V: NEUROLOGY
Delirium Definition • Acute state of temporary or fluctuating disturbance of consciousness (eg, impaired cognition, perception disturbances, reduced attention, hypo- or hyperactivity) that is caused by an organic medical condition…
EMERGENCY MEDICINE
IV: INFECTIOUS DISEASE
ENDOCARDITIS (Arch Intern Med 2009;169(5):463) History • RFs: IVDU, congenital or acquired valvular dz, prosthetic valves, structural heart dz, HD, indwelling venous catheters, cardiac surgery, bacteremia, chronic alcoholism, previous endocarditis…
III: GASTROINTESTINAL
RIGHT UPPER QUADRANT PAIN Cholelithiasis Presentation • Acute, severe, intermittent RUQ pain, +N/V, a/w fatty meals • In biliary colic, sxs generally resolve completely in b/w episodes • Mild RUQ…
XIII: OTOLARYNGOLOGY/DENTAL/OPHTHALMOLOGY
Otitis Externa (Swimmer’s Ear) Definition • Infection (Pseudomonas, S. aureus) of the outer ear due to breakdown of natural barriers History • Summer, water exposure, cotton swab trauma, hearing aids,…
XI: HEMETOLOGY & ONCOLOGY
Definition • Anaphylaxis – acute onset skin, mucosal or GI involvement w/ at least 1 of the following: Respiratory distress, hypotension, end-organ Dysfxn History • Exposures: Nuts, shellfish, medication (abx,…
XII: MUSCULOSKELETAL & RHEUMOTELOGICAL
PERIPHERAL VASCULAR DISEASE Claudication History • Ischemic muscle pain reproducible w/ exertion, improves w/ rest • Pts often place legs in dependent position to improve flow • 1–2% have chronic…
XVII: AIRWAY MANAGEMENT
• Anticipated need for airway management in pts at risk for deterioration • Assess difficulty of intubation early • In pts w/ acute respiratory failure, BVM ventilation or noninvasive positive…
VIII: DERMATOLOGY
• ROS, PMH, h/o skin lesions, travel, exposures (pets or hobbies), sick contacts, immunizations, sexual hx, menstrual hx, new medication hx (including OTC) • Physical exam: Assess for fever, hypotension,…
VI: RENAL & GENITOURINARY
URINARY TRACT INFECTIONS Definitions UTIs are classified according to a spectrum of dz & the predominant clinical sxs: Asymptomatic bacteriuria, uncomplicated lower UTI (cystitis), uncomplicated pyelonephritis, complicated UTI w/ or…
II: PULMONARY
Disposition • CAP: See PNA Severity Index Score & CURB-65 (below) • HCAP: Generally requires admission for IV abx • PCP: Inpt unless SpO2 >95% w/o desaturation on exertion •…
