Renal losses: diuretics, RTA, DKA, Bartter’s and Gittleman’s syndromes Gastrointestinal losses: diarrhea, emesis, gastric suction, laxative abuse, malabsorption Transcellular shift: alkalemia, insulin, beta-agonists/bronchodilators, catecholamines, Hyperaldosteronism Critical presentation Severe hypokalemia (<2.5…
Foreign bodies (button batteries) Caustic ingestions Trauma (blunt or penetrating) Violent emesis (Boerhaave syndrome) Valsalva (cough, heavy lifting, childbirth) Severe esophagitis Peptic esophageal ulcer Spontaneous Other iatrogenic causes (nasogastric tube…
Spontaneous clonus Inducible clonus plus agitation or diaphoresis Ocular clonus plus agitation or diaphoresis Tremor plus hyperreflexia Hypertonia plus temperature above 38C plus ocular clonus or inducible clonus Table 64.2….
Viral • Hepatitis –A, B, D, E• Herpes simplex virus• Cytomegalovirus• Epstein–Barr virus• Herpes varicella zoster• Adenovirus Drugs and toxins • Acetaminophen• Carbon tetrachloride• Sulfonamides• Tetracycline• Isoniazid• NSAIDs• Rifampicin• Valproic…
Systolic dysfunction Diastolic dysfunction Impaired contractility Structural abnormality Myocardial infarctionDilated cardiomyopathy, including peripartum cardiomyopathyMyocarditisAlcohol abusePapillary muscle rupture Ventricular hypertrophy (often related to hypertension)Hypertrophic or constrictive cardiomyopathyConstrictive pericarditisInfiltrative disease such as…
Sick sinus syndrome Infiltrative diseases (e.g., sarcoidosis) Collagen vascular diseases (e.g., scleroderma) Atrioventricular conduction block Acute or chronic ischemic heart disease Increased vagal tone (e.g., Valsalva maneuver) Drugs (e.g., digoxin,…
Arterial supply Target organs Celiac Esophagus, stomach, proximal duodenum, liver, gallbladder, pancreas, and spleen Superior mesenteric artery Distal duodenum, jejunum, ileum, colon to the splenic flexure Inferior mesenteric artery Descending…
Toxicological • Chronic ethanol abuse• Toxic alcohols• Azathioprine• Mercaptopurine• Valproic acid• Didanosine• Corticosteroids• Sulfa drugs• Scorpion venom Obstructive • Gallstones• Pancreatic tumors• External compression• Pancreatic divisum• Parasites: clonorchiasis, ascariasis Trauma…
a Glucose: 1 mg/dL = 0.0555 mmol/L. Critical management Antibiotic treatment should not be delayed for CT scan or until lumbar puncture results are available. Empiric antibiotics are based on…
