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Emergency Medicine

Traumatic Brain Injury

Does this Patient with Traumatic Brain Injury (TBI) have Hypopituitarism? The question for the endocrinologist when presented with a patient with traumatic brain injury (TBI) is whether the TBI has resulted in hypopituitarism, and if so, whether treating the hypopituitarism will ameliorate the patient’s condition. The patient may present in the acute or chronic phase…

Symptoms, diagnosis don’t match

Mr. R, age 54, was a diabetic, moderately overweight construction worker. One day he tripped at a job site, falling heavily on his right hip. Despite the pain, he finished his shift, then he went home, took an ibuprofen tablet, and went to bed. When he awoke in agony at…

Role of D-dimer in suspected thromboembolism

D-dimer testing is now routinely done in the emergency department. How should the results be interpreted in the setting of a patient presenting with possible thromboembolism?—Erik L. Schuls, MD, Gastonia, N.C. The very high sensitivity and negative predictive value of certain D-dimer assays make them useful to help rule out thromboembolism in patients with a…

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