Endocrine / Metabolic Archives - Page 3 of 4 - The Emergency Medical Minute

Endocrine / Metabolic

Podcast #290: The Biochemistry of DKA

Author: Dave Rosenberg, M.D. Educational Pearls DKA commonly causes hyperkalemia, leading to peaked T-waves on ECG. However, DKA causes hypokalemia at the same time. In DKA, glucose cannot be taken into the cells. This signals the body to create and use acidic ketones for energy. This leads to acidosis. To compensate for increased acid, H…

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Podcast #186: IV Contrast

Run Time: 2 minutes Author: Aaron Lessen M.D. Educational Pearls: Regularly a patient’s creatinine level is an important factor in determining whether a patient will receive IV contrast with a CT because it is thought that contrast can harm the kidneys and could worsen underlying kidney disease. A recent retrospective study compared the rates of…

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Podcast #181: Electrolyte Emergency

Run Time: 5 minutes Author: Peter Bakes, MD Educational Pearls: Calcium is ubiquitous ion in the body necessary for bone, muscle, and nerve function Hypocalcemia is associated with tetany (elicit Chvostek’s sign and Trousseau’s sign) and irritability Hypocalcemia can progress to seizures and prolonged QT which can cause cardiac arrest Hypocalcemia can be caused by…

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Podcast #178: Lupus Myocarditis

Run Time:  3 minutes Author: Gretchen Hinson M.D. Educational Pearls: Case presentation: a 44 year-old male after a syncope was found to have a heart rate of 261 wide complex tachycardia and a SBP in the 80s for EMS in the field. The patient was given adenosine on arrival to the ED, but with no…

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Podcast #167: Adrenal Glands

Run Time: 3 minutes Author: Jared Scott M.D. Educational Pearls: Adrenal glands sit on top of kidneys, and are approximately the size of a walnut. Each of the different layers of the adrenal glands make hormones and those hormones become more desirable with each layer – salt hormones→ sugar hormones→ sex hormones. Top layer: the…

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Podcast #141: Heat Stroke

Run Time: 4 minutes Author: Nicholas Hatch M.D. Educational Pearls: It is possible to acclimatize to heat, however it takes approximately 2-3 weeks. Never give tylenol for a heat related illness and heat related hyperthermia, it is not helpful. Heat rash: most common in kids. Lotion should not be used because it blocks the ducts…

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Podcast #130: DIC

Run Time: 3 minutes Author: Susan Brion M.D. Educational Pearls: Presentation: an elderly known diabetic presents via EMS confused with an elevated blood glucose. Upon arrival the patient is found to be in DKA, with evidence of a hip fracture from a fall yesterday. The patient develops signs of shock with declining BP. INR is…

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Podcast #110:  Elevated Lactate

Run Time:  3 minutes Author:  Susan Brion M.D. Educational Pearls: Not all that is elevated lactate is sepsis. Lactate is produced under anaerobic conditions whenever there is any state of hypoperfusion or hypermetabolic state. It is produced by all tissues, most prominently by muscle tissue, and is cleared by the liver. A normal level can…

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Podcast #104: Peds Glomerulonephritis

Run Time: 4 minutes Author: Suzanne Chilton M.D. Educational Pearls:       The streptococcal strain that causes Impetigo also causes post strep glomerulonephritis.       Symptoms of glomerulonephritis can present themselves up to 1 month after having impetigo including: edema hypertension, coke colored urine w/ red cells and high protein.       The main treatment is supportive care and diuretics –…

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Podcast #68: Beer!

Run Time: 3 minutes Author: Dr. Michael Hunt Educational Pearls: 1/3 of Americans have Metabolic Syndrome or Syndrome X. The risk factors for Metabolic Syndrome are obesity, lack of physical activity, and genetics. You need three of the five qualifications to be diagnosed with Metabolic Syndrome. Waistline greater than 40 inches for men and 35 inches…

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