal aortic aneurysm (AAA), 157alkali ingestion, 425aortic dissection, 37, 39appendicitis, 124diabetic ketoacidosis (DKA), 452Meckel’s diverticulitis, 135midgut malrotation, 131snakebite, 415subarachnoid hemorrhage (SAH), 193–194, 216

ureteral colic, 169ventriculoatrial shunt infection, 109vertebrobasilar stroke, 221

neck painaortic dissection, 69cerebellar stroke, 201, 203cervical spine fracture, 239, 250cervical spine subluxation, 254subarachnoid hemorrhage (SAH), 216

neck radiographyepiglottitis, 3–4esophageal foreign body, 341–342

necrotizing epididymo-orchitis, 183–185negative pressure room, for tuberculosis, 392–393Neisseria gonorrhoeae, septic arthritis caused by, 288–289neoplasms, ileocecal valve, 160nephrology consultation, 413, 436nephrotic syndrome, 435–436nerve roots, spinal, 207neurologic deficits, aortic dissection, 71neurology consultation, 445neurosurgical consultation

for brain arteriovenous malformation (AVM), 364for cauda equina syndrome (CES), 206for cervical spine fracture, 252for hypopituitarism, 463for Moyamoya disease (MMD), 354for pediatric head trauma, 326for status epilepticus, 215–216for stroke, 202for subarachnoid hemorrhage (SAH), 194for traumatic brain injury (TBI), 248, 249

newbornscongestive heart failure (CHF), 322–323supraventricular tachycardia (SVT), 318–319

nicardipine, 216nimodipine, 216nitrates, contraindications, 52nitroglycerin, 26, 69, 81, 92nitroprusside

for aortic dissection, 39, 40, 70, 71, 86for status epilepticus, 216

nonsteroidal anti-inflammatory drugs (NSAIDs). See also specificdrug

abdominal pathology and, 149for pericarditis, 43, 44

norepinephrinefor diabetic ketoacidosis (DKA), 451for mesenteric ischemia, 151for pneumococcal sepsis, 381for rhabdomyolysis, 413for septic shock, 384

NSAIDs (nonsteroidal anti-inflammatory drugs). See also specificdrug

abdominal pathology and, 149for pericarditis, 43, 44

obstetrics consultation, 174, 179–180obstructive hydrocephalus, 337–340obstructive pyelonephritis, 171obturator sign, 124ocular surgery, endophthalmitis after, 17–18odontoid fracture, 251–253odynophagia, 3omeprazole, 426open fractures, 285, 292

forearm, 269–271, 279–282






484 Subject index

open reduction and internal fixation (ORIF), 262, 266, 270, 281,284

ophthalmology consultation, 6, 10, 14, 18opioids. See also specific drug

abdominal pathology and, 149for aortic dissection, 40

oral contraceptives, combined, 180orbital cellulitis, 5–7orchitis, 183–185ORIF (open reduction and internal fixation), 262, 266, 270, 281,

284orthopedics consultation, 236, 240, 262–263, 266, 270, 274, 276, 284,

288Osborn (J) waves, 402osteomyelitis, vertebral, 369–371

psoas muscle abscess with, 387–389ovarian cyst, 165–167ovarian torsion, 165–167overdose

acetaminophen, 403–406digoxin, 429–432

oxygen therapyfor digoxin toxicity, 431for dilated cardiomyopathy (DCM), 323for pneumonia, 117for pulmonary edema, 98for RSV bronchiolitis, 333

pacemakers, 67, 75, 89Paget-Schroetter syndrome, 466pain

abdominal (See abdominal pain)arm, 261, 269, 279back (See back pain)chest (See chest pain)elbow, 261, 275eye, 5, 17flank, 165foot (See foot pain)groin, 387–388hand, 297, 299, 303, 311head (See headache)hip, 287–288, 388knee, 283neck (See neck pain)penile, 177–178rectal, 143scrotal, 183–184shoulder, 227thigh, 235, 291throat, 3

paint gun hand injury, 299–301palivizumab, 335palpitations. See also specific arrhythmia

cocaine-associated, 25idiopathic fascicular ventricular tachycardia (IFVT), 21pulmonary embolism (PE), 101scombroid fish poisoning, 407ventricular tachycardia, 57–59

panhypopituitarism, 461–464paralysis

aortic dissection, 37, 39spinal epidural abscess, 197, 199vertebrobasilar stroke, 221

parenchymal hematoma, 364parenchymal hemorrhage, 445paresthesia, snakebite, 415, 418

paronychia, 298, 304paroxysmal atrial tachycardia, digitalis-induced, 431paroxysmal supraventricular tachycardia (PSVT), 317–319PCI (percutaneous coronary intervention), 51, 81–82PE (pulmonary embolism), 101–107, 454, 466

septic, 109–112PEA (pulseless electrical activity), 241Pediatric Intensive Care Unit (PICU), 322, 326, 350, 359, 398pediatrics consultation, 318–319, 322–323, 326, 338, 342, 347, 354, 359,

