Answer Index

Cambridge University Press 978-0-521-71964-3 - Clinical Emergency Medicine Casebook Joel T. Levis and Gus M. Garmel Index More information

Answer index

I. HEENT (Head, Eyes, Ears, Nose and Throat) 31. Midgut malrotation 1. Acute epiglottitis 32. Perforated Meckel’s diverticulitis 2. Endophthalmitis and orbital cellulitis 33. Perforated cecal volvulus 3. Retinal detachment 34. Foreign body in the rectum 4. Temporal arteritis 35. Gangrenous cholecystitis 5. Endophthalmitis with hypopyon 36. Acute mesenteric ischemia 37. Ruptured abdominal aortic aneurysm (AAA) II. Cardiology/Cardiovascular Surgery 38. Colonic intussusception 6. Idiopathic fascicular ventricular tachycardia (IFVT) 7. Cocaine-associated chest pain V. Genitourinary and Gynecology 8. New-onset atrial ﬁbrillation 39. Right ovarian torsion due to a dermoid cyst 9. Cardiac tamponade from a pericardial effusion 40. Right obstructing ureteral stone with urosepsis 10. Type B aortic dissection 41. Ruptured ectopic pregnancy 11. Acute pericarditis 42. Penile incarceration from a constricting penile ring 12. Supraventricular tachycardia (SVT) 43. Uterine arteriovenous malformation (AVM) 13. Inferior ST-segment elevation myocardial infarction 44. Bilateral necrotizing epididymo-orchitis (STEMI) with complete heart block 14. Cardiac tamponade due to hemopericardium VI. Neurology/Neurosurgery 15. Ventricular tachycardia (VT) 45. Right middle cerebral artery (MCA) thrombus with 16. Takotsubo syndrome acute cerebrovascular accident (CVA) 17. Type II second-degree atrioventricular block 46. Spontaneous subarachnoid hemorrhage (SAH) 18. Type A aortic dissection 47. Spinal epidural abscess (SEA) 19. VT converting to third-degree heart block 48. Vertebral artery dissection resulting in acute CVA 20. Acute anterior STEMI 49. Cauda equina syndrome (CES) 21. Painless type A aortic dissection 50. Cerebral venous sinus thrombosis 22. Third-degree heart block 51. Status epilepticus and traumatic SAH 23. Descending thoracic aortic hematoma 52. Brainstem stroke from “top of the basilar” syndrome

VII. Trauma III. Pulmonology 53. Splenic laceration 24. Right-sided pneumothorax complicated by re-expansion 54. Penetrating abdominal stab wound with herniated bowel pulmonary edema and early small bowel obstruction (SBO) 25. Massive pulmonary embolism treated with 55. Acute compartment syndrome of the thigh thrombolytics 56. Clay-shoveler’s fracture of the C7 vertebral process 26. Ventriculoatrial shunt causing septic emboli and 57. Traumatic arrest from penetrating chest trauma recurrent pneumonias 58. Rectus sheath hematoma 27. Bacterial infection of a cavitary lesion from previous 59. Traumatic SAH coccidioidomycosis infection 60. Type II odontoid fracture of the neck 28. Community-acquired pneumonia (CAP) 61. C5-C6 subluxation of the neck

IV. Gastroenterology VIII. Orthopedics 29. Ruptured appendicitis with abscess 62. Type II lateral condyle fracture of the elbow 30. Spontaneous splenic laceration from infectious 63. Lisfranc fracture-dislocation and compartment mononucleosis syndrome of the foot

469

470 Answer index

64. Open both bone forearm fracture XI. Infectious Disease 65. Jones fracture (base of the 5th metatarsal) 88. Vertebral osteomyelitis 66. Occult radial head fracture with associated fat pad 89. Plasmodium vivax malaria signs 90. Purpura fulminans from S. pneumoniae sepsis 67. Open Monteggia fracture-dislocation of the left 91. Sepsis from a liver abscess forearm 92. Psoas muscle abscess with vertebral osteomyelitis 68. Depressed tibial plateau fracture 93. Miliary tuberculosis 69. Septic arthritis of the hip 70. Closed femur fracture XII. Toxicology/Environmental 94. Jimson weed poisoning IX. Hand 95. Hypothermia with ECG changes 71. Subungual abscess of the thumb 96. Intentional acetaminophen overdose 72. High-pressure injection injury to the hand 97. Scombroid fish poisoning 73. Felon of the distal phalanx of the finger 98. Rhabdomyolysis and acute renal failure from 74. Extensor tendon laceration of the finger methamphetamine abuse 75. Infected cat bite to the finger 99. Pit viper (rattlesnake) envenomation 100. Angioedema X. Pediatrics 101. Intentional alkali ingestion with caustic esophageal 76. Paroxysmal supraventricular tachycardia (PSVT) injury 77. Dilated cardiomyopathy 102. Digoxin toxicity 78. Subdural hematoma 79. Colocutaneous fistula from PEG tube placement XIII. Miscellaneous 80. Respiratory syncytial virus (RSV) bronchiolitis with 103. Nephrotic syndrome concomitant bacterial pneumonia 104. Thrombotic thrombocytopenic purpura (TTP) 81. Hydrocephalus from a posterior fossa brain tumor 105. Morbilliform drug eruption 82. Esophageal coin 106. Acute myelogenous leukemia (AML) with blast crisis 83. Ileocolic intussusception and leukostasis 84. Hemolytic uremic syndrome (HUS) 107. Diabetic ketoacidosis (DKA) 85. Moyamoya disease 108. Right leg deep vein thrombosis (DVT) 86. Third-degree heart block from Lyme carditis 109. Sweet’s syndrome 87. Intracranial hemorrhage from an arteriovenous 110. Panhypopituitarism from a pituitary adenoma malformation (AVM) 111. Left internal jugular vein DVT

Subject index

AAA (abdominal aortic aneurysm), ruptured, 155–157 ovarian torsion, 165–166 AAD (acute aortic dissection). See aortic dissection PEG tube complication, 329–331 ABCDEFG (airway, breathing, circulation, disability, exposure, Foley psoas muscle abscess, 387 and gastric tube), 231 rectal foreign body, 143–144 ABCs (Airway, Breathing, Circulation) rectus sheath hematoma (RSH), 245–246 acetaminophen overdose, 404 splenic laceration, 127–128, 225–228 acute myelogenous leukemia (AML), 447 stab wounds, 229–231 alkali ingestion, 426 ureteral colic, 169–171 angioedema (AE), 422 ABG. See arterial blood gas analysis heart block, 89 ABS (apical ballooning syndrome), 63 intracranial hemorrhage (ICH), 364 abscess snakebite, 418 felon, 303–305 status epilepticus, 215–216 hepatic, 383–386 STEMI, 51–52 psoas muscle, 387–389 stroke, 191, 221 scrotal, 183–185 subarachnoid hemorrhage (SAH), 195 spinal epidural (SEA), 197–199 supraventricular tachycardia (SVT), 318 subungual, 297–298 traumatic brain injury (TBI), 249 accidents. See falls; motor vehicle accidents; trauma abdominal aortic aneurysm (AAA), ruptured, 155–157 ACE inhibitors, angioedema induced by, 422 abdominal injuries Acetadote. See N-acetylcysteine (NAC) blunt, 225–228 acetaminophen penetrating, 229–233 for bronchiolitis, 333 abdominal pain for cholecystitis, 149 acetaminophen overdose, 403 for intracranial hemorrhage, 365 alkali ingestion, 425 for malaria, 373 appendicitis, 123–124 overdose, 403–406 cecal volvulus, 139 for pneumonia, 117 diabetic ketoacidosis (DKA), 452 for vertebral osteomyelitis, 369 ectopic pregnancy, 173–174 acetyl-para-aminophenol (APAP). See acetaminophen in elderly patients, 149 acidemia, diabetic ketoacidosis (DKA), 451 foreign body, 143 acid ingestion, 426 gangrenous cholecystitis, 147 ACLS (advanced cardiac life support) guidelines, 59 hepatic abscess, 383 ACP (Antivenin Crotalidae Polyvalent), 418 intestinal intussusception, 159, 345–346 ACTH (adrenocorticotrophic hormone) deﬁciency, Meckel’s diverticulitis, 135, 138 463–464 mesenteric ischemia, 151 activated charcoal midgut malrotation, 131 for acetaminophen overdose, 404 rectus sheath hematoma (RSH), 245 contraindications, 426 splenic laceration, 127–128, 225 for digoxin toxicity, 431 ureteral colic, 169 for Jimson weed poisoning, 398 abdominal radiography activated protein C, 381, 384 aortic aneurysm, 156–157 acute abdomen. See abdominal pain aortic intramural hematoma (IMH), 92 acute aortic dissection (AAD). See aortic dissection appendicitis, 125 acute febrile neutrophilic dermatosis. See Sweet’s syndrome cecal volvulus, 139–140 acute ischemic stroke (AIS). See stroke cholecystitis, 147, 149 acute lymphoblastic leukemia (ALL), 447 esophageal foreign body, 341–342 acute myelogenous leukemia (AML), 445–447 hepatic abscess, 384 acute myocardial infarction (AMI). See myocardial infarction intestinal intussusception, 159–160, 345–347 acute renal failure. See renal failure Meckel’s diverticulitis, 135–138 acute respiratory distress syndrome (ARDS), 381 mesenteric ischemia, 153 acute tubular necrosis (ATN), 413 midgut malrotation, 131–133 acyclovir, 459

471

472 Subject index

ADAMTS-13, 438 middle cerebral artery (MCA) thrombus, 190 adenosine, 46–48, 58, 319 Moyamoya disease (MMD), 353–355 adenosine triphosphate (ATP), 413 myocardial infarction (MI), 51 adnexal torsion, 165–167 pericarditis, 41 adrenal insufficiency, 385 pulmonary embolism (PE), 103, 105–106 adrenergic agents, 408. See also specific drug stroke, 202–203, 220–221 adrenocorticotrophic hormone (ACTH) deficiency, 463–464 subarachnoid hemorrhage (SAH), 194–195, 215 advanced cardiac life support (ACLS) guidelines, 59 Takotsubo cardiomyopathy, 61, 63 Advanced Trauma Life Support (ATLS), 231 animal bites adverse drug reactions, dermal hypersensitivity, 441–443 cat, 311–313 AE (angioedema), 421–423 snake, 415–419 agitation, Jimson weed poisoning, 396 Anopheles mosquito, 375 airway management. See also ABCs (Airway, Breathing, anorexia Circulation) appendicitis, 124 epiglottitis, 4 mesenteric ischemia, 151 traumatic brain injury (TBI), 249 anterior compartment syndrome (CS), 235–237 AIS (acute ischemic stroke). See stroke anterior humeral line, 262–263, 276 alanine aminotransferase (ALT), 404–406, 457, 459 antiarrhythmic drugs. See also specific drug albuterol for atrial fibrillation, 30–31 for bronchiolitis, 333 digoxin interactions with, 431 for pneumonia, 109, 118, 451 for supraventricular tachycardia (SVT), 47 for respiratory distress, 321 antibiotics. See also specific drug alcohol ingestion, acetaminophen overdose and, 404 for alkali ingestion, 426, 427 alkali ingestion, intentional, 425–427 for appendicitis, 124 alkalinization, for rhabdomyolysis, 413 for biliary disease, 150 ALL (acute lymphoblastic leukemia), 447 for bite wounds, 312–313 allergic angioedema, 422 for bronchiolitis, 335 ALT (alanine aminotransferase), 404–406, 457, 459 for coccidioidomycosis, 114 alteplase. See tissue plasminogen activator digoxin interactions with, 431 altered consciousness for endophthalmitis, 6–7, 18 cerebral venous thrombosis (CVT), 210 for epididymo-orchitis, 184–185 diabetic ketoacidosis (DKA), 452 for epiglottitis, 4 intestinal intussusception, 346 gastrointestinal side effects of, 149 ischemic stroke, 219 for hepatic abscess, 384–385 subarachnoid hemorrhage (SAH), 194 for high-pressure injection hand injury, 300 amenorrhea, ectopic pregnancy, 173–174 for ileocecal intussusception, 160 AMI (acute myocardial infarction). See myocardial infarction intravitreal injection of, 18 amiodarone, 58, 59, 319, 431 for Lyme disease, 361 AML (acute myelogenous leukemia), 445–447 for mesenteric ischemia, 153 ammonia ingestion, 426 morbilliform drug eruption caused by, 442 amoxicillin, 334, 361 for open fractures, 270 amoxicillin/clavulanate, 119, 304, 308, 311 for orbital cellulitis, 6–7 amphotericin B, 114 for PEG tube complication, 331 ampicillin, 114 for pneumococcal sepsis, 381 amylase, 153, 232 for pneumonia, 109, 111, 119, 334–335, 451 analgesics. See also specific drug for psoas muscle abscess, 388–389 for cervical spine subluxation, 256 for septic arthritis, 288–289 for femoral fracture, 292 for spinal epidural abscess, 198 for rectus sheath hematoma (RSH), 246 for subungual abscess, 298 anal wink reflex, 207 for vertebral osteomyelitis, 369–371 anaphylactoid reactions, N-acetylcysteine (NAC), 405 anticholinergic toxidrome, Jimson weed poisoning, 396–399 anemia anticoagulation. See also specific drug acute myelogenous leukemia (AML), 445–447 for acute ischemic stroke, 191 microangiopathic hemolytic, 438 before cardioversion, 31 normochromic, normocytic, 13–15 for cerebellar stroke, 203 Sweet’s syndrome, 459 for cerebral venous thrombosis (CVT), 210 aneurysm contraindications, 71, 106 abdominal aortic, 155–157 for deep venous thrombosis, 455, 466 intracranial, 194 for pulmonary embolism (PE), 106 angioedema (AE), 421–423 reversal of, 55 angiography anticonvulsants. See also specific drug aortic dissection, 38–40, 85–86 DRESS syndrome caused by, 442 aortic intramural hematoma (IMH), 92 for status epilepticus, 215–216 brain arteriovenous malformation (AVM), 364–365 for traumatic brain injury (TBI), 249 cerebral venous thrombosis (CVT), 211 antiemetics. See also specific drug deep vein thrombosis (DVT), 466 for midgut malrotation, 131 mesenteric ischemia, 153 for subarachnoid hemorrhage (SAH), 216

