Emergency Medicine - Common and Serious Cases

Consciousness loss splits into gradual and sudden. Gradual cases check glucose, oxygen, and labs; sudden cases require brain CT, EEG, and cardiac tests, noting aortic stenosis as a cardiogenic cause.

Identify common newborn rashes such as nevus simplex with blanching pink patches that fade. Differentiate hemangioma, port wine stain, melanoma, congenital melanocytic nevus, congenital melanocytosis, and cafe au lait patches.

The radial nerve originates from C5 to T1, travels through axilla along the humerus, innervating the triceps and forearm extensors; injuries cause drop wrist, tested by first finger whip sensation.

Study superficial skin infections, including impetigo, folliculitis, and erysipelas, and deeper dermal infections such as eczema and foreign nucleuses. Learn cellulitis, necrotizing fasciitis, and myonecrosis with pain out of proportion.

Examine how preload, cardiac output, and afterload drive shock outcomes in heart damage, hypovolemia, and fistula-induced high-output heart failure. Track how these changes affect blood flow and pressure.

Explore vertigo diseases, from benign paroxysmal positional vertigo and endolymph fistula to vestibular schwannoma, with MRI and baseline audiometry for diagnosis.

Central vertigo from brainstem or cerebellar lesions, often tumors, shows q deviation and rapid, multi-directional eye movements; peripheral vertigo involves cranial nerve eight or inner ear with delayed horizontal nystagmus.

Identify kidney stone types: calcium oxalate, calcium phosphate, struvite, uric acid, and cystine, and their causes, risks, and treatments, including surgical excision for struvite stones.

Identify tension headaches as bilateral, band-like pain lasting 0.5–5 hours with triggers. Describe migraines as unilateral with aura and triggers, and cluster headaches as unilateral with severe eye pain.

Identify signs of liver failure, including jaundice, pruritus, spider angiomas, and palm erythema. Recognize complications such as portal hypertension with varices, ascites, hepatorenal syndrome, and hepatic encephalopathy.

Rheumatic fever is an autoimmune reaction to group A streptococci infection cross-reacting with renal tissue. Jones criteria diagnose it; penicillin treats it for five years, ten years with cardiac symptoms.

Recognize rheumatoid arthritis as an autoimmune disease linked to HLA-D4, with systemic inflammation and antibodies like rheumatoid factor and anti-cyclic cent related peptide antibodies.

Identify ophthalmia neonatorum in newborns by age, from chemical irritation within one day to Neisseria under seven days, chlamydia after seven days, viral infection after twenty days, and birth prophylaxis.

Identify sepsis as infection with end organ dysfunction and septic shock as sepsis with vital instability and lactate above 18 mg/dl; treat with source elimination, intravenous antibiotics, fluids, and vasopressors.

treat meningitis by etiology: start ceftriaxone with vancomycin and adjust after cultures; newborns with group b streptococci receive iv penicillin g or ampicillin, and hiv cryptococcal meningitis needs amphotericin b.

Under stress, the body demands rapid T3 production as organs convert T4, the inactive form, to T3, but limited conversion creates sick thyroid syndrome with normal TSH and T4.

Identify diverticulitis, an inflamed sigmoid colon diverticulum causing left abdominal pain with diarrhea or constipation. Diagnose with ct scan or colonoscopy and treat with antibiotics and a high fiber diet.

Emphysema, from smoking or alpha one antitrypsin deficiency, causes centrosomal or pan acinar destruction of alveoli, barrel-chest x-ray findings, decreased dlco, and prolonged expiration with pursed lips.

Implement choking protocols for conscious and unconscious patients, including encouraging coughing, performing back blows and the Heimlich maneuver, using chest thrusts for pregnancy or obesity, and CPR for unresponsive cases.

Identify underlying causes of delirium, including infection, withdrawal, electrolyte disturbance, urinary or fecal retention, or anticholinergics, and orient the elderly or long-stay hospital patients while avoiding sedatives.

