Table of Contents
Cover
Dedicated
Title page
Copyright page
List of contributors
Foreword
Preface
Illustration credits
Part I: Case Presentations and Questions
CASE 1 Slash Wound to the Neck
CASE 2 “I’ve Got Blood in My Eye”
CASE 3 Forearm Fracture After Falling
CASE 4 A Neonate with Fever and Rash
CASE 5 A Missing Button Battery
CASE 6 Anorexia, Hair Loss, and Fingernail Bands
CASE 7 Wide Complex Tachycardia in a Young Adult
CASE 8 Wide Complex Tachycardia in an Older Male Patient
CASE 9 Muscle Spasms Following a Spider Bite
CASE 10 Necrotic Skin Lesion
CASE 11 Intense Pain Following High-pressure Injection Injury
CASE 12 Prenatal Vitamin Overdose
CASE 13 Blurred Vision Following Yard Work
CASE 14 Foot Pain in a Gymnast
CASE 15 A Child with Bruises of Different Ages
CASE 16 Sudden Shortness of Breath after Removal of a Central Line
CASE 17 “My Eyes Are Yellow!”
CASE 18 Pleuritic Chest Pain in a Young Adult Male
CASE 19 Exposed During a Blizzard
CASE 20 FAST Evaluation of a Trauma Patient
CASE 21 Chest Pain with Sudden Cardiac Death
CASE 22 Wrist “Sprain” in a Child
CASE 23 Acute Eye Pain and Blurred Vision in an Elderly Female
CASE 24 Heel Pain Following a Fall
CASE 25 Confluent Rash on a Child
CASE 26 Bradycardia Following an Herbal Ingestion
CASE 27 A Pain-free Adult with Persistent T Wave Abnormalities
CASE 28 Caustic Ingestion with Cardiotoxic Effects
CASE 29 Chemical Eye Exposure
CASE 30 Acute Abdominal Pain in Pregnancy
CASE 31 Coma Following Head Trauma
CASE 32 Tongue Swelling in a Hypertensive Female
CASE 33 Purulent Eye Discharge in an Adult
CASE 34 Shoulder Pain Following Direct Blow
CASE 35 A Gagging Child
CASE 36 Adult Male with a Sudden, Severe Headache
CASE 37 New Facial Droop
CASE 38 Eye Pain After Tree Branch Strike
CASE 39 An Elderly Woman with Groin Pain
CASE 40 Rash and Joint Pain in a Child
CASE 41 Radiology Findings after Laparoscopy
CASE 42 Postprandial Abdominal Pain in an Elderly Woman
CASE 43 “Pink Eye” in a Contact Lens Wearer
CASE 44 Suspicious Hand Pain
CASE 45 Fever and Rash in a Child
CASE 46 An Alcoholic with Dyspnea
CASE 47 Dark Urine from an Immigrant
CASE 48 Chest Pain and Lead aVR ST Segment Elevation
CASE 49 Hand Pain after Striking a Wall
CASE 50 A Refugee with Skin Lesions
CASE 51 Pain out of Proportion to Examination
CASE 52 Leg Pain Following a Motor Vehicle Collision
CASE 53 Deformed Globe Following Trauma
CASE 54 Foot Pain Following Breaking
CASE 55 Lamp Oil Ingestion
CASE 56 Intermittent Abdominal Pain in a Female
CASE 57 Hallucinations in a Botanist
CASE 58 Altered Mental Status with an Abnormal Electrocardiogram
CASE 59 Fishing in the Stomach
CASE 60 Overdose-induced Boiled Lobster Skin
CASE 61 Back Pain Following a Fall
CASE 62 Painful Facial Rash
CASE 63 Intense Wrist Pain Following Trauma
CASE 64 Fever and Drooling in a Child
CASE 65 Syncope and Flank Pain in an Elderly Man
CASE 66 Get Them Undressed!
