Postoperative Bleeding
Condition Comments Surgical bleeding Bleeding from a major artery or vein that was missed during surgery must be ruled out first, especially in the immediate postoperative period Medications Inquire about…
Infant with Nonbilious Emesis
Diseases managed medically Diseases managed surgically Acute gastroenteritis Antral web Gastroesophageal reflux disease Enteric duplication cyst Metabolic disorders (congenital adrenal hyperplasia, electrolyte imbalance, glycogen storage disease) Gastroesophageal reflux disease Pylorospasm…
Multiple Extremity Injuries After Motorcycle Accident
Fig. 26.1 Right mid-shaft humerus fracture (With kind permission from Springer Science + Business Media: Skeletal Radiol, The “rising bubble” sign: a new aid in the diagnosis of unicameral bone cysts, 38,…
New Onset of Painless Jaundice
Condition Comments Prehepatic (hemolytic) Hemolytic anemia Pallor, fatigue, shortness of breath Gilbert’s syndrome Benign condition triggered by overexertion, dehydration, menstruation, concurrent illness; decreased activity of the enzyme UDP-glucuronyl transferase Hepatic…
Right Upper Quadrant Pain, Fever, Nausea, and Vomiting
Disease Pathophysiology Acute calculous cholecystitis Obstruction of cystic duct by gallstone Choledocholithiasis Common bile duct (CBD) obstruction by gallstone Gallstone pancreatitis Transient obstruction of the distal CBD (and pancreatic duct)…
Stab Wound to the Chest
Lethal six Characteristics Airway obstruction Laryngeal trauma, foreign body aspiration, stridor, expanding neck hematoma, and gurgling Tension pneumothorax Hemodynamic instability, tracheal shift away from injury, one-way valve in injured lung…
Progressively Hoarse Voice
Diagnosis History and Physical Viral laryngitis Acute onset of fever, sore throat, cough, and/or other symptoms consistent with upper respiratory tract infection Vocal cord paralysis Breathy voice, most commonly idiopathic…
Chronic Constipation Presenting With Severe Abdominal Pain
Pathophysiology Comments Colon cancer Mass causes mechanical LBO History of weight loss, change in bowel habits, bloody stools Volvulus (sigmoid or cecal) Twisting of colon causes mechanical LBO Sigmoid…
New Palpable Mass in Right Breast
Condition History and physical Features Fibrocystic change Vague irregularity of breast tissue (lumpy breast), often in upper quadrants, cysts have a blue-dome appearance on exam Most common breast mass in…
Abnormal Screening Mammogram
Select benign calcifications Skin calcifications May be secondary to dermatitis or hygiene products (e.g., deodorants, ointments) Vascular calcifications Linear or parallel tracks; may be associated with underlying vascular disease Coarse…
