1. HEENT
1.1. Eye Pain/Visual Loss
1.1.1. CRAO/CRVO
1.1.2. Orbital Cellulitis
1.1.3. Corneal Ulcer/Endophthalmitis
1.1.4. Scleral Penetration
1.1.5. Conjunctivitis Bacterial
1.1.6. Retrobulbar Hematoma
1.1.7. Hypoglycemia/Hyperglycemia
1.1.8. Increased ICP/Tumor
1.1.9. CVA/TIA
1.1.10. Caustic Exposure
2. CNS
2.1. CVA/TIA
2.2. Epidural Abscess/Hematoma
2.3. Spinal Fracture with Cord Impingement
2.4. Compressive Malignancy
2.5. Cauda Equina Sdr
3. GU
3.1. Male
3.1.1. Paraphimosis
3.1.2. Testicular Torsion
3.1.3. Phimosis
3.1.4. Gonadal Torsion
3.2. Female
3.2.1. Uterine Rupture
3.2.2. Pregnancy
3.2.2.1. Precipitous Delivery
3.2.2.2. Placenta Abruption
3.2.2.3. Ectopic Pregnancy
3.2.2.4. Placenta Previa/Vasa Previa
3.2.2.5. Fatty Liver of Preganancy
3.2.2.6. Pre-eclampsia/Eclampsia
3.2.2.7. Hyperemesis Gravidarum
4. AFE
5. ABD Pain
5.1. 3 Types of Abd Px
5.1.1. Visceral Pain
5.1.1.1. Quality
5.1.1.1.1. Poorly characterized/localized
5.1.1.1.2. Intermittant/crampy/colicky
5.1.1.1.3. sometimes perceived far from location
5.1.1.2. Where
5.1.1.2.1. Upper Abd Pain in Foregut
5.1.1.2.2. Periumbilical Pain in Midgut
5.1.1.2.3. Lower Abd Pain in Hindgut
5.1.2. Somatic Pain
5.1.2.1. Where
5.1.2.1.1. Parietal Peritoneum
5.1.2.2. Quality
5.1.2.2.1. well localized
5.1.2.2.2. Intense/Constant
5.1.3. Referred Pain
5.1.3.1. nerve roots collect simuli from many peripheral nerves
5.1.3.1.1. i.e. epigastric w MI
5.1.3.1.2. shoulder w diaphragm irritation
5.2. ABD Trauma
5.2.1. Trama in Pregnancy
5.2.2. Pelvic Fractures
5.2.2.1. Acetabular
5.2.2.2. Open Book
5.2.2.3. Straddle
5.2.2.4. Avulsion
5.2.3. GU Trauma
5.2.4. Solid Organ Injury
5.2.4.1. Liver Trauma
5.2.4.2. Spenic Injury
5.2.4.3. Diaaphragm Injury
5.2.4.4. Renal
5.2.5. Hollow Viscous Injury
5.2.5.1. Ureter
5.2.5.2. Retroperitoneal Hemorrhage
5.2.5.2.1. Workup
5.2.5.2.2. Classification
5.2.5.2.3. Management
5.2.5.2.4. Dispo
5.2.5.3. Abd Compartment Sdr
5.3. Flank Pain
5.3.1. Pyelonephritis
5.3.2. Nephrolithiasis
5.3.3. PID/TOA
5.4. Diarrhea
5.4.1. Dehydration
5.4.2. IBD
5.4.3. Diverticulitis
5.5. Perforated Viscous/Peritonitis
5.6. Appendicitis
5.7. Bowel Obstruction/ Ileus/Volvulus
5.8. Cholecystitis
5.9. Pancreatitis
5.10. Cholangitis
5.11. Incarcerated Hernia
5.12. AAA
5.13. Mesenteric Ischemia
5.14. DKA
5.15. Extra-Abdominopelvic
5.15.1. Thoracic
5.15.1.1. ACS
5.15.1.2. Pneumonia
5.15.1.3. Herniated Thoracic Disk
5.15.1.4. PE
5.15.2. Infectious
5.15.2.1. Strep Pharyngitis (kids)
5.15.2.2. RMSF
5.15.2.3. Mono
5.15.3. Systemic
5.15.3.1. DKA/AKA
5.15.3.2. Glaucoma