Subject index 473

antihistamines. See also specific drug for myocardial infarction (MI), 49, 51 for angioedema (AE), 422 for pericarditis, 41 for morbilliform drug eruption, 441–442 for stroke, 202 for scombroid fish poisoning, 408 for Takotsubo cardiomyopathy, 61, 63 antihypertensive agents. See also specific drug for uterine arteriovenous malformation (AVM), 191 for aortic dissection, 40 assault, stab wounds, 229–233 for subarachnoid hemorrhage (SAH), 216 AST (aspartate aminotransferase), 153, 404–406 antimalarial drugs, 375–376 atenolol, 30, 429, 431 antiplatelet agents. See also specific drug Ativan. See lorazepam for acute ischemic stroke, 191 atlantoaxial complex, 252 for cerebellar stroke, 203 ATLS (Advanced Trauma Life Support), 231 antithrombotic agents. See thrombolysis ATN (acute tubular necrosis), 413 antitubercular drugs, 392–393 atovaquone, 375–376 Antivenin Crotalidae Polyvalent (ACP), 418 ATP (adenosine triphosphate), 413 antiviral agents, DRESS syndrome caused by, 442 atrial collapse, cardiac tamponade, 35 anuria, hemolytic uremic syndrome (HUS), 349–250 atrial fibrillation, 59, 402, 431 aortic aneurysm, abdominal, 155–157 new-onset, 29–31 aortic dissection atrial impulse, nonconducted, 67 classification of, 39, 70, 85 atrial tachycardia, digitalis-induced, 431 intramural hematoma (IMH) leading to, 92 atrioventricular (AV) block, 47, 58 type A, 39, 40, 69–72 first-degree, 67, 75, 359, 463 painless, 83–86 second-degree, 65–67, 75 type B, 37–40, 70–72, 86 third-degree (See complete heart block (CHB)) aortic intramural hematoma (IMH), 91–93 atrioventricular (AV) conduction delay, with hypothermia, aortography, 71 402 APAP (acetyl-para-aminophenol). See acetaminophen atrioventricular node re-entry tachycardia (AVNRT), 318 apical ballooning syndrome (ABS), 63 atropine, 49, 51, 52, 89, 398, 429, 431 appendectomy, 124 Augmentin, 298 appendiceal perforation, 123–126 AV block. See atrioventricular (AV) block appendicitis AVM (arteriovenous malformation) versus Meckel’s diverticulitis, 138 brain, 363–365 ruptured, 124–125 uterine, 179–181 ARDS (acute respiratory distress syndrome), 381 AVNRT (atrioventricular node re-entry tachycardia), 318 Arixtra. See fondaparinux azithromycin, 119, 184, 334 arms. See also fingers; hands deep vein thrombosis (DVT), 465–467 bacitracin, 304 pain, 261, 269, 279 back pain swelling, 465 abdominal aortic aneurysm (AAA), 155 trauma, 261–263, 269–271, 270, 275–277, 279–282 aortic dissection, 37, 71, 85 weakness, 209, 255, 353 aortic intramural hematoma (IMH), 91 arrhythmias. See also palpitations; specific arrhythmia cauda equina syndrome (CES), 205–206 digitalis-induced, 431 physical examination for, 206 with hypothermia, 402 psoas muscle abscess, 388 arterial blood gas (ABG) analysis spinal epidural abscess, 198 acute myelogenous leukemia (AML), 445 vertebral osteomyelitis, 369 diabetic ketoacidosis (DKA), 451 bacteremia, 109–112, 199 pneumococcal sepsis, 381 bacterial arthritis, 287–289 pulmonary embolism (PE), 101–105 bacterial infection. See also specific infection septic shock, 384 bite wounds, 312 stab wounds, 232 felon, 303–305 status epilepticus, 215 hepatic, 383–386 arteriovenous malformation (AVM) pulmonary, 117–120, 333–336 brain, 363–365 purpura fulminans (PF), 379–382 uterine, 179–181 vertebral osteomyelitis, 369–371 arteritis, temporal, 13–15 Bado classification, 281 arthralgias bag-valve-mask (BVM) ventilation, 241 Lyme disease, 357, 359 barbiturates. See also specific drug Sweet’s syndrome, 459 for status epilepticus, 216 arthritis for traumatic brain injury (TBI), 249 rheumatoid, 288 barium contrast enema, for intestinal intussusception, 346–347 septic, 287–289 barium enteroclysis, Meckel’s diverticulitis, 137–138 aspartate aminotransferase (AST), 153, 404–406 basilar artery (BA) occlusion, stroke secondary to, 219–222 aspiration, diagnostic peritoneal (DPA), 231 batteries, button, ingestion of, 343 aspirin Benadryl, 422, 442 for cocaine-induced chest pain, 26 benzodiazepines. See also specific drug for coronary artery disease, 51, 81 for cocaine intoxication, 26 for dilated cardiomyopathy (DCM), 322 for status epilepticus, 215–216

474 Subject index

beta-adrenergic blockers. See also specific drug brain injury, traumatic, 248–249 for aortic dissection, 40, 71, 86 brainstem stroke, 219–222 for atrial fibrillation, 31 brain tumor, posterior fossa, 337–340 contraindications, 26, 52 broken heart syndrome. See Takotsubo cardiomyopathy for supraventricular tachycardia (SVT), 47, 319 bronchiolitis, 333–336 Betadine, 304 bronchoalveolar lavage, 393 beta-human chorionic gonadotropin (β-hCG), 174–175, bronchodilators. See also specific drug 179 for bronchiolitis, 335 Bezold-Jarisch reflex, 52 for respiratory distress, 321 bicycle injuries, 225–228 bronchoscopy, 393 bifascicular blocks, 75 bruising, thrombotic thrombocytopenic purpura (TTP), 437 biliary disease, 149–150 bulbocavernosus reflex, 207 bilirubin, 437–438 BUN (blood urea nitrogen), 413, 451 biofilms, 111 bupivacaine, 298, 304 biopsy burns, alkali ingestion, 425–427 bone marrow, 445 button batteries, ingestion of, 343 renal, 436 buttonhole deformity, 308 skin, 441–442, 459 BVM (bag-valve-mask) ventilation, 241 temporal artery, 13–14 bites CAD (cervical artery dissection), 201–204 cat, 311–313 calcium-channel blockers. See also specific drug snake, 415–419 for atrial fibrillation, 30–31 blast crisis, 445–447 contraindications, 319 bleach (sodium hypochlorite) ingestion, 426 for subarachnoid hemorrhage (SAH), 216 bleeding. See also hemorrhage for supraventricular tachycardia (SVT), 47, 58, 319 acute myelogenous leukemia (AML), 445–447 “calcium sign,” 39 finger laceration, 307 camel-hump sign, 402 head laceration, 247 CAP (community-acquired pneumonia), 117–120, 334 stab wounds, 231 captopril, 322 urinary tract, 169, 171 cardiac arrest, traumatic, 241–244 vaginal (See vaginal bleeding) cardiac catheterization, 51, 81 blood cardiac glycosides, 431. See also specific drug in emesis, 241 cardiac ischemia, cocaine-associated, 25–27 in stool, 346, 350 cardiac tamponade, 43, 85 blood cultures from hemopericardium, 53–56 bacteremia, 109 from pericardial effusion, 33–36 malaria, 373, 375 cardiology consultation pneumococcal sepsis, 381 aortic dissection, 85 pneumonia, 119 aortic intramural hematoma (IMH), 92 psoas muscle abscess, 388 complete heart block, 67, 75, 89 septic arthritis, 289 dilated cardiomyopathy (DCM), 322–323 vertebral osteomyelitis, 370 Lyme carditis, 359 blood glucose, diabetic ketoacidosis (DKA), 451–452 myocardial infarction (MI), 51 blood transfusion supraventricular tachycardia (SVT), 318–319 abdominal aortic aneurysm (AAA), 156–157 cardiomyopathy acute myelogenous leukemia (AML), dilated (DCM), 321–323 445 Takotsubo, 61–64 cardiac tamponade, 55 cardiopulmonary resuscitation (CPR), 241–242 hemolytic uremic syndrome (HUS), 350 cardioversion septic shock, 384 atrial fibrillation, 30–31 thrombotic thrombocytopenic purpura (TTP), 437–438 supraventricular tachycardia (SVT), 47, 48, 318–319 blood urea nitrogen (BUN), 413, 451 ventricular tachycardia, 58–59 blunt injuries cardioverter-defibrillator, implantable (ICD), 58, 59, 75 abdominal, 225–228 carotid artery dissection, 203 head, 213, 216, 247–249, 325–327 cat bite, 311–313 bone fracture. See fractures catecholamine release, stress-induced, 63 bone marrow biopsy, acute myelogenous leukemia (AML), cauda equina syndrome (CES), 205–208 445 caustic alkali ingestion, 425–427 bone scans, vertebral osteomyelitis, 370 cavitary lesions, coccidioidal, 113–115 Borrelia burgdorferi, 359–361 CBC. See complete blood count boutonniere` deformity, 308 cecal volvulus, 139–141 bowel obstruction, with cecal volvulus, 139–141 cefazolin bradycardia for elbow trauma, 270, 281 atrioventricular (AV) block, 65–67 for orbital cellulitis, 6 digoxin toxicity, 429 for stab wounds, 229 hypothermia, 401 for subungual abscess, 297 bradykinin, 422 cefotaxime, 384 brain arteriovenous malformation (AVM), 363–365 cefotetan, 149

