First Aid for the Emergency Medicine Oral Boards, Second Edition

Title Page......Page 2
Copyright Page......Page 3
Dedication......Page 6
Contents......Page 7
Contributors......Page 21
Preface......Page 32
Section 1. Taking the Boards......Page 33
Chapter 1. Introduction and Technique......Page 34
Introduction......Page 35
Detailed Description of the Exam Day......Page 36
The Oral Board Exam Format......Page 37
Recommended Study Plan......Page 43
General Information......Page 46
Approach......Page 47
Section 2. Resuscitation and Procedures......Page 75
Initial Assessment......Page 76
Basic Airway Management......Page 79
Noninvasive Ventilatory Support......Page 80
Indications for Intubation......Page 81
Initial Approach to Intubation......Page 82
Orotracheal Intubation Technique......Page 85
Chapter 3. Shock......Page 97
Definition of Shock......Page 98
Pathophysiology......Page 99
Recognizing Shock......Page 101
Identify the Cause......Page 103
The Bottom Line......Page 110
Chapter 4. BLS/ACLS......Page 112
BLS: Basic Life Support......Page 114
ACLS: Advanced Cardiac Life Support......Page 115
Immediate Interventions......Page 117
Cardiac Arrest Algorithms......Page 118
Management of Bradycardia......Page 123
Management of Tachycardia......Page 125
Initial Assessment......Page 132
Basic Life Support......Page 133
NRP......Page 144
Joint Injuries/Reductions......Page 147
Section 3. Cardinal Symptoms......Page 175
Chapter 7. Fever......Page 176
Initial Assessment......Page 177
Initial History and Physical Examination......Page 178
Differential Diagnosis......Page 181
Urinary Tract Infections......Page 183
Endocarditis......Page 186
Neutropenic Fever......Page 188
HIV/AIDS......Page 190
Cellulitis/Necrotizing Fasciitis......Page 192
Thyroid Storm......Page 195
Chapter 8. Chest Pain......Page 201
Initial Assessment......Page 202
Initial History and Physical Examination......Page 203
Differential Diagnosis......Page 204
Acute Coronary Syndrome......Page 205
Aortic Dissection......Page 215
Pulmonary Embolism......Page 228
Pneumothorax......Page 233
Chapter 9. Syncope and Palpitations......Page 240
Initial History and Physical Examination......Page 242
Differential Diagnosis......Page 244
Reflex-Mediated Syncope......Page 246
Orthostatic Hypotension Syncope......Page 248
Neurologic Syncope......Page 250
Cardiovascular Syncope......Page 252
Chapter 10. Shortness of Breath......Page 263
Initial Assessment......Page 264
Initial History and Physical Examination......Page 265
Differential Diagnosis......Page 267
Asthma......Page 270
COPD Exacerbation......Page 274
Congestive Heart Failure/Pulmonary Edema......Page 276
Cardiac Tamponade......Page 281
Pneumonia......Page 284
Chapter 11. Sore Throat/Dysphagia......Page 290
Initial History and Physical Examination......Page 291
Differential Diagnosis......Page 294
Ludwig Angina......Page 298
Epiglottitis......Page 301
Peritonsillar Abscess......Page 304
Chapter 12. Abdominal Pain......Page 307
Initial History and Physical Examination......Page 310
Peritonitis/SBP/PD Related......Page 316
Intestinal Obstruction......Page 321
Mesenteric Ischemia......Page 328
Perforated Viscus......Page 333
Appendicitis......Page 338
Pancreatitis......Page 342
Cholecystitis/Cholangitis......Page 346
Diverticulitis/Abscess......Page 351
Pelvic Pain/PID/TOA......Page 355
Ovarian Torsion......Page 358
Chapter 13. GI Bleed......Page 364
Initial History and Physical Examination......Page 365
Differential Diagnosis......Page 367
Upper GI Bleed......Page 368
Lower GI Bleed......Page 372
Chapter 14. Back Pain......Page 376
Initial History and Physical Examination......Page 377
Physical Examination......Page 378
Differential Diagnosis......Page 379
Abdominal Aortic Aneurysm......Page 381
Epidural Abscess......Page 384
Chapter 15. Painful Extremity......Page 389
Initial History and Physical Examination......Page 390
Arterial Embolus......Page 392