CASE 67 A “Blue Hue” Following Endoscopy
CASE 68 Acute-onset Blurred Vision
CASE 69 Elbow Pain in a Child After a Fall
CASE 70 Confusion, Anemia, and Abdominal Pain in a Toddler
CASE 71 A Ground-level Fall with Ankle Pain
CASE 72 Traumatic Eye Pain and Proptosis
CASE 73 Diffuse Ankle Pain Following a Fall
CASE 74 Rash Following Brush Fire
CASE 75 Abdominal Pain in a Trauma Victim
CASE 76 Skin Target Lesion
CASE 77 Chest Pain and a Confounding Electrocardiogram Pattern
CASE 78 Sudden Sedation in a Student
CASE 79 Skin Lesions in a Comatose Patient
CASE 80 Raccoon Eyes
CASE 81 Fall on an Outstretched Hand in a Young Adolescent
CASE 82 Eye Pain and Facial Swelling
CASE 83 Wrist Pain Following Fall on an Outstretched Hand
CASE 84 Rash on a Child with Epilepsy
CASE 85 Abdominal Pain in an Alcoholic
CASE 86 Chest Pain with Electrocardiographic ST Segment and T Wave Abnormalities
CASE 87 A Heroin Abuser with Multiple Skin Lesions
CASE 88 Chest Pain in a Middle-aged Male Patient with ST Segment Elevation
CASE 89 Fire Victim with Hoarseness
CASE 90 A Gardener with a Non-healing Rash
CASE 91 A Bite to the Leg in Tall Grass
CASE 92 An Elderly Man with Diffuse Facial Edema
CASE 93 Acute-onset Double Vision
CASE 94 Low Back Pain in a Car Accident Victim
CASE 95 Pain and Rash Following Contact with a Caterpillar
CASE 96 Moonshine-induced Basal Ganglion Necrosis and Metabolic Acidosis
CASE 97 A Rock Climber with Finger Pain, Swelling, and Redness
CASE 98 Vomiting and Syncope Following Ingestion of Ramps
CASE 99 Chest Pain and Subtle ST Segment Elevation
CASE 100 Herbalist with Bradycardia and Vision Changes
CASE 101 Painless Penile Ulcer
CASE 102 Hyperthermia, Autonomic Instability, and Confusion in a Traveler
CASE 103 An Immigrant with Neck Swelling
CASE 104 Eyelid Laceration Following a Brawl
CASE 105 Young Athlete with Back Pain
CASE 106 Chest Pain and Hypotension in an Adult Male Patient
CASE 107 Adult Male with Atraumatic Lower Back Pain and Leg Weakness
CASE 108 Facial Swelling in a Patient with Poor Dentition
CASE 109 Weakness and Bradycardia in an Elderly Female Patient
CASE 110 Lightning Strike Induced Skin Changes
Part II: Answers, Diagnoses, and Discussion
CASE 1 Slash Wound to the Neck
CASE 2 “I’ve Got Blood in my Eye”
CASE 3 Forearm Fracture After Falling
CASE 4 A Neonate with Fever and Rash
CASE 5 A Missing Button Battery
CASE 6 Anorexia, Hair Loss, and Fingernail Bands
CASE 7 Wide Complex Tachycardia in a Young Adult
CASE 8 Wide Complex Tachycardia in an Older Male Patient
CASE 9 Muscle Spasms Following a Spider Bite
CASE 10 Necrotic Skin Lesion
CASE 11 Intense Pain Following High-pressure Injection Injury
CASE 12 Prenatal Vitamin Overdose
CASE 13 Blurred Vision Following Yard Work
CASE 14 Foot Pain in a Gymnast
CASE 15 A Child with Bruises of Different Ages
CASE 16 Sudden Shortness of Breath after Removal of a Central Line
CASE 17 “My Eyes Are Yellow!”
CASE 18 Pleuritic Chest Pain in a Young Adult Male
CASE 19 Exposed During a Blizzard
CASE 20 FAST Evaluation of a Trauma Patient
CASE 21 Chest Pain with Sudden Cardiac Death
CASE 22 Wrist “Sprain” in a Child
CASE 23 Acute Eye Pain and Blurred Vision in an Elderly Female
CASE 24 Heel Pain Following a Fall
CASE 25 Confluent Rash on a Child
CASE 26 Bradycardia Following an Herbal Ingestion
CASE 27 A Pain-free Adult with Persistent T Wave Abnormalities
CASE 28 Caustic Ingestion with Cardiotoxic Effects
CASE 29 Chemical Eye Exposure
CASE 30 Acute Abdominal Pain in Pregnancy
CASE 31 Coma Following Head Trauma
CASE 32 Tongue Swelling in a Hypertensive Female
CASE 33 Purulent Eye Discharge in an Adult
CASE 34 Shoulder Pain Following Direct Blow
CASE 35 A Gagging Child
CASE 36 Adult Male with a Sudden, Severe Headache
CASE 37 New Facial Droop
CASE 38 Eye Pain After Tree Branch Strike
CASE 39 An Elderly Woman with Groin Pain
CASE 40 Rash and Joint Pain in a Child
CASE 41 Radiology Findings after Laparoscopy
CASE 42 Postprandial Abdominal Pain in an Elderly Woman
CASE 43 “Pink Eye” in a Contact Lens Wearer
CASE 44 Suspicious Hand Pain
CASE 45 Fever and Rash in a Child
CASE 46 An Alcoholic with Dyspnea
CASE 47 Dark Urine from an Immigrant
CASE 48 Chest Pain and Lead aVR ST Segment Elevation
CASE 49 Hand Pain after Striking a Wall
CASE 50 A Refugee with Skin Lesions
CASE 51 Pain out of Proportion to Examination
CASE 52 Leg Pain Following a Motor Vehicle Collision
CASE 53 Deformed Globe Following Trauma
CASE 54 Foot Pain Following Breaking
CASE 55 Lamp Oil Ingestion
CASE 56 Intermittent Abdominal Pain in a Female
CASE 57 Hallucinations in a Botanist
CASE 58 Altered Mental Status with an Abnormal Electrocardiogram
CASE 59 Fishing in the Stomach
CASE 60 Overdose-induced Boiled Lobster Skin
CASE 61 Back Pain Following a Fall
CASE 62 Painful Facial Rash
CASE 63 Intense Wrist Pain Following Trauma
CASE 64 Fever and Drooling in a Child
CASE 65 Syncope and Flank Pain in an Elderly Man
CASE 66 Get Them Undressed!
