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Consultant Vol 43 No 14

A 73-year-old man with chronic constipation presented to the emergency department with hematochezia. Mild, colicky abdominal pain had begun 3 days earlier; obstipation had been present for 10 days.The patient’s history included a cerebrovascular accident 2 years earlier and Parkinson disease; he was taking anticholinergic drugs.

A 40-year-old woman who said she had asthma was admitted to the hospital with worsening dyspnea and cough. A β-adrenergic agent was her only medication. The patient denied cigarette smoking and alcohol consumption. Except for an appendectomy 20 years earlier, her medical history was unremarkable. The patient was afebrile.

A 75-year-old obese woman with subacute-onset dyspnea and lower right posterior chest pain was brought to the emergency department. She had a history of diastolic heart failure, arthritis, and suspected obstructive sleep apnea. The patient was dyspneic at rest.

Several times a year a rash erupts on the chest, axillae, and neck of a 41-year-old woman. Her father and siblings have a similar history. A biopsy of the affected skin confirmed the suspected diagnosis of benign familial pemphigus, which is also called Hailey-Hailey disease.

Diffuse petechiae suddenly arose on the back and abdomen of a 79-year-old woman. Within several days, the asymptomatic lesions covered her arms and face as well.

Examine patients’ carotid arteries immediately
after you examine their


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