Subject index 475

cefpodoxime proxetil, 4 esophageal foreign body in, 341–342 ceftriaxone gunshot wound (GSW), 242–243 for epididymo-orchitis, 184 heart block, 87–89 for epiglottitis, 4 pericarditis, 41–43 for hemolytic uremic syndrome (HUS), 349 pneumococcal sepsis, 379–381 for Lyme disease, 359, 361 pneumonia, 109–110, 117–118 for orbital cellulitis, 6 pulmonary edema, 97–99 for pneumococcal sepsis, 381 pulmonary embolism (PE), 101–105 for septic arthritis, 288 stab wounds, 229–232 for Sweet’s syndrome, 459 tuberculosis, 391–393 cellulitis chest tube thoracostomy, 242–243 fingers, 304, 311–313 CHF. See congestive heart failure orbital, 5–7 children. See also infants; newborns central venous catheters (CVC), venous thrombosis with, acute ischemic stroke, 188–191 466 brain tumors, 337–340 cephalexin, 300 dilated cardiomyopathy (DCM), 322 cephalosporins, 6–7, 289 elbow fractures, 261–263, 281 cerebellar stroke, 201–204 esophageal foreign body, 340–343 cerebral angiography foot trauma, 267 arteriovenous malformation (AVM), 364 forearm fractures, 270 Moyamoya disease (MMD), 353–355 head trauma, 326–327 subarachnoid hemorrhage (SAH), 194–195 hemolytic uremic syndrome (HUS), 349–350 cerebral ischemia, Moyamoya disease (MMD), 354 hemorrhagic stroke, 355, 363–365 cerebral venous thrombosis (CVT), 209–212 intestinal intussusception, 345–347 cerebrospinal fluid (CSF) analysis intra-abdominal injury (IAI), 225–228 cerebral venous thrombosis (CVT), 211 Jimson weed poisoning, 396–399 subarachnoid hemorrhage (SAH), 195 lower respiratory tract infection, 334–335 cerebrospinal fluid shunt infection, 109–112 Moyamoya disease (MMD), 353–355 cerebrovascular accident (CVA), 219–222. See also stroke chills middle cerebral artery (MCA) thrombus with, 188–191 malaria, 373 vertebral artery dissection with, 201–204 vertebral osteomyelitis, 369 cervical artery dissection (CAD), 201–204 chloroquine, 375–376 cervical os, open, in ectopic pregnancy, 175 choking, esophageal foreign body, 340 cervical spine cholecystectomy, 149 fracture, 239–240, 251–253 cholecystitis, gangrenous, 147–150 subluxation, 254–257 cimetidine, 408 trauma series, 256–257 C1-INH (C1-esterase inhibitor) deficiency, 422 CES (cauda equina syndrome), 205–208 ciprofloxacin, 124, 171, 183, 184, 370, 426 C1-esterase inhibitor (C1-INH) deficiency, 422 CK (creatine kinase), 413 CHB. See complete heart block clarithromycin, 119, 431 chest decompression, 242–243 clay-shoveler’s fracture, 239–240 chest injuries, penetrating, 241–244 clindamycin, 385 chest pain clopidogrel, 63 aortic dissection, 39, 69, 71, 85 closed reduction of fractures, 270, 274, 281, 292 atrioventricular (AV) block, 73, 357 coagulopathy cocaine-associated, 25–27 acetaminophen-induced, 405 myocardial infarction (MI), 50–52, 79 acute myelogenous leukemia (AML), 445–446 pericarditis, 41, 43 snakebite, 418 pleuritic, 97, 118 cocaine-associated chest pain, 25–27 pulmonary embolism (PE), 101, 104 coccidioidomycosis, 113–115 supraventricular tachycardia (SVT), 45 coins, esophageal, 340–343 Takotsubo cardiomyopathy, 61 colchicine, 43 chest pressure colocutaneous fistula, as PEG tube complication, 329–331 atrioventricular (AV) block, 73 colonic intussusception, 159–161 cardiac tamponade, 33 community-acquired pneumonia (CAP), 117–120, 334 idiopathic fascicular ventricular tachycardia (IFVT), 21 compartment pressure, measurement of, 236, 267 myocardial infarction (MI), 79 compartment syndrome (CS) pulmonary edema, 98 elbow, 262–263 Takotsubo cardiomyopathy, 61 foot, 266–267 chest radiography thigh, 235–237, 292 acute myelogenous leukemia (AML), 445, 447 complete blood count (CBC) aortic dissection, 39–40, 69–71, 83–86 acute myelogenous leukemia (AML), 445 aortic intramural hematoma (IMH), 91–93 diabetic ketoacidosis (DKA), 451 bronchiolitis, 333–335 intra-abdominal injury (IAI), 227 cardiac tamponade, 33–36, 53–56 mesenteric ischemia, 151, 153 coccidioidomycosis, 113–115 pneumonia, 334 diabetic ketoacidosis (DKA), 450–451 splenic laceration, 225 dilated cardiomyopathy (DCM), 321–322 stab wounds, 232

476 Subject index

complete heart block (CHB), 67, 87–89 cardiac tamponade, 33, 35 from Lyme carditis, 357–361 dilated cardiomyopathy (DCM), 321 STEMI with, 50–52 pneumonia, 117–118 ventricular tachycardia (VT) converting to, 73–77 pulmonary edema, 98 compression ultrasound, deep vein thrombosis (DVT), 455 respiratory syncytial virus (RSV) infection, 333 computed tomography (CT) Coumadin. See warfarin abdominal aortic aneurysm (AAA), 156–157 CPK (creatine phosphokinase), 153, 235, 413 acute abdomen, 149 CPR (cardiopulmonary resuscitation), 241–242 appendicitis, 124, 125 cranial decompression, 249 brain, 13, 247–248 C-reactive protein (CRP) brain arteriovenous malformation (AVM), 364–365 appendicitis, 125 brain tumor, 338–339 psoas muscle abscess, 387 cecal volvulus, 140 septic arthritis, 287 cerebral venous thrombosis (CVT), 209–211 Sweet’s syndrome, 457, 459 cervical spine fracture, 251–253 temporal arteritis, 13–14 cholecystitis, 147, 149 vertebral osteomyelitis, 369–370 deep vein thrombosis (DVT), 466 creatine kinase (CK), 413 hepatic abscess, 384–385 creatine phosphokinase (CPK), 153, 235, 413 ileocecal intussusception, 159–160 creatinine, 349–350, 406, 413, 451 intra-abdominal injury (IAI), 227–228 Crotalidae Polyvalent Immune Fab (CroFab), 417 intracerebral hemorrhage (ICH), 363, 446 CRP. See C-reactive protein knee trauma, 284 crystalloids Meckel’s diverticulitis, 135–138 for rhabdomyolysis, 413 mesenteric ischemia, 152–153 for septic shock, 384 midgut malrotation, 131–133 CS. See compartment syndrome Moyamoya disease (MMD), 354 CSF (cerebrospinal fluid) analysis necrotizing epididymo-orchitis, 184 cerebral venous thrombosis (CVT), 211 orbital cellulitis, 6 subarachnoid hemorrhage (SAH), 195 ovarian torsion, 165–166 CT. See computed tomography psoas muscle abscess, 387–389 cubitus varus, 263 pulmonary infection, 114 culdocentesis, 174 rectus sheath hematoma (RSH), 245–246 CURB-65 rule, 120 septic arthritis, 289 CVA (cerebrovascular accident), 188–191, 219–222 spinal epidural abscess, 198 See also stroke splenic laceration, 127–128, 225–227 CVC (central venous catheter), venous thrombosis with, stab wounds, 229–232 466 stroke, 189–190, 201–202, 219–221 CVT (cerebral venous thrombosis), 209–212 subarachnoid hemorrhage (SAH), 193–194, 213–216, cyst, ovarian, 165–167 247–248 cytochrome p450 enzyme system, 404 subdural hematoma (SDH), 325–327 tuberculosis, 392–393 danazol, 422 ureteral colic, 169–171 Datura stramonium poisoning, 396–399 vertebral osteomyelitis, 370 DCM (dilated cardiomyopathy), 321–323 computed tomography angiography (CTA) D-dimer tests, 41, 105–106, 454–455 aortic dissection, 38–40, 70, 85–86 DeBakey classification of aortic dissection, 85 aortic intramural hematoma (IMH), 92 debridement middle cerebral artery (MCA) thrombus, 190 high-pressure injection hand injury, 300 pericarditis, 41 subungual abscess, 298 pulmonary embolism (PE), 103, 105–106 Decadron, 4, 198, 206, 381 computed tomography enteroclysis (CTE), Meckel’s diverticulitis, decompression 137–138 chest, 242–243 conduction abnormalities. See also specific abnormality cranial, 249 intraventricular (IVCA), 75 decontamination, for poisoning, 398, 404, 426, 431 confusion, Jimson weed poisoning, 396 deep vein thrombosis (DVT) congestive heart failure (CHF), 87–89 lower extremity, 103, 105–106, 453–456 pediatric, 318, 322–323 upper extremity, 465–467 consciousness, alterations in. See altered consciousness defibrillation, for ventricular tachycardia, 58–59, 75 constipation, in elderly patients, 149 dehydration, panhypopituitarism, 461 contrecoup injury, 247–249 dermatology consult, 459 coronary angiography dermatosis, acute febrile neutrophilic. See Sweet’s syndrome myocardial infarction (MI), 51 dermoid cyst, 165–167 Takotsubo cardiomyopathy, 61, 63 descending thoracic aortic hematoma, 91–93 coronary artery disease, 51, 81 Devil’s Trumpet flower poisoning, 396–399 corticosteroids. See steroids; specific drug dexamethasone, 199, 207, 385 cortisol, 463 diabetic ketoacidosis (DKA), 449–452 cough. See also hemoptysis diagnostic peritoneal aspiration (DPA), 231 aortic dissection, 83 diagnostic peritoneal lavage (DPL), 231–232

