Endocrine emergencies overview

Apr 17, 2014Download as PPT, PDF16 likes1,941 views

د/ يحيى الفقي Endocrine emergencies overview المحاضرة التي قدمت يوم الثلاثاء 8 ابريل 2014 في دار الحكمة بالقاهرة من فعاليات مشروع اعداد طبيب حكيم ناجح بالتعاون مع معتمد باتحاد الاطباء العرب و ضمن موديول الطوارئ و التخدير و العناية المركزة

WhyThe Endocrinal Emergencies
• DELAYED DIAGNOSIS DEVASTATING COMPLICATIONS AND DEATH

MalignantThyrotoxicosis
(Thyroid Storm )

Dr. Stacy Arvinna presented on various endocrine emergencies including: 1. Diabetic ketoacidosis is characterized by hyperglycemia, ketosis and acidemia due to insulin deficiency. It requires fluid resuscitation and insulin therapy. 2. Thyroid storm is a severe exacerbation of hyperthyroidism with multi-organ involvement. It has a high mortality and requires beta blockade, antithyroid drugs, iodine and corticosteroids. 3. Myxedema coma is the severe manifestation of hypothyroidism leading to decreased mental status and hypothermia. It requires gradual rewarming and high dose thyroid hormone replacement.

Diabetic emergencySoe Myat Thwe

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This document provides information on diabetic emergencies including diabetic ketoacidosis (DKA), hyperglycemic hyperosmolar state (HHS), and hypoglycemia. It defines each condition, describes their pathogenesis and precipitating factors, outlines their clinical features and diagnostic criteria, and provides guidance on management and treatment. DKA is characterized by hyperglycemia, metabolic acidosis, and high ketone levels, while HHS involves severe hyperglycemia, hyperosmolality, and minimal ketosis. Hypoglycemia is defined as a blood glucose level below 3.9 mmol/L. The document emphasizes the need for prompt treatment of these diabetic emergencies.

Hyperglycemic emergenciesrishi raj

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Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are life-threatening emergencies characterized by severe hyperglycemia and electrolyte abnormalities. DKA is defined by blood glucose over 250 mg/dL, venous pH below 7.3, bicarbonate below 15 mEq/L, and ketonemia or ketonuria. HHS involves blood glucose over 600 mg/dL, venous pH above 7.3, and minimal ketone production. Treatment involves fluid resuscitation, insulin therapy to lower blood glucose, electrolyte replacement, and identifying/treating precipitating causes. Transition to subcutaneous insulin can occur when blood glucose is below

Primary hyperaldosteronismAbdulmoein AlAgha

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1) Primary hyperaldosteronism, also known as Conn's syndrome, is characterized by excessive secretion of the hormone aldosterone from the adrenal glands, causing increased sodium retention and potassium excretion. 2) It can be caused by an aldosterone-producing adenoma, idiopathic bilateral adrenal hyperplasia, or adrenal carcinoma. Aldosterone-producing adenomas account for 65-70% of cases. 3) Symptoms include hypertension, hypokalemia, headaches, and muscle weakness. Diagnostic tests include measuring aldosterone and renin levels, with an elevated aldosterone-to-renin ratio confirming the diagnosis. Treatment options include surgical removal of

Addison diseaseGagan Velayudhan

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Addison disease is caused by primary adrenocortical deficiency due to destruction of the adrenal cortex, most commonly from autoimmune disease or tuberculosis. It presents with weakness, weight loss, hyperpigmentation, and hypotension due to glucocorticoid and mineralocorticoid deficiency. The diagnosis is made by demonstrating a subnormal response on ACTH stimulation testing with failure to increase cortisol levels above the normal range.

SHOCKDr. Abdullah Al Mamun

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1. Shock is defined as a state where the delivery of oxygen to tissues is inadequate to meet metabolic demands, resulting in cellular dysfunction. 2. Shock is classified into five main types: hypovolemic, cardiogenic, obstructive, distributive, and endocrine. 3. Treatment for shock involves rapid fluid resuscitation to restore circulating volume, with vasopressors or inotropes as needed depending on the type of shock. Ongoing monitoring of vital signs and urine output is also critical.