CASE 67 A “Blue Hue” Following Endoscopy
CASE 68 Acute-onset Blurred Vision
CASE 69 Elbow Pain in a Child After a Fall
CASE 70 Confusion, Anemia, and Abdominal Pain in a Toddler
CASE 71 A Ground-level Fall with Ankle Pain
CASE 72 Traumatic Eye Pain and Proptosis
CASE 73 Diffuse Ankle Pain Following a Fall
CASE 74 Rash Following Brush Fire
CASE 75 Abdominal Pain in a Trauma Victim
CASE 76 Skin Target Lesion
CASE 77 Chest Pain and a Confounding Electrocardiogram Pattern
CASE 78 Sudden Sedation in a Student
CASE 79 Skin Lesions in a Comatose Patient
CASE 80 Raccoon Eyes
CASE 81 Fall on an Outstretched Hand in a Young Adolescent
CASE 82 Eye Pain and Facial Swelling
CASE 83 Wrist Pain Following Fall on an Outstretched Hand
CASE 84 Rash on a Child with Epilepsy
CASE 85 Abdominal Pain in an Alcoholic
CASE 86 Chest Pain with Electrocardiographic ST Segment and T Wave Abnormalities
CASE 87 A Heroin Abuser with Multiple Skin Lesions
CASE 88 Chest Pain in a Middle-aged Male Patient with ST Segment Elevation
CASE 89 Fire Victim with Hoarseness
CASE 90 A Gardener with a Non-healing Rash
CASE 91 A Bite to the Leg in Tall Grass
CASE 92 An Elderly Man with Diffuse Facial Edema
CASE 93 Acute-onset Double Vision
CASE 94 Low Back Pain in a Car Accident Victim
CASE 95 Pain and Rash Following Contact with a Caterpillar
CASE 96 Moonshine-induced Basal Ganglion Necrosis and Metabolic Acidosis
CASE 97 A Rock Climber with Finger Pain, Swelling, and Redness
CASE 98 Vomiting and Syncope Following Ingestion of Ramps
CASE 99 Chest Pain and Subtle ST Segment Elevation
CASE 100 Herbalist with Bradycardia and Vision Changes
CASE 101 Painless Penile Ulcer
CASE 102 Hyperthermia, Autonomic Instability, and Confusion in a Traveler
CASE 103 An Immigrant with Neck Swelling
CASE 104 Eyelid Laceration Following a Brawl
CASE 105 Young Athlete with Back Pain
CASE 106 Chest Pain and Hypotension in an Adult Male Patient
CASE 107 Adult Male with Atraumatic Lower Back Pain and Leg Weakness
CASE 108 Facial Swelling in a Patient with Poor Dentition
CASE 109 Weakness and Bradycardia in an Elderly Female Patient
CASE 110 Lightning Strike Induced Skin Changes
Index
End User License Agreement
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Alexander B. Baer, MD
Assistant Clinical Professor
Division of Medical Toxicology
Department of Emergency Medicine
University of Virginia School of Medicine
Charlottesville, VA USA
Roger A. Band, MD
Assistant Professor
Hospital of the University of Pennsylvania
Philadelphia, PA, USA
Kevin S. Barlotta, MD
Assistant Professor and Assistant Program Director
Department of Emergency Medicine
Medical Director
Department of Critical Care Transport
University of Alabama at Birmingham, AL, USA
Mara L. Becker, MD, MSCE
Associate Professor of Pediatrics
University of Missouri Kansas City
Children’s Mercy Hospitals and Clinics
Kansas City, MO, USA
Chris S. Bergstrom, MD, OD
Assistant Professor
Department of Ophthalmology
Emory University
Atlanta, GA, USA
Heather A. Borek, MD
Medical Toxicology Fellow
Division of Medical Toxicology
Department of Emergency Medicine
Charlottesville, VA, USA
Christopher T. Bowe, MD
Assistant Professor and Associate Residency Director
Department of Emergency Medicine
Maine Medical Center
Portland, ME, USA
Jennifer S. Boyle, MD
Staff Physician
Salem Veterans Affairs Medical Center
Salem, VA, USA
William J Brady, MD
Professor of Emergency Medicine & Medicine
Chair, Resuscitation Committee
Medical Director, Center for Emergency Management
University of Virginia Health System
Charlottesville, VA
Operational Medical Director
Charlottesville-Albemarle Rescue Squad & Albemarle County Fire Rescue
Charlottesville, VA, USA
Brendan G. Carr, MD, MS
Assistant Professor
Departments of Emergency Medicine and Epidemiology
University of Pennsylvania
Philadelphia, PA, USA
Nathan P. Charlton, MD
Wilderness Medicine Director
Division of Medical Toxicology
Associate Residency Director
Assistant Professor
Department of Emergency Medicine
University of Virginia School of Medicine
Charlottesville, VA, USA
Maureen Chase, MD
Instructor
Harvard Medical School
Department of Emergency Medicine
Beth Israel Deaconess Medical Center
Boston, MA, USA
Esther H. Chen, MD
Associate Professor
Department of Emergency Medicine
University of California
San Francisco General Hospital
San Francisco, CA, USA
David L. Eldridge, MD
Assistant Professor
Clerkship Director
Department of Pediatrics
Brody School of Medicine at East Carolina University
Greenville, NC, USA
