A unique, comprehensive discussion of the diagnosis and management of endocrine emergencies
Includes the latest evidence and treatment modalities for acute adrenal insufficiency, diabetic ketoacidosis, thyroid storm, hyponatremia, and more
A valuable resource for practitioners in endocrinology and internal medicine, as well as emergency room physicians, hospital support staff, fellows and residents
Medical emergencies due to disorders of the endocrine system represent a unique category of clinical care. Hypotension, fever, palpitations, confusion, and electrolyte abnormalities are all signs of disparate endocrine emergencies that require immediate diagnoses and treatment. Recognition of endocrine emergencies will frequently lead to rapid improvement and stabilization of the patient.
Now in a revised and expanded second edition including the latest clinical guidelines and protocols, Endocrine Emergencies serves as a handy single reference for any endocrinologist, internist, hospitalist, and emergency medicine physician to rapidly identify and initiate treatment. Topics covered include acute adrenal insufficiency, diabetic ketoacidosis, thyroid storm, hyponatremia, and myxedema coma, among many others. Each chapter opens with a precis that provides, in a single page, a presentation of symptoms, workup, and therapy. This serves as a rapid, “off the shelf” cue to immediately begin a differential diagnoses and therapy plan. The remainder of each chapter is an in-depth review of the pathophysiology, diagnoses, and management of the disease process. Book chapters are written by experts in the field and reflect the consensus and standard of care for specific endocrine emergencies.
Updated with the latest clinical evidence and treatment options, Endocrine Emergencies remains a valuable resource for practitioners in endocrinology and internal medicine, as well as emergency room physicians, hospital support staff, fellows and residents.
Author(s): Chaim Vanek, Lynn Loriaux
Series: Contemporary Endocrinology
Edition: 2
Publisher: Springer
Year: 2021
Language: English
Tags: Emergency medicine; Endocrinology & Metabolism; Endocrine Emergencies
Series Editor Foreword
Preface
Contents
Contributors
Chapter 1: Acute Adrenal Insufficiency
Précis
Acute Adrenal Insufficiency
The Adrenal Response to Stress
The Cortrosyn® Stimulation Test
Conclusion
References
Chapter 2: Diabetic Ketoacidosis and Hyperosmolar Hyperglycemic Syndrome
Précis
Introduction
Pathogenesis
Diagnosis
History and Physical Examination
Laboratory Findings
Differential Diagnosis
Treatment
Fluid Therapy
Insulin Therapy
Potassium Replacement
Phosphate Replacement
Bicarbonate Therapy
Search for Precipitating Factors
Resolution of DKA and HHS
Transition to Subcutaneous Insulin
Complications
Prevention
References
Chapter 3: Hypoglycemia
Précis
Frequency and Impact of Hypoglycemia
Physiologic and Behavioral Defenses Against Hypoglycemia
Pathophysiology of Hypoglycemia
Risk Factors for Hypoglycemia and Risk Factor Reduction in Diabetes
References
Chapter 4: Necrotizing Soft Tissue Infections
Précis
Necrotizing Soft Tissue Infection
Clinical Presentation
Diagnosis
Treatment
Summary
References
Chapter 5: Malignant (Necrotizing) Otitis Externa
Précis
Malignant (Necrotizing) Otitis Externa
Diabetic Susceptibility
Pathogenesis
Clinical Presentation
Diagnosis
Treatment
Prognosis
Summary
References
Chapter 6: Mucormycosis
Précis
Mucormycosis
Diabetic Susceptibility
Pathogenesis and Microbiology
Clinical Presentation
Diagnosis
Treatment
Mortality
Summary
References
Chapter 7: Emphysematous Cholecystitis
Précis
Emphysematous Cholecystitis
Pathogenesis and Microbiology
Clinical Presentation
Diagnosis
Treatment
Prognosis
Summary
References
Chapter 8: Emphysematous Pyelonephritis
Précis
Infectious Emergencies in Diabetics