Deep Venous Thrombosis......Page 395
Septic Joint......Page 398
Acute Compartment Syndrome......Page 401
Chapter 16. Altered Mental Status: Toxicology Emergencies......Page 405
Initial History and Physical Examination......Page 412
Acetaminophen......Page 432
Salicylates......Page 435
Beta-Blocker/Calcium Channel Blocker......Page 438
Cardiac Glycoside (Digoxin)......Page 440
Theophylline......Page 442
Valproic Aid (Depacon, Depakene, Depakote)......Page 445
Tricyclic Antidepressants......Page 447
Antipsychotics......Page 451
Lithium......Page 452
Iron......Page 454
Lead......Page 457
Methemoglobinemia......Page 461
Carbon Monoxide......Page 462
Cyanide......Page 465
Hydrocarbon and Petroleum Distillates......Page 467
Organophosphates/Nerve Agents......Page 469
Ethylene Glycol......Page 471
Methanol......Page 474
Opioids......Page 477
Anticholinergic......Page 479
Cocaine and Amphetamines (Methylphenidate, Metamphetamine)......Page 481
Serotonin Syndrome......Page 483
Neuroleptic Malignant Syndrome......Page 485
Chapter 17. Altered Mental Status: Environment and Endocrine......Page 489
Initial Assessment/Intervention......Page 492
Initial History and Physical Examination......Page 493
Differential Diagnosis......Page 494
Hyperthermia......Page 496
Hypothermia......Page 498
High-Altitude Illness......Page 502
Endocrine: Myxedema Coma......Page 505
Hypoglycemia......Page 507
Acute Adrenal Insufficiency......Page 509
Diabetic Ketoacidosis......Page 511
Hyperosmolar Hyperglycemic State......Page 514
Hypernatremia......Page 515
Hypercalcemia......Page 517
Chapter 18. Headache......Page 521
Initial Assessment......Page 522
Initial History and Physical Examination......Page 523
Differential Diagnosis......Page 525
Subarachnoid Hemorrhage......Page 527
Temporal Arteritis......Page 529
Subdural Hematoma......Page 530
Hypertensive Encephalopathy......Page 531
Idiopathic Intracranial Hypertension AKA Pseudotumor Cerebri......Page 533
Meningitis and Encephalitis......Page 534
Chapter 19. Weakness......Page 536
Initial History and Physical Examination......Page 538
Differential Diagnosis......Page 539
Acute Renal Failure......Page 540
Rhabdomyolysis......Page 544
Hyperkalemia......Page 546
Hypokalemia......Page 549
Chapter 20. Paralysis......Page 554
Initial History and Physical Examination......Page 555
Differential Diagnosis......Page 557
Ischemic Stroke......Page 558
Spinal Cord Compression......Page 563
Guillain-Barré Syndrome......Page 565
Myasthenia Gravis......Page 566
Chapter 21. Seizure......Page 570
Initial History and Physical Examination......Page 572
Differential Diagnosis......Page 574
Generalized Seizure Disorders......Page 576
Status Epilepticus......Page 579
Meningitis......Page 582
Metabolic Abnormalities......Page 584
Alcohol Withdrawal/DTS......Page 585
Head Trauma......Page 586
Management......Page 591
Chapter 22. Eye Problems......Page 593
Initial History and Physical Examination......Page 595
Differential Diagnosis......Page 597
Acute Angle-Closure Glaucoma......Page 604
Endophthalmitis......Page 606
Anterior Uveitis (Iritis)......Page 607
Corneal Ulcer......Page 609
Central Retinal Artery Occlusion......Page 611
Chapter 23. Rash and Skin Complaints......Page 616
Initial Assessment......Page 617
Initial History and Physical Examination......Page 618
Differential Diagnosis......Page 621
Urticaria/Angioedema......Page 626
Anaphylaxis......Page 630
Risk Stratification......Page 631
Erythema Multiforme......Page 633
Chapter 24. Acid–Base Derangements......Page 636
Stepwise Approach to Acid–Base Interpretation......Page 637
Respiratory Alkalosis......Page 638
Metabolic Acidosis......Page 639
Metabolic Alkalosis......Page 640
Section 4. Special Populations......Page 641
Chapter 25. Trauma Patients......Page 642
Initial Trauma Assessment and Resuscitation......Page 644
System-Based Approach to the Trauma Patient: Head Injuries......Page 649
