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Georgia
1 month ago
8

A 37 year old man presents to the triage desk of the ER where you work. He is tall, thin, pale, and has dry and flaky skin. He h

as rapid shallow respirations and seems to have difficulty focusing on your questions. Your quick assesment is:
Patient Values Normal Values
Heart rate 140 bpm 60-100 bpm
Pulse Quality Regular, thready, weak Strong, regular
Respiratory rate 25 beats/min 12-18 breaths/minute
Blood Pressure 92/55 mmHg Systolic: 100-120 mmHg
Diastolic 60-80 mmHgh

You immediatley admit him to the hospital and start IV fluids. Before you start the fluids, you draw blood to analyze in your I-Stat (besides chemistry analyzer) and you send it to the lab.

Laboratory results:

Patient Values Normal Ranges
Blood glucose 70 mg/dL 80-120 mg/dL
serum sodium 125 mEg/L 135-145 mEg/L
Serum potassium 6.2 mEg/L 3.5-5.0 mEg/L
TSH 3.5 uU/ml 0.5-4.5 uU/ ml
T3 80 ng/dl 60-180 ng/dL
T4 9.2 uU/ml 4.5-11.5 uU/mL
ACTH 75 pg/mL 9-52 pg/ml
Cortisol 1.8 mg/dL 6-23 mg/dL

1.) Make a list of this man's significant medical problems and abnormal lab values.
2.) Propose a single underlying cause to explain these problems. List the problems that can be associated to this proposed underlying cause. For each item on your list, briefly, (a short phrase), explain how that problem (or abnormal value) is related to others.
Medicine
1 answer:
sdas [145]1 month ago
7 0
1.) Abnormal findings include: Difficulty in maintaining focus (confusion), elevated heart rate (tachycardia) represented by a thready and weak pulse, increased respiratory rate (tachypnea), low blood pressure (hypotension), decreased blood glucose (hypoglycemia), low serum sodium (hyponatremia), high serum potassium (hyperkalemia), and elevated ACTH alongside low cortisol (hypocortisolism). 2.) Addison’s disease manifests confusion stemming from hyponatremia leading to neuronal imbalances, tachycardia as a response to hypotension for adequate cardiac output, tachypnea due to acid-base disturbance associated with hyperkalemia, hypotension resulting from ineffective sodium retention due to hyponatremia, and hypoglycemia due to hypocortisolism impacting glucose levels.
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