Emphysematous Pyelonephritis
Diabetic Susceptibility to Emphysematous Pyelonephritis
Clinical Presentation
Diagnosis
Radiographic Classification
Treatment
Prognosis
Summary
References
Chapter 9: Thyrotoxic Crisis: Thyroid Storm
Précis
Pathogenesis
Etiology (See Table 9.1)
Clinical Presentation
Diagnosis
Management
Antithyroid Medications (Thionamides)
Iodine Therapy
β-Blockade
Steroids
Alternative Therapies (See Table 9.4)
Lithium
Potassium Perchlorate
Anti-adrenergic Agents
Cholestyramine
Plasmapheresis, Charcoal, and Resin Hemoperfusion
Supportive Care/Treatment of Precipitating Cause
Perioperative Management
Elective/Nonurgent Procedures
Emergent Procedures
Definitive Therapy
References
Chapter 10: Myxedema Coma
Précis
Introduction
Historical Remarks
Pathogenesis
Clinical Presentation
Diagnosis
Management
References
Chapter 11: Acute Suppurative Thyroiditis
Précis
Acute Suppurative Thyroiditis
Predisposing Factors
Microbiology
Clinical Presentation
Diagnosis
Treatment
Summary
References
Chapter 12: Hyponatremia: SIADH
Précis
Syndrome of Inappropriate Antidiuretic Hormone
Antidiuretic Hormone Secretion
Presentation and Diagnosis
Treatment of Symptomatic SIADH
References
Chapter 13: Diabetes Insipidus
Précis
Diabetes Insipidus
Antidiuretic Hormone Secretion
Causes and Classification of Diabetes Insipidus
Presentation and Diagnosis
Treatment of Hypernatremia
Correcting the Water Deficit
Ongoing Losses
Treating the Underlying Disorder
References
Chapter 14: Pheochromocytoma Hypertensive Crisis
Précis
Pheochromocytoma
References
Chapter 15: Hypocalcemia
Précis
Introduction
Etiology
Clinical Signs and Features
Laboratory Evaluation
Treatment
References
Chapter 16: Hypercalcemia
Précis
Etiology
Clinical Signs and Features
Laboratory Evaluation
Treatment
References
Chapter 17: Pituitary Apoplexy
Précis
Introduction
Pathogenesis of Pituitary Apoplexy and Clinical Manifestations
Pituitary Anatomy
Pituitary Blood Supply
Pathogenesis
Pathophysiology of the Clinical Manifestations
Pathophysiology of Hypopituitarism
Epidemiology
Recognition
Clinical History
Initial Laboratory Assessment
Imaging Evaluation
Etiologies
Precipitating Factors
Differential Diagnosis
Management and Outcomes
Initial Assessment
Endocrine Assessment
Radiological Assessment
Treatment and Outcomes
Steroid Therapy
Surgical Versus Conservative Management
Timing of Surgery
Outcomes of Visual Function
Outcomes of Ocular Palsies
Outcomes of Hypopituitarism
Postoperative Care
Long-Term Management
Mortality
Conclusion
References
Chapter 18: Ovarian Hyperstimulation Syndrome (OHSS)
Précis
Pathophysiology
Clinical Presentation
Prevention of OHSS
Selection of Stimulation Regimens Based on Risk Stratification
Cryopreserving All Embryos and Delaying Embryo Transfer to Another Cycle
Treatment of OHSS
Recombinant Tissue Plasminogen Activator to Treat Thrombosis
Pregnancy Outcome
References
Chapter 19: Ambiguous Genitalia in the Newborn
Précis
Clinical Issues
A Word about “Sex” and “Gender”
Embryology
Pathophysiology of DSD
46,XX DSD
46,XY DSD
Other Disorders to Consider
Diagnosis
Clinical Setting
History
Physical Examination
Laboratory Evaluation
Imaging Studies
Treatment
Medical Management
Surgical Management
Complications
Prognosis
References
Chapter 20: Porphyrias: Acute Manifestations
Précis
Introduction
Acute Porphyrias: AIP, HCP, VP, and ADP
Clinical Presentation
Pertinent History and Exam
Pertinent Laboratory Data
Diagnosis: Key Tests
Treatment
Erythropoietic Protoporphyria “Hepatic Crisis”
Clinical Presentation
Pertinent History
Pertinent Physical Findings
Pertinent Laboratory Data
Treatment
References
Chapter 21: Acute Pancreatitis Due to Hyperchylomicronemia
Précis
Triglyceride Metabolism
Mechanism of Chylomicron-Induced Pancreatitis
Clinical Presentation
Treatment
Summary
References
Index