Subject index 477

dialysis, for acute renal failure, 413 aortic dissection, 69, 83 diarrhea atrial fibrillation, 29 appendicitis, 124 cardiac tamponade, 33, 35, 55 bloody, 350 cocaine-associated, 25 cecal volvulus, 139 dilated cardiomyopathy (DCM), 321–322 hemolytic uremic syndrome (HUS), 348 heart block, 87 hepatic abscess, 383 mesenteric ischemia, 151 ventriculoatrial shunt infection, 109 pericarditis, 43 diazepam, 215, 216 pneumonia, 117, 333–335 DIC (disseminated intravascular coagulation), 381, 413, 418, 438, pulmonary edema, 97 446 pulmonary embolism (PE), 101, 104 Digibind. See digoxin-Fab fragments scombroid fish poisoning, 407 digital felon, 303–305 supraventricular tachycardia (SVT), 45 digital injection injuries, 300 dysrhythmias. See also palpitations; specific dysrhythmia “digitalis effect,” 431 digitalis-induced, 431 digital rectal examination, 144 with hypothermia, 402 digoxin, 319, 322 dysuria, appendicitis, 123 toxicity, 429–432 digoxin-Fab fragments, 431–432 early goal-directed therapy (EGDT), 384 Dilantin, 350. See phenytoin EBV (Epstein-Barr virus), 128 dilated cardiomyopathy (DCM), 321–323 ECG. See electrocardiography Dilaudid, 39, 169, 369 echocardiography diltiazem, 30–31 aortic dissection, 40, 71 “dinner fork” deformity, 269–271 cardiac tamponade, 33–36, 55–56 diphenhydramine, 404, 408 dilated cardiomyopathy (DCM), 322–323 DIP (distal interphalangeal) joint, 297, 303, 308 pericarditis, 43 discectomy, 206–207, 256 pulmonary embolism (PE), 105 disc herniation, 206 supraventricular tachycardia (SVT), 47 discitis, 387–389 Takotsubo cardiomyopathy, 61, 63 dislocation ventriculoatrial shunt, 111 elbow, 261–263, 270, 279–282 ectopic pregnancy, ruptured, 173–175 foot, 265–268 EDAS (encephaloduroarteriosynangiosis), 354–355 disseminated intravascular coagulation (DIC), 381, 413, 418, 438, edema 446 alkali ingestion, 426 distal interphalangeal (DIP) joint, 297, 303, 308 arm, 465 diuretics. See also specific drug bite wound, 313, 415 for dilated cardiomyopathy (DCM), 323 cerebral, 194 for pulmonary edema, 98 eyelid, 5, 17 for rhabdomyolysis, 413 facial, 421, 435, 442 for traumatic brain injury (TBI), 249 fingers, 297, 303, 311 diving reflex, cardioversion using, 318–319 foot, 411, 415 dizziness forearm, 269 cerebellar stroke, 201 hand, 435 diabetic ketoacidosis (DKA), 449 intracerebral hemorrhage (ICH), 364–365 intracerebral hemorrhage (ICH), 363 leg, 435, 445, 453 vertebrobasilar stroke, 220–221 nephrotic syndrome, 435–436 DKA (diabetic ketoacidosis), 449–452 psoas muscle abscess, 387 dobutamine, 322, 323, 384 pulmonary, 97–99 dog bites, 312–313 scrotal, 183 dopamine, 103, 323, 381, 413 EDH (epidural hemorrhage), 248 doxycycline, 119, 184, 313, 361 ED thoracotomy, 243 DPA (diagnostic peritoneal aspiration), 231 EEG (electroencephalography), status epilepticus, DPL (diagnostic peritoneal lavage), 231–232 215–216 Drano ingestion, 425–427 EGD (esophagogastroduodenoscopy), 427 DRESS syndrome, 442 EGDT (early goal-directed therapy), 384 drug eruption, morbilliform, 441–443 elbow trauma, 261–263, 270, 275–277, 279–282 drug interactions, digoxin toxicity, 431 elderly patients drug use. See also specific drug abdominal pain in, 149 abdominal pathology and, 149 injuries in, 253, 284 duodenal malrotation, 131–134 septic arthritis in, 289 DVT. See deep vein thrombosis electrocardiography (ECG) dysarthria, vertebrobasilar stroke, 221 aortic dissection, 69, 71, 83–86 dysphagia aortic intramural hematoma (IMH), 91 alkali ingestion, 425 atrial fibrillation, 29–31 vertebrobasilar stroke, 221 atrioventricular (AV) block, 65–67, 73–77, 87–89 dyspnea Lyme disease, 357–360 acute myelogenous leukemia (AML), 445 panhypopituitarism, 463

478 Subject index

electrocardiography (ECG) (cont.) ertapenem, 370 cardiac tamponade, 33–36, 43, 53–56 erythema cerebral venous thrombosis (CVT), 209 bite wound, 313 cocaine-associated chest pain, 25–27 eyelid,5,17 diabetic ketoacidosis (DKA), 450–452 finger, 297, 303, 311 digoxin toxicity, 429–431 purpura fulminans (PF), 379–381 dilated cardiomyopathy (DCM), 322 snakebite, 415 hypothermia, 401–402 Sweet’s syndrome, 457, 459 idiopathic fascicular ventricular tachycardia (IFVT), 21–23 erythrocyte sedimentation rate (ESR) myocardial infarction (MI), 50–52, 79–82 psoas muscle abscess, 387 pericarditis, 41–44 septic arthritis, 287 pneumonia, 117 spinal epidural abscess, 197–198 pulmonary embolism (PE), 101–105 Sweet’s syndrome, 457, 459 rhabdomyolysis, 411–413 temporal arteritis, 13–14 supraventricular tachycardia (SVT), 45–48, 58, 317–318 vertebral osteomyelitis, 370 Takotsubo cardiomyopathy, 61–63 erythromycin, 119, 431 ventricular tachycardia, 57–59 Escherichia coli O157:H7 infection, 349–350 electroencephalography (EEG), status epilepticus, 215–216 esmolol, 39, 40, 70, 71, 86 ELISA, Lyme disease, 359, 361 esophagogastroduodenoscopy (EGD), 427 embolectomy, 106, 153 esophagus embolism alkali injury to, 426 mesenteric, 152–153 foreign body in, 340–343 pulmonary (PE), 101–107, 454, 466 ESR. See erythrocyte sedimentation rate septic, 109–112 estrogen, 180 venous, 103, 105–106, 453–456 ethambutol, 392–393 embolization ethanol ingestion, acetaminophen overdose and, 404 arteriovenous malformation (AVM), 365 ethmoid sinusitis, 6 middle cerebral artery (MCA), 194–195 evisceration, from stab wounds, 231 uterine arteries, 180 EVUS (endovaginal ultrasonography), uterine arteriovenous emesis. See vomiting malformation (AVM), 180 emotional stress, chest pain following, 61 exanthematous drug eruption, 441–443 encephaloduroarteriosynangiosis (EDAS), 354–355 extensor tendon laceration of finger, 307–309 endocarditis, with cerebrospinal fluid shunts, 111 eye discharge, 5, 17 endocrinology consult, 463 eye examination, 5, 9–10, 17 Endograft, 157 eyelid edema, 5, 17 endophthalmitis eyepain,5,17 with hypopyon, 17–18 and orbital cellulitis, 5–7 facial swelling, 421, 435, 442 endoscopy factor Xa inhibitor, 455 alkali ingestion, 426 falls esophageal coin, 342–343 abdominal injury, 227 endovaginal ultrasonography (EVUS), uterine arteriovenous anterior compartment syndrome (CS), 235–237 malformation (AVM), 180 arm fractures, 269–271, 465 endovascular stenting, for aortic dissection, 39, 40, 72 cervical spine fracture, 251–253 enema, barium contrast, intestinal intussusception, 346–347 cervical spine subluxation, 254–257 enoxaparin elbow fractures, 261–263, 275–277, 281 for cerebral venous thrombosis (CVT), 210 by elderly patients, 253 for deep vein thrombosis (DVT), 455, 466 femoral fracture, 291–293 for middle cerebral artery (MCA) thrombus, 190 head trauma, 325–327 for pulmonary embolism (PE), 103 knee fractures, 284 enteroenteric intussusception, 160 fasciitis, necrotizing, 184–185 envenomation, snake, 415–419 fasciotomy, 236, 266–267 ependymoma, 337–340 FAST (Focused Assessment with Sonography for Trauma) exam, epididymo-orchitis, necrotizing, 183–185 173–174, 227, 232, 242–243 epidural abscess, 197–199 fatigue epidural hemorrhage (EDH), 248 acute myelogenous leukemia (AML), 445 epiglottitis, 3–4 atrioventricular (AV) block, 65–67, 87 epinephrine miliary tuberculosis, 391 for angioedema (AE), 422 fat pad sign, 262, 276 for gunshot wound (GSW), 241 FDA (Food and Drug Administration), acetaminophen overdose for morbilliform drug eruption, 442 guidelines, 404–405 for scombroid fish poisoning, 408 FDS (flexor digitorum superficialis), 308 for subarachnoid hemorrhage (SAH), 247 felon, 303–305 EpiPen, 422 femoral fracture, 291–293 Epsom salt soaks, 304 femoral radiography, anterior compartment syndrome (CS), 235 Epstein-Barr virus (EBV), 128 femoral venous thrombosis, 103, 105–106 eptifibatide, 51, 61, 81 fentanyl, 270

Subject index 479

fever penile, 177–178 acute myelogenous leukemia (AML), 445 rectal, 143–145 appendicitis, 123–124 fosphenytoin, 216, 338 dilated cardiomyopathy (DCM), 321 Fothergill’s sign, 246 epiglottitis, 3 Fournier’s gangrene, 184–185 hemolytic uremic syndrome (HUS), 350 fractures hepatic abscess, 383 cervical spine, 239–240, 251–253 malaria, 373 compartment syndrome (CS) with, 236 Meckel’s diverticulitis, 135 elbow, 261–263, 275–277, 279–282 miliary tuberculosis, 391 in elderly patients, 253 pericarditis, 43 femoral, 291–293 pneumococcal sepsis, 379 foot, 265–268, 273–274 pneumonia, 109, 117–118 forearm, 269–271 psoas muscle abscess, 388 humeral, 261–263, 465 respiratory syncytial virus (RSV) infection, 333 odontoid, 251–253 sepsis, 384 open, 269–271, 279–282, 285, 292 septic arthritis, 288 skull, 248, 326–327 spinal epidural abscess, 198 tibial plateau, 283–286 Sweet’s syndrome, 457, 459 free intraperitoneal air, 160, 232 thrombotic thrombocytopenic purpura (TTP), 437–438 free intraperitoneal fluid, 225, 227, 232 vertebral osteomyelitis, 369 fresh frozen plasma, 55 fibrinolysis “frog sign,” 46 contraindications, 71, 81 furosemide, 98, 322, 323, 436 for coronary artery disease, 52, 81–82 for deep vein thrombosis (DVT), 466 Galeazzi fracture-dislocation, 270 for pulmonary embolism (PE), 106 gallstones, 144–149 fight bite, 312 gamma knife surgery, 365 figure-of-eight assessment, for elbow trauma, 262–263 gangrenous cholecystitis, 147–150 fingers Gartland classification system, 263 cat bite, 311–313 gastroenterology consultation, 342, 426 felon, 303–305 gastrointestinal decontamination, for poisoning, 398, 404, 426, 431 high-pressure injection injury, 300 gastrostomy tube complication, 329–331 laceration, 307–309 gatifloxacin, 18, 119 pain and swelling, 297, 303 GCA (giant-cell arteritis). See temporal arteritis subungual abscess, 297 GCS (Glasgow Coma Scale), 248 fish poisoning, scombroid, 407–409 genital trauma, 177–178 flank pain, ovarian torsion, 165 giant-cell arteritis (GCA). See temporal arteritis flexion-extension testing gingivitis, acute myelogenous leukemia (AML), 445 cervical spine injury, 256–257 Glasgow Coma Scale (GCS), 248 elbow trauma, 262 glucocorticoids flexor digitorum superficialis (FDS), 308 for angioedema (AE), 422 floaters, visual, 9 for hypopituitarism, 464 fluconazole, 114 for thrombotic thrombocytopenic purpura (TTP), 437–438 fluid management glucometry, 451 alkali ingestion, 426 glucose, 431 diabetic ketoacidosis (DKA), 451–452 diabetic ketoacidosis (DKA), 451–452 hemolytic uremic syndrome (HUS), 350 glucose-6-phosphate dehydrogenase (G6PD) deficiency, 376 intracerebral hemorrhage (ICH), 365 glutathione (GSH), 404–405 pneumococcal sepsis, 382 glycoprotein IIb/IIIa inhibitors, 51, 81–82. See also specific drug septic shock, 384 gonococcal arthritis, 288–289 fluocinonide, 441 greenstick fractures, 270 fluoroscopy groin pain, 387–388 ileocolic intussusception, 346 GSH (glutathione), 404–405 PEG tube complication, 329–331 gunshot wound (GSW), 231, 241–244 Focused Assessment with Sonography for Trauma (FAST) exam, Gustilo classification, 270 173–174, 227, 232, 242–243 gynecology consultation, 166, 174, 179–180 fondaparinux, 106, 454, 455 Food and Drug Administration (FDA), acetaminophen overdose HAE (hereditary angioedema), 422 guidelines, 404–405 Haemophilus influenzae (Hib), 4 food-borne disease, scombroid fish poisoning, 407–409 hallucinations, Jimson weed poisoning, 396 foot pain Hampton’s hump, 105 rhabdomyolysis, 411 hands. See also fingers snakebite, 415 bite wounds, 312 trauma, 265–268, 273–274 paint gun injury, 299–301 forearm trauma, 269–271, 279–282 surgery consultation, 308 foreign body swelling, 435 esophageal, 340–343 tendon laceration, 308

