Emergency medicine clinics of North America
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The clinical spectrum of hyperthyroidism varies from asymptomatic,subclinical hyperthyroidism to the life-threatening "thyroid storm". Hyperthyroidism is a common form of thyroid disease that mimics many of the common complaints in the emergency department. The diagnosis of hyperthyroidism is often challenging due to the multitude of physical and even psychiatric complaints. Recognition and treatment by emergency physicians of severe hyperthyroidism is critical and can be life saving.
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Emerg. Med. Clin. North Am. · Aug 2005
Review Case ReportsRecognition and management of adrenal emergencies.
Although clinical conditions associated with dysfunction of the ad-renal gland are often subtle, even insidious, in their presentation,and diagnosis and treatment usually are confined to outpatient clinics and offices, there are several situations that warrant the attention of emergency physicians. Recognition of the spectrum of presentations of pheochromocytoma, adrenal insufficiency, and pituitary apoplexy, and the sequelae of corticosteroid therapy and withdrawal, are critically important areas to emergency medicine. Prompt diagnosis with appropriate treatment and referral will reduce morbidity and mortality in many patients each year. A related topic pertinent to emergency physicians is the management of incidental adrenal masses that are discovered on abdominal radio-logic imaging.
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Hyperosmolar hyperglycemic state (HHS) is the most serious acute complication of type 2 diabetes mellitus. Emergency department management focuses on prompt diagnosis and restoration of hemodynamic stability with appropriate fluid therapy while maintaining electrolyte homeostasis. Identification of any precipitating illness is essential. The emergence of HHS as a critical presentation of type 2 diabetes mellitus in adolescents is highlighted.
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Emerg. Med. Clin. North Am. · Aug 2005
ReviewAltered mental status due to metabolic or endocrine disorders.
The differential diagnoses for mental status alteration is broad. Endocrine or metabolic causes for emergency department patients who present with lethargy, anxiety, psychosis, and seizures should be considered. Using the complaint-based approach, this article discusses some of the often less obvious etiologies for these presentations related to endocrine and metabolic disease states.
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Diabetic ketoacidosis (DKA) is an acute metabolic complication of diabetes characterized by hyperglycemia, ketosis and acidosis. The pathophysiology of DKA is reviewed and diagnostic and therapeutic modalities are discussed in the context of the currently available evidence. Complications associated with DKA are often a result of the treatment itself, and these issues are also discussed.