By John F. O'Brien

This new quantity within the verified and well-respected sequence of Self-Assessment colour stories covers all points of grownup emergency drugs. a few 250 instances are awarded randomly to mirror real-life perform.

Each case includes a number of questions, illustrated by means of stimulating visible fabric together with scientific photos, imaging and electrocardiograms. solutions and whole dialogue then stick with protecting differential and definitive diagnoses, administration and refined insights to supply optimum care and stop problems.

The publication appeals to a large readership, starting from trainees to practitioners in emergency medication or basic care, for exam revision and carrying on with schooling.

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Extra resources for Adult Emergency Medicine: Self-Assessment Color Review

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Diagnosis is time urgent, with salvage rates of 90–100% if successful detorsion within 6 hours of pain onset, 20–50% after 12 hours, and <10% if delayed >24 hours. Main physical findings include a tender, elevated testicle with horizontal lie, as well as testicular and scrotal enlargement. Testicular torsion is a clinical diagnosis. If obvious, imaging only delays emergency detorsion, best done bedside or by immediate urologist management. Doppler ultrasound is the optimal imaging modality, with 90–100% sensitivity and specificity.

Infusion of fluids by this route (essentially all medications and blood products) compares favorably with IV access in terms of infusion rates and delivery to the central circulation. Intraosseous access is probably underutilized or inserted late in clinical situations where it may be life saving. qxp:SACR 10/16/12 10:17 PM Page 41 37, 38: Questions 37 37 A very muscular 26-year-old male presented with acute weakness in his extremities, lower more than upper, to the point that he could not stand.

How should the patient be managed? iii. Is further imaging indicated? qxp:SACR 10/16/12 10:17 PM Page 46 41, 42: Answers 41 i. This patient has psychogenic polydipsia, a disorder seen in mental illness where excessive water consumption leads to dilutional hyponatremia. Severe hyponatremia causes muscle weakness, fatigue, altered mental status, and, occasionally, seizures. g. phenothiazines) may cause dry mouth, increased thirst, and help create the problem. Serum sodium should be measured promptly and a glucose test done, as hypoglycemia is always part of the differential diagnosis of altered mental status and seizures.

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