First aid for the Emergency Medicine Oral Boards

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DEDICATION
Contents
Contributors
Preface
Chapter 1.0. Getting Started
	Introduction
	Timing and Location
	Detailed Description of the Exam Day
	The Oral Board Exam Format
	Content
	Pass Rates
	Recommended Study Plan
Chapter 2.0. The General Approach: Keys to Managing and Organizing Your Information
	General Information
	Approach
	Pearls
Chapter 3.1. Airway Management
	Initial Assessment
	Basic Airway Management
	Noninvasive Ventilatory Support
	Indications for Intubation
	Initial Approach to Intubation
	Orotracheal Intubation Technique
Chapter 3.2. BLS/ACLS
	BLS: Basic Life Support
	ACLS: Advanced Cardiac Life Support
	Immediate Interventions
	Management of Pulseless Arrest
	Management of Bradycardia
	Management of Acute Pulmonary Edema, Hypotension, and Shock
	Management of Tachycardia
Chapter 3.3. PALS/NALS
	Initial Assessment
	Basic Life Support
	Neonatal Advanced Life Support
Chapter 3.4. Shock
	Definition of Shock
	Pathophysiology
	Recognizing Shock
	Identify the Cause
		Table 3-4-1. The Differential Diagnosis of Shock
		• PMHx:
		• SH:
	Winning Strategies
		Key Elements Applying to All Patients
		Specifi c Treatments/Interventions (Critical Patients)
		Use of Pressors
		Other Considerations (Fig. 3-4-1)
		Figure 3-4-1. Algorithm for diagnosis of shock.
	THE BOTTOM LINE
Chapter 3.5. Trauma/ATLS Review
	General Comments
	Initial Assessment
	Primary Survey
		A: Airway Maintenance with Cervical Spine Protection
		B: Breathing and Ventilation
		C: Circulation with Hemorrhage Control
		D: Disability (Neurologic Evaluation)
		E: Exposure and Environmental Control
		Table 3-5-1. Glasgow Coma Scale
	Between the Primary and Secondary Survey
	Secondary Survey
		Pertinent History
		Head-to-toe Examination
	Completing the Case
	WINNING STRATEGIES
Chapter 3.6. Acid-Base Derangements
	Stepwise Approach to Acid-Base Interpretation
	Respiratory Acidosis
	Respiratory Alkalosis
	Metabolic Acidosis
	Metabolic Alkalosis
Chapter 3.7. Common Procedures
	Joint Injuries/Reductions
Chapter 4.1. Abdominal Pain
	Initial Assessment
	Initial History and Physical Examination
	Differential Diagnosis
	Peritonitis/SBP/PD Related
	Intestinal Obstruction
	Mesenteric Ischemia
	Perforated Viscus
	Appendicitis
	Pancreatitis
	Cholecystitis/Cholangitis
	Diverticulitis/Abscess
	Pelvic Pain/PID/TOA
	Ovarian Torsion
Chapter 4.2. Back Pain
	Initial Assessment
	Initial History and Physical Examination
	Differential Diagnosis
	Abdominal Aortic Aneurysm
	Epidural Abscess
Chapter 4.3. Bleeding Disorders
	Initial Assessment
	Initial History and Physical Examination
	Differential Diagnosis
	Acquired Bleeding Disorders
	Hereditary Bleeding Disorders
Chapter 4.4. Burns
	Initial Assessment
	Initial History and Physical Examination
	Differential Diagnosis
	Electrical Burn
	Chemical Burn
	Thermal Burn
Chapter 4.5. Change in Mental Status/Coma
	Initial Assessment/Intervention
	Initial History and Physical Examination
	Differential Diagnosis
	Hyperthermia
	Hypothermia
	High-Altitude Illness
	Endocrine: Myxedema Coma
	Hypoglycemia
	Acute Adrenal Insufficiency
	Diabetic Ketoacidosis
	Hyperosmotic Nonketotic Coma
	Hypernatremia
	Hypercalcemia
Chapter 4.6. Chest Pain
	Initial Assessment
	Initial History and Physical Examination
	Differential Diagnosis
	Acute Coronary Syndrome
	Aortic Dissection
	Pulmonary Embolism
	Pneumothorax
Chapter 4.7. Psychiatric Emergencies
	Initial Assessment
	Initial History and Physical Examination
	Differential Diagnosis
	Depression
	Psychosis
	Sexual Assault
Chapter 4.8. The Dialysis Patient
	Initial Assessment
	Initial History and Physical Examination
	Differential Diagnosis
	Hyperkalemia
	Pericardial Tamponade
	Volume Overload
	Bleeding from Vascular Access Site
Chapter 4.9. Dyspnea/Shortness of Breath
	Initial Assessment
	Initial History and Physical Examination
	Differential Diagnosis
