List of contributors ix Foreword xii Preface xiv Illustration credits xv Part I Case Presentations and Questions 1 1 Slash Wound to the Neck 3 Kevin S. Barlotta MD and Alexander B. Baer MD 2 "I''ve Got Blood in My Eye" 3 Chris S. Bergstrom MD and Alexander B. Baer MD 3 Forearm Fracture After Falling 4 Alexander B. Baer MD 4 A Neonate with Fever and Rash 4 David L. Eldridge MD 5 A Missing Button Battery 5 Brendan G. Carr MD and Sarah E.

Winters MD MSCE 6 Anorexia Hair Loss and Fingernail Bands 6 Christopher P. Holstege MD 7 Wide Complex Tachycardia in a Young Adult 6 William J. Brady MD 8 Wide Complex Tachycardia in an Older Male Patient 7 William J. Brady MD 9 Muscle Spasms Following a Spider Bite 8 J. Michael Kowalski DO and Adam K. Rowden DO 10 Necrotic Skin Lesion 8 David A. Kasper DO MBA Aradhna Saxena MD and Kenneth A. Katz MD 11 Intense Pain Following High-pressure Injection Injury 9 David T.

Lawrence DO 12 Prenatal Vitamin Overdose 9 Christopher P. Holstege MD and Adriana I. Goldberg MD 13 Blurred Vision Following Yard Work 10 Allyson Kreshak MD 14 Foot Pain in a Gymnast 11 Hoi K. Lee MD 15 A Child with Bruises of Different Ages 11 David L. Eldridge MD 16 Sudden Shortness of Breath after Removal of a Central Line 12 Christopher P. Holstege MD 17 "My Eyes Are Yellow!" 13 David T. Lawrence DO 18 Pleuritic Chest Pain in a Young Adult Male 13 William J. Brady MD 19 Exposed During a Blizzard 14 Joseph D.

Forrester MD and Christopher P. Holstege MD 20 FAST Evaluation of a Trauma Patient 15 John S. Rajkumar MD and James H. Moak MD RDMS 21 Chest Pain with Sudden Cardiac Death 15 William J. Brady MD 22 Wrist "Sprain" in a Child 16 Jennifer S. Boyle PharmD MD 23 Acute Eye Pain and Blurred Vision in an Elderly Female 17 Chris S. Bergstrom MD and Alexander Baer MD 24 Heel Pain Following a Fall 17 Jennifer S. Boyle PharmD MD 25 Confluent Rash on a Child 18 Sarah E.

Winters MD MSCE and Brendan G. Carr MD 26 Bradycardia Following an Herbal Ingestion 18 Alexander B. Baer MD 27 A Pain-free Adult with Persistent T Wave Abnormalities 19 William J. Brady MD 28 Caustic Ingestion with Cardiotoxic Effects 20 Heather A. Borek MD and Christopher P. Holstege MD 29 Chemical Eye Exposure 21 Chris S. Bergstrom MD and Alexander B. Baer MD 30 Acute Abdominal Pain in Pregnancy 22 James H.

Moak MD RDMS and John S. Rajkumar MD 31 Coma Following Head Trauma 22 Andrew L. Homer MD and William J. Brady MD 32 Tongue Swelling in a Hypertensive Female 23 Kevin S. Barlotta MD and Alexander B. Baer MD 33 Purulent Eye Discharge in an Adult 24 Chris S. Bergstrom MD and Alexander B. Baer MD 34 Shoulder Pain Following Direct Blow 24 Nathan P.

Charlton MD 35 A Gagging Child 25 Maureen Chase MD and Worth W. Everett MD 36 Adult Male with a Sudden Severe Headache 25 Andrew L. Homer MD and William J. Brady MD 37 New Facial Droop 26 Andrew D. Perron MD and Christopher T. Bowe MD 38 Eye Pain After Tree Branch Strike 26 Chris S. Bergstrom MD and Alexander B. Baer MD 39 An Elderly Woman with Groin Pain 27 Brendan G.

Carr MD 40 Rash and Joint Pain in a Child 28 Mara L. Becker MD 41 Radiology Findings after Laparoscopy 28 Munish Goyal MD 42 Postprandial Abdominal Pain in an Elderly Woman 29 Hoi K. Lee MD 43 "Pink Eye" in a Contact Lens Wearer 30 Chris S. Bergstrom MD and Alexander B. Baer MD 44 Suspicious Hand Pain 30 Rex G. Mathew MD 45 Fever and Rash in a Child 31 David L. Eldridge MD 46 An Alcoholic with Dyspnea 31 James H. Moak MD RDMS and John S.

Rajkumar MD 47 Dark Urine from an Immigrant 32 Suzanne M. Shepherd MD 48 Chest Pain and Lead aVR ST Segment Elevation 33 William J. Brady MD 49 Hand Pain after Striking a Wall 34 William J. Brady MD and Kevin S. Barlotta MD 50 A Refugee with Skin Lesions 35 Roger A. Band MD and Jeanmarie Perrone MD 51 Pain out of Proportion to Examination 35 J. Michael Kowalski DO and Adam K. Rowden DO 52 Leg Pain Following a Motor Vehicle Collision 36 Nathan P.

