Frank J Baker

A case of alcoholic ketoacidosis in a 23-year-old chronic alcoholic, gravada V, para IV, is reported. Symptoms were constant, severe, nonradiating pain with crampy exacerbations, anorexia, nausea and vomiting. The patient had a tender and irritable full-term uterus. She was treated inhospital with vigorous fluid therapy and 5% dextrose in normal saline, sodium bicarbonate, glucose and insulin and showed improvement overnight. Alcoholic ketoacidosis has not been reported in pregnant ...

Phencyclidine-induced psychosis should be suspected in young adults with a history of poor social and academic performance, who present with marked anxiety, psychotic ideation, and physical signs such as nytagmus and ataxia. Phencyclidine ingestion should be suspected when the patient fails to respond to the usual reassurance and “talk-down” for other “bad trips.” A variety of drugs, as well as encephalitis or primary psychosis, can present a similar picture. Phenothiazines should be ...

Arthrocentesis and the subsequent evaluation of synovial fluid is often the definitive diagnostic procedure for the patient presenting with a joint effusion or intrasynovial hemorrhage. The difficulty of performing arthrocentesis varies with the joint in question, but those joints most frequently involved are easily entered. The indications and contraindications for this procedure are discussed. Effusion-producing pathologic processes often yield fluids of a characteristic nature ...

In 40 patients treated in the Billings Hospital emergency department for acute exacerbations of bronchial asthma, pulsus paradoxus was noted at presentation and at the time of admission to the hospital or discharge. No level of initial pulsus paradoxus predicting eventual admission was found. High initial pulsus paradoxus was more frequent in admitted patients. A correlation between the percent drop of pulsus paradoxus and success or failure of treatment was noted. Treatment failure was ...

Because hypoglycemia may be rapidly fatal it must be diagnosed and treated early. Ketoacidosis may be difficult to differentiate from hypoglycemia. The diagnosis, treatment and causes of both diabetic emergencies are described. Once rehydration is instituted, further management can be directed using appropriate laboratory and bedside studies that allow stabilization with a high degree of control.