Key Concepts All septic patients should be treated with antibiotics as soon as possible, even before a definitive diagnosis is made. Patients with pneumococcemia, meningococcemia, and aggressive soft tissue infections can decompensate rapidly. The source of sepsis should be identified…
Key Concepts Hyperthyroidism Hyperthyroidism induces a hypermetabolic state and increases β-adrenergic activity. The resulting clinical manifestations range from vague constitutional symptoms to more organ-specific symptoms (see Box 117.1 ). BOX 117.1 Symptoms of Thyrotoxicosis Constitutional: Weight loss despite hyperphagia, fatigue,…
Key ConceptS Rhabdomyolysis is a process wherein striated muscle cells break down, resulting in the release of creatine kinase, potassium, calcium, phosphate, and uric acid. Rhabdomyolysis is associated with a variety of causes including overexertion, extreme body temperature changes, ischemia,…
Key Concepts The diagnosis of diabetes can be determined by one or more of four methods—random plasma glucose level above 200 mg/dL, fasting plasma glucose concentration above 126 mg/dL, 2-hour, 75-g post-load oral glucose tolerance test (OGTT) > 200 mg/dL,…
Key Concepts Electrolyte abnormalities are common in emergency medicine and can vary greatly in importance, severity, and symptoms. Asymptomatic electrolyte abnormalities can be gradually corrected, whereas those causing alterations in consciousness or life-threatening dysrhythmias require immediate therapy to avoid permanent…
Key Concepts Metabolic acidoses are classified into wide anion gap and normal anion gap acidoses, based on basic metabolic panel (BMP) values. A wide anion gap metabolic acidosis is present when the gap exceeds 15 mmol Common causes of a…
Foundations As improved therapies prolong the lives of cancer patients, the prevalence of oncologic emergencies continues to increase. However, nonspecific clinical features misattributed to the underlying cancer complicate their diagnosis. In this chapter, we review febrile neutropenia, metastatic spinal cord…
Key Concepts Although hemostatic disorders are confirmed through laboratory testing, a careful history and thorough physical examination may provide clues to the diagnosis. The use of antithrombotic agents remains widespread, whereas diseases such as hemophilia or disseminated intravascular coagulation (DIC)…
Key Concepts Chronic lymphocytic leukemia (CLL) is the most common leukemia in the elderly, and acute lymphocytic leukemia (ALL) is the most common leukemia in children. Splenomegaly is a common finding in leukemias. Leukostasis is usually not accompanied by clinical…
Key Concepts Anemia is caused by three basic mechanisms: loss of red blood cells (RBCs) through bleeding, destruction of RBCs, or decrease in production of RBCs. RBC indices along with a peripheral blood smear can help determine the mechanism of…