Identify breastfeeding jaundice caused by immaturity of the bilirubin-conjugating enzyme, leading to high unconjugated (indirect) bilirubin; continue breastfeeding to counter dehydration, with phototherapy at 20 and exchange at 25.

Explore how Bordetella pertussis, a gram-negative bacterium, causes a three-stage illness—catarrhal; paroxysmal (whooping cough); convalescent—and how macrolides such as azithromycin are most effective when started in the catarrhal stage.

Identify ankle pain from sprain, Achilles tendonitis, bursitis, or fracture; rest, ice, compression, and elevation, with pain relief as needed. Seek urgent care for severe pain or inability to walk.

Classify hip pain by symptoms to identify hip strain, septic arthritis needing hospital admission and joint aspiration, fracture after trauma, or arthritis such as osteoarthritis or rheumatoid arthritis.

Identify common heel pain causes—plantar fasciitis, Achilles tendinitis, bursitis, and possible ruptures or fractures—and seek care for severe, persistent pain, numbness, or diabetes-related symptoms.

Learn seizure first aid: stay calm, time event, create a safe space, clear the airway, and position the person on their side with head supported until they are fully awake.

Lower total cholesterol and LDL through diet, exercise, weight loss, and smoking cessation, while improving HDL with fiber and fish. Escalate to statins, PCSK9 inhibitors, fibrates, and niacin if needed.

Explain how bilirubin buildup causes yellow skin and eyes, itching, pale urine, and fatty stools in jaundice. Classify jaundice as pre hepatic, hepatic, or post hepatic.

Dengue fever begins 4–6 days after a mosquito bite with high fever and rash, then headache and muscle pain, fatigue, and low platelets that can lead to dengue shock syndrome.

Understand how dengue and chikungunya spread via the Aedes mosquito, the four dengue subtypes, and the global burden, then explore prevention through environmental control, vaccination, and symptom-based treatment.

The dengue virus, a flavivirus spread by Aedes mosquitoes and often co-infected with chikungunya, can be prevented by a recombinant vaccine using yellow fever shell, plus repellents and clothing.

Explore asthma severity from intermittent to severe and implement a four-step acute exacerbation plan—salbutamol, prednisolone, magnesium, then intubation—guided by carbon dioxide levels.

Describe Bacillus anthracis as a spore-forming rod that germinates in tissues, releases toxins, and forms spores; distinguish cutaneous anthrax with a painless black eschar from pulmonary anthrax.

Explore how aortic dissection splits tunica intima, media, and adventitia to form true and false lumens, with Stanford type a or b and DeBakey types 1–3 guiding diagnosis and treatment.

Cauda equina syndrome results from compression below L2, with saddle anesthesia, sensory loss, absent reflexes, and bladder incontinence. Urgent surgery is needed, with steroids to reduce swelling.

Understand compartment syndrome, a pressure rise in confined areas from trauma, electrical burn, or excessive fluids, treated by escharotomy within six hours or fasciotomy if needed.

Gonococci are intracellular gram-negative pathogens with high mutation rates causing local spread, pelvic inflammatory disease, infertility, and septic complications; meningococci transmit by droplets and can cause meningitis.

Hemochromatosis stems from defective iron sensing, increasing iron absorption and ferritin, transferring, and iron levels with decreased total iron binding capacity; symptoms include cirrhosis and diabetes, treated by phlebotomy.

Explain the four intracranial hemorrhages—epidural, subdural, subarachnoid, intraparenchymal—by location, causes, imaging features, and key signs like lucid interval and worst headache.

Address catatonia by stopping the current medication, then treat with lorazepam and, if needed, electroconvulsive therapy, noting features like mutism, negativism, posturing, and echolalia.

Lyme disease, caused by borrelia transmitted by the deer tick, progresses in three stages with erythema migrans, carditis and Bell's palsy, then encephalopathy and chronic arthritis; treated with doxycycline.

Identify measles (rubeola), a paramyxovirus that spreads via coughing and sneezing and causes fever with cough, coryza, conjunctivitis, Koplik spots, and a maculopapular rash.

