HYPOTHERMIA

HYPOTHERMIA: Excerpt from Algorithmic Diagnosis of Symptoms and Signs

Ask the Following Questions:

1. Is there a history of drug or alcohol ingestion? Alcoholic intoxication, opium poisoning, tricyclic antidepressants, and phenothiazine may cause hypothermia.
2. Is there a history of severe vomiting or diarrhea? Severe vomiting or diarrhea may induce dehydration and electrolyte disturbances, which will induce hypothermia. Intestinal obstruction, cholera, and peritonitis are among the many disorders that may lead to severe vomiting or diarrhea.
3. Are there endocrine abnormalities? Signs of hypothyroidism and Addison's disease may be obvious, but hypopituitarism, hypoglycemia, and diabetes mellitus may also be the cause of hypothermia.
4. Are there abnormalities on the neurologic examination? Focal neurologic findings may be seen in a cerebral vascular accident or epidural or subdural hematoma. However, thiamine deficiency may also result in hypothermia.

DIAGNOSTIC WORKUP

Routine laboratory tests include a CBC and differential count, a sedimentation rate and chemistry panel, electrolytes, thyroid profile, blood cultures, urinalysis, and a urine drug screen. An EKG and chest x-ray should also be done. A CT scan of the brain is done if there are focal neurologic abnormalities or disorders of consciousness.

An infusion of dextrose intravenously and thiamine are given as soon as blood studies are drawn in case there is hypoglycemia or thiamine deficiency.

If the above studies are normal, a thorough endocrine workup is indicated, including tests for serum cortisol, FSH, lutein-stimulating hormone (LSH), and growth hormone. A cardiologist, neurologist, or endocrinologist may need to be consulted to help solve the diagnostic dilemma.

Book Source Details

• Book Title: Algorithmic Diagnosis of Symptoms and Signs
• Author(s): R. Douglas Collins
• Year of Publication: 2003
• Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2003 Lippincott Williams & Wilkins.

More About Hypothermia

• Back to disease: Hypothermia: Introduction
• Next Book Extract About Hypothermia: Hypothermia (In a Page: Signs and Symptoms)
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Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.

More About This Book: Title: Algorithmic Diagnosis of Symptoms and Signs Authors: R. Douglas Collins Publisher: Lippincott Williams & Wilkins Copyright: 2003 ISBN: 0-7817-3805-9

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