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Medicine, 07.04.2020 03:29 brillamontijo

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 has 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.

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