Carolinas Core Concepts Core Concepts in EM; a repository for Carolinas lecture summaries.


M&M 8/22/11

Adam Brunfeldt

  • Synthesize information from all sources (referring docs, your own exam...) instead of believing the PCL call 100%.
  • Boerhaave's requires early surgical consultation 2/2 high mortality (35%) and much worse prognosis with delay.
  • Alcoholics get hypoglycemic easily due to poor glycogen stores/poor liver function.
  • Glucose before thiamine is OK in life-threatening situations; subsequent thiamine dosing (500mg IV) can avoid Wernicke's.


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  1. Total body stores of thiamine = 25-30 mg and is water soluble. 100mg is plenty. Remainder goes out in the urine. Not expensive so not a big deal. Would also remind that Mg++ is a co-factor for thiamine.

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