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• W2298757047 abstract "* ALT: : alanine aminotransferase AST: : aspartate aminotransferase BUN: : blood urea nitrogen CBC: : complete blood count CNS: : central nervous system CSF: : cerebrospinal fluid CT: : computed tomography ECG: : electrocardiography ED: : emergency department EEG: : electroencephalography ESR: : erythrocyte sedimentation rate GI: : gastrointestinal GU: : genitourinary Hct: : hematocrit Hgb: : hemoglobin MRI: : magnetic resonance imaging WBC: : white blood cellA 15-year-old boy presents with a 4-day history of fatigue, intermittent mild headache, and a 1-day history of generalized weakness, body aches, sleepiness, dizziness, and three episodes of nonbilious, nonbloody emesis. He denies cough, shortness of breath, palpitations, or chest pain, as well as abdominal pain, joint pain, rash, vision changes, weight loss, polyuria, polydipsia, or change in urine color. He currently takes methylphenidate for attention-deficit/hyperactivity disorder and sertraline for depression. He denies any over-the-counter or illicit drug use.Physical examination reveals a well-developed, tired-appearing adolescent. His temperature is 100.6°F with otherwise normal vital signs, including blood pressure. Physical examination of the heart, lungs, and abdomen are within normal limits. His proximal muscle strength is 4 of 5; the rest of his neurologic examination is within normal limits.Initial laboratory examination includes the following levels: sodium, 133 mmol/L; potassium, 2.4 mmol/L; chloride, 90 mmol/L; bicarbonate, 30 mmol/L; BUN, 9 mg/dL; creatinine, 0.5 mg/dL; glucose, 103 mg/dL; calcium, 9.4 mg/dL; magnesium, 2.0 mg/dL; and phosphorus, 4.3 mg/dL. CBCs, liver function test results, and hepatic enzyme levels are normal. ECG shows a prolonged QT interval at 550 milliseconds.On admission, the patient receives a potassium bolus, followed by maintenance intravenous (IV) fluids containing potassium chloride. He has no vomiting or diarrhea on his first hospital day. A follow-up laboratory examination of his chemistry studies shows persistence of his initial abnormalities.A 19-year-old female presents to the ED 3 hours after intentional ingestion of an unknown substance. On initial presentation, she is afebrile, with a blood pressure of 100/59 mmHg, respiratory rate of 20 breaths per minute, heart rate of 110 beats per minute, and oxygen saturation of 99% on room air. She is alert, oriented, and conversational.Within 20 minutes of arrival to the ED, her blood pressure drops to 61/24 mmHg, …" @default.
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• W2298757047 date "2013-04-01" @default.
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• W2298757047 title "Index of Suspicion" @default.
• W2298757047 doi "https://doi.org/10.1542/pir.34-4-192" @default.
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