480 Subject index

headache for deep vein thrombosis (DVT), 455, 466 aortic dissection, 69 for middle cerebral artery (MCA) thrombus, 190 cerebellar stroke, 201, 203 for myocardial infarction (MI), 51, 81, 82 cerebral venous thrombosis (CVT), 209–210 for pulmonary embolism (PE), 106 head trauma, 326–327 for stroke, 191, 203 intracerebral hemorrhage (ICH), 363 for supraventricular tachycardia (SVT), 58 malaria, 373 for Takotsubo cardiomyopathy, 61 panhypopituitarism, 461 hepatic abscess, 383–386 scombroid fish poisoning, 407 hepatic dysfunction, rhabdomyolysis, 413 subarachnoid hemorrhage (SAH), 193, 213, 216, hepatotoxicity, acetaminophen-induced, 403–406 247 hereditary angioedema (HAE), 422 temporal arteritis, 13 hernia, inguinal, Meckel’s diverticulitis with, 135 thrombotic thrombocytopenic purpura (TTP), 437 herniated bowel, abdominal stab wound with, 229–233 head trauma herniation, disc, 206 blunt, 213, 216, 247–249 herniation syndrome, 445 pediatric, 325–327 high-pressure injection hand injury, 299–301 heart block. See atrioventricular (AV) block hip arthritis, septic, 287–289, 388 heart rate, abnormal. See arrhythmias; palpitations; specific His-Purkinje conduction delay, 67, 75 disorder histamine, scombroid fish poisoning and, 408 heart sounds histamine-induced angioedema, 422 in aortic dissection, 71 Homan’s sign, 454 muffled, with cardiac tamponade, 35–36, 53, 55 Horner’s syndrome, 221 hematocrit humeral fracture, 261–263, 465 cerebral venous thrombosis (CVT), 209 HUS (hemolytic uremic syndrome), 348–351 diabetic ketoacidosis (DKA), 451 hydrocephalus, obstructive, 337–340 intra-abdominal injury (IAI), 227 hydrocodone, 135 rectus sheath hematoma (RSH), 246 hydrocortisone, 385, 463 ruptured ectopic pregnancy, 173–174 hydronephrosis, 170–171 septic shock, 384 hydroxyzine, 441–442 splenic laceration, 225, 227 hyoscyamine, 398 thrombotic thrombocytopenic purpura (TTP), 437–438 hyperdense MCA sign, 190 uterine arteriovenous malformation (AVM), 179 hyperglycemia hematologic tests. See also specific test diabetic ketoacidosis (DKA), 451–452 acetaminophen overdose, 405–406 hyperosmolar nonketotic, 451 acute myelogenous leukemia (AML), 445–446 hyperkalemia, 151, 153, 413 hemolytic uremic syndrome (HUS), 350 diabetic ketoacidosis (DKA), 451–452 malaria, 375 digoxin toxicity, 431 rhabdomyolysis, 413 hyperlipidemia, nephrotic syndrome, 436 snakebite, 418 hyperosmolar nonketotic hyperglycemia, 451 thrombotic thrombocytopenic purpura (TTP), 437–438 hyperphosphatemia, 151, 153 hematology consultation, 438 hypersensitivity reaction hematoma drug-induced, 441–443 compartment syndrome (CS) with, 236 food-induced, 421–423 parenchymal, 364 hypertension rectus sheath (RSH), 245–246 aortic dissection, 37, 40, 71, 86 retroperitoneal, 156–157 hemolytic uremic syndrome (HUS), 350 splenic trauma, 228 nephrotic syndrome, 435–436 subdural (SDH), 325–327 subarachnoid hemorrhage (SAH), 216 hematuria, 169, 171 hyperventilation, for traumatic brain injury (TBI), 249 hemodialysis, 350 hypoalbuminemia, 436 hemolytic uremic syndrome (HUS), 348–351 hypocalcemia, 413 hemopericardium, 53–56 hypopituitarism, 463 hemoptysis hypopyon, 17–18 coccidioidomycosis, 113, 115 hypotension pulmonary embolism (PE), 104 abdominal aortic aneurysm (AAA), 156–157 hemorrhage. See also bleeding aortic dissection, 71 alkali ingestion, 426 cardiac tamponade, 33, 35–36, 43, 54, 55 elbow trauma, 262, 276 diabetic ketoacidosis (DKA), 449, 451–452 femoral fracture, 292 mesenteric ischemia, 151 intracranial (ICH), 363–365, 446–447 penetrating thoracic injury, 243 splenic laceration, 225–227 pulmonary embolism (PE), 101, 103, 106 subarachnoid (See subarachnoid hemorrhage septic shock, 383–384 (SAH)) hypothermia, 401–402 traumatic brain injury (TBI), 248 hypovolemia, ectopic pregnancy, 175 hemorrhagic stroke, 355, 363–365 hypoxemia, pulmonary embolism (PE), 104 heparin hypoxia, pneumonia, 118 for cerebral venous thrombosis (CVT), 211 hysterectomy, 180

Subject index 481

IAI (intra-abdominal injury) intestinal malrotation, 131–134, 139–141 blunt, 225–228 intestinal perforation, 160 penetrating, 231 intra-abdominal injury (IAI) ibuprofen, 43 blunt, 225–228 ICD (implantable cardioverter-defibrillator), 58, 59, 75 penetrating, 231 ice packs intracranial hemorrhage (ICH) for elbow trauma, 275 acute myelogenous leukemia (AML), 446–447 for femoral fracture, 291–292 arteriovenous malformation (AVM), 363–365 for foot trauma, 265, 274 intracranial injury (ICI), pediatric, 326–327 for rectus sheath hematoma (RSH), 246 intracranial pressure (ICP) for snakebite, 415 brain tumors, 339 for supraventricular tachycardia (SVT), 318–319 intracerebral hemorrhage (ICH), 364–365 for tibial plateau fracture, 285 subarachnoid hemorrhage (SAH), 216 ICH (intracranial hemorrhage) traumatic brain injury (TBI), 249 acute myelogenous leukemia (AML), 446–447 intramedullary nailing, for femoral fracture, 292 arteriovenous malformation (AVM), 363–365 intramural hematoma (IMH), aortic, 91–93 ichthyotoxicosis, scombroid, 407–409 intrauterine device (IUD), 174 ICI (intracranial injury), pediatric, 326–327 intraventricular conduction abnormalities (IVCA), 75 ICP. See intracranial pressure intussusception, intestinal, 159–161 I&D (incision and drainage), of felon, 304 pediatric, 345–347 idiopathic fascicular ventricular tachycardia (IFVT), 21–23 ischemia ileocecal intussusception, 159–161 brainstem, 221 ileocecal valve tumor, 160 cardiac, cocaine-associated, 25–27 ileocolic intussusception, 345–347 mesenteric, 151–153 IM (infectious mononucleosis), splenic laceration with, 127–129 Moyamoya disease (MMD), 354 IMH (intramural hematoma), aortic, 91–93 ischemic stroke. See stroke immobilization isoniazid, 392–393 cervical spine fracture, 251–253 isoproterenol, 89 cervical spine subluxation, 256–257 IUD (intrauterine device), 174 elbow trauma, 261, 276, 281 IVCA (intraventricular conduction abnormalities), 75 femoral fracture, 292 finger injuries, 298, 308, 312 jaw claudication, 14–15 foot fracture, 274 Jimson weed poisoning, 396–399 tibial plateau fracture, 285 Jones fracture, 273–274 implantable cardioverter-defibrillator (ICD), 58, 59, 75 jugular venous distension, cardiac tamponade, 33, 35–36, 43, 53, 55 incision and drainage (I&D), of felon, 304 J (Osborn) waves, 402 indomethacin, 43 infants. See also newborns Kayexelate, 413, 431 dilated cardiomyopathy (DCM), 321–323 Kehr’s sign, 128, 227 head trauma, 325–327 ketonemia, diabetic ketoacidosis (DKA), 451 intestinal intussusception, 346 ketonuria, 451 PEG tube complications, 329–331 ketorolac, 165 pneumonia, 333–336 King’s College Criteria, 406 supraventricular tachycardia (SVT), 317–319 kinin-induced angioedema, 422 infection. See also bacterial infection; specific infection knee trauma, 283–286 bite wound, 311–313 Kussmaul sign, 55, 452 nail bed, 297–298 pulmonary, 113–115, 117–120, 333–336 labetalol, 40, 71 ventriculoatrial shunt, 109–112 laceration infectious mononucleosis (IM), splenic laceration with, 127–129 finger, 307–309 inguinal hernia, Meckel’s diverticulitis with, 135 head, 247 injuries. See trauma; specific injury splenic, 127–129, 225–228 inotropic agents, contraindications, 71 lactate, 384, 451 INR. See international normalized ratio lactate dehydrogenase (LDH), 153, 437–438 insulin, 413, 431 Ladd’s bands, 133 for diabetic ketoacidosis (DKA), 451–452 Ladd’s procedure, 133–134 Integrilin. See eptifibatide LAFB (left anterior fascicular block), 75 internal jugular vein thrombosis, 465–467 laminectomy, 206–207 international normalized ratio (INR) Lasix, 98 acetaminophen overdose, 403–404 lateral condyle fracture, 261–263 acute myelogenous leukemia (AML), 445 lavage, diagnostic peritoneal (DPL), 231–232 cardiac tamponade, 53, 55 LBBB (left bundle branch block), 75, 81 cerebral venous thrombosis (CVT), 211 LDH (lactate dehydrogenase), 153, 437–438 deep vein thrombosis (DVT), 466 left anterior fascicular block (LAFB), 75 pulmonary embolism (PE), 106, 454–455 left bundle branch block (LBBB), 75, 81 intestinal intussusception, 159–161 left posterior fascicular block (LPFB), 75 pediatric, 345–347 left ventricular (LV) dysfunction, Takotsubo cardiomyopathy, 61, 63

