, 3251 Riverport Lane
St. Louis, Missouri 63043
EMERGENCY MEDICINE SECRETS, FIFTH EDITION ISBN: 978-0-323-07167-3
Copyright © 2011, 2006, 2003, 1999, 1993 by Mosby, Inc., an affiliate of Elsevier Inc.
No part of this publication may be reproduced or transmitted in any form or by any means, electronic or
mechanical, including photocopying, recording, or any information storage and retrieval system, without
permission in writing from the publisher. Details on how to seek permission, further information about the
Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center
and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions.
This book and the individual contributions contained in it are protected under copyright by the Publisher (other
than as may be noted herein).
Notices
Knowledge and best practice in this field are constantly changing. As new research and experience broaden
our understanding, changes in research methods, professional practices, or medical treatment may become
necessary.
Practitioners and researchers must always rely on their own experience and knowledge in evaluating and
using any information, methods, compounds, or experiments described herein. In using such information or
methods they should be mindful of their own safety and the safety of others, including parties for whom they
have a professional responsibility.
With respect to any drug or pharmaceutical products identified, readers are advised to check the most
current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be
administered, to verify the recommended dose or formula, the method and duration of administration, and
contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of
their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient,
and to take all appropriate safety precautions.
To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors assume any
liability for any injury and/or damage to persons or property as a matter of products liability, negligence or
otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the
material herein.
Library of Congress Cataloging-in-Publication Data
Emergency medicine secrets / [edited by] Vincent J. Markovchick, Peter T.
Pons, Katherine M. Bakes. -- 5th ed.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-0-323-07167-3 (pbk. : alk. paper)
1. Emergency medicine--Examinations, questions, etc. I. Markovchick,
Vincent J. II. Pons, Peter T. III. Bakes, Katherine M.
[DNLM: 1. Emergencies--Examination Questions. 2. Emergency
Medicine--Examination Questions. WB 18.2]
RC86.9.M37 2011
616.02’5--dc22
2010040474
Senior Acquisitions Editor: James Merritt
Developmental Editor: Barbara Cicalese
Publishing Services Manager: Anne Altepeter
Senior Project Manager: Cheryl A. Abbott
Design Direction: Steven Stave
Printed in the United States of America
Last digit is the print number: 9 8 7 6 5 4 3 2 1
,DEDICATION
To my wife, Leslie, and daughters, Nicole, Tasha, and Nadia—the four greatest ladies in my world. I
wish to thank them for their lifelong support of all my endeavors and, in particular, for understanding
the time that the editing of this manuscript has taken away from my time with them. I would also like
to acknowledge all the medical students, residents, and attending staff physicians with whom I have
had the pleasure of working at the Denver Health Emergency Department over the past 33 years.
Their enthusiasm and intellectual curiosity have stimulated many of the questions in this book.
VJM
To my wife, Kathy, whose love, support, and remarkable patience make every day worthwhile.
PTP
To Vince, for being a true mentor. To my parents, Phil and Ursula Awad, for believing in me more
than I ever have myself. To my husband and eternal soulmate, Peter, for allowing me the freedom
and support to follow my dreams. And to our children, Sam, Jessie, and Avery, because coming
home to you is my favorite part of the day—I love you…plus one.
KMB
The editors also express their heartfelt thanks to Carol Lucas for her organizational skills, tenacity,
good humor, hard work, and incredible dedication to the preparation of the fifth edition. We could
not have accomplished this without her help.
,
St. Louis, Missouri 63043
EMERGENCY MEDICINE SECRETS, FIFTH EDITION ISBN: 978-0-323-07167-3
Copyright © 2011, 2006, 2003, 1999, 1993 by Mosby, Inc., an affiliate of Elsevier Inc.
No part of this publication may be reproduced or transmitted in any form or by any means, electronic or
mechanical, including photocopying, recording, or any information storage and retrieval system, without
permission in writing from the publisher. Details on how to seek permission, further information about the
Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center
and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions.
This book and the individual contributions contained in it are protected under copyright by the Publisher (other
than as may be noted herein).
Notices
Knowledge and best practice in this field are constantly changing. As new research and experience broaden
our understanding, changes in research methods, professional practices, or medical treatment may become
necessary.
Practitioners and researchers must always rely on their own experience and knowledge in evaluating and
using any information, methods, compounds, or experiments described herein. In using such information or
methods they should be mindful of their own safety and the safety of others, including parties for whom they
have a professional responsibility.
With respect to any drug or pharmaceutical products identified, readers are advised to check the most
current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be
administered, to verify the recommended dose or formula, the method and duration of administration, and
contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of
their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient,
and to take all appropriate safety precautions.
To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors assume any
liability for any injury and/or damage to persons or property as a matter of products liability, negligence or
otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the
material herein.
Library of Congress Cataloging-in-Publication Data
Emergency medicine secrets / [edited by] Vincent J. Markovchick, Peter T.
Pons, Katherine M. Bakes. -- 5th ed.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-0-323-07167-3 (pbk. : alk. paper)
1. Emergency medicine--Examinations, questions, etc. I. Markovchick,
Vincent J. II. Pons, Peter T. III. Bakes, Katherine M.
[DNLM: 1. Emergencies--Examination Questions. 2. Emergency
Medicine--Examination Questions. WB 18.2]
RC86.9.M37 2011
616.02’5--dc22
2010040474
Senior Acquisitions Editor: James Merritt
Developmental Editor: Barbara Cicalese
Publishing Services Manager: Anne Altepeter
Senior Project Manager: Cheryl A. Abbott
Design Direction: Steven Stave
Printed in the United States of America
Last digit is the print number: 9 8 7 6 5 4 3 2 1
,DEDICATION
To my wife, Leslie, and daughters, Nicole, Tasha, and Nadia—the four greatest ladies in my world. I
wish to thank them for their lifelong support of all my endeavors and, in particular, for understanding
the time that the editing of this manuscript has taken away from my time with them. I would also like
to acknowledge all the medical students, residents, and attending staff physicians with whom I have
had the pleasure of working at the Denver Health Emergency Department over the past 33 years.
Their enthusiasm and intellectual curiosity have stimulated many of the questions in this book.
VJM
To my wife, Kathy, whose love, support, and remarkable patience make every day worthwhile.
PTP
To Vince, for being a true mentor. To my parents, Phil and Ursula Awad, for believing in me more
than I ever have myself. To my husband and eternal soulmate, Peter, for allowing me the freedom
and support to follow my dreams. And to our children, Sam, Jessie, and Avery, because coming
home to you is my favorite part of the day—I love you…plus one.
KMB
The editors also express their heartfelt thanks to Carol Lucas for her organizational skills, tenacity,
good humor, hard work, and incredible dedication to the preparation of the fifth edition. We could
not have accomplished this without her help.
,