364PEG (percutaneous endoscopic gastrostomy) tube complication,

329–331penetrating injuries. See also laceration

cat bite, 311–313gunshot wound (GSW), 241–244paint gun, 299–301snake bite, 415–419stab, 229–233

penicillin, 288, 289, 361penile incarceration, 177–178pentolamine, 26Pepcid, 422percutaneous catheter drainage

hepatic abscess, 384–385psoas muscle abscess, 388–389

percutaneous coronary intervention (PCI), 51, 81–82percutaneous endoscopic gastrostomy (PEG) tube complication,

329–331percutaneous transluminal coronary angioplasty (PTCA), 81–82pericardial effusion, cardiac tamponade from, 33–36, 53–56, 85pericardial friction rub, 43, 44, 55pericardial tamponade, 242–243pericardiocentesis, 35, 55, 56, 243pericarditis, acute, 41–44peritoneal aspiration, diagnostic (DPA), 231peritoneal lavage, diagnostic (DPL), 231–232pertechnetate, 138PF (purpura fulminans), sepsis-induced, 379–382Phenergan, 139, 169, 363phenobarbital, 216phenylephrine, 18phenytoin, 210, 213, 215–216, 364phosphate

for diabetic ketoacidosis (DKA), 452ingestion, 426

photophobia, 17, 193–194physostigmine, 398PICU (Pediatric Intensive Care Unit), 322, 326, 350, 359, 398piperacillin, 184, 312, 369, 388PIP (proximal interphalangeal) joint, 303, 307–308pituitary adenoma, 461–464pituitary hormone deficiency, 461–464pit viper envenomation, 417plasma anion gap, in diabetic ketoacidosis (DKA), 451–452plasmapheresis, for thrombotic thrombocytopenic purpura (TTP),

437–438Plasmodium vivax malaria, 373–377platelet count

acute myelogenous leukemia (AML), 445thrombotic thrombocytopenic purpura (TTP), 437–438

pleural effusionaortic dissection, 85heart block, 88–89ventriculoatrial shunt infection, 109

pleuritic chest pain, 97, 118pneumatosis intestinalis, 152pneumococcal sepsis, 379–382






Subject index 485

pneumoniacoccidioidal, 114community-acquired (CAP), 117–120, 334with diabetic ketoacidosis (DKA), 451RSV bronchiolitis with, 333–336with ventriculoatrial shunt infection, 109–112

Pneumonia Severity Index (PSI), 118–119pneumoperitoneum, with Meckel’s diverticulitis, 136–137pneumothorax

with pulmonary edema, 97–99tension, 242–243

podiatry consultation, 266, 417Poison Control Center consultation, 404, 417poisoning

acetaminophen, 403–406alkali, 425–427digoxin, 429–432Jimson weed, 396–399scombroid fish, 407–409snakebite, 415–419

polydipsia, 452polyuria, 452pontine infarction, 221popliteal vein thrombosis, 453–456positive psoas sign, 124possible toxicity line, 404posterior fossa brain tumor, 337–340potassium

for diabetic ketoacidosis (DKA), 452for panhypopituitarism, 463

prednisolone, 18, 321, 459prednisone

for hepatic abscess, 385for morbilliform drug eruption, 441–442for nephrotic syndrome, 436for Sweet’s syndrome, 459for temporal arteritis, 14for thrombotic thrombocytopenic purpura (TTP), 437–438

