Multisystem Processes & Disorders


{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/M21_F1.jpg"}},{"insert":"\n\n\u0027...you heard me right, 111 degrees today! For you metric folks out there, that\u0027s 44 Celsius, so switch on your ACs, hydrate, and avoid the great outdoors...\u0027\n\n\u0022You have no idea,\u0022 you mutter, as you mop your sweaty brow with your soaked handkerchief. You really should have had your car\u0027s air conditioning fixed\n\nOnce in the on-call room, you grab a bottle of cold water and slump into your usual spot on the couch. A few seconds later though, your pager sounds. A new patient has arrived.\n"}]}


{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/M21_F4.jpg"}},{"insert":"\n\nYou are shown to 46-year-old Walter Cole (as per his ID). He was found unconscious at your local park around 10 minutes ago by emergency services, who were alerted by an onlooker.\n\nWalter is unresponsive, with a Glasgow Coma Scale (GCS) of 7\/15 (E1-V2-M4). His rectal core temperature is 105\u02daF (40.6\u02daC ), pulse is 128 bpm, blood pressure is 100\/60 mmHg, respiratory rate is 32\/min, and SpO2 is 94% on oxygen via a standard face mask.\n\nAlthough Walter\u0027s skin is hot to your touch, he is not sweating. A quick systemic exam reveals no abnormalities. A capillary blood glucose reads 98 mg\/dL. Samples are sent off for a complete blood count, electrolyte assay, liver and renal profiles, and blood gases. \n"}]}


{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/M21_F6.jpg"}},{"insert":"\n\nWalter\u0027s wife arrives in the meantime. She states that he was in good health before this, producing the (unremarkable) results of a routine health checkup just a month ago. She also states that he is not on any medications, including over-the-counter drugs or supplements; and that he has never used recreational drugs.\n\nYou also find out that Walter was jogging in the park. He\u0027d probably been exercising for around an hour or so, if not slightly longer.\n"}]}


{"ops":[{"insert":"Running the differentials through your head, you ponder your next step.\n\nWhat will you do now?\n"}]}
1. Order Ice water immersion
2. Perform exposure and tepid sponging
3. Administer parenteral antipyretics