Visual Diagnosis in Emergency and Critical Care Medicine

Christopher P. Holstege, MD, Assistant Professor of Emergency Medicine and Pediatrics and Director of the Medical Toxicology Division at the University of Virginia Health Sciences Center; Medical Director of the Blue Ridge Poison Center, Charlottesville, Virginia Alexander B. Baer, MD, Clinical Assistant Professor, Department of Emergency Medicine, University of Virginia Health Sciences Center, Charlottesville, Virginia Jesse M. Pines, MD, Lecturer in Emergency Medicine, Department of Emergency Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania William J. Brady, MD, Associate Professor, Department of Emergency Medicine and Internal Medicine, University of Virginia Health Sciences Center, Charlottesville, Virginia

List of contributors. Foreword. Preface. Illustration credits. Part 1. Case Presentations and Questions. 1. Rash following brush fire (Christopher P. Holstege). 2. Herbalist with bradycardia and vision changes (William J. Brady). 3. Acute eye pain and blurred vision in an elderly female (Chris S. Bergstrom and Alexander B. Baer). 4. Suspicious hand pain (Rex Mathew). 5. An elderly man with flank pain (Daniel K. Vining and Anthony J. Dean). 6. An immigrant child with skin lesions (Roger A. Band). 7. Wrist pain following a fall (Rex Mathew). 8. Rash in a child with epilepsy (Alexander B. Baer and Christopher P. Holstege). 9. Dark urine in an immigrant (Suzanne M. Shepherd, Susan A. O'Malley and William H. Shoff). 10. Fever and drooling in a child (Sarah G. Winters and Brendan E. Carr). 11. Altered mental status with an abnormal electrocardiogram (William J. Brady). 12. Purulent eye discharge in an adult (Chris S. Bergstrom and Alexander B. Baer). 13. Wrist pain in a young child (Craig S. Brummer). 14. Postprandial abdominal pain (Anthony J. Dean). 15. An elderly man from a house fire (Christopher P. Holstege). 16. Back pain following a fall (Andrew D. Perron and Christopher T. Bowe). 17. A bite to the leg in tall grass (Christopher P. Holstege). 18. Facial swelling in a patient with poor dentition (Alexander B. Baer and Christopher P. Holstege). 19. Elbow pain in a child after a fall (Alexander B. Baer). 20. A man with diffuse facial edema (Kevin S. Barlotta and Alexander B. Baer). 21. Chest pain and hypotension in an adult male patient (William J. Brady). 22. Eye pain after tree branch strike (Chris S. Bergstrom and Alexander B. Baer). 23. A missing button battery (Brendan E. Carr and Sarah G. Winters). 24. Acute abdominal pain in pregnancy (Anthony J. Dean). 25. Painless penile ulcer (Andrea L. Neimann). 26. Low back pain in car accident victim (Edward G. Walsh and William J. Brady). 27. A gardener with a non-healing rash (Roger A. Band). 28. An immigrant with neck swelling (Suzanne M. Shepherd, Anthony J. Dean and William H. Shoff). 29. Fall on an outstretched hand in a young adolescent (William J. Brady and Kevin S. Barlotta). 30. Raccoon eyes (Angela M. Mills). 31. Chest pain and a confounding electrocardiogram pattern (William J. Brady). 32. Eye pain in a contact lens wearer (Chris S. Bergstrom and Alexander B. Baer). 33. Heel pain following a fall (David F. Gaieski). 34. FAST evaluation following trauma (Bon S. Ku and Anthony J. Dean). 35. Skin lesion in a heroin addict (Christopher P. Holstege and Alexander B. Baer). 36. Young athlete with back pain (Edward G. Walsh and William J. Brady). 37. Skin lesions in a comatose patient (Christopher P. Holstege). 38. Chest pain with sudden cardiac death (William J. Brady). 39. Fall on an outstretched hand with wrist pain (William J. Brady and Kevin S. Barlotta). 40. Necrotic skin lesion (David A. Kasper, MBA, Aradhna Saxena and Kenneth A. Katz). 41. Chest pain with electrocardiographic ST-segment/T-wave abnormalities (William J. Brady). 42. Chemical eye exposure (Chris S. Bergstrom and Alexander B. Baer). 