482 Subject index

legs. See also foot pain aortic intramural hematoma (IMH), 93 deep vein thrombosis (DVT), 103, 105–106, 453–456 brain arteriovenous malformation (AVM), 364–365 swelling, 435, 445, 453 brain tumor, 338–339 trauma, 283–286 cauda equina syndrome (CES), 206–207 weakness, 37, 197, 353 cerebral venous thrombosis (CVT), 210–211, 211 lethargy, 346, 401. See also fatigue cervical spine subluxation, 256 leukemia compartment syndrome (CS), 236 acute lymphoblastic (ALL), 447 deep vein thrombosis (DVT), 466 acute myelogenous (AML), 445–447 discitis, 388–389 leukocyte count ileocecal intussusception, 160 acute myelogenous leukemia (AML), 445–447 knee trauma, 285 alkali ingestion, 425 Moyamoya disease (MMD), 353–354 anterior compartment syndrome (CS), 235 pituitary adenoma, 463 appendicitis, 123, 125 septic arthritis, 288–289 diabetic ketoacidosis (DKA), 451 spinal epidural abscess, 198–199 diverticulitis, 135 stroke, 190, 202–203, 220–221 epiglottitis, 3 vertebral osteomyelitis, 370, 388–389 hemolytic uremic syndrome (HUS), 349–350 mahi mahi fish, 408 midgut malrotation, 131 malaria, 373–377 morbilliform drug eruption, 442 Malarone. See atovaquone; proguanil chloride necrotizing epididymo-orchitis, 183 malrotation, intestinal, 131–134, 139–141 pneumonia, 117–118 mammalian bites, 311–313 sepsis, 384 mandatory reporting subarachnoid hemorrhage (SAH), 213 scombroid food poisoning, 408 Sweet’s syndrome, 457, 459 tuberculosis, 393 urinary tract infection, 169 mannitol, 364, 413 vertebral osteomyelitis, 369 MCA (middle cerebral artery) “leukocyte larceny,” 447 aneurysm, 194 leukocytosis, Sweet’s syndrome, 457, 459 occlusion, 190 leukostasis, 445–447 McBurney’s point, 124 levocarnitine, 322 MCNS (minimal change nephrotic syndrome), 435–436 levofloxacin, 119 MCP (metacarpophalangeal) joint, 307 Levophed, 103 mechanical ventilation, for septic shock, 384 Levothroid, 463 Meckel’s diverticulitis, perforated, 135–138 LFT. See liver function tests medullary infarction, 221 lidocaine mefloquine, 376 for blunt head trauma, 247 meniscus sign, 347 for cholecystitis, 147 meropenem, 370, 385 for digoxin toxicity, 431 mesenteric ischemia, acute, 151–153 for heart block, 73, 75 metabolic acidosis, 215, 322, 406 for stab wounds, 229 diabetic ketoacidosis (DKA), 451–452 lipase, 232 metacarpophalangeal (MCP) joint, 307 lipohemarthrosis, 284 metatarsal fractures, 265–268, 273–274 Lisfranc injuries, 265–268 methamphetamine abuse, rhabdomyolysis induced by, 411–414 liver abscess, 383–386 Methergine, 179 liver function tests (LFT) methicillin-resistant Staphylococcus aureus (MRSA), 381 acetaminophen overdose, 403–406 methotrexate, 175 intra-abdominal injury (IAI), 227 methylergonovine maleate, 180 stab wounds, 232 methylprednisolone, 385 LMWH (low-molecular-weight heparin), 106, 455, 466 metoprolol, 65, 71, 73, 81, 86 lorazepam, 26, 213, 215, 216, 338, 349, 398 metronidazole, 124, 384, 385, 426 low back pain. See back pain MI. See myocardial infarction low-molecular-weight heparin (LMWH), 106, 455, 466 microangiopathic hemolytic anemia, 438 LPFB (left posterior fascicular block), 75 midazolam, 215, 216, 270 lumbar puncture, 195, 210 middle cerebral artery (MCA) lung infection, 113–115 aneurysm, 194 lung-protective ventilation, for septic shock, 384 thrombus, with cerebrovascular accident (CVA), 188–191 lung sounds, pneumonia, 118 midgut malrotation, 131–134 LV (left ventricular) dysfunction, Takotsubo cardiomyopathy, 61, 63 Milch classification system, 263 Lyme carditis, 357–361 miliary tuberculosis (TB), 391–393 lymphadenopathy, with drug eruptions, 442 minimal change nephrotic syndrome (MCNS), 435–436 lymphangitis, hand, 311–313 miscarriage, recurrent vaginal bleeding after, 179 MMD (Moyamoya disease), 353–355 Maalox, 147 Mobitz I (Wenckebach) block, 67 magnesium, for panhypopituitarism, 463 Mobitz II block, 67 magnetic resonance imaging (MRI) mononucleosis, splenic laceration with, 127–129 aortic dissection, 40, 71, 86 Monteggia fracture-dislocation, 270, 279–281

Subject index 483

morbilliform drug eruption, 441–443 ureteral colic, 169 morphine sulfate ventriculoatrial shunt infection, 109 for anterior compartment syndrome (CS), 235 vertebrobasilar stroke, 221 for cauda equina syndrome (CES), 205 neck pain for elbow trauma, 270, 279 aortic dissection, 69 for femoral fracture, 291 cerebellar stroke, 201, 203 for foot trauma, 265 cervical spine fracture, 239, 250 for hand injury, 299 cervical spine subluxation, 254 for intestinal malrotation, 139 subarachnoid hemorrhage (SAH), 216 for intra-abdominal injury (IAI), 225 neck radiography for intracerebral hemorrhage (ICH), 363 epiglottitis, 3–4 for knee trauma, 283 esophageal foreign body, 341–342 for Meckel’s diverticulitis, 135 necrotizing epididymo-orchitis, 183–185 for necrotizing epididymo-orchitis, 183 negative pressure room, for tuberculosis, 392–393 for ovarian torsion, 165 Neisseria gonorrhoeae, septic arthritis caused by, 288–289 for penile incarceration, 177 neoplasms, ileocecal valve, 160 for pericarditis, 41, 43 nephrology consultation, 413, 436 for rectal foreign body, 143 nephrotic syndrome, 435–436 for rectus sheath hematoma (RSH), 245 nerve roots, spinal, 207 for septic arthritis, 287 neurologic deficits, aortic dissection, 71 for snakebite, 415 neurology consultation, 445 for splenic laceration, 127 neurosurgical consultation for stab wounds, 229 for brain arteriovenous malformation (AVM), 364 for subarachnoid hemorrhage (SAH), 193 for cauda equina syndrome (CES), 206 mosquitoes, malaria transmitted by, 375 for cervical spine fracture, 252 motor vehicle accidents for hypopituitarism, 463 blunt head trauma, 247–249 for Moyamoya disease (MMD), 354 foot trauma, 265 for pediatric head trauma, 326 forearm trauma, 279–282 for status epilepticus, 215–216 knee trauma, 283–286 for stroke, 202 moxifloxacin, 109, 118, 119, 298 for subarachnoid hemorrhage (SAH), 194 Moyamoya disease (MMD), 353–355 for traumatic brain injury (TBI), 248, 249 MRI. See magnetic resonance imaging newborns MRSA (methicillin-resistant Staphylococcus aureus), 381 congestive heart failure (CHF), 322–323 MRV (magnetic resonance venography), cerebral venous thrombosis supraventricular tachycardia (SVT), 318–319 (CVT), 211 nicardipine, 216 Mucomyst. See N-acetylcysteine (NAC) nimodipine, 216 multi-organ failure, pneumococcal sepsis, 379–382 nitrates, contraindications, 52 myalgia, rhabdomyolysis, 411, 413 nitroglycerin, 26, 69, 81, 92 Mycobacterium tuberculosis, 392 nitroprusside myelography, spinal epidural abscess, 198 for aortic dissection, 39, 40, 70, 71, 86 myocardial infarction (MI) for status epilepticus, 216 aortic dissection, 71 nonsteroidal anti-inflammatory drugs (NSAIDs). See also specific cocaine-associated, 25–27 drug diabetic ketoacidosis (DKA), 452 abdominal pathology and, 149 inferior ST-segment elevation (STEMI), 50–52, 79–82 for pericarditis, 43, 44 myocarditis, 43 norepinephrine myoglobin, 413 for diabetic ketoacidosis (DKA), 451 for mesenteric ischemia, 151 N-acetylcysteine (NAC), 404–405 for pneumococcal sepsis, 381 N-acetyl-p-benzoquinone imine (NAPQI), 404 for rhabdomyolysis, 413 nafcillin, 198 for septic shock, 384 nail bed infection, 297–298 NSAIDs (nonsteroidal anti-inflammatory drugs). See also specific NAPQI (N-acetyl-p-benzoquinone imine), 404 drug Narcan, 219 abdominal pathology and, 149 nasopharyngeal swab, RSV infection, 334–335 for pericarditis, 43, 44 nasopharyngoscopy, 4 nausea obstetrics consultation, 174, 179–180 abdominal aortic aneurysm (AAA), 157 obstructive hydrocephalus, 337–340 alkali ingestion, 425 obstructive pyelonephritis, 171 aortic dissection, 37, 39 obturator sign, 124 appendicitis, 124 ocular surgery, endophthalmitis after, 17–18 diabetic ketoacidosis (DKA), 452 odontoid fracture, 251–253 Meckel’s diverticulitis, 135 odynophagia, 3 midgut malrotation, 131 omeprazole, 426 snakebite, 415 open fractures, 285, 292 subarachnoid hemorrhage (SAH), 193–194, 216 forearm, 269–271, 279–282

484 Subject index

open reduction and internal fixation (ORIF), 262, 266, 270, 281, paronychia, 298, 304 284 paroxysmal atrial tachycardia, digitalis-induced, 431 ophthalmology consultation, 6, 10, 14, 18 paroxysmal supraventricular tachycardia (PSVT), 317–319 opioids. See also specific drug PCI (percutaneous coronary intervention), 51, 81–82 abdominal pathology and, 149 PE (pulmonary embolism), 101–107, 454, 466 for aortic dissection, 40 septic, 109–112 oral contraceptives, combined, 180 PEA (pulseless electrical activity), 241 orbital cellulitis, 5–7 Pediatric Intensive Care Unit (PICU), 322, 326, 350, 359, 398 orchitis, 183–185 pediatrics consultation, 318–319, 322–323, 326, 338, 342, 347, 354, 359, ORIF (open reduction and internal fixation), 262, 266, 270, 281, 364 284 PEG (percutaneous endoscopic gastrostomy) tube complication, orthopedics consultation, 236, 240, 262–263, 266, 270, 274, 276, 284, 329–331 288 penetrating injuries. See also laceration Osborn (J) waves, 402 cat bite, 311–313 osteomyelitis, vertebral, 369–371 gunshot wound (GSW), 241–244 psoas muscle abscess with, 387–389 paint gun, 299–301 ovarian cyst, 165–167 snake bite, 415–419 ovarian torsion, 165–167 stab, 229–233 overdose penicillin, 288, 289, 361 acetaminophen, 403–406 penile incarceration, 177–178 digoxin, 429–432 pentolamine, 26 oxygen therapy Pepcid, 422 for digoxin toxicity, 431 percutaneous catheter drainage for dilated cardiomyopathy (DCM), 323 hepatic abscess, 384–385 for pneumonia, 117 psoas muscle abscess, 388–389 for pulmonary edema, 98 percutaneous coronary intervention (PCI), 51, 81–82 for RSV bronchiolitis, 333 percutaneous endoscopic gastrostomy (PEG) tube complication, 329–331 pacemakers, 67, 75, 89 percutaneous transluminal coronary angioplasty (PTCA), 81–82 Paget-Schroetter syndrome, 466 pericardial effusion, cardiac tamponade from, 33–36, 53–56, 85 pain pericardial friction rub, 43, 44, 55 abdominal (See abdominal pain) pericardial tamponade, 242–243 arm, 261, 269, 279 pericardiocentesis, 35, 55, 56, 243 back (See back pain) pericarditis, acute, 41–44 chest (See chest pain) peritoneal aspiration, diagnostic (DPA), 231 elbow, 261, 275 peritoneal lavage, diagnostic (DPL), 231–232 eye, 5, 17 pertechnetate, 138 flank, 165 PF (purpura fulminans), sepsis-induced, 379–382 foot (See foot pain) Phenergan, 139, 169, 363 groin, 387–388 phenobarbital, 216 hand, 297, 299, 303, 311 phenylephrine, 18 head (See headache) phenytoin, 210, 213, 215–216, 364 hip, 287–288, 388 phosphate knee, 283 for diabetic ketoacidosis (DKA), 452 neck (See neck pain) ingestion, 426 penile, 177–178 photophobia, 17, 193–194 rectal, 143 physostigmine, 398 scrotal, 183–184 PICU (Pediatric Intensive Care Unit), 322, 326, 350, 359, 398 shoulder, 227 piperacillin, 184, 312, 369, 388 thigh, 235, 291 PIP (proximal interphalangeal) joint, 303, 307–308 throat, 3 pituitary adenoma, 461–464 paint gun hand injury, 299–301 pituitary hormone deficiency, 461–464 palivizumab, 335 pit viper envenomation, 417 palpitations. See also specific arrhythmia plasma anion gap, in diabetic ketoacidosis (DKA), 451–452 cocaine-associated, 25 plasmapheresis, for thrombotic thrombocytopenic purpura (TTP), idiopathic fascicular ventricular tachycardia (IFVT), 21 437–438 pulmonary embolism (PE), 101 Plasmodium vivax malaria, 373–377 scombroid fish poisoning, 407 platelet count ventricular tachycardia, 57–59 acute myelogenous leukemia (AML), 445 panhypopituitarism, 461–464 thrombotic thrombocytopenic purpura (TTP), 437–438 paralysis pleural effusion aortic dissection, 37, 39 aortic dissection, 85 spinal epidural abscess, 197, 199 heart block, 88–89 vertebrobasilar stroke, 221 ventriculoatrial shunt infection, 109 parenchymal hematoma, 364 pleuritic chest pain, 97, 118 parenchymal hemorrhage, 445 pneumatosis intestinalis, 152 paresthesia, snakebite, 415, 418 pneumococcal sepsis, 379–382

