Urgencias endocrinológicas clase 1

Urgencias Endocrinológicas 05 - 05 -10 Ciudad de Buenos Aires Dra. Paula Guido

Temas a desarrollar ,[object Object],[object Object],[object Object],[object Object]

Insuficiencia Suprarrenal Aguda

Definición ISR ,[object Object],[object Object],[object Object],[object Object],[object Object]

Causas ISR 1ª ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Causas de ISR 2ª y 3ª ,[object Object],[object Object],[object Object]

Manifestaciones clínicas Laboratorio ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Insuficiencia Suprarrenal Aguda ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Clínica y Laboratorio ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Pautas Anti-Estres ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Tratamiento ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Insuficiencia Suprarrenal Relativa ,[object Object],[object Object],[object Object],[object Object],[object Object]

Generalidades ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Patogénesis ,[object Object],[object Object],[object Object]

Manifestaciones clínicas ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Escala Dx de Wartofsky . < 25: tirotoxicosis improbable . 25-45: tirotoxicosis inminenente . >45: tirotoxicosis instalada 0 10 Historia precipitante Negativo Positivo Ictericia de causa no definida 10 20 Moderado Diarrea , náuseas, vó mitos , dolor abdominal severo Disfunción gastrointestinal-hepática 5 10 15 10 Leve Edema pedal Moderado Rales pulmonares bibasales Severo Edema pulmonar Fibrilación auricular Insuficiencia cardiaca congestiva 10 20 30 Leve Agitación Moderado Delirio, psicosis, letargia extrema Severa Convulsiones, coma Sistema nervioso central 5 10 15 20 25 99-109 110-119 120-129 130-139 >140 Disfunción cardiovascular (Taquicardia) 5 10 15 20 25 30 37,2 - 37,7 37,8 - 38,2 38,3 - 38,8 38,9 - 39,3 39,4 -39,9 >40 Disfunción termorregulatoria

Laboratorio ,[object Object],[object Object],[object Object],[object Object],[object Object]

Tratamiento  Medidas generales ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Tratamiento específico ,[object Object],[object Object],[object Object],[object Object]

Respuesta al tratamiento ,[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],Definición y epidemiología

Patógenesis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Factores precipitantes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Clínica ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Laboratorio ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object]

Tratamiento ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Tratamiento con GC ,[object Object],[object Object],[object Object],Previo a la administración de T4 Dosis: 100 mg de hidrocortisona en bolo EV y luego goteo de 200 mg a pasar en 24 hs o 100 mg c/8hs EV

Tratamiento con T4 ,[object Object],[object Object],[object Object],[object Object]

Factores de mal pronóstico ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Generalidades ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],La unión a la albúmina es PH dependiente: La acidosis aguda disminuye la unión a la albúmina y aumenta el Ca i. La alcalosis aumenta la unión a la albúmina y disminuye el Cai

Laboratorio ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

REGULACIÓN DE CALCEMIA HIPOCALCEMIA RIÑON Exc. P Reab.Ca Act. Vit D INTESTINO Abs. Ca y P HUESO Resorción ósea CALCEMIA PTH

Causas de Hipercalcemia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Hipercalcemia tumoral ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Manifestaciones clínicas ,[object Object],[object Object],[object Object],[object Object],[object Object]

DIAGNÓSTICO ,[object Object],[object Object],[object Object],[object Object],[object Object]

TRATAMIENTO ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

TRATAMIENTO ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Causas de hipocalcemia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Más frecuente: LISIS TUMORAL, DROGAS, POSTQURÚRGICA

Manifestaciones clínicas (Agudo) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

TRATAMIENTO ,[object Object],[object Object],[object Object],[object Object],[object Object]

Muchas gracias! Mendoza – Argentina -

Urgencias endocrinológicas clase 1

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Urgencias endocrinológicas clase 1