Shortness of Breath (Dyspnea) in the Emergency Department
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
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.
ECG Case 1
A 52 years old woman presented with this ECG. The computer interpretation is : Atrial Fibrillation with Ventricular Response of 95Chronic Pulmonary Disease PatternQT Interval long rate Do you agree…
Anxiety in the Emergency Department
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
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…
Black Pleural Effusion
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…
Blue–black eyes and legs
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…
Nail Sign observed in a 19 year old man
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 and Hypophosphatemia: Clinical Features and Management
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…