Subject index 485

pneumonia septic, 109–112 coccidioidal, 114 treated with thrombolytics, 101–107 community-acquired (CAP), 117–120, 334 pulmonary infection, 113–115, 333–336. See also pneumonia with diabetic ketoacidosis (DKA), 451 pulmonary leukostasis, 447 RSV bronchiolitis with, 333–336 pulse deficits, aortic dissection, 37, 39, 71 with ventriculoatrial shunt infection, 109–112 pulseless electrical activity (PEA), 241 Pneumonia Severity Index (PSI), 118–119 pulse oximetry, pneumonia, 117–118, 333–334 pneumoperitoneum, with Meckel’s diverticulitis, 136–137 pulsus paradoxus, 43, 55 pneumothorax puncture wounds. See also penetrating injuries with pulmonary edema, 97–99 cat bite, 311–313 tension, 242–243 snake bite, 415–419 podiatry consultation, 266, 417 pupillary abnormalities, vertebrobasilar stroke, 221 Poison Control Center consultation, 404, 417 purpura fulminans (PF), sepsis-induced, 379–382 poisoning pyelonephritis, obstructive, 171 acetaminophen, 403–406 pyonephrosis, 171 alkali, 425–427 pyrazinamide, 392–393 digoxin, 429–432 Jimson weed, 396–399 quinidine, 431 scombroid fish, 407–409 snakebite, 415–419 radial fracture, 269–271, 275–277 polydipsia, 452 radial head dislocation, 279–281 polyuria, 452 radioallergosorbent tests (RAST), 422 pontine infarction, 221 radiography popliteal vein thrombosis, 453–456 abdominal (See abdominal radiography) positive psoas sign, 124 anterior compartment syndrome (CS), 235 possible toxicity line, 404 chest (See chest radiography) posterior fossa brain tumor, 337–340 elbow trauma, 261–263, 275–276, 279–281 potassium epiglottitis, 3–4 for diabetic ketoacidosis (DKA), 452 femoral fracture, 291–292 for panhypopituitarism, 463 foot trauma, 265–266, 273–274 prednisolone, 18, 321, 459 forearm trauma, 269–270, 279–281 prednisone hand injury, 299–300, 308, 312 for hepatic abscess, 385 head trauma, 326–327 for morbilliform drug eruption, 441–442 humeral neck fracture, 465–466 for nephrotic syndrome, 436 knee trauma, 283–285 for Sweet’s syndrome, 459 septic arthritis, 287–289 for temporal arteritis, 14 spinal (See spinal radiography) for thrombotic thrombocytopenic purpura (TTP), 437–438 thumb, 297 pregnancy radionuclide studies, vertebral osteomyelitis, 370 ectopic, ruptured, 173–175 radius, subluxation injury, 261–263 miscarriage, 179 ranitidine, 408, 442 premature ventricular beats, digitalis-induced, 431 rapid sequence intubation (RSI) primaquine, 375–376 for acute respiratory distress syndrome, 381 probable toxicity line, 404 for traumatic brain injury (TBI), 249 probenecid, drug eruption caused by, 441–443 rash procainamide, 59, 319 acute myelogenous leukemia (AML), 445 procedural sedation, 270 morbilliform drug eruption, 441 progesterone, 174, 180 pneumococcal sepsis, 379 proguanil chloride, 375–376 scombroid fish poisoning, 407 prolactin, 463 Sweet’s syndrome, 457, 459 promethazine, 109 RAST (radioallergosorbent tests), 422 propofol, 216 rattlesnake envenomation, 415–419 proptosis, 5 RBBB (right bundle branch block), 73, 75, 81 proteinuria, 435–436 RBC (red blood cell) count, subarachnoid hemorrhage (SAH), 195 prothrombin time, 406 rectal bleeding, intestinal intussusception, 346 proximal interphalangeal (PIP) joint, 303, 307–308 rectal foreign body, 143–145 pseudohypoxemia, 447 rectus sheath hematoma (RSH), 245–246 PSI (Pneumonia Severity Index), 118–119 red blood cell (RBC) count, subarachnoid hemorrhage (SAH), 195 psoas muscle abscess, 387–389 “red currant jelly” stool, 346 PSVT (paroxysmal supraventricular tachycardia), 317–319 re-expansion pulmonary edema (RPE), 97–99 psychiatric consultation, 404, 426 reflex arcs, 207 PTCA (percutaneous transluminal coronary angioplasty), 81–82 renal biopsy, nephrotic syndrome, 436 public health reporting renal failure scombroid food poisoning, 408 hemolytic uremic syndrome (HUS), 350 tuberculosis, 393 nephrotic syndrome, 435–436 pulmonary edema, re-expansion (RPE), 97–99 rhabdomyolysis, 411–414 pulmonary embolism (PE), 454, 466 thrombotic thrombocytopenic purpura (TTP), 437–438

486 Subject index

renal stones, 169–172 sinusitis, orbital cellulitis caused by, 6 respiratory distress SIRS (systemic inflammatory response syndrome), 384 dilated cardiomyopathy (DCM), 321–322 SJS (Stevens-Johnson syndrome), 441–442 pneumococcal sepsis, 381 skateboard injuries, anterior compartment syndrome (CS), 235–237 respiratory syncytial virus (RSV) infection, 333–336 skin biopsy reticulocytes, 438 morbilliform drug eruption, 441–442 retinal detachment, 9–11 Sweet’s syndrome, 459 retroperitoneal hematoma, 156–157 skull fracture, 248, 326–327 “reverse Segond” fracture, 284 SMA (superior mesenteric artery), 133 rhabdomyolysis, 411–414 embolic occlusion of, 152 rheumatoid arthritis, 288 small bowel obstruction (SBO), 229–233 Rh immunoglobulin, 175 small bowel perforation, 160 ribavirin, 335 SMV (superior mesenteric vein), 133 rifampin, 392–393 snakebite, 415–419 right bundle branch block (RBBB), 73, 75, 81 sodium bicarbonate, 413, 431, 452 right flank pain, ovarian torsion, 165 sodium carbonate ingestion, 426 Rovsing’s sign, 124 sodium hydroxide ingestion, 426 RPE (re-expansion pulmonary edema), 97–99 sodium hypochlorite (bleach) ingestion, 426 RSH (rectus sheath hematoma), 245–246 sodium nitroprusside. See nitroprusside RSI (rapid sequence intubation) Solu-Medrol, 422, 442 for acute respiratory distress syndrome, 381 sore throat, 3–4 for traumatic brain injury (TBI), 249 sotalol, 317–318 RSV (respiratory syncytial virus) infection, 333–336 SPECT (single photon emission computed tomography), Moyamoya RSV-IVIG, 335 disease (MMD), 354 Rumack-Matthew nomogram, 404–405 spinal cord compression, 197–199 spinal epidural abscess (SEA), 197–199 SAH. See subarachnoid hemorrhage spinal nerve roots, 207 “sail sign,” 262, 276 spinal radiography SBO (small bowel obstruction), 229–233 cervical fracture, 239–240, 251–253 scalp hematoma, 325–327 cervical spine trauma series, 256–257 scalp tenderness, 14 cervical subluxation, 255–256 Schatzker system, 284–285 vertebral osteomyelitis, 370 schistocytes, 437–438 spinal surgery consult, 198, 256 sciatica, 206 spironolactone, 322 scintigraphy, Meckel’s diverticulitis, 138 splenic laceration, 225–228 scombroid fish poisoning, 407–409 with mononucleosis, 127–129 scopolamine, 398 splenomegaly, 128 scrotal abscesses, 183–185 sports injuries scrotal pain, necrotizing epididymo-orchitis, 183–184 anterior compartment syndrome (CS), 235–237 SDH (subdural hematoma), 248, 325–327 blunt abdominal, 225–228 SE (status epilepticus), 213–217 cervical spine fracture, 239–240 SEA (spinal epidural abscess), 197–199 elbow trauma, 275–277 sedation, procedural, 270 foot fracture, 273–274 Segond fracture, 284 forearm fractures, 269–271 seizures hand tendons, 308 brain tumor, 338 sputum analysis cerebral venous thrombosis (CVT), 210 pneumonia, 118–119 hemolytic uremic syndrome (HUS), 348 tuberculosis, 392–393 status epilepticus, 213–217 stab wounds, 229–233 sepsis stanazol, 422 from liver abscess, 383–386 Stanford classification, aortic dissection, 39, 70, 85 pneumococcal, 379–382 Stanford classification of aortic intramural hematoma (IMH), septic arthritis, 287–289 92–93 septic embolism, 109–112 Staphylococcus aureus septic shock, with hepatic abscess, 383–386 felon caused by, 304 Serratia bacteremia, 109–112 methicillin-resistant (MRSA), 381 Serratia marcescens, 370 psoas muscle abscess caused by, 387–389 sexually transmitted illnesses (STI), orchitis caused by, septic arthritis caused by, 288–289 184 spinal epidural abscess caused by, 198–199 Sheehan’s syndrome, 464 status epilepticus (SE), 213–217 Shiga toxin, 350 STEMI (ST-segment elevation myocardial infarction), 50–52 Shigella dysenteriae, 350 acute anterior, 79–82 shivering artifact, 402 stents shoulder pain, with splenic rupture, 227 abdominal aortic aneurysm (AAA), 156–157 silica ingestion, 426 aortic, 39, 40, 72 single photon emission computed tomography (SPECT), Moyamoya coronary artery occlusion, 51, 81 disease (MMD), 354 ureteral, 171

Subject index 487

steroids. See also specific drug syncope for alkali ingestion, 427 abdominal aortic aneurysm (AAA), 157 for angioedema (AE), 422 anemia, 13 for bronchiolitis, 335 aortic dissection, 39, 71 for cauda equina syndrome (CES), 207 atrial fibrillation, 30 contraindications, 365 atrioventricular (AV) block, 73 for epiglottitis, 4 cardiac tamponade, 54 for high-pressure injection hand injury, 300 digoxin toxicity, 429 for morbilliform drug eruption, 441–442 myocardial infarction (MI), 50 for nephrotic syndrome, 436 synovial fluid analysis, in septic arthritis, 288–289 for pericarditis, 43 systemic inflammatory response syndrome (SIRS), 384 for pneumococcal sepsis, 381 for respiratory distress, 321 tachycardia for septic shock, 385 atrioventricular (AV) block, 73 for spinal epidural abscess, 199 atrioventricular node re-entry (AVNRT), 318 for Sweet’s syndrome, 459 diabetic ketoacidosis (DKA), 450–451 for temporal arteritis, 13–14 digitalis-induced, 431 Stevens-Johnson syndrome (SJS), 441–442 pneumonia, 109, 117 STI (sexually transmitted illnesses), orchitis caused by, sepsis, 384 184 supraventricular (SVT), 45–48, 58 stool, blood in, 346, 350 paroxysmal (PSVT), 317–319 stool culture, Escherichia coli O157:H7 infection, 349–350 ventricular (See ventricular tachycardia (VT)) straight-leg-raise test, 206 tachypnea Streptococcus bronchiolitis, 333–335 pneumonia caused by, 334 sepsis, 384 septic arthritis caused by, 288–289 TAD (thoracic aortic dissection), 70–71 Streptococcus constellatus infection, 383–386 Takotsubo cardiomyopathy, 61–64 Streptococcus pneumoniae sepsis, purpura fulminans from, target sign, 347 379–382 TAT (thrombin-antithrombin) complexes, 438 streptomycin, 393 tazobactam, 184, 312, 369, 388 stress, chest pain following, 61 TB (tuberculosis), miliary, 391–393 stroke TBI (traumatic brain injury), 248–249, 326–327 with atrial fibrillation, 30–31 Td (tetanus toxoid), 313 cerebellar, 201–204 Tdap (tetanus, diphtheria and pertussis toxoid), 313 hemorrhagic, 355, 363–365 TEE. See transesophageal echocardiography pediatric, 188–191, 353–355, 363–365 temporal arteritis, 13–15 vertebrobasilar, 219–222 TEN (toxic epidermal necrolysis), 442 Stryker device, 236, 267 tendon injuries, hand, 307–309 ST-segment elevation myocardial infarction (STEMI), 50–52 tension pneumothorax, 242–243 acute anterior, 79–82 testicular abscesses, 183–185 subarachnoid hemorrhage (SAH) testicular torsion, 184 spontaneous, 193–196 tetanus, diphtheria and pertussis toxoid (Tdap), 313 traumatic, 213–217, 247–249 tetanus immune globulin (TIG), 313 subdural hematoma (SDH), 248, 325–327 tetanus prophylaxis guidelines, 313 subluxation injury tetanus toxoid (Td), 313 cervical spine, 254–257 tetracycline, 361, 431 elbow, 261–263, 279–282 thigh compartment syndrome (CS), 235–237, 292 subungual abscess, 297–298 thigh trauma, 291–293 suicide attempt thoracic aortic dissection (TAD), 70–71 acetaminophen overdose, 403–406 thoracic aortic intramural hematoma (IMH), 91–93 alkali ingestion, 425–427 thoracic injuries, penetrating, 241–244 sulbactam, 114 thoracostomy, 242–243 superior mesenteric artery (SMA), 133 thoracotomy, 243 embolic occlusion, 152 Thoravent, 97, 98 superior mesenteric vein (SMV), 133 thrombin-antithrombin (TAT) complexes, 438 supracondylar fracture, 261–263, 276 thrombocytopenia supraventricular tachycardia (SVT), 45–48, 58 acute myelogenous leukemia (AML), 446–447 paroxysmal (PSVT), 317–319 thrombotic thrombocytopenic purpura (TTP), 437–438 surgical consultation, 231, 300 thrombolysis, 52, 81–82 suturing, finger laceration, 308 for cerebral venous thrombosis (CVT), 211 SVT (supraventricular tachycardia), 45–48, 58 contraindications, 71, 81 pediatric, 317–319 for pulmonary embolism (PE), 101–107 sweats for stroke, 191, 203, 221 acute myelogenous leukemia (AML), 445 thrombosis miliary tuberculosis, 391 with atrial fibrillation, 30–31 Sweet’s syndrome, 457–460 cerebral venous (CVT), 209–212 swelling. See edema internal jugular vein, 465–467