pregnancyectopic, ruptured, 173–175miscarriage, 179

premature ventricular beats, digitalis-induced, 431primaquine, 375–376probable toxicity line, 404probenecid, drug eruption caused by, 441–443procainamide, 59, 319procedural sedation, 270progesterone, 174, 180proguanil chloride, 375–376prolactin, 463promethazine, 109propofol, 216proptosis, 5proteinuria, 435–436prothrombin time, 406proximal interphalangeal (PIP) joint, 303, 307–308pseudohypoxemia, 447PSI (Pneumonia Severity Index), 118–119psoas muscle abscess, 387–389PSVT (paroxysmal supraventricular tachycardia), 317–319psychiatric consultation, 404, 426PTCA (percutaneous transluminal coronary angioplasty), 81–82public health reporting

scombroid food poisoning, 408tuberculosis, 393

pulmonary edema, re-expansion (RPE), 97–99pulmonary embolism (PE), 454, 466

septic, 109–112treated with thrombolytics, 101–107

pulmonary infection, 113–115, 333–336. See also pneumoniapulmonary leukostasis, 447pulse deficits, aortic dissection, 37, 39, 71pulseless electrical activity (PEA), 241pulse oximetry, pneumonia, 117–118, 333–334pulsus paradoxus, 43, 55puncture wounds. See also penetrating injuries

cat bite, 311–313snake bite, 415–419

pupillary abnormalities, vertebrobasilar stroke, 221purpura fulminans (PF), sepsis-induced, 379–382pyelonephritis, obstructive, 171pyonephrosis, 171pyrazinamide, 392–393

quinidine, 431

radial fracture, 269–271, 275–277radial head dislocation, 279–281radioallergosorbent tests (RAST), 422radiography

abdominal (See abdominal radiography)anterior compartment syndrome (CS), 235chest (See chest radiography)elbow trauma, 261–263, 275–276, 279–281epiglottitis, 3–4femoral fracture, 291–292foot trauma, 265–266, 273–274forearm trauma, 269–270, 279–281hand injury, 299–300, 308, 312head trauma, 326–327humeral neck fracture, 465–466knee trauma, 283–285septic arthritis, 287–289spinal (See spinal radiography)thumb, 297

radionuclide studies, vertebral osteomyelitis, 370radius, subluxation injury, 261–263ranitidine, 408, 442rapid sequence intubation (RSI)

for acute respiratory distress syndrome, 381for traumatic brain injury (TBI), 249

rashacute myelogenous leukemia (AML), 445morbilliform drug eruption, 441pneumococcal sepsis, 379scombroid fish poisoning, 407Sweet’s syndrome, 457, 459

RAST (radioallergosorbent tests), 422rattlesnake envenomation, 415–419RBBB (right bundle branch block), 73, 75, 81RBC (red blood cell) count, subarachnoid hemorrhage (SAH), 195rectal bleeding, intestinal intussusception, 346rectal foreign body, 143–145rectus sheath hematoma (RSH), 245–246red blood cell (RBC) count, subarachnoid hemorrhage (SAH), 195“red currant jelly” stool, 346re-expansion pulmonary edema (RPE), 97–99reflex arcs, 207renal biopsy, nephrotic syndrome, 436renal failure

hemolytic uremic syndrome (HUS), 350nephrotic syndrome, 435–436rhabdomyolysis, 411–414thrombotic thrombocytopenic purpura (TTP), 437–438






486 Subject index

renal stones, 169–172respiratory distress

dilated cardiomyopathy (DCM), 321–322pneumococcal sepsis, 381

respiratory syncytial virus (RSV) infection, 333–336reticulocytes, 438retinal detachment, 9–11retroperitoneal hematoma, 156–157“reverse Segond” fracture, 284rhabdomyolysis, 411–414rheumatoid arthritis, 288Rh immunoglobulin, 175ribavirin, 335rifampin, 392–393right bundle branch block (RBBB), 73, 75, 81right flank pain, ovarian torsion, 165Rovsing’s sign, 124RPE (re-expansion pulmonary edema), 97–99RSH (rectus sheath hematoma), 245–246RSI (rapid sequence intubation)

for acute respiratory distress syndrome, 381for traumatic brain injury (TBI), 249

RSV (respiratory syncytial virus) infection, 333–336RSV-IVIG, 335Rumack-Matthew nomogram, 404–405

