Hyperthermia
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….
CRITICAL CARE
Fulminant hepatic failure
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…
Acute decompensated heart failure
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…
Bradyarrhythmias
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,…
Meningitis and encephalitis
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…
Acute pancreatitis
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…
Acute mesenteric ischemia
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…
Severe pelvic trauma
Figure 12.1. (a) Young–Burgess lateral compression (LC) pelvic fracture classifications; (b) computed tomography (CT) of LCI fracture pattern; (c) radiograph of LCI fracture pattern. (Reprinted with permission from Hammel J….
Infective endocarditis
History Common causative organism Native valve Streptococcus viridans, Staphylococcus aureus Prosthetic valve Staphylococcus epidermidis IVDA Staphylococcus aureus Presentation Classic presentation Presentation is nonspecific and variable, but the most common symptoms…
Sickle cell emergencies
Common causes Possible causes Pulmonary infectionFat embolismRib infarction ThromboembolismIn situ thrombosisLung sequestrationIatrogenic (excessive hydration, excessive narcotic use) Splenic sequestration Splenic sequestration, or intrasplenic trapping of RBCs, is a major cause…
