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…
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…
Pleural aspiration from a 56-year-old man, who presented with a massive right pleural effusion, yielded purely black coloured fluid. This fluid was determined to be an exudate with very high…
A 70-year-old woman presented with asymptomatic blue-black discoloration of her legs and sclerae. She had a history of oxacillin-resistant coagulase-negative staphylococcal endocarditis complicated by aortic root abscess, needing surgery and…
A 19-year-old man presented with pedal oedema and facial puffiness of 3 months' duration. He denied history of orthopnoea, paroxysmal nocturnal dyspnoea, oliguria, haematuria, fever, sore throat, joint pains, rashes, exposure to heavy metals, or any drug abuse.
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…
The goal for the patient in shock is rapidly identifying that the patient is in shock, finding the cause of shock and treating the cause while simultaneously resuscitating the patient.…
Meningitis can be caused by infectious or noninfectious etiologies. Noninfectious etiologies of meningitis include: malignancyautoimmune conditionsmedicationstraumaiatrogenic procedures. Infectious meningitis can be caused by a variety of bacterial, viral, fungal, and…
In the setting of life-threatening hemorrhage, the standard ABCs may be reconsidered as A2BC, with the additional “A” representing concomitant anticoagulant reversal. The anticoagulated patient with life-threatening hemorrhage does not…
Thyroid storm is an extreme version of hyperthyroidism with a mortality rate that approaches 30%, even with treatment. The recognition and management of thyroid storm can be difficult in the…