BOOK
Endocrine and Metabolic Emergencies, An Issue of Emergency Medicine Clinics of North America, E-Book
(2014)
Additional Information
Book Details
Abstract
This issue of Emergency Medicine Clinics edited by Drs. George Willis and Tyson Pillow focuses on Endocrine and Metabolic Emergencies and covers topics such as: Diabetes Mellitus, Hypothyroidism, Hyperthyroidism, Adrenal Emergencies, Derangements of Pottasium, Derangements of Sodium/Water Balance, Derangements of Calcium, Magnesium, and Phosphorus, Metabolic Acidosis, Neonatal Endocrine Emergencies and more.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Endocrine and Metabolic\rEmergencies | i | ||
| copyright\r | ii | ||
| Contributors | iii | ||
| Contents | vii | ||
| Emergency Medicine\rClinics Of North America\r | xi | ||
| Foreword\r | xv | ||
| Preface\r | xvii | ||
| Hyperthyroidism and Thyrotoxicosis | 277 | ||
| Key points | 277 | ||
| Epidemiology | 278 | ||
| Pathophysiology | 278 | ||
| Causes | 279 | ||
| Clinical presentation | 280 | ||
| Clinical examination | 283 | ||
| Unique populations | 284 | ||
| Thyroid storm | 285 | ||
| Diagnostic assessment | 285 | ||
| Management | 287 | ||
| Disposition | 290 | ||
| Summary | 291 | ||
| References | 291 | ||
| Alcoholic Metabolic Emergencies | 293 | ||
| Key points | 293 | ||
| Introduction | 293 | ||
| Alcohol intoxication | 294 | ||
| Intoxication and the endocrine system | 294 | ||
| Electrolyte derangements | 295 | ||
| Hyponatremia: A Consequence of Beer Potomania | 295 | ||
| Presentation | 295 | ||
| Diagnosis | 295 | ||
| Management | 295 | ||
| Hypomagnesemia | 296 | ||
| Alcoholic Ketoacidosis | 296 | ||
| Pathophysiology | 296 | ||
| Presentation | 297 | ||
| Diagnosis | 297 | ||
| Management | 297 | ||
| Alcoholic Encephalopathy | 297 | ||
| Cause and pathophysiology | 298 | ||
| Diagnosis | 298 | ||
| Treatment | 298 | ||
| Summary | 299 | ||
| References | 299 | ||
| Hypothyroidism | 303 | ||
| Key points | 303 | ||
| Introduction | 303 | ||
| Epidemiology | 304 | ||
| Pathophysiology | 304 | ||
| Emergency department presentation | 306 | ||
| Clinical features | 306 | ||
| Symptoms | 307 | ||
| Physical Examination Findings and Signs | 308 | ||
| Head and neck | 308 | ||
| Cardiovascular | 308 | ||
| Respiratory | 308 | ||
| Abdominal | 308 | ||
| Dermatologic | 308 | ||
| Neurologic | 308 | ||
| Psychiatric | 308 | ||
| Laboratory findings | 309 | ||
| Diagnosis of Hypothyroidism | 309 | ||
| High TSH | 309 | ||
| Normal TSH | 309 | ||
| Low TSH | 309 | ||
| Associated Laboratory Findings | 310 | ||
| Treatment | 310 | ||
| Hypothyroidism | 310 | ||
| Subclinical Hypothyroidism | 311 | ||
| Pregnancy | 311 | ||
| Disposition | 311 | ||
| Myxedema coma | 312 | ||
| Summary | 315 | ||
| References | 316 | ||
| The Changing Face of Diabetes in America | 319 | ||
| Key points | 319 | ||
| Introduction | 319 | ||
| Juvenile-onset type 2 diabetes mellitus | 320 | ||
| Risk Factors | 320 | ||
| Pathophysiology | 321 | ||
| Treatment | 322 | ||
| Latent autoimmune diabetes of adults | 323 | ||
| Prevalence and Proposed Mechanisms | 324 | ||
| Clinical Presentation | 324 | ||
| Treatment | 325 | ||
| Summary | 325 | ||
| References | 326 | ||
| Derangements of Potassium | 329 | ||
| Key points | 329 | ||
| Introduction and pathophysiology | 329 | ||
| Hyperkalemia | 333 | ||
| Etiology | 333 | ||
| Clinical Presentation | 335 | ||