Worth W. Everett, MD
Assistant Medical Director
Department of Emergency Medicine
Skagit Valley Hospital
Mount Vernon, WA ,USA
Joseph D. Forrester, MD
Instructor in Wilderness Medicine
University of Virginia School of Medicine
Charlottesville, VA, USA.
David F. Gaieski, MD
Assistant Professor
Department of Emergency Medicine
University of Pennsylvania School of Medicine
Philadelphia, PA, USA
Adriana Goldberg, BA
Medical Student
University of Virginia School of Medicine
University of Virginia
Charlottesville, VA, USA
Munish Goyal, MD
Associate Professor of Emergency Medicine
Georgetown University School of Medicine
Director of Emergency Intensive Care
Washington Hospital Center
Washington, DC, USA
Ashley L. Harvin, BS
Student
Department of Chemical Engineering
University of Virginia
Charlottesville, VA, USA
Christopher P. Holstege, MD
Chief, Division of Medical Toxicology
Medical Director, Blue Ridge Poison Center
Associate Professor
Departments of Emergency Medicine & Pediatrics
University of Virginia School of Medicine
Charlottesville, VA, USA
David A. Kasper, DO, MBA
Silverton Skin Institute
Genesys Regional Medical Center
Grand Blanc, MI, USA
Kenneth A. Katz, MD, MSCE
Assistant Clinical Professor
Division of Dermatology
Department of Medicine
University of California San Diego, CA, USA
J. Michael Kowalski, DO
Medical Toxicology Fellow
Department of Emergency Medicine
Albert Einstein Medical Center,
Philadelphia, PA, USA
Allyson Kreshak, MD
Clinical Assistant Professor
Department of Emergency Medicine
University of California San Diego
San Diego, CA, USA
Steve Larson, MD
Associate Professor
Department of Emergency Medicine
Hospital of the University of Pennsylvania
Philadelphia, PA, USA
David T. Lawrence, DO
Medical Toxicology Fellowship Director
Division of Medical Toxicology
Assistant Professor
Department of Emergency Medicine
University of Virginia School of Medicine
Charlottesville, VA, USA
Hoi K. Lee, MD
Staff Physician
Main Line Emergency Medicine Associates
Bryn Mawr Hospital Emergency Department
Bryn Mawr, PA, USA
Rex G. Mathew, MD
Vice President for Emergency Medicine Clinical Operations
Thomas Jefferson University Hospitals
Assistant Professor
Department of Emergency Medicine
Thomas Jefferson University
Philadelphia, PA, USA
Angela M. Mills, MD
Assistant Professor
Department of Emergency Medicine
University of Pennsylvania School of Medicine
Philadelphia, PA, USA
James H. Moak, MD, RDMS
Assistant Professor
Ultrasound Fellowship Director
Department of Emergency Medicine
University of Virginia School of Medicine
Charlottesville, VA, USA
Kathryn Mutter, MD
Emergency Medicine, Chief Resident
Department of Emergency Medicine
University of Virginia School of Medicine
Charlottesville, VA, USA
Andrea L. Neimann, MSCE
Dermatology Resident
Division of Dermatology
Albert Einstein College of Medicine
Bronx, NY, USA
Andrew D. Perron, MD
Professor and Residency Program Director
Department of Emergency Medicine
Maine Medical Center
Portland, ME, USA
Jeanmarie Perrone, MD
Associate Professor
Emergency Medicine Director
Division of Medical Toxicology
University of Pennsylvania School of Medicine
Philadelphia, PA, USA
Jesse M. Pines, MD, MBA, MSCE
Director, Center for Health Care Quality
Associate Professor
Departments of Emergency Medicine and Health Policy
George Washington University
Washington, DC, USA
Justin H. Price, MD
Chief Resident
Mountain Area Health Education Center Rural Program
Hendersonville, NC, USA
John S. Rajkumar, MD
Ultrasound Fellow
Department of Emergency Medicine
University of Virginia School of Medicine
Charlottesville, VA, USA
Adam Rowden, DO
Assistant Professor of Emergency Medicine
Director
Division of Toxicology
Department of Emergency Medicine
Jefferson Medical College
Philadelphia, PA, USA
Aradhna Saxena, MD
Faculty
Department of Dermatology
Abington Memorial Hospital
Abington, PA, USA
Suzanne M. Shepherd, MD, DTM&H
Professor
Director of Education & Research, PENN Travel Medicine
Director, Fast Track
Education Officer
Department of Emergency Medicine
Hospital of the University of Pennsylvania
Philadelphia, PA ,USA
William H. Shoff, MD, DTM&H
Director
Penn Travel Medicine
Associate Professor
Department of Emergency Medicine
Hospital of the University of Pennsylvania
Philadelphia, PA, USA
Mairin Smith, MD
Emergency Medicine Resident
Department of Emergency Medicine
University of Virginia School of Medicine
Charlottesville, VA, USA
Alejandro C. Stella, MD
Emergency Medicine Resident
Department of Emergency Medicine
