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Endocrine Emergencies, Myxedema Coma, Thyroid Storm, Hyperosmolar…
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Myxedema Coma
Treatment: IV thyroid hormone replacement, supportive care, treat underlying cause, maintain airway and hemodynamics
Assessment Findings: Hypothermia, bradycardia, hypotension, confusion, edema, hypoventilation
Pathophysiology: Severe hypothyroidism decreased metabolism hypothermia, bradycardia, hypotension, organ failure
Thyroid Storm
Pathophysiology: Excess thyroid hormones, hypermetabolic state, severe tachycardia, fever, and organ stress
Treatment: Beta-blockers, antithyroid medication, supportive care, treat precipitating cause
Assessment Findings: High fever, tachycardia/arrhythmias, agitation, confusion, diarrhea, vomiting
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Hypercalcemic Crisis
Pathophysiology: Severe hyperparathyroidism, high calcium, cardiac, neurological, renal complications
Treatment: IV fluids, bisphosphonates, dialysis in extreme cases, treat underlying cause
Assessment Findings: Confusion, nausea, vomiting, arrhythmias, polyuria, dehydration
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Hypoglycemia
Pathophysiology: Low blood glucose (from insulin overdose, missed meals, excessive exercise)
Treatment: Oral glucose if conscious, IV dextrose if unconscious, glucagon IM if no IV access
Assessment Findings: Shakiness, sweating, confusion, irritability, seizures, loss of consciousness