Other endocrine emergencies Flashcards
Hypopituitary coma Phaeochromocytoma
1
Q
How can acute hypopituitary crises and coma be precipitated?
A
- Pt w chronic pituitary failure following acute medical insult - infection, trauma/surgery, sedatives, hypothermia
- Prev healthy pt w acute insult to pituitary gland - trauma/surgery, haemorrhage (Sheehans)
2
Q
What is the presentation of hypopituitary coma?
A
headache ophthalmoplegia reduced consciousness hypotension hypothermia hypoglycaemia signs of hypopituitarism
3
Q
What tests can be done for pituitary coma?
A
Cortisol T4 TSH ACTH Glucose Pituitary fossa CT/MRI
4
Q
What is the treatment of hypopituitary coma?
A
Hydrocortisone
Lithyronine
Prompt surgery if cause is pituitary apoplexy
5
Q
What is pituitary apoplexy?
A
bleeding into or impaired blood supply of pituitary gland
6
Q
What emergency do phaeochromocytomas cause?
A
hypertensive crisis
7
Q
How do hypertensive crises present?
A
pallor pulsating headache HTN feels 'about to die' pyrexial
8
Q
What is the management of acute hypertensive crisis?
A
Short acting IV alpha blocker e.g. phentolamine
When BP controlled, give long acting alpha blocker e.g. phenoxybenzamien
Beta blocker may be given at this stage to control any tachycardia or myocardial ischaemia
Elective surgery