Endocrine emergenciesMohd Hanafi

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The document discusses various endocrine emergencies including diabetic ketoacidosis (DKA), hypoglycemia, and thyroid storm. It provides details on the causes, symptoms, diagnostic criteria and treatment approaches for each condition. DKA results from lack of insulin and needs urgent treatment including rehydration, insulin administration, and electrolyte correction. Hypoglycemia can be caused by too much insulin or too little food intake and requires glucose administration. Thyroid storm is a life-threatening exacerbation of hyperthyroidism that requires treatments to correct the hyperthyroidism and address any precipitating factors.

Approach to Hypoglycemia in childhoodRavi Kumar

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This document discusses the approach to hypoglycemia in childhood. It begins by defining hypoglycemia and describing the importance of glucose for brain development. It then discusses the pathophysiology of hypoglycemia, focusing on how the body maintains blood glucose levels through glycogenolysis, gluconeogenesis, and lipolysis. The clinical features of hypoglycemia are presented, distinguishing between sympathetic overactivity and neuroglycopenic symptoms. Common etiologies like hyperinsulinism, metabolic disorders, and systemic illnesses are outlined. The document concludes with recommendations for investigating hypoglycemia, managing acute episodes, and treating underlying causes to prevent long-term neurological consequences.

Hypercalcemia ,causes and treatment anilapasha

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This document discusses hypercalcemia, which is defined as a serum calcium level above 10.5 mg/dl. It outlines the causes of hypercalcemia including primary hyperparathyroidism, certain cancers, and excessive vitamin D or calcium supplementation. Signs and symptoms are noted such as abdominal pain, nausea, weakness and cardiac issues. Diagnostic testing including PTH, calcium, and phosphate levels as well as imaging are covered. Treatment focuses on rehydration, bisphosphonates, glucocorticoids, calcitonin, surgery if needed, and addressing the underlying cause. Complications of untreated hypercalcemia include osteoporosis, kidney stones, and kidney failure.

Fluids and Electrolytes in Infants and ChildrenNorthTec

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This document discusses fluid and electrolyte balance in infants and children. It covers normal fluid regulation, increased and decreased fluid needs, signs of dehydration and fluid overload, diagnostic tests including electrolyte levels, treatment for dehydration including oral and IV rehydration, and acid-base imbalances including causes and management of respiratory and metabolic acidosis and alkalosis.

Management of diabetic ketoacidosisNgọc Anh Lương

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The document provides information on the management of diabetic ketoacidosis (DKA). It discusses diagnosing DKA, including euglycemic DKA. Treatment involves three steps - correcting fluid deficits with isotonic saline, treating electrolyte abnormalities like potassium replacement, and administering insulin via continuous IV infusion. Monitoring of laboratory values is important to gauge resolution of ketoacidosis and switch to subcutaneous insulin when indicators are met. Complications can include hypoglycemia and hypokalemia.

Diabetes insipidus (DI)Ofonmbuk Umoh

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Adrenal Insufficiencyjenniferjensen123

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This presentation provides EMTs with information about adrenal insufficiency and adrenal crisis. It covers adrenal anatomy and physiology, epidemiology, clinical presentation, patient management, and medication profiles. The objectives are to increase awareness of adrenal insufficiency, including pathophysiology, signs and symptoms, effective treatment, and family-centered care. The presentation was created by MA EMS for Children using various cited sources and individuals.

Endocrine (part2)Stacy A.J

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ACUTE LIVER FAILURE - APPROACH AND MANAGEMENTNishant Yadav

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Acute liver failure is a clinical syndrome resulting from massive necrosis or impairment of hepatocytes, leaving insufficient liver function. It impairs synthetic, excretory, and detoxifying liver functions. Pediatric acute liver failure is defined by evidence of liver dysfunction within 8 weeks, uncorrectable coagulopathy, and no evidence of chronic liver disease. Causes include viral infections, drugs, and metabolic disorders. Management involves transport to a specialized center, intensive care, supportive care, measures for raised intracranial pressure, coagulopathy, sepsis, and potential liver transplantation.