Identify pheochromocytoma, an adrenal medullary tumor from chromaffin cells linked to neurofibromatosis type one; diagnose via urinary metanephrines and treat with alpha blockers, then beta blockers, and tumor removal.

Deep vein thrombosis often causes pulmonary embolism when leg or pelvic clots reach the lungs and block blood flow. Treat with noac medications or heparin followed by warfarin.

Rabies spreads via bites from bats, raccoons, skunks, and dogs; incubation lasts weeks to months, the virus travels via nerves to brain, binding to acetylcholine receptors, with treatment after exposure.

Scarlet fever, caused by group A streptococci, presents with sandpaper rash and strawberry tongue; diagnose with rapid strep test and treat with penicillin to prevent rheumatic fever.

Identify spontaneous bacterial peritonitis as sterile abdominal infection in ascites or ESRD; diagnose with paracentesis WBC over 250, treat with antibiotics 2–3 weeks, and differentiate secondary peritonitis requiring laparotomy.

Compare newborn staphylococcal scalded skin syndrome with Stevens-Johnson syndrome and toxic epidermal necrolysis, noting non-mucosal bullae, mucosal involvement, and full-thickness skin separation.

Identify gastric and duodenal ulcers as peptic ulcers from mucosal protection defects, due to NSAIDs or H. pylori, with bleeding risk and pain with meals differentiating gastric from duodenal ulcers.

Volvulus and intussusception present as emergency conditions, with twisted or telescoped gut causing obstruction and ischemia, coffee bean sign, currant jelly stool, and urgent surgery or air enema as needed.

Highlight the copper transport defects of Wilson disease due to ATP7B or ATP7A variants, with Kayser-Fleischer ring, liver involvement, neurologic and psychiatric symptoms, and treatments like trientine, zinc, and penicillamine.

Identify common foodborne pathogens: Campylobacter, E. coli, Listeria, Norovirus, Salmonella, and Staphylococcus aureus, and learn safe handling, washing hands and produce, cooking meat properly, and when to seek care.

Identify how food poisoning affects more than 128,000 people annually in the United States and causes cramps, diarrhea, nausea, vomiting, fever, weakness, and headache.

Explore how food poisoning bacteria produce symptoms from vomiting with Staphylococcus aureus to diarrhea with Clostridium perfringens, and when bloody diarrhea points to Salmonella or Shigella, with antibiotic cautions.

Assess burns from first to third degree, including debridement, skin grafting, and infection risks. Use Parkland formula with ringer's lactate, monitor urine output, and evaluate inhalational injury.

achieve burn control through airway first, assess breathing and circulation, and tailor fluid resuscitation to body surface area, while considering admission criteria and analgesia cautions.

Assess inhalation burns from flames, as prognosis depends on airway injury depth and bronchoscopy findings. Treat with bronchodilators, antioxidants, aerosolized heparin, and 100% oxygen for carbon monoxide poisoning.

Use parkland formula and revised box score to guide fluid resuscitation with ringer's lactate, monitor urine output, and assess prognosis via age, comorbidities, and body surface area.

Explains four hypersensitivity types, including type I IgE-mediated histamine release with epinephrine reversing effects, type II antibody-mediated effects, type III immune complex–driven inflammation, and type IV delayed T cell–driven responses.

Identify atopic dermatitis as an eczema form driven by type I hypersensitivity with IgE-mediated allergy. Note it causes red, itchy skin and coexists with asthma, allergic rhinitis, and food allergies.

Identify urticaria as an allergic skin syndrome presenting with itchy wheals and central pallor; caused by medications, infections, lotions, or idiopathic factors, and treat with antihistamines, corticosteroids, dapsone, and omalizumab.

Identify erythema multiforme by its red, multi-shaped lesions, including target rings, vesicles, bullae, or macules, caused by infections or drugs; treat by removing the trigger and reassessing.

Identify pityriasis rosea by a herald patch followed by fever and a trunk rash with a Christmas tree pattern; self-resolves in about two months, with itch relief.

red man syndrome from vancomycin triggers histamine release causing rash, redness, swelling, and possible breathing difficulty within ten minutes; stop infusion and administer antihistamines such as diphenhydramine.