SAH. See subarachnoid hemorrhage“sail sign,” 262, 276SBO (small bowel obstruction), 229–233scalp hematoma, 325–327scalp tenderness, 14Schatzker system, 284–285schistocytes, 437–438sciatica, 206scintigraphy, Meckel’s diverticulitis, 138scombroid fish poisoning, 407–409scopolamine, 398scrotal abscesses, 183–185scrotal pain, necrotizing epididymo-orchitis, 183–184SDH (subdural hematoma), 248, 325–327SE (status epilepticus), 213–217SEA (spinal epidural abscess), 197–199sedation, procedural, 270Segond fracture, 284seizures

brain tumor, 338cerebral venous thrombosis (CVT), 210hemolytic uremic syndrome (HUS), 348status epilepticus, 213–217

sepsisfrom liver abscess, 383–386pneumococcal, 379–382

septic arthritis, 287–289septic embolism, 109–112septic shock, with hepatic abscess, 383–386Serratia bacteremia, 109–112Serratia marcescens, 370sexually transmitted illnesses (STI), orchitis caused by,

184Sheehan’s syndrome, 464Shiga toxin, 350Shigella dysenteriae, 350shivering artifact, 402shoulder pain, with splenic rupture, 227silica ingestion, 426single photon emission computed tomography (SPECT), Moyamoya

disease (MMD), 354

sinusitis, orbital cellulitis caused by, 6SIRS (systemic inflammatory response syndrome), 384SJS (Stevens-Johnson syndrome), 441–442skateboard injuries, anterior compartment syndrome (CS), 235–237skin biopsy

morbilliform drug eruption, 441–442Sweet’s syndrome, 459

skull fracture, 248, 326–327SMA (superior mesenteric artery), 133

embolic occlusion of, 152small bowel obstruction (SBO), 229–233small bowel perforation, 160SMV (superior mesenteric vein), 133snakebite, 415–419sodium bicarbonate, 413, 431, 452sodium carbonate ingestion, 426sodium hydroxide ingestion, 426sodium hypochlorite (bleach) ingestion, 426sodium nitroprusside. See nitroprussideSolu-Medrol, 422, 442sore throat, 3–4sotalol, 317–318SPECT (single photon emission computed tomography), Moyamoya

disease (MMD), 354spinal cord compression, 197–199spinal epidural abscess (SEA), 197–199spinal nerve roots, 207spinal radiography

cervical fracture, 239–240, 251–253cervical spine trauma series, 256–257cervical subluxation, 255–256vertebral osteomyelitis, 370

spinal surgery consult, 198, 256spironolactone, 322splenic laceration, 225–228

with mononucleosis, 127–129splenomegaly, 128sports injuries

anterior compartment syndrome (CS), 235–237blunt abdominal, 225–228cervical spine fracture, 239–240elbow trauma, 275–277foot fracture, 273–274forearm fractures, 269–271hand tendons, 308

sputum analysispneumonia, 118–119tuberculosis, 392–393

stab wounds, 229–233stanazol, 422Stanford classification, aortic dissection, 39, 70, 85Stanford classification of aortic intramural hematoma (IMH),

92–93Staphylococcus aureus

felon caused by, 304methicillin-resistant (MRSA), 381psoas muscle abscess caused by, 387–389septic arthritis caused by, 288–289spinal epidural abscess caused by, 198–199

status epilepticus (SE), 213–217STEMI (ST-segment elevation myocardial infarction), 50–52

acute anterior, 79–82stents

abdominal aortic aneurysm (AAA), 156–157aortic, 39, 40, 72coronary artery occlusion, 51, 81ureteral, 171






Subject index 487

steroids. See also specific drugfor alkali ingestion, 427for angioedema (AE), 422for bronchiolitis, 335for cauda equina syndrome (CES), 207contraindications, 365for epiglottitis, 4for high-pressure injection hand injury, 300for morbilliform drug eruption, 441–442for nephrotic syndrome, 436for pericarditis, 43for pneumococcal sepsis, 381for respiratory distress, 321for septic shock, 385for spinal epidural abscess, 199for Sweet’s syndrome, 459for temporal arteritis, 13–14

Stevens-Johnson syndrome (SJS), 441–442STI (sexually transmitted illnesses), orchitis caused by,

184stool, blood in, 346, 350stool culture, Escherichia coli O157:H7 infection, 349–350straight-leg-raise test, 206Streptococcus

pneumonia caused by, 334septic arthritis caused by, 288–289

Streptococcus constellatus infection, 383–386Streptococcus pneumoniae sepsis, purpura fulminans from,

379–382streptomycin, 393stress, chest pain following, 61stroke

with atrial fibrillation, 30–31cerebellar, 201–204hemorrhagic, 355, 363–365pediatric, 188–191, 353–355, 363–365vertebrobasilar, 219–222