	Asthma
	COPD Exacerbation
	Congestive Heart Failure/Pulmonary Edema
	Cardiac Tamponade
	Pneumonia
Chapter 4.10. Fever
	Initial Assessment
	Initial History and Physical Examination
	Differential Diagnosis
	Urinary Tract Infections
	Endocarditis
	Neutropenic Fever
	HIV/AIDS
	Cellulitis/Necrotizing Fasciitis
	Thyroid Storm
Chapter 4.11. GI Bleed
	Initial Assessment
	Initial History and Physical Examination
	Differential Diagnosis
	Upper GI Bleed
	Lower GI Bleed
Chapter 4.12. Headache
	Initial Assessment
	Initial History and Physical Examination
	Pain Management
	Differential Diagnosis
	Subarachnoid Hemorrhage
	Temporal Arteritis
	Subdural Hematoma
	Hypertensive Encephalopathy
Chapter 4.13. Paralysis
	Initial Assessment
	Initial History and Physical Examination
	Differential Diagnosis
	Ischemic Stroke
	Spinal Cord Compression
	Guillain-Barré Syndrome
	Myasthenia Gravis
Chapter 4.14. The Painful Extremity
	Initial Assessment
	Initial History and Physical Examination
	Differential Diagnosis
	Arterial Embolus
	Deep Venous Thrombosis
	Septic Joint
Chapter 4.15. Emergencies in Pregnancy
	Initial Assessment
	Initial History and Physical Examination
	Differential Diagnosis/Common Emergency Presentations of Pregnancy
	Ectopic Pregnancy
	Placenta Previa
	Placental Abruption
	Pre-eclampsia/Eclampsia/HELLP Syndrome
Chapter 4.16. Ophthalmologic Emergencies
	Initial Assessment
	Initial History and Physical Examination
	Differential Diagnosis
	Acute Angle-Closure Glaucoma
	Endophthalmitis
	Anterior Uveitis (Iritis)
	Corneal Ulcer
	Central Retinal Artery Occlusion
Chapter 4.17. Rash/Skin Complaints
	Initial Assessment
	Initial History and Physical Examination
	Differential Diagnosis
	Urticaria/Angioedema
	Anaphylaxis
	Erythema Multiforme
Chapter 4.18. Seizure
	Initial Assessment
	Initial History and Physical Examination
	Differential Diagnosis
	Generalized Seizure Disorders
	Status Epilepticus
	Meningitis
	Metabolic Abnormalities
	Alcohol Withdrawal/Delirium Tremens
	Head Trauma
Chapter 4.19. Emergencies in Sickle Cell Patients
	Initial Assessment
	Initial History and Physical Examination
	Differential Diagnosis
	Acute Chest Syndrome
	Sepsis
	Aplastic Crisis
Chapter 4.20. Sore Throat/Dysphagia
	Initial Assessment
	Initial History and Physical Examination
	Differential Diagnosis
	Ludwig Angina
	Epiglottitis
	Peritonsillar Abscess
Chapter 4.21. Syncope and Palpitations
	Initial Assessment
	Initial History and Physical Examination
	Differential Diagnosis
	Reflex-Mediated Syncope
	Orthostatic Hypotension Syncope
	Neurologic Syncope
	Cardiovascular Syncope
Chapter 4.22. Trauma
	Initial Assessment
	Initial History and Physical Examination
	Differential Diagnosis
	Head Trauma
	Abdominal Trauma
	Thoracic Trauma
	Neck Trauma
	Spinal Trauma
	Musculoskeletal Trauma: Facial Trauma
	Musculoskeletal Trauma: Pelvic Trauma
	Musculoskeletal Trauma: Extremity Trauma
	Musculoskeletal Trauma: Compartment Syndrome
	Musculoskeletal Trauma: Closed Fist Injury
Chapter 4.23. Weakness
	Initial Assessment
	Initial History and Physical Examination
	Differential Diagnosis
	Acute Renal Failure
	Rhabdomyolysis
	Hyperkalemia
	Hypokalemia
Chapter 4.24. Poisonings and Overdoses
	Initial Assessment/Intervention
	Initial History and Physical Examination
	Acetaminophen
	Salicylates
	Beta-Blocker/Calcium Channel Blocker
	Cardiac Glycoside (Digoxin)
	Theophylline
	Valproic Aid (Depacon, Depakene, Depakote)
	Tricyclic Antidepressants
	Antipsychotics
	Lithium
	Iron
	Lead
	Methemoglobinemia
	Carbon Monoxide
	Cyanide
	Hydrocarbon and Petroleum Distillates
	Organophosphates/Nerve Agents
	Ethylene Glycol
	Methanol
	Opioids
	Anticholinergic
	Cocaine and Amphetamines (Methylphenidate, Metamphetamine)
	Serotonin Syndrome
	Neuroleptic Malignant Syndrome
Chapter 5.1. Abdominal Pain/Vomiting
	Initial Assessment
	Initial History and Physical Examination
	Differential Diagnosis
	Pyloric Stenosis
	Intussusception
