AVOID Aspirin (ASA) - Prevents binding of thyroglobulin, making the situation worse
Treatment: IV Fluids 1st, Beta Blockers (Propanolol), Steroids (Dexamethasone), and
Tylenol for fever.
Septic Shock (pg.113) - ANSWER-Someone who is in shock second degree to sepsis
(infection in the bloodstream)
Hypotensive with normal HR
Hypotensive while being refractory to fluids
Patient needs IV fluid therapy and vasopressors
Levophed (Norepinephrine) is vasopressor of choice in profound hypotension
Do not use Etomidate in RSI (due to its adrenal suppression) *Also do not use
Etomidate in Addison's Disease also due to the adrenal suppression
Pancreatitis (pg.113) - ANSWER-Pain that is usually centered in the upper middle or
upper left abdomen. Often radiates from the front of the abdomen through to the back,
begins or worsens after eating, lasts a few days, and may feel worse when a person lies
flat on their back.
The digestive enzymes in the pancreas are destroying the pancreas.
Increased lipase levels (usually >3x normal)
*Amylase may also be increased but Faudree did not preface this in his study guide
notes.
, Demerol for pain (b/c Morphine has the ability to cause spasms of the Sphincter of
Oddi)
Hypothyroidism/Myxedema Coma (pg. 112) - ANSWER-Patient presents with fatigue,
cold intolerance, weight gain, puffy eyelids, sparse hair, possibly goiter.
Primarily occurs in women.
>90% cases in winter (b/c the patient has cold intolerance and is not suffering from
hypothermia)
Officially Myxedema Coma upon changes in LOC.
Treatment: Levothyroxine (Synthroid) (T4) or Triostat (T3) IV
Cushing's Syndrome (pg.112) - ANSWER-Buffalo hump, moon face, thin arms and legs,
purple striae on abdomen.
Causes: Excessive use of corticosteroids (Iatrogenic, from corticosteroid treatment(s))
or Tumor
Treatment: Usually resolves when corticosteroids are stopped or tumor is removed.
Adrenal Insufficiency/Adrenal Crisis (pg. 112) - ANSWER-Also known as (AKA):
Addison's Disease
Patient presents with depression, malaise, salt craving, and bronze colored skin like
JFK.
Treatment: Oral steroids (Prednisone)
Negative Adrenocorticotropic hormone (ACTH) testing, also known as corticotropin or
cosyntropin test.
No Etomidate in RSI due to adrenal suppression.
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