Endocrine emergencies- Learning from Cases

[@renus6015]

Informative...

[@EndocrinologyIndia]

🎯 Key Takeaways for quick navigation: 00:00 🚑 *Discussion of various endocrine emergency cases* - The presenter discusses a variety of endocrine emergency cases. - Anecdotes include patients with different initial assessments, but ultimately similar outcomes. 01:37 👴 *Case study of a 67-year-old male patient* - The patient initially had fever and altered sensorium, thought to be cerebral malaria, but later found to have a large pituitary mass with a bleed. - The case emphasizes the necessity of knowledge and awareness for accurate diagnosis. 03:00 💡 *Pituitary apoplexy and its treatment* - Pituitary apoplexy refers to sudden hemorrhaging into the pituitary gland. - Immediate surgery is not always needed; medical management is primarily required in most cases. - The patient was discharged without surgery and had good long-term outcomes. 05:58 🙅‍♂️ *The drawbacks of immediate surgery in case of pituitary apoplexy* - Immediate surgery doesn’t necessarily improve outcomes and can sometimes lead to worse results. - The guideline suggests early or late surgery, but no emergency surgery. 07:33 📝 *Second case of a 57-year-old male patient with hyponatremia* - The patient had a history of similar episodes in the past, and the pattern was realized by his medical student daughter. - The hyponatremia was likely due to Central hypothyroidism or adrenal insufficiency. 10:05 📌 *The significance of adrenal insufficiency in hyponatremia* - Adrenal insufficiency and Central hypothyroidism are significant causes of hyponatremia, often overlooked. - When in doubt, treat for adrenal insufficiency, especially if there’s physiological stress. 13:09 🧪 *ACTH stimulation test revealing adrenal insufficiency* - The test conducted in this case revealed that the cortisol level was lesser than 18, proving adrenal insufficiency. - The patient improved after being treated with Hydrocortisone and oral hormones. 15:44 🧠 *Pituitary function post-surgery considerations* - Post pituitary surgery, all patients should be treated as patients of pan hypopituitarism unless proven otherwise. - Some patients may witness an improvement in pituitary function over time and some may need steroids in cases of physiological stress. 16:24 🤰 *Case study of a 25-year-old pregnant woman * - The patient experienced seizures in her third trimester due to severe hypoglycemia. - This case illustrates the potential seriousness of endocrine emergencies, particularly in situations of high risk, such as pregnancy. 16:51 💉 *The significance of hypoglycemia and the importance of critical samples* - Hypoglycemia, even if it seems drug-induced, should be seriously investigated. Always take a critical sample. - Having a sample in the event of hypoglycemia can save a lot of time and avoid unnecessary stress for the patient. 18:42 💊 *The dangers of unknown drug impacts and the importance of testing* - Discovery of a specific brand of medication causing unexplained hypoglycemia in wide-ranging cases. - Stresses the importance of thorough testing and the ability to identify and recall a harmful pharmaceutical batch in response to observed patterns. 21:24 🎯 *Swift diagnosis and treatment of insulin dependent hypoglycemia in a pregnant patient* - A near-immediate diagnosis and treatment of insulinoma drastically improved patient health. - Patient was able to deliver a healthy baby subsequently with no issues. 23:24 🏥 *Successful identification and treatment of pan hypopituitarism leading to patient's fertility* - Hypoglycemia combined with hyponatremia can indicate adrenal insufficiency. - This diagnosis helped address the patient's primary problem of infertility, leading to successful conception and childbirth. 25:05 🩺 *A case of unmonitored teriparatide leading to primary hyperparathyroidism, corrected after proper diagnosis and treatment.* - Crucial to do a calcium and PTH test before starting a patient on teriparatide. - Endocrinological missteps can lead to severe medical emergencies, stressing the importance of endocrine expertise even in orthopedic cases. 26:30 🚫 *The dangers of frequently prescribed vitamins and their impact on calcium levels* - Certain active vitamin D supplements can overload the body with calcium leading to dangerous hypercalcemia. - Advises that the body's own vitamin D activation mechanisms should be trusted except in specific cases. 29:12 🩹 *Case of distal Renal Tubular Acidosis leading to severe hypokalemia, corrected quickly by bicarbonate treatment* - Successful rapid treatment of a recurrent and severe case of hypokalemia. - With proper diagnosis and treatment, the patient quickly recovered, underscoring the importance of understanding the root cause of a patient's symptoms rather than just treating them. 32:11 ❤️ *The correlation between heart failure and endocrine issues* - Several reversible causes of heart failure are endocrine based including hypo-hypopituitarism, hypocalcemia and thyrotoxicosis. - These cases further emphasize the significant role of endocrinology in treating broader health issues including heart health. 34:26 💼 *Striving for excellence in all medical and healthcare undertakings* - Reflects on the drive to continuously improve and pursue excellence in healthcare. - Acknowledges technological advances and future trends in the healthcare environment, echoing the evolving methods of providing patient care. 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