WHAT'S THE DIFFERENTIAL?
A confused diabetic is pale and diaphoretic. Glucose is 41 mg/dL.
What is hypoglycemia?
RR 4, GCS 5 and pinpoint pupils.
What is an opioid toxidrome?
This bedside test should be obtained early in essentially every unexplained AMS patient.
What is a blood glucose?
This time determines eligibility for many time-sensitive stroke interventions.
What is last known well?
AMS, temp 103°F, HR 118 and a productive cough.
What is suspected sepsis?
HR 84
BP 136/82
RR 16
SpO₂ 98%
Glucose 39
What is hypoglycemia?
A 72-year-old suddenly develops aphasia and right arm weakness. Glucose is 124 mg/dL.
What is an acute stroke?
Agitation, diaphoresis, tachycardia, hypertension and dilated pupils.
What is a sympathomimetic toxidrome?
A diabetic is confused but awake enough to follow commands and safely swallow. Glucose is 48.
What is oral glucose?
Sudden facial droop, arm weakness and aphasia with glucose 106.
What is an acute stroke?
True or false: A normal blood pressure excludes serious sepsis.
What is false?
HR 64
BP 108/68
RR 5
SpO₂ 99% on O₂
ETCO₂ 76
GCS 6
What is severe hypoventilation/respiratory failure?
AMS, HR 126, RR 28, BP 94/58, temp 103.1°F. Family reports dysuria for 3 days.
What is sepsis from a suspected urinary source?
Confused, tachycardic, flushed, hot and dry with dilated pupils.
What is an anticholinergic toxidrome?
Glucose 510, vomiting, abdominal pain, RR 34 and ETCO₂ 17.
What is DKA?
A patient has unilateral weakness immediately after a witnessed seizure.
What is Todd paralysis?
An elderly patient is confused, tachypneic and hypotensive but has a temperature of 97°F.
What is possible sepsis?
HR 126
BP 110/72
RR 34 deep
SpO₂ 98%
ETCO₂ 16
Glucose 524
What is DKA with respiratory compensation for metabolic acidosis?
AMS, glucose 488, RR 32 and deep, ETCO₂ 18. Skin is warm and dry.
What is DKA with metabolic acidosis?
AMS with salivation, lacrimation, vomiting, diarrhea, bronchorrhea and bradycardia.
What is a cholinergic toxidrome?
An older diabetic has glucose 860, profound dehydration and severe AMS but minimal evidence of ketosis.
What is HHS?
Sudden severe vertigo, vomiting, ataxia and inability to walk despite a negative FAST.
What is a posterior circulation stroke?
AMS, HR 122, BP 88/52, RR 30 and temp 102.8°F. Family reports urinary symptoms.
What is sepsis with shock/hypoperfusion?
HR 116
BP 96/58
RR 28
SpO₂ 95%
ETCO₂ 27
Temp 103°F
Glucose 174
What is suspected sepsis with hypoperfusion?
A diabetic has slurred speech and left arm weakness. Glucose is 38. Dextrose raises glucose to 112, but the weakness remains.
What is suspected acute stroke after correction of hypoglycemia?
A patient is altered after an unknown overdose. ECG shows a wide QRS with hypotension and ventricular dysrhythmias.
What is tricyclic antidepressant toxicity?
AMS, hypotension, abdominal pain and vomiting. Glucose is 68. The patient takes chronic corticosteroids.
What is an adrenal crisis?
Patient understands your commands and knows what they want to say, but speech is slurred and poorly articulated.
What is dysarthria?
Glucose 428, temp 103.4°F, HR 128, RR 30 and AMS. The patient has a diabetic history.
What is a patient requiring evaluation for BOTH sepsis and a hyperglycemic emergency?
HR 112
BP 102/66
RR 26
SpO₂ 96%
ETCO₂ 31
Glucose 286
GCS 13
There isn't enough information to determine it?