Essentials 1 Abdominal pain accounts for 4% to 10% of all emergency department visits. 2 Abdominal pain most frequently arises from pathologies in the gastrointestinal and the genitourinary systems; however, it may also result from cardiovascular, pulmonary, metabolic, infective and/or…
Essentials 1 Dysphagia is a diagnostic challenge and a broad differential diagnosis should be considered. A carefully taken history will reveal the likely cause in most cases. 2 Dysphagia due to a new-onset stroke, pharyngeal or oesophageal disorder will increase…
Essentials 1 Most patients are stable and can be managed and investigated as outpatients. 2 It is essential to differentiate between haemoptysis, haematemesis and bleeding from the upper airway. 3 Chest x-ray is normal in 30% of patients with haemoptysis…
Essentials 1 In the majority of patients, a posteroanterior and lateral chest x-ray will confirm and localize an effusion. Ultrasound, lateral decubitus films and computed tomography scanning are more sensitive in diagnosing and localizing small effusions. 2 Pleural fluid analysis…
Essentials 1 Pneumothorax can occur spontaneously, as a result of trauma or iatrogenically. Spontaneous pneumothorax has traditionally been further subdivided into primary and secondary (related to underlying lung pathology). The utility of this distinction is being challenged, as there is…
Essentials 1 Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation that is not fully reversible. 2 The majority of exacerbations of COPD are due to infection, but other important precipitants must be excluded. 3 It is prudent to…
Essentials 1 Influenza is infectious before symptoms appear. 2 Pneumonia and exacerbation of underlying chronic disease are the most common complications of influenza. 3 The sensitivity and specificity of clinical signs is poor. Testing by polymerase chain reaction (PCR) is…
Essentials 1 The term community-acquired pneumonia refers to a syndrome of acute lower respiratory tract infection with a new infiltrate on chest x-ray (CXR) in a patient who has not been hospitalized in the preceding 14 days. 2 Recent studies…
Essentials 1 Asthma is a major health problem worldwide, resulting in significant morbidity and mortality. 2 Asthma is characterized by episodic bronchoconstriction and wheeze in response to a variety of stimuli. 3 Features suggesting an increased risk of life-threatening asthma…
Essentials 1 Management of the airway, breathing and circulation (ABCs) takes precedence over the history, examination and specific treatment of upper airway obstruction. 2 Direct laryngoscopy can be an important technique for both the investigation and management of upper airway…