endocrinology

EM@3AM: Decompensated Hypothyroidism

A 43-year-old female presents with altered mental status.  Her husband states she has had weight gain, constipation, fatigue, and skin changes. Vital signs include BP 92/60, HR 48, T 93.2 rectal, RR 13, SpO2 96% on room air. She is alert and oriented x 1, and her neck reveals a well-healed midline anterior neck scar. Her abdomen is soft but distended, and her extremities are cool. What’s the likely diagnosis?

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EM@3AM: Hyper- and HypoCa

A 59-year-old male with history of CML presents to the emergency department with left sided flank pain. He was sitting in a chair 4 hours ago when the pain suddenly started. The pain has been constant since onset. He appears uncomfortable, with mild tenderness in the LLQ. Testicular exam is normal. What is your presumed diagnosis, and what is the most likely contributor?

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