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Year3 Endo Conditions > Hyperthermia and Hypothermia > Flashcards

Hyperthermia and Hypothermia Flashcards

1
Q

What is the definition hypothermia?

A

core body temperature <35°C (<95°F)

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2
Q

What are RF for hypothermia?

A
  1. General anaesthetic use
  2. Extremes of age
  3. Immobility
  4. Substance misuse
  5. Impaired cognition
  6. Hypothyroidism
  7. Stroke
  8. Parkinson’s disease
  9. Homelessness
  10. Gram-ve septicaemia
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3
Q

What are two ways you can get hyperthermia?

A
  1. Passive severe environmental heat esp at risk patients during heat wave
  2. Strenuous physical exercise in heat
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4
Q

What are RF for hyperthermia?

A
  1. Extremities of age
  2. Poor physical condition
  3. Pre-existing dehydration
  4. Obesity
  5. Environmental factors
  6. Drugs e.g. amphetamines
  7. Alcohol misuse
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5
Q

What are symptoms and signs of hypothermia?

A
  1. Cold exposure and body temp <35 degrees
  2. Cognitive impairment
  3. Shivering
  4. Frostbite
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6
Q

What are symptoms and signs of hyperthermia?

A
  1. Central Nervous System dysfunction
  2. Hyperthermia (>40degrees)
  3. Anhidrosis
  4. Intense thirst
  5. Weakness
  6. Anxiety
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7
Q

What is differential diagnosis for hypothermia?

A
  1. Sepsis

2. Hypothyroidism

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8
Q

What is differential diagnosis for hyperthermia?

A
  1. Delirium
  2. Meningitis
  3. DKA
  4. Hyperthyroidism
  5. Serotonin syndrome
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9
Q

What investigations do you do for hypothermia?

A
  1. core temp measurement
  2. 12 lead ECG
  3. Blood glucose
  4. Blood gas
  5. Serum urea, electrolytes and creatinine
  6. FBC
  7. Clotting screen
  8. CXR
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10
Q

Why is a 12 lead ECG used in hypothermia?

A

continuous monitoring for arrythmias that could be fatal e.g. could have sinus bradycardia, AF

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11
Q

What may a blood gas show in hypothermia?

A

respiratory alkalosis or metabolic acidosis or both

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12
Q

What would respiratory acidosis be suggested by?

A

pH <7.35 and PCO2 >40 mmHg

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13
Q

What would metabolic acidosis be suggested by?

A

pH <7.35, bicarbonate ≤24 mEq/L, and a normal PCO2, although it may be low with compensation

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14
Q

What would PaO2 being low suggest?

A

may be low with severe hypothermia, and/or if there are pulmonary infiltrates or oedema

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15
Q

What would serum urea, electrolytes and creatinine be like in hypothermia?

A
  1. hyperkalemia

2. hypokalaemia

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16
Q

What would the clotting screen show in hypothermia?

A

elevated PT and PTT

17
Q

What would the CXR suggest in hypothermia?

A

may show pulmonary infiltrates, oedema

18
Q

What investigations would you do for hyperthermia?

A
  1. Rectal Temp
  2. FBC
  3. LFTs
  4. RFTs
  5. Electrolytes
  6. ABG
  7. CK
  8. Clotting profile
  9. Urinalysis
  10. Glucose
  11. ECG
19
Q

What would FBC show in hyperthermia?

A
  1. Neutrophilia
  2. Anaemia
  3. Thrombocytopenia
20
Q

What would the RFTs show in hyperthermia?

A

elevated creatine and blood urea

21
Q

What would electrolytes show in hyperthermia?

A

hypo or hyperkalaemia

22
Q

What would ABG show in hyperthermia?

A
  1. elevated lactate
  2. metabolic acidosis
  3. respiratory alkalosis
23
Q

What would the CK show in hyperthermia?

A

elevated esp w/ rhambodylosis

24
Q

What would clotting profile show in hyperthermia?

A

may show elevated prothrombin time, activated PTT, INR; hypofibrinogenaemia

25
Q

What may the urinalaysis show in hyperthermia?

A

myoglobinuria and/or haemoglobinuria

26
Q

What would the ECG show in hyperthermia?

A
  1. arrhythmias
  2. conduction abnormalities
  3. non-specific ST/T wave changes
27
Q

How would you manage hypothermia?

A
  1. Stop cooling
  2. CPR
  3. Humidified oxygen
  4. Warmed IV fluids
  5. Haemofiltration
28
Q

How would you manage hyperthermia?

A
  1. Stabilisation
  2. Active cooling
  3. Supportive care and observation
29
Q

What are possible complications of hypothermia?

A
  1. Hypoglycaemia
  2. Hyperkalaemia
  3. Cardiac arrythmias
  4. GI disorders
  5. Bleeding diathesis
30
Q

What are possible complications of hyperthermia?

A
  1. ARDS
  2. Shock
  3. AKI
  4. Acute liver failure
  5. Rhabdomylosis
  6. DIC
  7. CVD
  8. Mutli-system organ failure
31
Q

What is prognosis of hypothermia like?

A
  1. core temperature <26°C (<78.8°F) do not survive
  2. triad of coagulopathy, acidosis, and hypothermia is also associated with increased mortality.
  3. If >70to and temp<32 mortality 50%
32
Q

What is the prognosis of hyperthermia like?

A

mortality from heat stroke in older adults can exceed 50%

Year3 Endo Conditions (33 decks)

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