5.15.3.3. Uremia
5.15.3.4. Hbss
5.15.3.5. Porphyria
5.15.3.6. SLE/Vasculitis
5.15.3.7. ^T4
5.15.4. Toxic
5.15.4.1. Methanol
5.15.4.2. Metals
5.15.4.3. Scorpion
5.15.4.4. Black Widow
5.15.5. Abdominal Wall
5.15.5.1. Muscle Spasm
5.15.5.2. Hematoma
5.15.5.3. Zoster
5.15.6. GU
5.15.6.1. Testicular Torsion
5.16. Diffuse
5.16.1. Ddx
5.16.1.1. Peritonitis
5.16.1.2. Pancreatitis
5.16.1.3. Hbss
5.16.1.4. Early Appendicitis
5.16.1.5. Mesenteric Thrombosis
5.16.1.6. Gastroenteritis
5.16.1.7. AAA
5.16.1.8. Obstruction
5.16.1.9. DM
5.16.2. Ask
5.16.2.1. Constant or Intermittant?
5.16.2.1.1. Constant = Ominous
5.16.2.2. Pain or Vomitting first?
5.16.2.2.1. Pain first = Ominous
5.17. Localized/High Risk
5.17.1. LUQ
5.17.1.1. Gastritis
5.17.1.2. Pancreatitis
5.17.1.3. Spleen
5.17.1.3.1. Enlargement
5.17.1.3.2. Rupture
5.17.1.4. MI
5.17.1.5. LLL PNA
5.17.2. LLQ
5.17.2.1. Sigmoid Diverticulitis
5.17.2.2. Pregnancy
5.17.2.3. Advanced Age
5.17.2.4. Pain -> Vomiting
5.17.2.5. Acute Pain
5.17.2.5.1. <48H
5.17.2.6. Prior Abd Surgery
5.17.2.6.1. obstruction
5.17.2.7. Constant
5.17.2.8. No prior episodes
5.17.2.9. significant PMH
5.17.2.9.1. HIV
5.17.2.9.2. EtOH
5.17.2.9.3. Abx/Steriods
5.17.3. RUQ
5.17.3.1. Cholecystitis/Biliary Colic
5.17.3.2. Hepatitis
5.17.3.3. Hepatic Abscess
5.17.3.4. Hepatomegoly/Congestion
5.17.3.4.1. CHF
5.17.3.5. Perforated Duodenal Ulcer
5.17.3.6. Pancreatitis
5.17.3.7. Retrocecal Appendicitis
5.17.3.8. Zoster
5.17.3.9. MI
5.17.3.10. RLL PNA
5.17.4. RLQ
5.17.4.1. Appendicitis
5.17.4.2. Regional Enteritis
5.17.4.3. Meckel's Diverticulitis
5.17.4.4. Cecal Diverticulitis
5.17.4.5. Mesenteric Adenitis
5.17.4.6. Abd Wall Hematoma
5.17.5. b/l lower quadrant
5.17.5.1. AAA
5.17.5.2. Reptured Ectopic
5.17.5.3. PID
5.17.5.4. Hernia
5.17.5.4.1. Incarcerated
5.17.5.4.2. Strangulated
5.17.5.5. Psoas Abscess
5.17.5.5.1. Workup
5.17.5.5.2. Management
5.18. Empiric Management Options
5.18.1. NG Tube
5.18.2. Antiemetics
5.18.3. Abx
5.18.4. Analgesia
5.18.5. Antacids
5.18.6. Antimortality agents
6. Toxic Shock Sdr
7. Transverse Myelitis
8. Botulism
9. Rash
9.1. Tick Paralysis
9.2. HSP
9.3. SJS/TEN
9.4. ITP
9.5. Kawasaki's Dz
9.6. Abscess/Cellulitis/Fasciitis
9.7. TTP/HUS
9.8. SSSS
9.9. RMSF
10. Tachycardia
10.1. Anemia
10.2. Electrolyte Imbalance
10.3. Valvular Emergency
10.4. Sepsis/Bacteremia
10.5. Hypotension
10.6. Toxic Ingestion
11. Neuro
11.1. Myasthenia Gravis
11.2. Guillain-Barr Sdr
11.3. Tetanus
11.4. Seizure/Todd's Paralysis/NCSE
11.5. Seafood Toxins
12. Air Embolism
13. Headache
13.1. ICH
13.1.1. Trauma?
