Drugs for Maintaining Calcium Homeostasis
Three hormones are available to the body for maintaining a calcium homeostasis: Vitamin D, Parathormone, Calcitonin
Evaluation and Management of Sarcoidosis
Sarcoidosis is a multisystem granulomatous disorder that is characterized by noncaseating granulomas. Pulmonary involvement is the most common manifestation, but extrapulmonary manifestations are seen in up to 30% of patients.
Upper Abdominal Pain in the Emergency Department
Work-up for upper abdominal pain begins with resuscitation and exclusion of critical diagnoses. Then, through a detailed history and physical, consider all the causes of upper abdominal pain. The differential may then come down to Gallstone etiology vs Gastritis/PUD → will need further imaging based on suspicion (US abdomen)
Hyperthyroidism and Antithyroid Drugs
Thyroid overactivity in Graves’ disease results from formation of IgG antibodies that bind to and activate TSH receptors. Consequently, there is overproduction of hormone with cessation of TSH secretion. Graves’…
Acute Illnesses that Lead to Rapid Deterioration in Pulmonary Hypertension
Classification of Pulmonary Hypertension
Sudden deterioration in RV function can rapidly lead to shock, cardiovascular collapse, and death. In the ED, it is important to rapidly recognize and treat common precipitants of acute decompensation. These include sepsis, tachyarrhythmias, hypoxia, pulmonary embolism (PE), and the abrupt withdrawal of vasodilator medications.
Shortness of Breath (Dyspnea) in the Emergency Department
Shortness of Breath Algorithm
Assess severity of dyspnea, including need for intubation/airway management based on physical examination. Emergent intubation indicated regardless of cause if severe respiratory distress/arrest. Consider Critical diagnoses → may be able to cure patient and avert intubation if the underlying cause is corrected (i.e. chest tube insertion, foreign body removal…)
Measures and Regimens for Preventing Drug-Induced Cushing’s Syndrome
Cortisol release and its modification by glucocorticoids
When glucocorticoid medication is suddenly withheld, the atrophic cortex is unable to produce sufficient cortisol and a potentially life-threatening cortisol deficiency may develop. Therefore, glucocorticoid therapy should always be tapered off by gradual reduction of the dosage.
Anxiety in the Emergency Department
Medical Conditions with Anxiety as a Common Symptom
The Anxious State limbic system, in particular the amygdala, facilitates autonomic arousal under conditions of uncertainty or distress. The increase in sympathetic tone contributes to a state of readiness with…
Glucocorticoid Therapy – Principal and Adverse Effects
Glucocorticoids - principal and adverse effects
I. Replacement therapy The adrenal cortex (AC) produces the glucocorticoid cortisol (hydrocortisone) and the mineralocorticoid aldosterone. Both steroid hormones are vitally important in adaptation responses to stress situations, such as…
Hyperphosphatemia and Hypophosphatemia: Clinical Features and Management
Hypophosphatemia - Causes
Hyperphosphatemia Hyperphosphatemia is defined as a serum level above 2.5 mg/dL, but it is usually clinically significant only when levels are greater than 5 mg/dL. Although it is rare in…