University of Rochester
Rochester, NY, USA
Saumil M. Vaghela, PharmD
Pharmacy Practice Resident
Department of Pharmacy
Rockingham Memorial Hospital
Harrisonburg, VA, USA
Joseph T. Vance
Student
Virginia Polytechnic Institute and State University
Blacksburg, VA, USA
Elizabeth R. Cochran Ward, BS, MappSci, MBBS (Hons)
Medical Student
Sydney Medical School
University of Sydney
Sydney, NSW, Australia
Matthew D. Wilson
Medical Student
University of Virginia
Charlottesville, VA, USA
Sarah E. Winters, MD, MSCE
Attending Physician
Department of Pediatrics
The Children’s Hospital of Philadelphia
Philadelphia, PA, USA
This book stakes out a slightly different position from most educational publications. I believe it reaches a higher level, accomplishing more for the reader. Unlike the many texts that provide a compendium of information, this one presents cases, images, and information together in a way that parallels a clinical encounter. The work apparently intends to both enhance knowledge and also provide virtual experiences. In doing so perhaps it even helps advance the expertise of the reader. Each case is presented in a succinct paragraph accompanied by a high-quality visual image. Then a question is asked. Answers are accompanied by a detailed explanation that is longer than the case itself. The format seems simple, but it is effective, even powerful. It made me want to pick it up and read.
It takes over a decade of medical studies to become an expert physician. The journey requires relentless effort, with lots of reading, meaningful engagement in clinical situations, guidance from experts, and constructive feedback. This book offers all of this. It offers something for everyone, including even experts and teachers themselves. As teachers, we all can learn from the way the information is presented in this book. It displays the best attributes of expert teaching material. The cases are relevant and real; important questions are asked; “must-know” facts are presented. There is no excessive language or lengthy prose. The pace keeps moving. There is nothing dense to bog the reader down. This is the kind of teaching that students of all levels can enjoy.
On the journey toward expertise, a novice memorizes facts, confronts new experiences, tries to organize information, and, at first, relies heavily on short-term memory. After thousands of focused encounters, hundreds of hours of reading, timely feedback, and, crucially, guidance by experts, the novice grows to become expert. It is not an easy climb. Motivation is as important as innate skill and intellect since the work is hard. Given the length and the difficulty of the path, it is wonderful to have this teaching material, beautifully constructed, to make some of the necessary reading and memorization interesting. This kind of work will accelerate learning.
Beyond the novice, this work helps move all of us life-long learners farther forward toward greater expertise. Each brief, salient case gives rich information that automatically triggers the expert reader. Sometimes we know immediately what the case is about, sometimes we do not. Even as we read just the title of each case we begin to frame, or even try to diagnose, the problem. This will be natural for experienced physicians. Even when the answer is known, the case offers much additional information. The visual images are clear, compelling, and classic. Many of the cases will be variations of diagnoses that we have seen, some are unique, and all function as a high-yield clinical encounter. Every condition is central to our practice. A key question follows each case description, presenting a challenge, testing our knowledge and judgment. Some questions were easy, some were not. I have to admit that I enjoyed getting questions right, but even then I learned something more in the detailed answer. The answer set provides in-depth explanations that help us learn or relearn what we need to know.
Novices will move more slowly through the book, will encounter cases that are new to them, and will have the opportunity to mentally embed the images, along with the knowledge and facts. The relevance could not be greater. The work is visually engaging, the writing segments are brief, and the information is concentrated. The cases are not organized by organ system; they are presented in the way that an emergency physician encounters each case, as a complete unknown. At any speed, the readers’ energy and interest is kept high.
