Textbook of Adult Emergency Medicine

Neutropaenia

Essentials 1 The risk of infection increases significantly as the absolute neutrophil count drops below 1.0 × 10 9 2 Life-threatening neutropaenia is most likely due to impaired haematopoiesis. 3 A detailed medication history is vital to the ‘workup’…

Anaemia

Essentials 1 Anaemia is a condition in which the absolute number of red cells in the circulation is abnormally low. 2 Anaemia is not a diagnosis: it is a finding, which should prompt a search for an underlying cause. 3…

Electrolyte disturbances

Essentials 1 Sodium disorders are relatively common in hospitalized patients and elderly people. 2 The brain is most at risk from acute hyponatraemia because the osmotically expanded intracellular volume may induce increased intracranial pressure (hyponatraemic encephalopathy). 3 Treatment of hyponatraemia…

Acid–base disorders

Essentials 1 Acid–base homeostasis is one of the most tightly regulated systems within the body. It is maintained by buffering, respiratory and renal mechanisms. 2 Most acid–base disturbances are complex and require a systematic approach to determine underlying processes. 3…

Thyroid and adrenal emergencies

Essentials 1 The thyroid and adrenal emergencies that pose an acute threat to life are thyroid storm, myxoedema coma and acute adrenal insufficiency. Diagnosis of these conditions requires a high index of suspicion and treatment frequently must be initiated on…

Diabetic ketoacidosis and hyperosmolar, hyperglycaemic state

Essentials 1 Diabetic ketoacidosis (DKA) consists of the triad of ketonaemia, hyperglycaemia and acidaemia—a high anion-gap metabolic acidosis. 2 DKA is caused by insulin omission or error, intercurrent illness (including infection) or is a presenting feature of new diabetes. 3…

Diabetes mellitus and hypoglycaemia: an overview

Essentials 1 Type I diabetes is characterized by pancreatic beta cell destruction with an absolute insulin deficiency, usually but not exclusively associated with autoimmune damage. 2 Type II diabetes results from a progressive insulin secretory deficiency on the background of…

Renal colic

Essentials 1 The lifetime risk of developing kidney stones is 1 in 10 for men and 1 in 35 for women. 2 Approximately 75% of all stones are calcium based. 3 Management usually comprises adequate analgesia and hydration. 4 Computed…

The acute scrotum

Essentials 1 Torsion is the most time-critical diagnosis in acute scrotal pain. 2 Early surgery is mandatory if the diagnosis is strongly suspected. No investigation should delay surgery. 3 Colour Doppler ultrasound is helpful and is best used when testicular…

Acute kidney injury

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