13.1.2. Bleeding Diathesis?
13.1.3. Loss of conciousness?
13.2. SAH
13.2.1. Max intensity at onset?
13.3. Hypertensive Encephalopathy
13.3.1. HTN?
13.4. CO Exposure
13.4.1. Anyone else at home affected?
13.5. Temporal Arteritis
13.5.1. Elderly/Scandinavian?
13.5.2. Jaw, Visual, Scalp Sx?
13.6. Meningoencephalitis
13.6.1. Fever?
13.6.2. Meningismus?
13.7. Cerebral Sinus Thrombosis
13.7.1. Thrombophilia?
13.8. Altitude Sickness
13.8.1. Altitude?
13.9. Acute Angle Closure Glaucoma
13.9.1. Visual Disturbance?
13.9.2. Abnormal Eye Exam?
13.10. Cerebral Artery Dissection
13.10.1. Neck Pain?
13.10.2. Horners?
13.10.3. Neck Manipulation?
13.11. Tumor/Elevated ICP
13.11.1. CA Hx?
14. MSK
14.1. Extremity Pain
14.1.1. Knee Pain
14.1.1.1. Infectious Arthritis
14.1.1.1.1. Red/hot joint?
14.1.1.1.2. Exquisitely painful ROM?
14.1.1.1.3. RF?
14.1.1.2. Knee Dislocation
14.1.1.2.1. Trama?
14.1.1.2.2. Unstable Knee?
14.1.1.3. Fractrure
14.1.1.3.1. Trama?
14.1.1.3.2. Ottawa Positive?
14.1.1.4. Patellar Dislocation
14.1.1.4.1. Abn Patella location?
14.1.1.5. Quadriceps Tendon Rupture
14.1.1.5.1. Weakness or inability to extend knee?
14.1.1.6. DVT
14.1.1.6.1. Extra-articular Findings?
14.1.1.6.2. RF?
14.1.1.6.3. Wells DVT Score?
14.1.1.7. Soft tissue Infxn
14.1.1.7.1. Rubor, Calor, Dolor
14.1.1.7.2. Outside of Joint?
14.1.1.8. INTERVENTIONS
14.1.1.8.1. Arthrocentesis
14.1.1.8.2. XR
14.1.1.8.3. Immobilization
14.1.1.8.4. Referral
14.1.1.8.5. Analgesia
14.1.1.8.6. Crutches
14.1.2. Arterial Injury
14.1.3. Fracture
14.1.4. Arterial Occlusion
14.1.5. Comparment Sdr
14.1.6. Trauma
14.1.7. DVT
14.1.8. Dislocation
14.2. Occult Trauma/Abuse
14.3. Osteomyelitis
15. Hypothermia/Hyperthermia
16. Hypercapnia
17. Uremia
18. Neutropenia
19. NMS/Serotonin Sdr
20. Thyroid
20.1. Hypothyroidism
20.2. Hyperthyroidism
21. Epiglottitis/RPA/PTA
22. Endocarditis
23. Malaria
24. Pheochromocytoma
25. Autonomic Dysreflexia
26. Neurogenic Shock
27. Weakness
27.1. Spinal Cord Injury
28. Respiratory Distress
28.1. Anaphylaxis
28.2. Pulmonary Edema
28.3. Arrhythmia
28.4. Neuromuscular Ventilatory Failure
28.5. Pulmonary Embolism
28.6. Pheumonia
28.7. Acute Coronary Sdr
28.8. Asthma/COPD
28.9. Occult Foreign Body
28.10. Airway Obstruction
28.11. Esophageal Rupture
28.12. Myopericarditis/Tamponade
28.13. Aortic Dissection
28.14. Hypoxia
29. Addisonian Crisis
30. Bleeding Disorders
30.1. GI Bleed
30.1.1. UGIB
30.1.1.1. Tracheo-innominate Artery Fistula
30.1.1.2. Esophageal Varices
30.1.2. LGIB
30.1.2.1. Aorto-Enteric Fistula
30.1.2.1.1. PMH AAA repair?
30.1.3. Occult GI Bleed