Learning is most engaging and most efficient when well guided. Each case encapsulates critical information. I am told by expert educators and cognitive scientists that, in medical education, the human mind first uses short-term memory to recall facts but, with cumulative, guided experiences, begins to integrate the facts with the patterns of disease, and the visual imagery. All this moves mysteriously into long-term memory. This long-term memory subsequently enables our quick, automatic response to a case or clinical situation. This quick reaction is familiar to all of us who have been practicing any length of time. We often can make a key, visual diagnosis within seconds. We can develop an accurate therapeutic plan within minutes. We also take time to attend to the subtleties, variations, and clinical cues that indicate we may need to consider other possibilities. It seems very tricky when described, but quite natural in practice. A hallmark of experts is this speed with which patterns are recognized. When asked, “How did you know?” the expert has a difficult time explaining. The skill resides in parts of the brain where language does not. As learners move along the continuum to development of expertise, this book will help with both the short-term facts and the embedding into long-term memory.
It seems to me that this book does much more than present information, it serves as a trainer for those of us who aspire to be better at what we do. Every expert requires constructive challenges, a coach to provide feedback, help correct us and, perhaps even to inspire us to maintain our motivation. The book does all this for me, and is perhaps the next best thing to a live devoted teacher. It is ideal for residents and a pleasure for the experienced physician. It is designed by expert educators and expert emergency physicians who provide rich material, present a challenge, and then provide feedback and critical facts that helps us move forward toward that mysterious attribute called expertise.
James G. Adams, MD
Professor and Chair, Department of Emergency Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
1)
Slash Wound to the Neck. Case: Alexander B. Baer
2)
I’ve got Blood in My Eye. Case: Chris S. Bergstrom; Figure Chris S. Bergstrom
3)
Forearm Fracture after Falling. Case: Alexander B. Baer; Figure 1: Alexander B. Baer
4)
Neonate with Fever and Rash. Case: Alexander B. Baer
5)
A Missing Button Battery. Case: Sarah G. Winters; Figure 1: Brendan G. Carr; Figure 2: Christopher P Holstege; Figure 3: Brendan G. Carr; Figure 4: Brendan G. Carr; Figure 5: Brendan G Carr
6)
Anorexia, Hair Loss, and Fingernail Bands. Case: Christopher P. Holstege; Figure 1: Christopher P. Holstege
7)
Wide Complex Tachycardia in a Young Adult. Case: William J. Brady; Figure 1: William J. Brady
8)
Wide Complex Tachycardia in an Older Male Patient. Case: William J. Brady; Figure 1: William J. Brady; Figure 2: William J. Brady
9)
Muscle Spasms Following a Spider Bite. Case: Christopher P. Holstege
10)
Necrotic Skin Lesion. Case: Kenneth A. Katz
11)
Intense Pain following High-pressure Injection injury. Case: Alexander B. Baer; Figure 1: Alexander B. Baer
12)
Prenatal Vitamin Overdose. Case: Christopher P. Holstege; Figure 1: Christopher P. Holstege; Figure 2: Christopher P. Holstege
13)
Blurred Vision Following Yard Work. Case: Alexander B. Baer; Figure 1: Christopher P Holstege
14)
Foot Pain in a Gymnast. Case: Alexander B. Baer; Figure 1: Alexander B Baer
15)
Child with Bruises of Different Ages. Case: Christopher P. Holstege
16)
Sudden Shortness of Breath after Removal of a Central Line. Case: Christopher P. Holstege; Figure 1: Christopher P. Holstege; Figure 2: Christopher P. Holstege
17)
My Eyes are Yellow. Case: Alexander B. Baer
18)
Pleuritic Chest Pain in a Young Adult Male. Case: William J. Brady
19)
Exposed During a Blizzard. Case: Alexander B. Baer
20)
FAST Evaluation of a Trauma Patient. Case: Anthony J. Dean; Figure 1: Anthony J. Dean; Figure 2: Anthony J. Dean; Figure 3: James H. Moak; Figure 4: James H. Moak
21)
