Postgraduate medicine
-
Postgraduate medicine · May 1997
ReviewHeadache as a symptom of ominous disease. What are the warning signals?
Headache can be an invaluable premonitory signal of imminent subarachnoid hemorrhage and cerebral infarction and can herald the onset of ominous and sometimes elusive disorders (arterial dissection, encephalitis, systemic and central vasculitides, and cerebral venous thrombosis) which have the potential for neurologic catastrophe and are often not obvious on routine CT brain imaging. Only rarely does serious underlying disease give rise to a headache that exactly mimics a migraine or tension headache. ⋯ A limited number of serious causes for headache which may be "CT-negative" should be considered in patients with "red flag" manifestations, such as seizures and cognitive changes. These should prompt further investigation with MRI and/or lumbar puncture.
-
Postgraduate medicine · Apr 1997
ReviewDiabetic ketoacidosis. Why early detection and aggressive treatment are crucial.
Diabetic ketoacidosis is a preventable condition that usually has a satisfactory outcome. However, the potential for a poor outcome and even death demands early and aggressive treatment. Insulin administration, rehydration, and electrolyte replacement are the mainstays of treatment. A search for the underlying cause is also a priority if recurrences are to be avoided.
-
Postgraduate medicine · Mar 1997
ReviewEndocrine emergencies. Recognizing clues to classic problems.
Although the possibility of an endocrine emergency occurring in a primary care setting may seem remote, awareness of such emergencies is crucial for appropriate management. While some symptoms are specific to classic endocrine disorders, other symptoms, such as nausea, vomiting, and diarrhea, are so general that the diagnosis may not be considered initially. In these situations, careful and thoughtful diagnostic studies can be lifesaving.