Boerhaave syndrome is a spontaneous rupture of the esophagus. It usually results from barotrauma related to retching or any sudden increase in intraabdominal pressure against a closed glottis.
Headache is one of the most common presenting symptoms. There are often few clinical signs, and the history is the main diagnostic tool. Many different pathologic processes can result in headache or facial pain.
Blood clotting in the setting of chronic liver disease is complex and may result in a net prothrombotic or antithrombotic state. Complicating this situation is the lack of accurate lab assays to measure the net thrombotic state in liver disease patients.
Diuretics (saluretics) elicit increased production of urine (diuresis). In the strict sense, the term is applied to drugs with a direct renal action. The predominant action of such agents is to augment urine excretion by inhibiting the reabsorption of NaCl and water.
Hematuria is abnormal if there are more than 2 red blood cells per high-power field; proteinuria is defined as more than 150 mg of protein per 24-hour collection of urine.
Classic symptoms of appendicitis include pain that is initially vague and periumbilical followed by a more localized parietal pain in the right lower quadrant. Only 50% of people present with these classic symptoms; in the other 50%, appendicitis can be difficult to diagnosis.
Polyuria is the passing of excessive volumes of urine. Urine output depends on fluid intake and body losses, and typically ranges from 1-3.5 L/day. Polydipsia, the ingestion of excessive volumes of fluid, is usually a consequence of polyuria.
In the ED patient with syncope, the ECG should be scrutinized for signs of ischemia, bradydysrhythmias, tachydysrhythmias, and conduction delays. Critical diagnoses to consider that can be detected with the ECG include: Brugada syndrome, Long or short QT syndromes ...
Shortness of breath (dyspnea) is the subjective sensation of breathlessness which is excessive for any given level of activity. It is important to remember that any component of the respiratory system can cause dyspnea.
Diuretics may not be the preferred initial therapy, however, for those patients with vascular failure, who are often euvolemic, or those with cardiogenic shock, who are often hypovolemic. In these patients, the emergency provider should first optimize preload and afterload reduction with the use of noninvasive positive pressure ventilation (NPPV), nitrates, or inotropes as indicated.