Posted: May 17, 2016 | Author: Dr Sean Scott | Filed under: Tuesday Tutorials |Leave a commentCollaborate on SlackThis BMJ review article gives a nice overview of endocrine emergencies.DKA
Origen: Endocrine Emergencies
This BMJ review article gives a nice overview of endocrine emergencies.
You are asked to review a 27 year old female, a known diabetic, admitted following a 48 hour illness characterised by nausea, vomiting and shortness of breath. She has been unable to eat or drink and has not taken her regular insulin. On examination she has a heart rate of 137/min, respiratory rate of 36 breaths/min, O2 sats of 99% on room air, blood pressure of 92/34mmHg. She weights 80kg and her blood sugar level is 32mmol/L.
Outline your plan of management for the first 24 hours.
List the features which distinguish diabetic ketoacidosis (DKA) from the hyperosmolar hyperglycaemic state (HHS).
Describe your specific treatment for a 62-year-old female presenting with a decreased conscious state secondary to HHS.
Emergency Management of DKA
What features on history, examination and investigation would make you suspect thyroid storm in this patient?
Outline your approach to the management of thyrotoxic crises. Include in your answer the rationale for each drug used.
A 38 year old man presents with bradycardia, hypotension and a GCS of 14.
HR 45 BP 90/40 Sats 98% on RA Temp 35.9
What is you differential diagnosis?
What features on history, examination and investigation would make you consider hypothyroidism as an underlying cause
Outline your management of this patient if hypothyroidism is a likely cause of his presentation.
A 50-year-old Scottish male tourist presents with a three-day history of nausea, vomiting, general lethargy and dizziness.
HR 106 BP 90/55 Sats 99% on RA Temp 37.8
The results of his investigations are as follows:
Describe and interpret these results.
Outline the causes, consequences and management of adrenal insufficiency in the critically ill.
A 43 year old female presents with a severe episode of palpitations, sweating, vomiting and breathlessness after taking a dose of propranolol prescribed by her General Practitioner for panic attacks. She gives a history of similar symptoms occurring episodically over the preceding three months and her past medical history includes medullary thyroid cancer.
Vital signs: SaO2 88% on oxygen 15 L/min via mask Heart rate: 150, Atrial Fibrillation BP 175/100 mm Hg Chest X-Ray: Consistent with acute pulmonary oedema.
You suspect phaeochromocytoma outline your immediate management of at this patient.
Which signs and symptoms make you suspect this diagnosis?
What investigations will help you confirm the diagnosis?