Chest Pain with Sudden Cardiac Death. Case: William J. Brady
22)
Wrist Sprain in a Child. Case: Alexander B. Baer; Figure 1: Alexander B. Baer
23)
Acute Eye Pain and Blurred Vision in an Elderly Female. Case: Chris S. Bergstrom
24)
Heel Pain Following a Fall. Case: Alexander B. Baer; Figure 1: Alexander B. Baer
25)
Confluent Rash on a Child. Case: Brendan Carr
26)
Bradycardia Following an Herbal Ingestion. Case: Christopher P. Holstege
27)
Painfree Adult with Persistent T Wave Abnormalities. Case 1: William J. Brady; Figure 1: William J. Brady; Figure 2: William J. Brady
28)
Caustic Ingestion with Cardiotoxic Effects. Case: Christopher P. Holstege
29)
Chemical Eye Exposure. Case: Chris S. Bergstrom
30)
Acute Abdominal Pain in Pregnancy. Case: Anthony J. Dean; Figure 1: Anthony J. Dean; Figure 2: Anthony J. Dean; Figure 3 James Moak
31)
Coma Following Head Trauma. Case: Alexander B. Baer
32)
Tongue Swelling in a Hypertensive Female. Case: Christopher P. Holstege; Figure 1: Christopher P. Holstege
33)
Purulent Eye Discharge in an Adult. Case: Chris S. Bergstrom
34)
Shoulder Pain Following Direct Blow. Case: Alexander B. Baer; Figure 1: Alexander B Baer
35)
Gagging Child. Case: Christopher P. Holstege
36)
Adult Male with a Sudden, Severe Headache. Case: Alexander B. Baer
37)
New Facial Droop. Case: Alexander B. Baer
38)
Eye Pain after Tree Branch Strike. Case: Chris S. Bergstrom
39)
Elderly Woman with Groin Pain. Case: Alexander B. Baer
40)
Rash and Joint Pain in a Child. Case: Mara Becker
41)
Radiology Findings after Laparoscopy. Case: Munish Goyal
42)
Post-prandial Abdominal Pain in an Elderly Woman. Case: Alexander B. Baer
43)
“Pinkeye” in a Contact Lens Wearer. Case: Chris S. Bergstrom
44)
Suspicious Hand Pain. Case: Alexander B. Baer; Figure 1: Alexander B. Baer
45)
Fever and Rash in a Child. Case: Alexander B. Baer
46)
An Alcoholic with Dyspnea. Case: Anthony J. Dean; Figure 1: Anthony J. Dean; Figure 2: Anthony J. Dean; Figure 3: Anthony J. Dean; Figure 4: Anthony J. Dean
47)
Dark Urine from an Immigrant. Case: William H. Shoff; Figure 1: Suzanne M. Shepherd
48)
Chest Pain and Lead aVR ST Segment Elevation. Case: William J. Brady
49)
Hand Pain after Striking Wall. Case: Alexander B. Baer; Figure 1: Alexander B. Baer
50)
A Refugee with Skin Lesions. Case: Edward T. Dickinson
51)
Pain out of Proportion to Examination. Case: Robert M. Underwood
52)
Leg Pain Following a Motor Vehicle Collision. Case: Alexander B. Baer; Figure 1: Alexander B. Baer
53)
Deformed Globe Following Trauma. Case: Chris S. Bergstrom
54)
Foot Pain Following Breaking. Case: Alexander B. Baer
55)
Lamp Oil Ingestion. Case: Christopher P. Holstege
56)
Intermittent Abdominal Pain in a Female. Case: Anthony J. Dean; Figure 1: Anthony J. Dean
57)
Hallucinations in a Botanist. Case: Christopher P. Holstege & Alexander B Baer
58)
Altered Mental Status with an Abnormal Electrocardiogram. Case: William J Brady; Figure 1: William J Brady; Figure 2: William J Brady
59)
Fishing in the Stomach. Case: Christopher P. Holstege; Figure 1: Christopher P. Holstege
60)
Overdose-induced Boiled Lobster Skin. Case: Christopher P. Holstege; Figure 1: Christopher P. Holstege; Figure 2: Christopher P. Holstege
61)
Back Pain Following a Fall. Case: Alexander B. Baer; Figure 1: Alexander B. Baer
62)
Painful Facial Rash. Case: Alexander B. Baer
63)
Intense Wrist Pain Following Trauma. Case: Alexander B. Baer; Figure 1: Alexander B. Baer
64)
Fever and Drooling in a Child. Case: Alexander B. Baer
65)
Syncope and Flank Pain in an Elderly Man. Case: Anthony J. Dean; Figure 1: Anthony J. Dean; Figure 2: Anthony J. Dean
66)
Get them Undressed! Case: Christopher P. Holstege
67)
A “Blue Hue” Following Endoscopy. Case: Christopher P. Holstege; Figure 1 Christopher P. Holstege
68)
Acute Onset Blurred Vision. Case: Chris S. Bergstrom; Figure 1: Chris S. Bergstrom; Figure 2: Chris S. Bergstrom; Figure 3: Chris S. Bergstrom; Figure 4: Chris S. Bergstrom
69)
Elbow Pain in a Child After a Fall. Case: Stephen M. Borowitz; Figure 1: Stephen M. Borowitz
70)