Stryker device, 236, 267ST-segment elevation myocardial infarction (STEMI), 50–52

acute anterior, 79–82subarachnoid hemorrhage (SAH)

spontaneous, 193–196traumatic, 213–217, 247–249

subdural hematoma (SDH), 248, 325–327subluxation injury

cervical spine, 254–257elbow, 261–263, 279–282

subungual abscess, 297–298suicide attempt

acetaminophen overdose, 403–406alkali ingestion, 425–427

sulbactam, 114superior mesenteric artery (SMA), 133

embolic occlusion, 152superior mesenteric vein (SMV), 133supracondylar fracture, 261–263, 276supraventricular tachycardia (SVT), 45–48, 58

paroxysmal (PSVT), 317–319surgical consultation, 231, 300suturing, finger laceration, 308SVT (supraventricular tachycardia), 45–48, 58

pediatric, 317–319sweats

acute myelogenous leukemia (AML), 445miliary tuberculosis, 391

Sweet’s syndrome, 457–460swelling. See edema

syncopeabdominal aortic aneurysm (AAA), 157anemia, 13aortic dissection, 39, 71atrial fibrillation, 30atrioventricular (AV) block, 73cardiac tamponade, 54digoxin toxicity, 429myocardial infarction (MI), 50

synovial fluid analysis, in septic arthritis, 288–289systemic inflammatory response syndrome (SIRS), 384

tachycardiaatrioventricular (AV) block, 73atrioventricular node re-entry (AVNRT), 318diabetic ketoacidosis (DKA), 450–451digitalis-induced, 431pneumonia, 109, 117sepsis, 384supraventricular (SVT), 45–48, 58

paroxysmal (PSVT), 317–319ventricular (See ventricular tachycardia (VT))

tachypneabronchiolitis, 333–335sepsis, 384

TAD (thoracic aortic dissection), 70–71Takotsubo cardiomyopathy, 61–64target sign, 347TAT (thrombin-antithrombin) complexes, 438tazobactam, 184, 312, 369, 388TB (tuberculosis), miliary, 391–393TBI (traumatic brain injury), 248–249, 326–327Td (tetanus toxoid), 313Tdap (tetanus, diphtheria and pertussis toxoid), 313TEE. See transesophageal echocardiographytemporal arteritis, 13–15TEN (toxic epidermal necrolysis), 442tendon injuries, hand, 307–309tension pneumothorax, 242–243testicular abscesses, 183–185testicular torsion, 184tetanus, diphtheria and pertussis toxoid (Tdap), 313tetanus immune globulin (TIG), 313tetanus prophylaxis guidelines, 313tetanus toxoid (Td), 313tetracycline, 361, 431thigh compartment syndrome (CS), 235–237, 292thigh trauma, 291–293thoracic aortic dissection (TAD), 70–71thoracic aortic intramural hematoma (IMH), 91–93thoracic injuries, penetrating, 241–244thoracostomy, 242–243thoracotomy, 243Thoravent, 97, 98thrombin-antithrombin (TAT) complexes, 438thrombocytopenia

acute myelogenous leukemia (AML), 446–447thrombotic thrombocytopenic purpura (TTP), 437–438

thrombolysis, 52, 81–82for cerebral venous thrombosis (CVT), 211contraindications, 71, 81for pulmonary embolism (PE), 101–107for stroke, 191, 203, 221

thrombosiswith atrial fibrillation, 30–31cerebral venous (CVT), 209–212internal jugular vein, 465–467






488 Subject index

thrombosis (cont.)mesenteric, 152–153middle cerebral artery (MCA), 190popliteal vein, 453–456venous, 103, 105–106

thrombotic thrombocytopenic purpura (TTP), 350, 437–439thumb, subungual abscess, 297“thumbprint” sign, 4thyroid-stimulating hormone (TSH), 463TIAs (transient ischemic attacks), 190, 203, 355tibial plateau fracture, 283–286tick bite, Lyme disease, 357–361TIG (tetanus immune globulin), 313tissue plasminogen activator (t-PA), 103, 106, 191, 203, 221TMP-SMX (trimethoprim-sulfamethoxazole), 184tobramycin, 6“top of the basilar” syndrome, 219–222torsades de pointes, 75toxic epidermal necrolysis (TEN), 442t-PA (tissue plasminogen activator), 103, 106, 191, 203, 221tracheal foreign body, 342traction devices, for femoral fracture, 292transcutaneous pacing, 51–52, 89transesophageal echocardiography (TEE)