Maxillofacial Injuries......Page 655
Vascular Neck Trauma......Page 659
Thoracic Trauma......Page 661
Abdominal Trauma......Page 662
Spinal Trauma......Page 668
Pelvic Trauma......Page 674
Musculoskeletal Trauma......Page 679
Chapter 26. Burn Patients......Page 688
Initial Assessment......Page 689
Initial History and Physical Examination......Page 690
Differential Diagnosis......Page 692
Electrical Burn......Page 693
Chemical Burn......Page 698
Thermal Burn......Page 702
Chapter 27. Pregnant Patients......Page 707
Initial Assessment......Page 708
Initial History and Physical Examination......Page 709
Differential Diagnosis/Common Emergency Presentations of Pregnancy......Page 710
Ectopic Pregnancy......Page 714
Placenta Previa......Page 718
Placental Abruption......Page 720
Pre-Eclampsia/Eclampsia/HELLP Syndrome......Page 723
Chapter 28. The Dialysis Patient......Page 727
Initial Assessment......Page 728
Initial History and Physical Examination......Page 729
Differential Diagnosis......Page 731
Hyperkalemia......Page 735
Pericardial Tamponade......Page 738
Volume Overload......Page 740
Bleeding From Vascular Access Site......Page 742
Chapter 29. Emergencies in Sickle Cell Patients......Page 745
Initial History and Physical Examination......Page 746
Differential Diagnosis......Page 748
Acute Chest Syndrome......Page 749
Sepsis......Page 752
Review Initial Results......Page 753
Aplastic Crisis......Page 754
Splenic Sequestration......Page 755
Initial Assessment......Page 757
Initial History and Physical Examination......Page 758
Differential Diagnosis......Page 760
Acquired Bleeding Disorders......Page 761
Hereditary Bleeding Disorders......Page 765
Chapter 31. Psychiatric Emergencies......Page 770
Initial History and Physical Examination......Page 771
Depression/Suicide......Page 773
Psychosis......Page 776
Sexual Assault......Page 779
Section 5. Pediatric Patients......Page 784
Chapter 32. Pediatric Fever......Page 785
Initial History and Physical Examination......Page 787
Differential Diagnosis......Page 790
Fever of Unknown Etiology: 0-1-Month Age Group......Page 794
1-3-Month Age Group......Page 796
3-36-Month Age Group......Page 801
Meningococcemia......Page 806
Rocky Mountain Spotted Fever......Page 809
Kawasaki Disease......Page 811
Cellulitis......Page 814
Fever With Joint Pain......Page 816
Osteomyelitis......Page 817
Chapter 33. Pediatric Shortness of Breath......Page 821
Initial Assessment......Page 823
Initial History and Physical Examination......Page 824
Differential Diagnosis......Page 827
Congenital Cardiac Abnormalities......Page 833
Asthma......Page 837
Bronchiolitis......Page 839
Pediatric Foreign Bodies......Page 842
Croup......Page 844
Acute Events in Infancy Including Brief Resolved Unexplained Events (BRUE)......Page 846
Chapter 34. Pediatric Sore Throat......Page 853
Initial Assessment......Page 854
Initial History and Physical Examination......Page 855
Differential Diagnosis......Page 857
Acute Bacterial Pharyngitis......Page 860
Acute Viral Pharyngitis......Page 863
Epiglottitis......Page 864
Mononucleosis......Page 867
Retropharyngeal Abscess......Page 869
Diphtheria......Page 871
Chapter 35. Pediatric Abdominal Pain......Page 875
Initial Assessment......Page 876
Initial History and Physical Examination......Page 877
Differential Diagnosis......Page 879
Infantile Hypertrophic Pyloric Stenosis......Page 882
Intussusception......Page 885
Midgut Volvulus......Page 890
Testicular Torsion......Page 893
Appendicitis......Page 897
Chapter 36. Pediatric Joint Pain......Page 903
Initial History and Physical Examination......Page 904
Mechanical Causes of Joint Pain or Limping......Page 906
Systemic/Inflammatory Causes of Joint Pain or Limping......Page 907
Common Fractures and Dislocations in Children......Page 908
Slipped Capital Femoral Epiphysis......Page 916
Legg-Calvé-Perthes Disease......Page 918
Transient Synovitis......Page 920