| Diagnostic Testing | 335 | ||
| Treatment | 337 | ||
| Key Points | 341 | ||
| Hypokalemia | 341 | ||
| Etiology | 341 | ||
| Clinical Presentation | 343 | ||
| Diagnostic Testing | 343 | ||
| Treatment | 345 | ||
| Key Points | 345 | ||
| Summary | 346 | ||
| References | 346 | ||
| Calcium, Magnesium, and Phosphate Abnormalities in the Emergency Department | 349 | ||
| Key points | 349 | ||
| Introduction | 349 | ||
| Epidemiology | 350 | ||
| Normal physiology | 350 | ||
| Maintaining homeostasis | 351 | ||
| Pathophysiology of calcium, magnesium, and phosphate disorders | 352 | ||
| Calcium abnormalities | 352 | ||
| Hypercalcemia | 352 | ||
| Definition and classification | 352 | ||
| Cause | 353 | ||
| Signs and symptoms | 353 | ||
| Management | 353 | ||
| Hypocalcemia | 356 | ||
| Definition and classification | 356 | ||
| Cause | 356 | ||
| Altered Mental Status and Endocrine Diseases | 367 | ||
| Key points | 367 | ||
| Introduction | 367 | ||
| Evaluation and treatment of the patient | 368 | ||
| History | 368 | ||
| Physical Examination | 368 | ||
| Glucose-related causes of altered mental status | 369 | ||
| Hypoglycemia | 369 | ||
| Diabetic Ketoacidosis/Hyperglycemic Hyperosmolar Syndrome | 371 | ||
| Thyroid-related causes of altered mental status | 372 | ||
| Myxedema Coma | 372 | ||
| Thyroid Storm | 373 | ||
| Adrenal-related causes of altered mental status | 374 | ||
| Adrenal Insufficiency | 374 | ||
| Pheochromocytoma | 376 | ||
| Summary | 376 | ||
| References | 377 | ||
| Disorders of Sodium and Water Balance | 379 | ||
| Key points | 379 | ||
| Introduction | 379 | ||
| Physiology | 380 | ||
| Hyponatremia | 381 | ||
| Signs and Symptoms | 382 | ||
| Evaluation and Diagnosis | 382 | ||
| Hypovolemic hyponatremia | 382 | ||
| Hypervolemic hyponatremia | 383 | ||
| Euvolemic hyponatremia | 383 | ||
| Treatment | 385 | ||
| Unstable patients | 385 | ||
| Stable patients | 385 | ||
| Cerebral Edema | 389 | ||
| Osmotic Demyelination Syndrome | 389 | ||
| Pediatric Considerations | 390 | ||
| Hypernatremia | 390 | ||
| Signs and Symptoms | 391 | ||
| Evaluation and Diagnosis | 391 | ||
| Hypovolemic hypernatremia | 391 | ||
| Hypervolemic hypernatremia | 392 | ||
| Euvolemic hypernatremia | 392 | ||
| Treatment | 392 | ||
| Unstable patients | 392 | ||
| Stable patients | 393 | ||
| Pediatric Considerations | 394 | ||
| Fluids used for resuscitation | 394 | ||
| Summary | 395 | ||
| References | 396 | ||
| Approach to Metabolic Acidosis in the Emergency Department | 403 | ||
| Key points | 403 | ||
| Introduction | 403 | ||
| Respiratory Physiology | 404 | ||
| Renal Physiology | 404 | ||
| Pathophysiology | 404 | ||
| Approach to acid-base disorders | 404 | ||
| Respiratory Compensation | 405 | ||
| Serum Anion Gap | 405 | ||
| Delta Gap/Ratio | 405 | ||
| Osmol Gap | 406 | ||
| Urinary Anion Gap | 406 | ||
| Elevated anion gap acidoses | 407 | ||
| Carbon Monoxide | 407 | ||
| Cyanide | 408 | ||
| Alcoholic Ketoacidosis (and Starvation Ketoacidosis) | 409 | ||
| Toluene | 409 | ||
| Methanol | 410 | ||
| Uremia | 410 | ||
| Diabetic Ketoacidosis | 410 | ||
| Propylene Glycol, Paraldehyde | 411 | ||
| Isoniazid, Iron | 411 | ||
| Lactic Acidosis | 412 | ||
| Ethylene Glycol, Ethanol | 412 | ||
| Salicylates | 413 | ||
| Normal anion gap (hyperchloremic) acidoses | 413 | ||
| Hyperalimentation | 413 | ||
| Acetazolamide | 413 | ||
| Renal Tubular Acidosis | 414 | ||
