Epistaxis is an acute hemorrhage from within the nasal cavity, including the nasopharynx, and accounts for 0.5% of all U.S. emergency department visits. Approximately 60% of individuals experience epistaxis at least once in their lifetime, although only 6% of cases…
The mediastinum is the thoracic space confined by the sternum anteriorly, the spine posteriorly, the pleural laterally, the diaphragm inferiorly, and the thoracic outlet superiorly. It can be divided anatomically into superior and inferior compartments by the sternal angle. The…
Alfred Blalock demonstrated that injury precipitates local and regional fluid loss, the effects of which can be ameliorated by vigorous restoration of intravascular volume. This concept is foundational to understanding the pathophysiology of shock and provides the rationale underlying intravenous…
Patients presenting to the hospital with overdoses and poisonings should undergo an initial evaluation to determine whether a specific poisoning can be detected that would lead to specific management options. History and physical examination are key to determine what poisoning,…
Critically ill patients suffer from a variety of physiologic insults that result in a rapidly changing physiologic status, thus making appropriate drug dosing a challenging problem. Understanding how these changes affect pharmacokinetics and pharmacodynamics can result in improved dosing decisions.…
Diabetes insipidus is a disorder of water metabolism associated with polyuria, urine hypotonicity, and hypernatremia. , The quantitative criteria include urine output greater than 200 mL/hr or 3 mL/kg/hr, urine osmolality less than 150 mOsm/kg, and plasma sodium greater than…
Normal thyroid hormone economy Regulation Synthesis and secretion of thyroid hormone is under the control of the anterior pituitary hormone thyrotropin (or thyroid-stimulating hormone [TSH]). Consistent with a classic negative feedback system, TSH secretion increases when serum thyroid hormone levels…
During stress response, the central nervous system (CNS) induces activation of both the sympathoadrenergic system (by release of catecholamines) and the hypothalamic-pituitary-adrenal (HPA) axis (by release of steroid hormones, glucocorticoids [GCs], and mineralocorticoids), with the target of maintaining homeostasis by…
Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) are endocrine emergencies occurring in diabetes patients. Both conditions require prompt, adequate treatment to avoid mortality. In patients with known diabetes mellitus, both conditions are most commonly triggered by noncompliance with diabetes…
Obstetric hemorrhage remains a leading cause of maternal mortality and morbidity worldwide, with most deaths occurring in the postpartum period. Recognition of blood loss in obstetric hemorrhage can be challenging. Therefore interventions focused at the patient level, provider and unit…