Case Challenge: The Devil of Dementia

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Case Challenge: The Devil of Dementia

A 48-year-old woman with a history of pituitary surgery and irradiation is scheduled for elective surgery. She currently requires replacement thyroxine, hydrocortisone, estrogen, and progesterone. In the perioperative period you should treat her with which of the following?
Glucose infusion
Increased hydrocortisone
ACTH infusion
Increased estrogen
Increased thyroxine

Spoiler for Answer:

Neurology Cases, discussion, MCQs and member-contributed revision notes in Neurology & Neurosurgery

Tags: case, challenge, dementia, devil

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18-01-06, 08:44	#1
DrIreland Erik Administrator Join Date: Jan 2006 Posts: 168	Case Challenge: The Devil of Dementia 86y African American female is admitted to the hospital after she had a seizure while waiting for swallow evaluation as outpatient. Family reports that the patient has baseline advanced dementia, which has been worsening over the last year. She is not verbal. You are the medical student on call. PMH: Dementia, HTN, constipation Medications: FeSO4, ASA, Colace SH: NH resident, totally dependent in ADL/IADL Physical examination: VS: Temp:36.5, HR:94; RR:14; BP:120/87 HEENT: NC/AT, dry MM Chest: CTA (B) CVS: Clear S1S2, tachycardic Extremities: no c/c/e Neuro: somnolent, non focal What is going on? Why would this occur? What are you going to do?
OFF CALL

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