Endocrine Emergencies: Recognition and Treatment (Contemporary Endocrinology)

Description

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. 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