Endocrine emergency casesRVHEM

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A 24-year-old female presented with fever, abdominal pain, nausea, vomiting, dysuria, palpitations, anxiety, eye swelling and pain, and atrial fibrillation. She had a history of Graves' disease and was non-compliant with medication for 2 months. Examination found tachycardia, enlarged thyroid with bruit, and exophthalmos. This presentation, along with recent stress and UTI, was consistent with thyroid storm. Treatment for thyroid storm focuses on cooling, hydration, antithyroid drugs to prevent synthesis and release of thyroid hormone, and beta-blockers to treat peripheral effects.

Acute Coronary Syndrome (ACS), Medicineautumnpianist

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This document defines and describes acute coronary syndrome, which includes unstable angina and myocardial infarction. It discusses the etiology, pathogenesis, clinical features, investigations, management, and prognosis of acute coronary syndrome. The key points are that acute coronary syndrome is caused by atherosclerosis and involves plaque disruption and thrombosis in the coronary arteries, leading to symptoms such as chest pain. Diagnosis involves electrocardiography, cardiac biomarker tests, and imaging. Treatment focuses on analgesia, antithrombotics, reperfusion therapy, and long-term secondary prevention. Prognosis depends on factors like the infarct location and timeliness of treatment.

PphnVarsha Shah

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Persistent pulmonary hypertension of the newborn (PPHN) is a major problem in neonatal intensive care units that can lead to death or neurological injury in newborns. It occurs when the pulmonary circulation fails to transition from the high resistance fetal state. Causes include meconium aspiration syndrome, idiopathic PPHN, and pulmonary hypoplasia from conditions like congenital diaphragmatic hernia. Treatment involves optimizing oxygenation and cardiac function along with pulmonary vasodilators like inhaled nitric oxide. Future therapies may include phosphodiesterase inhibitors and prostacyclin analogs to further reduce pulmonary hypertension in newborns.

Diabetes ketoacidosisOmkar Singh

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The document discusses diabetic ketoacidosis (DKA), providing definitions, pathophysiology, precipitating events, symptoms, diagnosis, and treatment. DKA is defined as hyperglycemia, ketosis, and acidemia. It results from insulin deficiency leading to lipolysis, ketogenesis, and hyperglycemia. Common causes include infection, inadequate insulin, drugs like cocaine, and pregnancy. Treatment involves fluid resuscitation, insulin therapy to lower glucose levels to 140-180 mg/dL, electrolyte replacement, and treating the underlying precipitant once the patient is stabilized. Potassium levels require close monitoring during treatment.

Heart failure in childhoodReyad Al_Faky

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Addisonian 1Victor Effiom

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The document provides information on Addisonian crisis, also known as an acute adrenal crisis. It begins with objectives of being able to promptly identify and treat an Addisonian crisis to save a patient's life, as the presentation can mimic other conditions. The document then contrasts acute adrenal crisis with Addison's disease, which develops more gradually over months to years. It provides an overview of epidemiology, anatomy, physiology of the adrenal glands and cortisol. It describes the signs and symptoms of Primary/Addison's adrenal insufficiency and discusses various causes including autoimmune disease and exogenous steroid use. Acute adrenal crisis can be fatal if not identified and treated immediately with cortisol replacement.

Hyperkalemia.pptxDr Ankit Agrawal

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Hypokalaemia and Hyponatraemia Acute MxSCGH ED CME

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This document provides guidance on managing hypo-K (low potassium) and hypo-Na (low sodium) in the emergency department. It defines mild, moderate and severe levels for each and describes associated ECG changes, symptoms and appropriate labs. For hypo-K, it recommends giving IV or oral K to raise levels to 4-4.5 mmol/L and giving Mg if low. For severe hypo-Na, it recommends a stepwise approach of treating CNS symptoms with 3% saline, being conservative to avoid complications, and consulting nephrology if needed. It also presents two case studies as examples.

osmotic deyelination syndromeSachin Adukia

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This document provides an overview of osmotic demyelination syndrome (ODS), also known as central pontine myelinolysis. It discusses the history, controversies in nomenclature, pathology, epidemiology, pathophysiology, clinical features, diagnosis, management including prevention, re-lowering sodium levels, supportive care and investigational therapies, prognosis, and key references. The document is intended as an educational resource for physicians on ODS.