| Renal Failure | 415 | ||
| Diarrhea/Diuretics | 415 | ||
| Dilutional (or Volume Expansion) Acidosis | 416 | ||
| Ureteroenterostomy | 416 | ||
| Pancreatic Fistula | 416 | ||
| Treatment of acidosis | 416 | ||
| Summary | 417 | ||
| References | 417 | ||
| Neonatal Endocrine Emergencies | 421 | ||
| Key points | 421 | ||
| Introduction | 421 | ||
| Hypoglycemia | 422 | ||
| Hypothyroidism | 424 | ||
| Hyperbilirubinemia | 426 | ||
| Unconjugated Hyperbilirubinemia | 426 | ||
| Conjugated Hyperbilirubinemia | 428 | ||
| Electrolytes | 428 | ||
| Hyponatremia | 428 | ||
| Hypocalcemia | 429 | ||
| Congenital adrenal hyperplasia | 430 | ||
| Inborn errors of metabolism | 432 | ||
| Summary | 433 | ||
| References | 433 | ||
| Current Diagnosis and Treatment of Hyperglycemic Emergencies | 437 | ||
| Key points | 437 | ||
| Introduction | 437 | ||
| Epidemiology | 438 | ||
| Pathophysiology | 438 | ||
| Causes | 439 | ||
| Differential Diagnosis | 439 | ||
| Clinical Presentation | 439 | ||
| Diagnostic Evaluation | 441 | ||
| Treatment | 443 | ||
| Fluid Resuscitation | 443 | ||
| Insulin | 444 | ||
| Potassium | 445 | ||
| Bicarbonate | 446 | ||
| Phosphate | 446 | ||
| Complications | 447 | ||
| Cerebral Edema | 447 | ||
| Pulmonary Edema | 447 | ||
| Disposition | 448 | ||
| Summary | 449 | ||
| Acknowledgments | 449 | ||
| References | 449 | ||
| Approach to Metabolic Alkalosis | 453 | ||
| Key points | 453 | ||
| Introduction | 453 | ||
| Clinical presentation | 453 | ||
| Diagnosis | 454 | ||
| Cause and management | 454 | ||
| Chloride Depletion Alkalosis | 455 | ||
| Gastrointestinal losses | 456 | ||
| Vomiting or nasogastric suction | 456 | ||
| Congenital chloridorrhea | 457 | ||
| Villous adenoma of the colon | 457 | ||
| High-output ileostomy drainage | 457 | ||
| Renal losses | 457 | ||
| Diuretic administration | 457 | ||
| Impairment of chloride-linked sodium transport | 457 | ||
| Treatment | 458 | ||
| Mineralocorticoid Excess Syndromes | 459 | ||
| The Clinical Manifestations, Diagnosis, and Treatment of Adrenal Emergencies | 465 | ||
| Key points | 465 | ||
| Introduction | 465 | ||
| Emergencies of the adrenal cortex | 466 | ||
| Primary Adrenal Insufficiency (Addison Disease) | 466 | ||
| Epidemiology | 466 | ||
| Anatomy and physiology | 466 | ||
| Clinical presentation | 468 | ||
| Secondary Adrenal Insufficiency | 469 | ||
| Epidemiology | 469 | ||
| Anatomy and physiology | 469 | ||
| Clinical presentation | 469 | ||
| Tertiary Adrenal Insufficiency | 472 | ||
| Epidemiology | 472 | ||
| Anatomy and physiology | 472 | ||
| Clinical presentation | 473 | ||
| Differentiating PAI, SAI, and TAI | 473 | ||
| Differential Diagnosis | 473 | ||
| Adrenal Crisis | 474 | ||
| Epidemiology | 474 | ||
| Clinical presentation | 474 | ||
| Emergency Department Management of Adrenal Insufficiencies and Adrenal Crisis | 474 | ||
| Treatment before diagnostic testing | 474 | ||
| Confirmatory diagnostic testing | 475 | ||
| Disposition | 476 | ||
| Emergencies of the adrenal medulla | 476 | ||
| Pheochromocytomas | 476 | ||
| Epidemiology | 476 | ||
| Anatomy and physiology | 477 | ||
| Clinical presentation | 477 | ||
| Differential diagnosis | 479 | ||
| Surgical and Medical Management of Pheochromocytoma | 479 | ||
| Confirmatory Diagnostic Testing | 481 | ||
| Disposition | 481 | ||
| Incidentalomas | 481 | ||
| References | 481 | ||
| Index | 485 |