	Midgut Volvulus
	Testicular Torsion
	Appendicitis
Chapter 5.2. Pediatric Difficulty Breathing
	Initial Assessment
	Initial History and Physical Examination
	Differential Diagnosis
	Congenital Cardiac abnormalities: Tetralogy of Fallot
	Asthma
	Bronchiolitis
	Pediatric Foreign bodies
	Croup
	ALTE (“Near SIDS”)
Chapter 5.3. Pediatric Fever
	Initial Assessment
	Initial History and Physical Examination
	Differential Diagnosis
	Fever of Unknown Etiology: 0-1-Month Age Group
	1-3-month Age Group
	3-36-month Age Group
	Fever Associated with Rash
	Meningococcemia
	Rocky Mountain Spotted Fever (RMSF)
	Kawasaki Syndrome (KS)
	Fever Without Rash
	Cellulitis
	Osteomyelitis
Chapter 5.4. Pediatric Joint Pain
	Initial Assessment
	Initial History and Physical Examination
	Differential Diagnosis
	Mechanical Causes of Joint Pain or Limping
	Systemic/Inflammatory Causes of Joint Pain or Limping
	Common Fractures and Dislocations in Children
	Slipped Capital Femoral Epiphysis
	Legg-Calvé-Perthes Disease
	Toxic/Transient Synovitis
	Septic Arthritis
Chapter 5.5. Pediatric Seizure
	Initial Assessment
	Initial History and Physical Examination
	Differential Diagnosis
	Generalized Seizure Disorder
	Status Epilepticus
	Febrile Seizures
	Meningitis
	Metabolic Abnormalities
	Head Trauma
Chapter 5.6. Pediatric Trauma
	Initial Assessment
	Immediate Actions
	Differential Diagnoses and Considerations: The Secondary Survey
	Head Trauma
	Neck Trauma
	Chest Trauma
	Abdominal Trauma
	Genitourinary Trauma
	Child Abuse
	Near Drowning
Chapter 5.7. Pediatric Sore Throat
	Initial Assessment
	Initial History and Physical Examination
	Differential Diagnosis
	Acute Bacterial Pharyngitis
	Acute Viral Pharyngitis
	Epiglottitis
	Mononucleosis
	Retropharyngeal Abscess
	Diphtheria
Cases
	1. 55 y/o Male With Chest Pain
	2. 44 y/o Female With Headache
	3. 20 y/o Male Pedestrian Struck by a Car
	4. A 24 y/o Female With Vaginal Bleeding
	5. 55 y/o Male With Mental Status Changes
	6. A 50 y/o Female With Syncope
	7. 35 y/o Male With Head Injury
	8. 70 y/o Female With Abdominal Pain (AAA)
	9. 1 mo/o Male With Fever of Unknown Origin
	10. 6 y/o Female With Abdominal Pain
	11. 90 y/o Male With Headache
	12. 50 y/o Female Dialysis Patient With Fever
	13. 44 y/o Male With Hypotension
	14. 16 y/o Female With Mental Status Change
	15. 40 y/o Male With Chest Pain
	16. 28 y/o Female With HIV, Back Pain, and Fever
	17. 85 y/o Male With Abdominal Pain
	18. 45 y/o Female With Shortness of Breath
	19. 2 y/o Fussy Male With Abdominal Pain
	20. 24 y/o Female Who Has a Fall
	21. 55 y/o Male With Sore Throat
	22. 33 y/o Female With Headache and Weakness
	23. 1½ y/o Male With SOB
	24. 35 y/o Female Pedestrian Struck by an Auto
	25. 24 y/o Male With GSW to Chest and Neck
	26. 5 y/o Female With Abdominal Pain
	27. 7 y/o Male With Asthma
	28. A 22 y/o Female With Abdominal Pain
	29. A 68 y/o Male With Shortness of Breath
	30. 28 y/o Female in an MVA
	31. 2 y/o Female with Seizure
	32. 8 mo/o Female With SIDS/Pediatric ACLS
	33. 38 y/o Male With Thermal Burns
	34. 44 y/o Female With Fever and Bizarre Behavior
	35. 88 y/o Male With Fever and Change in Mental Status
	36. 80 y/o Female With Weakness
	37. 38 y/o Male With Sore Throat and Fever
	38. 55 y/o Female With Hematemesis
	39. 28 y/o Male With Sickle Cell Disease and Chest Pain
	40. 68 y/o Female With Palpitations
	41. 58 y/o Male With Shortness of Breath
	42. 37 y/o Female With Depression and Suicide Attempt
	43. 44 y/o Male With Weakness
	44. 78 y/o Female With Paralysis
	45. A 2 y/o Male Near Drowning
	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
	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
	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
	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
	50. Situation Encounter: A 2 y/o Febrile Child, a 85 y/o Male With Eye Pain, and a 48 y/o Male With CP
Index
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