488 Subject index

thrombosis (cont.) tropicamide, 18 mesenteric, 152–153 troponin I, 26, 43, 44, 46, 58, 105, 322, 445, 451 middle cerebral artery (MCA), 190 TSAH (traumatic subarachnoid hemorrhage), 213–217, 247–249 popliteal vein, 453–456 TSH (thyroid-stimulating hormone), 463 venous, 103, 105–106 TTE. See transthoracic echocardiography thrombotic thrombocytopenic purpura (TTP), 350, 437–439 TTP (thrombotic thrombocytopenic purpura), 350, 437–439 thumb, subungual abscess, 297 tuberculin skin test, 393 “thumbprint” sign, 4 tuberculosis (TB), miliary, 391–393 thyroid-stimulating hormone (TSH), 463 TVUS (transvaginal ultrasound), 174 TIAs (transient ischemic attacks), 190, 203, 355 Tylenol. See acetaminophen tibial plateau fracture, 283–286 tick bite, Lyme disease, 357–361 UA. See urinalysis TIG (tetanus immune globulin), 313 UFH (unfractionated heparin), 455, 466 tissue plasminogen activator (t-PA), 103, 106, 191, 203, 221 UGI (upper gastrointestinal series), midgut malrotation, 133 TMP-SMX (trimethoprim-sulfamethoxazole), 184 ulnar fracture, 269–271, 279–282 tobramycin, 6 ultrasonography. See also echocardiography “top of the basilar” syndrome, 219–222 abdominal aortic aneurysm (AAA), 155–157 torsades de pointes, 75 appendicitis, 125 toxic epidermal necrolysis (TEN), 442 cerebellar stroke, 203 t-PA (tissue plasminogen activator), 103, 106, 191, 203, 221 cholecystitis, 147–150 tracheal foreign body, 342 deep vein thrombosis (DVT), 103, 105, 454–455, 466 traction devices, for femoral fracture, 292 ectopic pregnancy, 173–174 transcutaneous pacing, 51–52, 89 epididymo-orchitis, 184 transesophageal echocardiography (TEE) hepatic abscess, 385 aortic dissection, 40, 71, 86 intestinal intussusception, 347 pulmonary embolism (PE), 105 intra-abdominal injury (IAI), 227 ventriculoatrial shunt infection, 111 Meckel’s diverticulitis, 137 transient ischemic attacks (TIAs), 190, 203, 355 midgut malrotation, 133 transthoracic echocardiography (TTE) ovarian torsion, 166 aortic dissection, 40 penetrating thoracic injury, 243 pericarditis, 43 psoas muscle abscess, 389 pulmonary embolism (PE), 105 rectus sheath hematoma (RSH), 246 ventriculoatrial shunt infection, 111 retinal detachment, 9–10 transvaginal ultrasound (TVUS), 174 septic arthritis, 289 transvenous pacing, 75, 89 splenic laceration, 225 trauma splenomegaly, 128 alkali ingestion, 426 ureteral colic, 171 blunt abdominal, 227–228 uterine arteriovenous malformation (AVM), 179–180 cat bite, 311–313 unfractionated heparin (UFH), 455, 466 cervical spine fracture, 239–240, 251–253 unifascicular blocks, 75 cervical spine subluxation, 254–257 upper gastrointestinal series (UGI), midgut malrotation, 133 elbow, 261–263, 270, 275–277, 279–282 ureteral colic, 169–172 in elderly patients, 253, 284 urinalysis (UA) ﬁnger laceration, 307–309 appendicitis, 123, 125 foot, 265–268, 273–274 intra-abdominal injury (IAI), 227 forearm, 269–271, 279–282 nephrotic syndrome, 435–436 genital, 177–178 rhabdomyolysis, 411, 413 gunshot wound (GSW), 231, 241–244 stab wounds, 232 hand (See ﬁngers; hands) ureteral colic, 169, 171 knee, 283–286 urinary alkalinization, for rhabdomyolysis, 413 ocular, 5–7 urinary incontinence, back pain with, 207 rectus sheath hematoma (RSH), 245–246 urinary tract infection (UTI) snakebite, 415–419 orchitis caused by, 184 splenic, 225–228 ureteral colic with, 169–172 stab wound, 229–233 urinary tract stones, 169–172 tetanus prophylaxis guidelines, 313 urokinase, 211 thigh, 291–293 urology consultation, 171, 178, 184 traumatic brain injury (TBI), 248–249, 325–327 urosepsis, 169–172 traumatic subarachnoid hemorrhage (TSAH), 213–217, 247–249 urticaria, 422 travelers uterine arteriovenous malformation (AVM), 179–181 malaria in, 373–377 uterine curettage, diagnostic, 174 pneumococcal sepsis in, 379–382 UTI (urinary tract infection), 169–172 tuberculosis in, 391–393 orchitis caused by, 184 Treacher Collins syndrome, 329 ureteral colic with, 169–172 tremor artifact, 402 triamcinolone, 442 vaccines, tetanus, 313 trifascicular block, 75 vagal maneuvers, for supraventricular tachycardia (SVT), 46–48, 58, trimethoprim-sulfamethoxazole (TMP-SMX), 184 319

Subject index 489

vaginal bleeding acute myelogenous leukemia (AML), 445 acute myelogenous leukemia (AML), 445 appendicitis, 124 ectopic pregnancy, 173–174 blood with, 241 uterine arteriovenous malformation (AVM), 179–180 diabetic ketoacidosis (DKA), 449, 452 Valium, 240 head trauma, 326–327 vancomycin hemolytic uremic syndrome (HUS), 348 for orbital cellulitis, 6–7 ileocolic intussusception, 345 for pneumococcal sepsis, 381 intracerebral hemorrhage (ICH), 363 for psoas muscle abscess, 388 midgut malrotation, 131 for septic arthritis, 288 obstructive hydrocephalus, 337 for spinal epidural abscess, 198 subarachnoid hemorrhage (SAH), 193–194, 216 for vertebral osteomyelitis, 369 ventriculoatrial shunt infection, 109 Vantin. See cefpodoxime proxetil von Willebrand factor (vWF), 438 vascular surgery consultation, 39, 70, 156–157 VP (ventriculoperitoneal) shunts, 111 VA (ventriculoatrial) shunt infection, 109–112 VT (ventricular tachycardia), 47–48, 57–59, 73, 75 vasodilators. See also specific drug VTE (venous thromboembolism), 103, 105–106, 453–456 for aortic dissection, 71, 86 vWF (von Willebrand factor), 438 vasopressors, for septic shock, 384 VATS (video-assisted thoracoscopic surgery), 35 Wallenberg syndrome, 203, 221 venography warfarin cerebral venous thrombosis (CVT), 211 for aortic aneurysm, 56 deep vein thrombosis (DVT), 466 for atrial fibrillation, 31 venoms, snake, 417 for cardiac tamponade, 54 venous thromboembolism (VTE), 103, 105–106, 453–456 for cerebral venous thrombosis (CVT), 210–211 venous thrombosis, cerebral (CVT), 209–212 for deep vein thrombosis (DVT), 466 ventilation/perfusion (V/Q) scanning, pulmonary embolism (PE), 105 for pulmonary embolism (PE), 454–455 ventricular collapse, with cardiac tamponade, 35, 55–56 for stroke, 203 ventricular fibrillation, 402 WBC (white blood cell) count. See leukocyte count ventricular tachycardia (VT), 47–48, 57–59, 75 WCT (wide complex tachycardia), 47, 57–59, 73, 75 converting to complete heart block, 73–77 weakness idiopathic fascicular (IFVT), 21–23 aortic dissection, 37 ventriculoatrial (VA) shunt infection, 109–112 atrioventricular (AV) block, 65–67, 87 ventriculoperitoneal (VP) shunts, 111 cauda equina syndrome (CES), 205–206 verapamil, 319, 431 cerebral venous thrombosis (CVT), 209 vertebral artery dissection, 201–204 cerebrovascular accident (CVA), 188 vertebral fracture, cervical, 239–240, 251–253 cervical spine subluxation, 254 vertebral osteomyelitis, 369–371 diabetic ketoacidosis (DKA), 452 psoas muscle abscess with, 387–389 Moyamoya disease (MMD), 353 vertebrobasilar stroke, 219–222 panhypopituitarism, 461 vertigo. See dizziness rhabdomyolysis, 411, 413 Vicodin, 240 spinal epidural abscess, 197, 199 video-assisted thoracoscopic surgery (VATS), 35 weight loss, miliary tuberculosis, 391 viral infection Wells criteria cardiac tamponade caused by, 35 for deep vein thrombosis (DVT), 454–455 lower respiratory tract, 333–336 for pulmonary embolism (PE), 104 Virchow’s triad, 103, 454 Wenckebach (Mobitz I) block, 67 vision, blurred, 17 Westermark’s sign, 105 vision loss whirlpool sign, 133, 140 endophthalmitis, 5–7 white blood cell (WBC) count. See leukocyte count retinal detachment, 9–11 wide complex tachycardia (WCT), 47, 57–59, 73, 75 temporal arteritis, 13–15 Wolff-Parkinson-White syndrome (WPWS), 317–319 visual field defect, 9 wounds. See trauma; specific injury vitamin K, 55, 106, 404 WPWS (Wolff-Parkinson-White syndrome), 317–319 vitrectomy, 18 vitritis, 5–7 xanthochromia, 195 volume augmentation, for cardiac tamponade, 35, 36, 56 volvulus Zofran cecal, 139–141 for aortic dissection, 39 duodenal, 131–134 for Meckel’s diverticulitis, 135 vomiting for ovarian torsion, 165 abdominal aortic aneurysm (AAA), 157 for snakebite, 415 acetaminophen overdose, 403 for subarachnoid hemorrhage (SAH), 193