Key Concepts Critical diagnoses, such as caustic injury, orbital compartment syndrome, and narrow angle (acute angle closure) glaucoma, require immediate treatment and ophthalmology consultation. Prompt and prolonged irrigation is essential for patients who experience caustic injury to the eye. Headache…
Key Concepts The diagnostic approach to diplopia is aimed at determining (1) if the diplopia is monocular, (2) if there is a restrictive or mechanical issue in the orbit or orbital structures, (3) if there is a palsy of one…
Key Concepts Patients with a known headache disorder who present with a change in the character of the headache should be evaluated for potential serious causes. The physical examination in the headache patient focuses primarily on mental status, funduscopic exam,…
Key Concepts Neurologic complaints, such as imbalance, dysarthria, or numbness in patients with dizziness/vertigo raise the likelihood of transient ischemic attack (TIA) or stroke as the cause. Benign paroxysmal positional vertigo (BPPV) requires head movement to elicit symptoms. Consequently, the…
Key Concepts Lifetime seizure incidence reaches up to 10% in the US population and depends upon multiple factors including age, history of epilepsy, structural brain or neurodegenerative disease, genetic predisposition, acuity and severity of metabolic derangements. Seizures are the result…
Key Concepts Confusion and delirium are symptoms, not a diagnosis. Focal cortical dysfunction, such as from tumor or stroke, typically does not cause confusion. Any underlying clinical process that disrupts optimal central nervous system (CNS) functioning can result in confusion.…
Key Concepts Coma is a state of depressed consciousness in which a patient is not aware, is not awake, and does not respond to vigorous stimulation. Consciousness consists of arousal (subcortical) and awareness (cortical). Damage to the dorsal brainstem, thalamus,…
Foundations Epidemiology Syncope is a common clinical entity with a lifetime prevalence between 20% and 40%, and is slightly more common in women than in men. Key Concepts Syncope is defined as a sudden, spontaneous loss of consciousness and postural…
Key Concepts Cyanosis occurs due to an absolute amount of desaturated hemoglobin (∼5 g/dL) rather than a percentage; anemic patients exhibit cyanosis at a lower Pa o 2 than those with normal hemoglobin levels. Cyanosis is an insensitive indicator of…
Key Concepts Weakness is a common complaint among emergency department (ED) patients, with a preponderance in elders and those with chronic disease, and therefore may require a broad approach to investigating underlying causes. Patients may use the term weakness to…