43. Hand pain after striking a wall (William J. Brady and Kevin S. Barlotta). 44. Dyspnea in an alcoholic (Anthony J. Dean). 45. Slash wound to the neck (Kevin S. Barlotta and Alexander B. Baer). 46. Foot pain following breaking (Munish Goyal). 47. Confluent rash in a child (Sarah G. Winters and Brendan E. Carr). 48. Lost in the cold (Adam K. Rowden and Christopher P. Holstege). 49. Bradycardia following an herbal ingestion (Alexander B. Baer). 50. Abdominal pain in an alcoholic (Angela M. Mills). 51. Pain out of proportion to examination (Adam K. Rowden). 52. Pleuritic chest pain in a young adult male (William J. Brady). 53. Eye pain following a bar fight (Chris S. Bergstrom and Alexander B. Baer). 54. Forearm fracture after falling (Alexander B. Baer). 55. An elderly woman with groin pain (Brendan E. Carr). 56. Painful facial rash (Chris S. Bergstrom and Alexander B. Baer). 57. Confusion, anemia, and abdominal pain in a toddler (Alexander B. Baer and Christopher P. Holstege). 58. Cardiotoxic effects following caustic ingestion (Alexander B. Baer and Christopher P. Holstege). 59. Rash and joint pain in a child (Mara Becker). 60. X-ray findings after laparoscopy (Munish Goyal). 61. Injector injury to the hand (Tracy H. Reilly). 62. Chest pain in a middle-aged male patient with ST segment elevation (William J. Brady). 63. Deformed globe following trauma (Joseph Robson and Worth W. Everett). 64. Adult male with atraumatic lower back pain and leg weakness (William J. Brady). 65. Fever and rash in a child (David L. Eldridge). 66. Yellow eyes and skin (Jane M. Prosser). 67. Fishing in the stomach (Christopher P. Holstege). 68. Agitation in a botanist (Alexander B. Baer and Christopher P. Holstege). 69. Skin target lesion (Mara Becker). 70. Adult male with a sudden, severe headache (Andrew L. Homer and William J. Brady). 71. Get them undressed (Munish Goyal). 72. Chest pain and subtle ST segment elevation (William J. Brady). 73. Fluid in my eye (Chris S. Bergstrom and Alexander B. Baer). 74. Coma following head trauma (Andrew L. Homer and William J. Brady). 75. Blue hue following endoscopy (Andrew L. Homer and Christopher P. Holstege). 76. Shoulder pain following direct blow (David F. Gaieski). 77. An overdose of prenatal vitamins (Christopher P. Holstege and Adam K. Rowden). 78. Fever and rash in a child (David L. Eldridge). 79. Lamp oil ingestion (David L. Eldridge). 80. Diffuse ankle pain following a fall (Andrew D. Perron and Christopher T. Bowe). 81. Emergency department drop-off (Tracy H. Reilly). 82. Weakness and bradycardia in an elderly female patient (William J. Brady). 83. Blurred vision following yard work (Allyson Kreshak). 84. A gagging child (Maureen Chase and Worth W. Everett). 85. A child with bruises of different ages (David L. Eldridge). 86. Traumatic eye pain and proptosis (Chris S. Bergstrom and Alexander B. Baer). 87. Post-prandial abdominal pain in an elderly woman (Hoi Lee). 88. Hyperthermia, tachycardia, and confusion in a teenager (Alexander B. Baer). 89. Acute onset double vision (Chris S. Bergstrom and Alexander B. Baer). 90. Ankle pain and inability to walk (Christopher T. Bowe). 91. Tongue swelling in a hypertensive female (Kevin S. Barlotta and Alexander B. Baer). 92. Wide complex tachycardia in an older male patient (William J. Brady). 93. Acute onset double vision (Chris S. Bergstrom and Alexander B. Baer). 94. Foot pain in a gymnast (Hoi Lee). 95. New facial droop (Andrew D. Perron and Christopher T, Bowe). 96. Eye pain and swelling (Adam K. Rowden and Chris S. Bergstrom). 97. Shortening and rotation of the leg following trauma (Jane M. Prosser). 98. Spider bite in the night (Adam K. Rowden and Christopher P. Holstege). 99. Wide complex tachycardia in a young adult (William J. Brady). 100. Abdominal pain in a trauma victim (Esther H. Chen). Part 2. Answers, Diagnoses, and Discussion. Index.