aortic dissection, 40, 71, 86pulmonary embolism (PE), 105ventriculoatrial shunt infection, 111

transient ischemic attacks (TIAs), 190, 203, 355transthoracic echocardiography (TTE)

aortic dissection, 40pericarditis, 43pulmonary embolism (PE), 105ventriculoatrial shunt infection, 111

transvaginal ultrasound (TVUS), 174transvenous pacing, 75, 89trauma

alkali ingestion, 426blunt abdominal, 227–228cat bite, 311–313cervical spine fracture, 239–240, 251–253cervical spine subluxation, 254–257elbow, 261–263, 270, 275–277, 279–282in elderly patients, 253, 284finger laceration, 307–309foot, 265–268, 273–274forearm, 269–271, 279–282genital, 177–178gunshot wound (GSW), 231, 241–244hand (See fingers; hands)knee, 283–286ocular, 5–7rectus sheath hematoma (RSH), 245–246snakebite, 415–419splenic, 225–228stab wound, 229–233tetanus prophylaxis guidelines, 313thigh, 291–293

traumatic brain injury (TBI), 248–249, 325–327traumatic subarachnoid hemorrhage (TSAH), 213–217, 247–249travelers

malaria in, 373–377pneumococcal sepsis in, 379–382tuberculosis in, 391–393

Treacher Collins syndrome, 329tremor artifact, 402triamcinolone, 442trifascicular block, 75trimethoprim-sulfamethoxazole (TMP-SMX), 184

tropicamide, 18troponin I, 26, 43, 44, 46, 58, 105, 322, 445, 451TSAH (traumatic subarachnoid hemorrhage), 213–217, 247–249TSH (thyroid-stimulating hormone), 463TTE. See transthoracic echocardiographyTTP (thrombotic thrombocytopenic purpura), 350, 437–439tuberculin skin test, 393tuberculosis (TB), miliary, 391–393TVUS (transvaginal ultrasound), 174Tylenol. See acetaminophen

UA. See urinalysisUFH (unfractionated heparin), 455, 466UGI (upper gastrointestinal series), midgut malrotation, 133ulnar fracture, 269–271, 279–282ultrasonography. See also echocardiography

abdominal aortic aneurysm (AAA), 155–157appendicitis, 125cerebellar stroke, 203cholecystitis, 147–150deep vein thrombosis (DVT), 103, 105, 454–455, 466ectopic pregnancy, 173–174epididymo-orchitis, 184hepatic abscess, 385intestinal intussusception, 347intra-abdominal injury (IAI), 227Meckel’s diverticulitis, 137midgut malrotation, 133ovarian torsion, 166penetrating thoracic injury, 243psoas muscle abscess, 389rectus sheath hematoma (RSH), 246retinal detachment, 9–10septic arthritis, 289splenic laceration, 225splenomegaly, 128ureteral colic, 171uterine arteriovenous malformation (AVM), 179–180

unfractionated heparin (UFH), 455, 466unifascicular blocks, 75upper gastrointestinal series (UGI), midgut malrotation, 133ureteral colic, 169–172urinalysis (UA)

appendicitis, 123, 125intra-abdominal injury (IAI), 227nephrotic syndrome, 435–436rhabdomyolysis, 411, 413stab wounds, 232ureteral colic, 169, 171

urinary alkalinization, for rhabdomyolysis, 413urinary incontinence, back pain with, 207urinary tract infection (UTI)

orchitis caused by, 184ureteral colic with, 169–172

urinary tract stones, 169–172urokinase, 211urology consultation, 171, 178, 184urosepsis, 169–172urticaria, 422uterine arteriovenous malformation (AVM), 179–181uterine curettage, diagnostic, 174UTI (urinary tract infection), 169–172

orchitis caused by, 184ureteral colic with, 169–172

vaccines, tetanus, 313vagal maneuvers, for supraventricular tachycardia (SVT), 46–48, 58,

319






Subject index 489

vaginal bleedingacute myelogenous leukemia (AML), 445ectopic pregnancy, 173–174uterine arteriovenous malformation (AVM), 179–180

