Key Concepts Constipation is a variable term used by patients and may refer to straining with defecation, hard or infrequent stools, pain with a bowel movement, a sensation of incomplete evacuation, or abdominal bloating. Primary constipation is caused by functional…
Key Concepts Hospital-acquired Clostridioides difficile and norovirus infection are the most prevalent causes of fatal illness from diarrhea in the United States. Key elements of the history in the patient with diarrhea include recent travel, hospitalization or antibiotic use, dietary…
Key Concepts Routine placement of a nasogastric tube in patients with suspected upper gastrointestinal bleeding (UGIB) is not recommended, because this procedure fails to reliably provide useful data to guide management and is associated with unnecessary patient discomfort and potential…
Key Concepts Nausea and vomiting can result from a primary problem in the gastrointestinal (GI) tract but can also result from problems in the neurological, vestibular, urogenital, cardiac, or other systems. In the acutely vomiting patient, associated symptoms and medication…
Key Concepts Jaundice is the clinical manifestation of elevated serum bilirubin, which arises through the metabolism of hemoglobin. Elevated bilirubin occurs when: (1) increased bilirubin is produced due to hemolysis, (2) liver dysfunction prevents conjugation of bilirubin, (3) an obstruction…
Key Concepts While the etiology of abdominal pain is frequently benign, requiring little work-up or intervention, abdominal pain can also be the presenting symptom of catastrophic illness, requiring life-saving interventions to be implemented within minutes to hours (see Table 23.1…
Key Concepts Tension pneumothorax is a clinical diagnosis, treated with needle decompression, followed by tube thoracostomy. Patients with suspected acute coronary syndrome (ACS) are risk-stratified by history, electrocardiogram (ECG), and troponin levels. Those with ST segment elevation myocardial infarction (STEMI)…
Key Concepts Dyspnea results from a variety of conditions, ranging from nonurgent to life-threatening. Neither the clinical severity nor the patient’s perception correlates well with the seriousness of underlying pathology. Dyspnea is subjective and the differential diagnosis can be divided…
Key Concepts Hemoptysis is caused by infection, trauma, cancer, or coagulopathy or as a complication of invasive pulmonary procedures. “Massive hemoptysis” is defined as greater than 100 mL of blood loss or approximately ½ cup of blood in a 24-hour…
Key Concepts Sore throat can indicate a range of pathology, from simple pharyngitis to deep space infection, with or without airway compromise. Physical examination, supplemented by nasopharyngoscopy when appropriate, is key to determining threats to the airway and establishing a…