Confusion, Anemia, and Abdominal Pain in a Toddler. Case: Christopher P. Holstege; Figure 1: Christopher P. Holstege
71)
Ground-level Fall with Ankle Pain. Case: Alexander B. Baer; Figure 1: Alexander B Baer
72)
Traumatic Eye Pain and Proptosis. Case: Chris S. Bergstrom
73)
Diffuse Ankle Pain Following a Fall. Case: Alexander B. Baer; Figure 1: Alexander B Baer
74)
Rash Following Brush Fire. Case: Christopher P. Holstege; Figure 1: Christopher P. Holstege; Figure 2: Christopher P. Holstege
75)
Abdominal Pain in a Trauma Victim. Case: Alexander B. Baer
76)
Skin Target Lesion. Case: Carlos Rosé
77)
Chest Pain and a Confounding Electrocardiogram Pattern. Case: William J Brady; Figure 1: William J Brady
78)
Sudden Sedation in a Student. Case: Alexander B. Baer
79)
Skin Lesions in a Comatose Patient. Case: Christopher P. Holstege; Figure 1: Christopher P. Holstege
80)
Raccoon Eyes. Case: Alexander B. Baer
81)
Fall on an Outstretched Hand in a Young Adolescent. Case: William J Brady; Figure 1: William J Brady; Figure 2: William J Brady
82)
Eye Pain and Facial Swelling. Case: Alexander B. Baer; Figure 1: Chris S. Bergstrom; Figure 2: Chris S. Bergstrom
83)
Wrist Pain Following Fall on an Outstretched Hand. Case: Alexander B. Baer; Figure 1: Alexander B. Baer; Figure 2: Alexander B. Baer
84)
Rash on a Child with Epilepsy. Case: Christopher P. Holstege; Figure 1: Christopher P. Holstege; Figure 2: Christopher P. Holstege
85)
Abdominal Pain in an Alcoholic. Case & Figure: Alexander B. Baer
86)
Chest Pain with Electrocardiographic ST Segment & T-Wave Abnormalities. Case: William J. Brady; Figure 1: William J. Brady
87)
Heroin Abuser with Multiple Skin Lesions. Case: Alexander B. Baer; Figure 1: Alexander B. Baer; Figure 2: Alexander B. Baer; Figure 3: Alexander B. Baer; Figure 4: Christopher P. Holstege
88)
Chest Pain in a Middle-aged Male Patient with ST Segment Elevation. Case: William J. Brady; Figure 1: William J. Brady
89)
Fire Victim with Hoarseness. Case: Christopher P. Holstege; Figure 1: Christopher P. Holstege
90)
Gardener with a Non-Healing Rash. Case: Steve Larson
91)
Bite to the Leg in Tall Grass. Case: Alexander B. Baer; Figure 1: Christopher P. Holstege; Figure 2: Christopher P. Holstege
92)
Elderly Man with Diffuse Facial Edema. Case: Alexander B. Baer
93)
Acute-onset Double Vision. Case: Chris S. Bergstrom
94)
Low Back Pain in a Car Accident Victim. Case: Alexander B. Baer; Figure 1: Alexander B. Baer
95)
Pain and Rash following Contact with a Caterpillar. Case 1: Christopher P. Holstege; Case 2: Sue O. Kell; Figure 1: Christopher P. Holstege
96)
Moonshine-induced Basal Ganglion Necrosis and metabolic acidosis. Case: Christopher P. Holstege; Figure 1: Christopher P. Holstege
97)
Rock Climber with Finger Pain, Swelling and Redness. Case: Joseph D. Forrester
98)
Vomiting and Syncope Following Ingestion of Ramps. Case: Christopher P. Holstege; Figure 1: Christopher P. Holstege
99)
Chest Pain and Subtle ST Segment Elevation. Case: William J. Brady
100)
Herbalist with Bradycardia and Vision Changes. Case: Christopher P. Holstege
101)
Painless Penile Ulcer. Case: William D. James
102)
Hyperthermia, Autonomic Instability, and Confusion in a Traveler. Case: Christopher P. Holstege; Figure 1: Christopher P. Holstege; Figure 2: Christopher P. Holstege
103)
Immigrant with Neck Swelling. Case: William H. Shoff; Figure 1: Suzanne M. Shepherd
104)
Eyelid Laceration following a Brawl. Case: Chris S. Bergstrom
105)
Young Athlete with Back Pain. Case: Christopher P. Holstege; Figure 1: Christopher P. Holstege
106)
Chest Pain and Hypotension in an Adult Male patient. Case: William J Brady; Figure 1: William J Brady
107)
Adult Male with Atraumatic Lower Back Pain and Leg Weakness. Case: Alexander B. Baer; Figure 1: Alexander B. Baer
108)
Facial Swelling in a Patient with Poor Dentition. Case: Alexander B. Baer
109)
Weakness and Bradycardia in an Elderly Female Patient. Case: William J. Brady
110)
Lightning Strike-induced Skin Changes. Case: Christopher P. Holstege; Figure 1: Christopher P. Holstege; Figure 2: Christopher P. Holstege