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Images

Lymphedema

Primary lymphedema of the right lower extremity

From the collection of Dr Arin K. Greene

Lymphedema

Secondary lymphedema: left lower extremity lymphedema after radiation, and lymphadenectomy for Hodgkin lymphoma

From the collection of Dr Arin K. Greene

Lymphedema

Lymphoscintigraphy showing dermal back flow and absent uptake of radiolabeled colloid in lymph nodes of left lower extremity consistent with lymphedema

From the collection of Dr Arin K. Greene

Evaluation of chest pain

Chest x-ray showing a widened mediastinum

From the collection of Professor James Brown; used with permission

Evaluation of chest pain

Distribution of final diagnoses in people over 35 years admitted to the hospital from one US hospital emergency department with chief complaint of nontraumatic chest pain, over a 5-year period (PE, pulmonary embolism)

Created by BMJ; based on data from Kohn MA, Kwan E, Gupta M, et al. Prevalence of acute myocardial infarction and other serious diagnoses in patients presenting to an urban emergency department with chest pain. J Emerg Med. 2005 Nov;29(4):383-90

Evaluation of chest pain

Varicella zoster virus

Courtesy of Daniel Eisen, MD; used with permission

Evaluation of chest pain

ECG showing ST depression

From the personal collection of Dr Syed W. Yusuf and Dr Iyad N. Daher, Department of Cardiology, University of Texas, Houston, TX; used with permission

Evaluation of chest pain

Composition of the HEART score for chest pain patients in the emergency department

Six AJ, et al. Neth Heart J. 2008;16:191-6; used with permission

Evaluation of chest pain

Chest x-ray showing a large globular heart in a patient with pericardial tamponade

From the collection of Professor James Brown; used with permission

Evaluation of chest pain

ECG showing changes of an acute inferior myocardial infarction with ST elevation in leads II, III, and aVF

From the collection of Professor James Brown; used with permission

Evaluation of chest pain

Angiogram showing occluded right artery

From the personal collection of Dr Mahi Ashwath; used with permission

Evaluation of chest pain

Spiral computed tomography pulmonary angiogram showing a large filling defect within the pulmonary vasculature compatible with a saddle embolus

From the collection of Professor James Brown; used with permission

Cocaine abuse

Crack lip: burns to the lips, caused by hot pipes, are characteristic of crack cocaine smokers

From: Karch S. Karch's pathology of drug abuse. 4th ed. Boca Raton, FL: CRC Press; 2008. Used with permission

Cocaine abuse

Coronary dissection: acute MI is uncommon in crack cocaine smokers but does occur occasionally. One cause, usually forgotten, is coronary artery dissection

From: Karch S. Karch's pathology of drug abuse. 4th ed. Boca Raton, FL: CRC Press; 2008. Used with permission

Cocaine abuse

H&E stained lung section from a 56-year-old male chronic cocaine abuser who died of an apparent arrhythmia. He had been complaining of shortness of breath for several weeks. Note the thickened alveolar septa; medial hyperplasia is obvious in several vessels. The very dark cells scattered among the alveoli are hemosiderin-containing macrophages, a common find in pulmonary hypertension

From the collection of Dr Steven B. Karch; used with permission

Evaluation of respiratory alkalosis

Sequential (or Sepsis-related) Organ Failure Assessment (SOFA) criteria

Created by BMJ, adapted from Vincent JL, Moreno R, Takala J, et al. The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine. Intensive Care Med 1996;22:707-710.

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