Valium, 240vancomycin

for orbital cellulitis, 6–7for pneumococcal sepsis, 381for psoas muscle abscess, 388for septic arthritis, 288for spinal epidural abscess, 198for vertebral osteomyelitis, 369

Vantin. See cefpodoxime proxetilvascular surgery consultation, 39, 70, 156–157VA (ventriculoatrial) shunt infection, 109–112vasodilators. See also specific drug

for aortic dissection, 71, 86vasopressors, for septic shock, 384VATS (video-assisted thoracoscopic surgery), 35venography

cerebral venous thrombosis (CVT), 211deep vein thrombosis (DVT), 466

venoms, snake, 417venous thromboembolism (VTE), 103, 105–106, 453–456venous thrombosis, cerebral (CVT), 209–212ventilation/perfusion (V/Q) scanning, pulmonary embolism (PE), 105ventricular collapse, with cardiac tamponade, 35, 55–56ventricular fibrillation, 402ventricular tachycardia (VT), 47–48, 57–59, 75

converting to complete heart block, 73–77idiopathic fascicular (IFVT), 21–23

ventriculoatrial (VA) shunt infection, 109–112ventriculoperitoneal (VP) shunts, 111verapamil, 319, 431vertebral artery dissection, 201–204vertebral fracture, cervical, 239–240, 251–253vertebral osteomyelitis, 369–371

psoas muscle abscess with, 387–389vertebrobasilar stroke, 219–222vertigo. See dizzinessVicodin, 240video-assisted thoracoscopic surgery (VATS), 35viral infection

cardiac tamponade caused by, 35lower respiratory tract, 333–336

Virchow’s triad, 103, 454vision, blurred, 17vision loss

endophthalmitis, 5–7retinal detachment, 9–11temporal arteritis, 13–15

visual field defect, 9vitamin K, 55, 106, 404vitrectomy, 18vitritis, 5–7volume augmentation, for cardiac tamponade, 35, 36, 56volvulus

cecal, 139–141duodenal, 131–134

vomitingabdominal aortic aneurysm (AAA), 157acetaminophen overdose, 403

acute myelogenous leukemia (AML), 445appendicitis, 124blood with, 241diabetic ketoacidosis (DKA), 449, 452head trauma, 326–327hemolytic uremic syndrome (HUS), 348ileocolic intussusception, 345intracerebral hemorrhage (ICH), 363midgut malrotation, 131obstructive hydrocephalus, 337subarachnoid hemorrhage (SAH), 193–194, 216ventriculoatrial shunt infection, 109

von Willebrand factor (vWF), 438VP (ventriculoperitoneal) shunts, 111VT (ventricular tachycardia), 47–48, 57–59, 73, 75VTE (venous thromboembolism), 103, 105–106, 453–456vWF (von Willebrand factor), 438

Wallenberg syndrome, 203, 221warfarin

for aortic aneurysm, 56for atrial fibrillation, 31for cardiac tamponade, 54for cerebral venous thrombosis (CVT), 210–211for deep vein thrombosis (DVT), 466for pulmonary embolism (PE), 454–455for stroke, 203

WBC (white blood cell) count. See leukocyte countWCT (wide complex tachycardia), 47, 57–59, 73, 75weakness

aortic dissection, 37atrioventricular (AV) block, 65–67, 87cauda equina syndrome (CES), 205–206cerebral venous thrombosis (CVT), 209cerebrovascular accident (CVA), 188cervical spine subluxation, 254diabetic ketoacidosis (DKA), 452Moyamoya disease (MMD), 353panhypopituitarism, 461rhabdomyolysis, 411, 413spinal epidural abscess, 197, 199

weight loss, miliary tuberculosis, 391Wells criteria

for deep vein thrombosis (DVT), 454–455for pulmonary embolism (PE), 104

Wenckebach (Mobitz I) block, 67Westermark’s sign, 105whirlpool sign, 133, 140white blood cell (WBC) count. See leukocyte countwide complex tachycardia (WCT), 47, 57–59, 73, 75Wolff-Parkinson-White syndrome (WPWS), 317–319wounds. See trauma; specific injuryWPWS (Wolff-Parkinson-White syndrome), 317–319

xanthochromia, 195

Zofranfor aortic dissection, 39for Meckel’s diverticulitis, 135for ovarian torsion, 165for snakebite, 415for subarachnoid hemorrhage (SAH), 193






Answer index - Cambridge University...

Documents

Transcript of Answer index - Cambridge University...