Septic Arthritis......Page 921
Chapter 37. Pediatric Seizure......Page 925
Initial Assessment......Page 926
Initial History and Physical Examination......Page 927
Differential Diagnosis......Page 929
Generalized Seizure Disorder......Page 932
Status Epilepticus......Page 934
Febrile Seizures......Page 937
Meningitis......Page 939
Metabolic Abnormalities......Page 941
Head Trauma......Page 943
Chapter 38. Pediatric Trauma......Page 952
Initial Assessment......Page 954
Immediate Actions......Page 955
Differential Diagnoses and Considerations: The Secondary Survey......Page 958
Head Trauma......Page 960
Neck Trauma......Page 964
Chest Trauma......Page 967
Abdominal Trauma......Page 971
Genitourinary Trauma......Page 973
Child Abuse......Page 974
Near Drowning......Page 976
Section 6. The Cases......Page 979
1. 55 y/o Male With Chest Pain......Page 981
2. 44 y/o Female With Headache......Page 994
3. 20 y/o Male Pedestrian Struck by a Car......Page 1004
4. A 24 y/o Female With Vaginal Bleeding......Page 1017
5. 55 y/o Male With Mental Status Changes......Page 1025
6. A 50 y/o Female With Syncope......Page 1034
7. 35 y/o Male With Head Injury......Page 1044
8. 70 y/o Female With Abdominal Pain......Page 1056
9. 1 mo/o Male With Fever of Unknown Origin......Page 1067
10. 6 y/o Female With Abdominal Pain......Page 1077
11. 90 y/o Male With Headache......Page 1085
12. 50 y/o Female Dialysis Patient With Fever......Page 1095
13. 44 y/o Male With Hypotension......Page 1105
14. 16 y/o Female With Mental Status Change......Page 1116
15. 40 y/o Male With Chest Pain......Page 1129
16. 28 y/o Female With HIV, Back Pain, and Fever......Page 1143
17. 85 y/o Male With Abdominal Pain......Page 1153
18. 45 y/o Female With Shortness of Breath......Page 1164
19. 2 y/o Fussy Male With Abdominal Pain......Page 1180
20. 24 y/o Female Who Has a Fall......Page 1192
21. 55 y/o Male With Sore Throat......Page 1201
22. 33 y/o Female With Headache and Weakness......Page 1211
23. 1½ y/o Male With SOB......Page 1218
24. 35 y/o Female Pedestrian Struck by an Auto......Page 1227
25. 24 y/o Male With Gunshot Wound to Chest and Neck......Page 1238
26. 5 y/o Female With Abdominal Pain......Page 1249
27. 7 y/o Male With Asthma......Page 1260
28. A 22 y/o Female With Abdominal Pain......Page 1267
29. A 68 y/o Male With Shortness of Breath......Page 1277
30. 28 y/o Female in an MVA......Page 1286
31. 2 y/o Female With Seizure......Page 1296
32. 8 mo/o Female With SIDS/PALS......Page 1309
33. 38 y/o Male With Thermal Burns......Page 1324
34. 44 y/o Female With Fever and Bizarre Behavior......Page 1333
35. 88 y/o Male With Fever and Change in Mental Status......Page 1346
36. 80 y/o Female With Weakness......Page 1358
37. 38 y/o Male With Sore Throat and Fever......Page 1370
38. 55 y/o Female With Hematemesis......Page 1380
39. 28 y/o Male With Sickle Cell Disease and Chest Pain......Page 1390
40. 68 y/o Female With Palpitations......Page 1400
41. 58 y/o Male With Shortness of Breath......Page 1416
42. 35 y/o Female With Depression and Suicide Attempt......Page 1426
43. 44 y/o Male With Weakness......Page 1435
44. 78 y/o Female With Paralysis......Page 1447
45. A 2 y/o Male Near Drowning......Page 1458
46. Situation Encounter: A 14 y/o Male With a Limp, a 45 y/o Male With Shoulder Pain, and a Woman With Abdominal Pain......Page 1478
47. Situation Encounter: A 24 y/o Male With a Hand Laceration, a 62 y/o Female With SOB, and a 2 y/o Male With SOB......Page 1500
48. Situation Encounter: A 74 y/o Female With Mental Status Changes, a 45 y/o Male With a Headache and Syncope, and an 8 y/o Male With SOB......Page 1521
49. Situation Encounter: A 10 y/o Male Struck by a Car, a 22 y/o Male With Hemophilia and a Hand Laceration, and a 36 y/o Female With Acute Abdominal Pain......Page 1543
50. Situation Encounter: A 2 y/o Febrile Child, an 85 y/o Male With Eye Pain, and a 48 y/o Male With CP......Page 1564
Index......Page 1589