Hyperglycemic hyperosmolar syndrome for nursingSafad R. Isam

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Hyperglycemic hyperosmolar syndrome (HHS) is a serious condition caused by low insulin levels and high blood glucose levels, resulting in excessive thirst, frequent urination, and dehydration. It predominantly affects older adults with type 2 diabetes and is triggered by illnesses that increase insulin demand. HHS is characterized by hyperglycemia, hyperosmolarity, and alterations in mental status without significant ketosis. Treatment involves fluid replacement, electrolyte management, and insulin administration to restore hydration and metabolic balance while closely monitoring for complications. Lifestyle changes and medical management after recovery can help prevent recurrence of HHS.

Adrenocortical insufficiencySasha Bondi

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Acute kidney injuryAHMED SOLIMAN

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1) Acute kidney injury (AKI) is common in intensive care units and can significantly impact patient prognosis if not recognized and treated early. 2) AKI is classified using the RIFLE criteria which evaluates risk, injury and failure based on changes in creatinine and urine output. Class F injury indicates the most severe form of AKI. 3) The main causes of AKI are pre-renal such as hypovolemia, post-renal such as obstructive uropathy, and intrinsic renal injury such as acute tubular necrosis. Early detection and treatment of the underlying cause is important to prevent complications.

Hyperglycemic hyperosmolar941531003

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This document provides information about hyperglycemic hyperosmolar syndrome (HHS), including other names for the condition, definitions, pathophysiology, diagnostic tests, treatment, complications, nursing diagnoses, and more. HHS is a life-threatening emergency caused by severe hyperglycemia and lack of insulin. It is characterized by extremely high blood glucose levels over 400 mg/dL, hyperosmolality due to water loss from cells, and lack of ketosis. Diagnostic tests show electrolyte imbalances. Treatment focuses on rapid fluid replacement and slow insulin administration to lower blood glucose levels over 24-48 hours. Complications can include organ failure, infection, and death if not properly treated.

Endocrineرائع emergenciesWael Eladl

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This document provides an overview of endocrine emergencies, including diabetic emergencies like diabetic ketoacidosis and hypoglycemia. It also covers other metabolic disorders such as thyrotoxicosis, Addisonian crisis, and electrolyte abnormalities. For each condition, it describes the symptoms, pathophysiology, diagnosis, and treatment approach. The goal is to help recognize and initiate management of these urgent endocrine conditions.

Endocrine emergenciesSCGH ED CME

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The most common endocrine emergencies are diabetic emergencies such as diabetic ketoacidosis (DKA) and hypoglycemia. Other less common but life-threatening emergencies include adrenal crisis, thyroid storm, hypoparathyroidism-related hypocalcemia, and pheochromocytoma. It is important to consider the diagnosis, triggers, and follow treatment protocols to stabilize the patient and address the underlying condition.

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Sudurpaschim logsewa aayog Medical Officer 8th Level CurriculumDr Ovels

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Eye assessment in polytrauma for undergraduates.pptxKafrELShiekh University

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Retinal Disease in Emergency Medicine: Timely Recognition and Referral for Sp...PVI, PeerView Institute for Medical Education

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Co-Chairs, Robert M. Hughes, DO, and Christina Y. Weng, MD, MBA, prepared useful Practice Aids pertaining to retinal vein occlusion for this CME activity titled “Retinal Disease in Emergency Medicine: Timely Recognition and Referral for Specialty Care.” For the full presentation, downloadable Practice Aids, and complete CME information, and to apply for credit, please visit us at https://bit.ly/3NyN81S. CME credit will be available until March 3, 2026.

One Health Rabies Control in Indonesia_APCAT meeting May 2022.pptxWahid Husein

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Role of Artificial Intelligence in Clinical Microbiology.pptxDr Punith Kumar

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Artificial Intelligence (AI) is revolutionizing clinical microbiology by enhancing diagnostic accuracy, automating workflows, and improving patient outcomes. This presentation explores the key applications of AI in microbial identification, antimicrobial resistance detection, and laboratory automation. Learn how machine learning, deep learning, and data-driven analytics are transforming the field, leading to faster and more efficient microbiological diagnostics. Whether you're a researcher, clinician, or healthcare professional, this presentation provides valuable insights into the future of AI in microbiology.