Identify sulfur allergy and the most common presentation, fever with urticaria; avoid sulfonamides and sulfur-containing medications such as furosemide, acetazolamide, celecoxib, and antacids to prevent severe reactions including Stevens-Johnson syndrome.

Giant cell arteritis involves the temporal artery with diagnosis by ESR or biopsy showing giant cells, and Takayasu affects large vessels like the aortic arch, presenting pulselessness and systemic inflammation.

Understand medium-vessel vasculitis with Kawasaki disease symptoms like conjunctivitis, rash, cervical adenopathy, strawberry tongue, and hand and foot edema. Treat Kawasaki disease with immunoglobulins and aspirin.

Small-vessel vasculitis presents with respiratory, renal symptoms and rash; subtypes include microscopic cholangitis without granulation and granulomatous cholangitis with elevated IgE, and p-anca–related forms, all treated with immunosuppression.

Learn how the x-ray serves as a fast, portable tool in emergency medicine, revealing fractures, pneumothorax, bowel obstruction, and foreign bodies while noting radiation risk and grainy soft-tissue limits.

Leverage ct scans in the emergency department for rapid, high-resolution imaging with iv contrast to assess trauma, stroke, abdominal injury, appendicitis, and vascular emergencies.

Ultrasound provides real-time, noninvasive imaging across emergencies, guiding trauma assessment, abdominal, cardiac, obstetric, and vascular care, including efast, acute cholecystitis, appendicitis, DVT, and abdominal aortic aneurysm screening.

Emergency physicians use MRI selectively to visualize soft tissues, including brain and spine, with IV contrast when needed, and note that MRI is not ionizing and can detect early stroke.

Learn how the CBC evaluates WBCs, RBC indices (hemoglobin, hematocrit, MCV, MCHC), and platelets to diagnose infections, leukocytosis/leukopenia, anemia types, dehydration, polycythemia, and coagulation issues.

the basic metabolic panel provides glucose levels first and key electrolytes—calcium, sodium, potassium, chloride—plus blood urea nitrogen and creatinine to assess hydration and renal function.

ABG rapidly yields vital values like pH (7.35–7.45), PaO2, PaCO2, bicarbonate, and oxygen saturation to identify acidemia or alkalosis, assess breathing status, and guide urgent treatment.

Cardiac enzymes guide evaluation of chest pain in high-risk patients, with troponin and CNB highly sensitive markers rising within hours, and myoglobin rising quickly—useful for detecting cardiac or muscle injury.

Learn how coagulation profiling guides surgical risk, including PT/RT and INR for warfarin, aPTT for heparin, fibrinogen, D-dimer for clot breakdown, and platelet counts to assess bleeding and thrombosis.

Interpret fasting glucose after an 8–12 hour fast to distinguish normal (70–99), pre-diabetic (100–125), and diabetic (>126); note random glucose under 140 or over 200, A1c reflects past 2–3 months.

Take blood cultures before starting IV antibiotics in septic shock to identify organisms; use culture results to tailor therapy and monitor response, and collect cultures in fever of unknown origin.

Learn how lactate signals tissue hypoxia and anaerobic metabolism, how acidemia and neurological symptoms arise, and how ranges reflect mild to severe hypoxemia and sepsis.

Examine how liver function tests reveal hepatocyte and biliary tree health, using ALT, AST, ALP, bilirubin, and albumin to assess hepatitis, cirrhosis, biliary obstruction, and alcohol-related liver disease.

Order a urine pregnancy test in the emergency department to rule out pregnancy-related causes in abdominal pain, shock, vaginal bleeding, trauma, amenorrhea, and before surgery.

Explain how CRP rises rapidly in acute inflammation and autoimmune disease, and how ESR, less sensitive than CRP, helps monitor inflammatory conditions like rheumatoid arthritis and lupus.

Learn to read ECG by identifying the P, QRS, and T waves, PR and QT intervals, and st segment changes that classify stemi versus non-stemi.