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…
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,…