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Hyperthyroidism and Thyroid Storm

2/5/2017

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Idrose A. Hyperthyroidism. In: Tintinalli JE, Stapczynski J, Ma O, Yealy DM, Meckler GD, Cline DM. eds. Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, 8e. New York, NY: McGraw-Hill; 2016.

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NIH Stroke Scale & Training

12/8/2016

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The NIH stroke scale it used to identify the severity of stroke like symptoms, and should be scored on the patient's initial presentation, without coaching or duplication. It is important to be consistent when scoring all patients, and identify all deficits. 

NIH stroke scale scores patients 0-42, with higher scores indicating increased severity.

Training for appropriate use of the NIH stroke scale is free, at http://nihss-english.trainingcampus.net/

iPhone applications, such as StatCoder, are available and free.
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Altered Consciousness & Coma

12/27/2015

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Adapted from Rosens, chp 16. 

Little Old Lady Workup (LOL)

Testing to consider in an elderly patient with altered mental status
ABG: hypoxia, CO2 retention, SOB
BMP/CMP: electrolyte abnormalities, hepatic encephalopathy
UA: infection, DKA, ingestion
PT/INT: hemorrhage, anemia, hypercoagulable
Lactate: ketotic state, ingestion, ischemia
TSH: thyroid storm, hypothyroid
Cardiac Enzymes: MI, ischemia, cardiogenic shock
CXR: infection, pneumothorax, CHF
CT head: hemorrhage, mass
MRI: edema, mass, ischemia
CTA: pulmonary emboli, aortic dissection
LP/CSF: infection, ICP

Confusion

Organic Confusion

Acute onset confusion with fluctuating consciousness and poor recent memory, possibly associated with focal deficits, hallucinations or abnormal vital signs. 

Functional Confusion

Chronic or slow-onset, normally alert and oriented, with some agitation or anxiety, possibly auditory hallucinations and normal vitals, no focal deficits, and illusions or delusions. 
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GW Internal Medicine Subspecialty Reading List

12/16/2015

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The Himmelfarb librarians have built an extensive reading list for internal medicine sub-specialties, from Cardiology to Infectious Disease. These are a great resource for studying up on both bread and butter as well as zebras. 
Click here to go to the GW Internal Medicine Reading List. 
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This site is independently owned and operated and not affiliated with the George Washington University, George Washington University Hospital, or Medical Faculty Associates. All information on this site is the opinion of the author alone and in no way should be seen to represent the views of the George Washington University, George Washington University Hospital, or Medical Faculty Associates. The information on this page is for personal use only and should not be see as medical advice or used directly for patient care. The author provides no guarantee of the accuracy of the information provided on this page. ​

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  • Clinical
    • Discharge Macros
    • Procedure Macros
    • Exam Macros
    • Pediatric Macros
    • Antibiogram
    • Follow Up
    • 2023 MDM
    • Heart Pathway
    • Jeromy's Macros
  • Education
    • EM Education
    • Critical Care
    • FOAM
  • Orientation
    • Dept Orientation
    • Cerner
    • Dragon
  • Links
    • Clinical Links
    • StatMacros
    • ICU Bootcamp
  • Private
    • MCS
    • GWU Contacts & Map