Charlton MD 53 Deformed Globe Following Trauma 36 Worth W. Everett MD 54 Foot Pain Following Breaking 37 Munish Goyal MD 55 Lamp Oil Ingestion 38 David L. Eldridge MD 56 Intermittent Abdominal Pain in a Female 38 John S. Rajkumar MD and James H. Moak MD RDMS 57 Hallucinations in a Botanist 39 Joseph D. Forrester MD and Christopher Holstege MD 58 Altered Mental Status with an Abnormal Electrocardiogram 40 William J. Brady MD 59 Fishing in the Stomach 41 Joseph D. Forrester MD and Christopher P.

Holstege MD 60 Overdose-induced Boiled Lobster Skin 41 Heather A. Borek MD and Christopher P. Holstege MD 61 Back Pain Following a Fall 42 Andrew D. Perron MD and Christopher T. Bowe MD 62 Painful Facial Rash 42 Chris S. Bergstrom MD and Alexander B. Baer MD 63 Intense Wrist Pain Following Trauma 43 Rex G. Mathew MD 64 Fever and Drooling in a Child 44 Sarah E.

Winters MD MSCE and Brendan G. Carr MD 65 Syncope and Flank Pain in an Elderly Man 44 John S. Rajkumar MD and James H. Moak MD RDMS 66 Get Them Undressed! 45 Munish Goyal MD 67 A "Blue Hue" Following Endoscopy 46 Saumil Vaghela PharmD and Christopher P. Holstege MD 68 Acute-onset Blurred Vision 46 Chris S. Bergstrom MD and Alexander B. Baer MD 69 Elbow Pain in a Child After a Fall 47 Elizabeth Cochran Ward MD and Alexander B. Baer MD 70 Confusion Anemia and Abdominal Pain in a Toddler 47 Christopher P.

Holstege MD and Joseph T. Vance 71 A Ground-level Fall with Ankle Pain 48 Christopher T. Bowe MD 72 Traumatic Eye Pain and Proptosis 49 Chris Bergstrom MD and Alexander Baer MD 73 Diffuse Ankle Pain Following a Fall 49 Andrew D. Perron MD and Christopher T. Bowe MD 74 Rash Following Brush Fire 50 Christopher P. Holstege MD and Alejandro C. Stella MD 75 Abdominal Pain in a Trauma Victim 51 Esther H. Chen MD 76 Skin Target Lesion 51 Mara L.

Becker MD 77 Chest Pain and a Confounding Electrocardiogram Pattern 52 William J. Brady MD 78 Sudden Sedation in a Student 53 David T. Lawrence DO 79 Skin Lesions in a Comatose Patient 53 Christopher P. Holstege MD and Matthew D. Wilson MD 80 Raccoon Eyes 54 Angela M. Mills MD 81 Fall on an Outstretched Hand in a Young Adolescent 55 William Brady MD and Kevin S. Barlotta MD 82 Eye Pain and Facial Swelling 55 Adam K. Rowden DO and Chris S.

Bergstrom MD 83 Wrist Pain Following Fall on an Outstretched Hand 56 William J. Brady MD and Kevin S. Barlotta MD 84 Rash on a Child with Epilepsy 56 Heather A. Borek MD and Christopher P. Holstege MD 85 Abdominal Pain in an Alcoholic 57 Angela M. Mills MD 86 Chest Pain with Electrocardiographic ST Segment and T Wave Abnormalities 58 William J. Brady MD 87 A Heroin Abuser with Multiple Skin Lesions 58 Christopher P. Holstege MD and Ashley L.

Harvin MD 88 Chest Pain in a Middle-aged Male Patient with ST Segment Elevation 59 William J. Brady MD 89 Fire Victim with Hoarseness 60 Kathryn Mutter MD and Christopher P. Holstege MD 90 A Gardener with a Non-healing Rash 60 Roger A. Band MD and Steve Larson MD 91 A Bite to the Leg in Tall Grass 61 Alejandro C. Stella MD and Christopher P. Holstege MD 92 An Elderly Man with Diffuse Facial Edema 62 Kevin S. Barlotta MD and Alexander B. Baer MD 93 Acute-onset Double Vision 62 Chris S.

Bergstrom MD and Alexander B. Baer MD 94 Low Back Pain in a Car Accident Victim 63 Edward G. Walsh MD and William J. Brady MD 95 Pain and Rash Following Contact with a Caterpillar 64 Nathan P. Charlton MD and Mairin Smith MD 96 Moonshine-induced Basal Ganglion Necrosis and Metabolic Acidosis 64 Nathan P. Charlton MD and Christopher P. Holstege MD 97 A Rock Climber with Finger Pain Swelling and Redness 65 Joseph D. Forrester MD and Christopher P.

Holstege MD 98 Vomiting and Syncope Following Ingestion of Ramps 66 Christopher P. Holstege MD and Justin H. Price MD 99 Chest Pain and Subtle ST Segment Elevation 66 William J. Brady MD 100 Herbalist with Bradycardia and Vision Changes 67 William J. Brady MD 101 Painless Penile Ulcer 68 Andrea L. Neimann MD 102 Hyperthermia Autonomic Instability and Confusion in a Traveler.