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First Aid for the Emergency Medicine Oral Boards

First Aid for the Emergency Medicine Oral Boards

Authors: David Howes, Rohit Gupta, Flora Waples-Trefil, Tyson Pillow and Janis Tupesis

Published: April 2010

eISBN: 9780071632546 0071632549 | ISBN: 9780071445078

Cover

Title Page

Copyright Page

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

Winning Strategies

Chapter 3.5. Trauma/ATLS Review

General Comments

Initial Assessment

Primary Survey

Between the Primary and Secondary Survey

Secondary Survey

Completing the Case

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