Symptoms of hypocalcemia
What is jitteriness, confusion, poor appetite/vomiting, seizure, apneic episodes, tetany, or laryngospasms?
What is sweaty, clammy, shaky and jittery?
Definition of a thyroid storm
What is a life-threatening health condition where an individual's heart rate, blood pressure, and body temperature can soar to dangerously high levels?
Symptoms of Adrenal Crisis
• Rapid, dramatic clinical deterioration
• Vomiting
• Hemodynamic instability
• Cardiorespiratory distress
• Hypotension/shock
Twitching of the facial muscles in response to tapping over the area of the facial nerve.
What is Chvostek sign?
What is Blood sugar below 50 in infant/child?
What is Burch and Wartofsky scoring system?
What is draw a cortisol level?
Carpopedal spasm caused by inflating the blood-pressure cuff to a level above systolic pressure for 3 minutes
What is Trousseau sign?
D10% 5-10 ml/kg or D25% 2-4ml/kg
What is D10% 5-10 ml/kg or D25% 2-4ml/kg?
Initial treatment for adrenal crisis
What is normal saline bolus: 20ml/kg IV or IO
Hydrocortisone 50-100 mg/m2 IV bolus followed by 50 mg/m2/day, divided q6h
If no IV access, SoluCortef IM or Dexamethasone IM
Critical sample that must be drawn before treatment?
Treatment for a thyroid storm
What is
oxygen
adrenergic blockade (if not in CHF) - goal HR<100
Propranolol (PO 2mg/kg/day div Q6-8 hrs or IV 0.01mg/kg/dose (max 5mg) over 10-15 min)
If contraindication to propranolol (ie asthma), can use atenolol (cardioselective) with caution
IV fluids (cooled if necessary)
Cooling blankets
Antipyretics should be avoided when possible
Sedation – phenobarbital stimulated thyroid hormone clearance
Hemodynamic support/treat CHF if present
Diagnoses with primary adrenal insufficiency (adrenal gland is broken)
What is congenital adrenal hyperplasia, addison’s disease (autoimmune adrenal failure), and adrenoleukodystrophy?
Acute treatment of symptomatic hypocalcemia
What is slow (<1 ml/min) IV infusion 10% Ca gluconate 1 ml/kg or 100 mg/ml Ca Gluconate = 9 mg/ml elemental Ca
5.3 per 1000 live births in Alaska Natives vs. 1.3 per 1000 live births in all Alaskans have this
Chris Kyper's middle name
Name one or more interventions to lessen or prevent cerebral edema
What is monitor neuro closely, avoid excessive fluids, avoid use of sodium bicarbonate, early recognition of DKA and proper management?