clinical assessment, 1341 clinical recognition, 1340 –1341 management, 1341 treatment goals, 1340 triage considerations, 1341 Urinary tract infection (UTI), 199 , 201 –202 , 235 , 237 , 292 , 338 , 384 , 501 t, 529 , 553 , 569 Urobilinogen, 289 Urosepsis, 503 Urticaria, 452 , 453 f, 650 –651 Urticaria pigmentosa, 465 Usher syndrome, 222 Uterine bleeding in adolescent patient, 537 –538 diagnostic approach, 540 f treatment guidelines for, 539 t Utstein Criteria, 45 V Vaginal bleeding differential diagnosis, 536 t evaluation and decision, 533 from infections, 535 in neonate, 534 in nonpregnant adolescent patient, 535 –539 precocious puberty, 535 in pregnant patient, 539 –541 early pregnancy, 540 –541 ectopic pregnancy, 541 late pregnancy, 541 in prepubertal patient, 533 –535 with shock, 541 from tumors, 535 vaginal foreign body and, 535 from vascular anomalies, 535 Vaginal cysts, 1339 Vaginal discharge, 36e in adolescent Amsel criteria for diagnosis, 546 t diagnostic testing, 545 –546 differential diagnosis, 545 examination, 545 treatment, 546 –547 , 546 t in prepubertal child diagnostic testing and treatment, 544 –545 , 545 f differential diagnosis, 543 –544 , 544 t examination, 544 Vaginal lacerations, 1141 Vaginal trauma, 533 Vaginitis, 530 Valproic acid (Depakene), 497 Valvular insufficiency, 501 Valvular stenosis, 501 Vancomycin, 81 t, 475 osteomyelitis, 1361 t for osteomyelitis, 1361 sinusitis, 1323 Varicella infection, C096 e096.8f Varicella lesions, 350 Varicella zoster virus (VZV), 438 , 1397 Varicoceles, 413 , 415 , 1339 Vascular injuries, 1168 –1169 Vascular lesions, 650 Vascular malformations, 1351 –1356 face, deep hemangioma of, 1352 f granuloma annulare, 1353 –1354 , 1354 f hand, superficial hemangioma of, 1352 f infantile hemangiomas, 1352 infected pilonidal cyst, 1355 f juvenile xanthogranuloma (JXG), 1354 keloid/hypertrophic scar, 1354 , 1355 f lipomas, 1352 –1353 lumbosacral hairy patch, 1355 f lumbosacral lesions, 1355 lymphatic malformations, 1351 –1352 neurofibroma, 1354 perineal lesions, 1356 pilomatricoma, 1353 port-wine stains, 1351 pyogenic granuloma, 1353 salmon patches, 1351 spinal dysraphism, cutaneous manifestations of, 1355 –1356 umbilical granuloma, 1353 , 1353 f Vascular papules and nodules, 638 , 638 f Vasculitis, 162 , 1002 –1003 Vasoactive therapy, for shock, 84 Vasopressin, 80 t Vasopressor therapy, 1295 Vasovagal syncope, 518 , 520 , 523 –524 Vecuronium, 39 t Venoocclusive disease (VOD) of the liver, 931 Ventricular arrhythmias, 520 Ventricular assist devices (VADs), 617 –618 Ventricular septal defect (VSD), 369 Ventricular tachycardia (VT), 424 –425 , 607 f Ventriculoseptal defect, 501 Ventriculostomy, 1254 , 1389 Vertebral compression injuries, 1246 compression injuries, 1245 f unilateral facet dislocation, 1246 f Vertebral defects, 1355 Vertebral discitis, 557 Vertebral infection, 305 Vertebral osteomyelitis, 328 Vertebrobasilar migraine, 520 Vertigo, 1329 acute, 157 benign paroxysmal, 158 chronic, 157 common causes of, 157 , 158 t differential diagnosis of headache, 158 infections, 157 Ménière disease, 159 migraine, 157 –158 motion sickness, 159 ototoxic drugs, 158 seizures, 158 trauma, 158 evaluation and decision, 159 –160 , 160 f ancillary tests, 160 history and physical examination, 159 –160 laboratory investigations, 160 management, 160 –161 medications, 161 pathophysiology, 157 posttraumatic, 158 vestibular system and, 157 Vesicles, 646 –647 Vesicular eruptions, 459 –461 Vesiculobullous (blistering) disorders, 445 –450 Vestibular concussion, 158 Vestibular neuronitis, 157 ViaSpan, 1109 Vibrio vulnificus , 440 Vicarious menstruation, 166 Video-assisted thoracoscopic surgery (VATS), 1407 Video laryngoscopes, 38 Vinblastine, 927 Vincent angina, 350 Vincristine, 927 Viral adenitis, 307 Viral conjunctivitis, 174 Viral croup, 479 Viral encephalitis, 891 , 891 t Viral gastroenteritis, 553 Viral myositis, 329 , 560 Viral respiratory tract infection, 948