Mayo Clinic critical care case review

313 Pages·2016·7.799 MB·English

by  Farmer, J. Christopher, Kashyap, Rahul, O'Horo, John C

MAYO CLINIC
CRITICAL CARE
CASE REVIEW
MAYO CLINIC SCIENTIFIC PRESS
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MAYO CLINIC
CRITICAL CARE
CASE REVIEW
EDITORS
Rahul Kashyap, MBBS
Senior Clinical Research Coordinator,
Department of Anesthesiology,
Mayo Clinic, Rochester, Minnesota
Assistant Professor of Anesthesiology
Mayo Clinic College of Medicine
John C. O’Horo, MD, MPH
Fellow in Infectious Diseases,
Mayo School of Graduate Medical Education and
Assistant Professor of Medicine
Mayo Clinic College of Medicine
Rochester, Minnesota
J. Christopher Farmer, MD
Chair, Department of Critical Care Medicine,
Mayo Clinic, Scottsdale, Arizona
Professor of Medicine
Mayo Clinic College of Medicine
ASSOCIATE EDITORS
Kianoush B. Kashani, MD
James A. Onigkeit, MD
Kannan Ramar, MBBS, MD
MAYO CLINIC SCIENTIFIC PRESS OXFORD UNIVERSITY PRESS
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Library of Congress Cataloging- in- Publication Data
Names: Kashyap, Rahul, editor. | O’Horo, John C., editor. | Farmer, J. Christopher, editor.
Title: Mayo Clinic critical care case review/editors, Rahul Kashyap, John C. O’Horo,
J. Christopher Farmer; associate editors, Kianoush B. Kashani, James A. Onigkeit, Kannan Ramar.
Other titles: Critical care case review | Mayo Clinic scientific press (Series)
Description: Oxford ; New York : Oxford University Press, [2015] |
Series: Mayo Clinic scientific press | Includes bibliographical references and index.
Identifiers: LCCN 2015040586 | ISBN 9780190464813 (alk. paper)
Subjects: | MESH: Critical Care—methods—Case Reports. | Diagnosis—Case Reports.
Classification: LCC RC86.8 | NLM WX 218 | DDC 616.02/8—dc23 LC record available
at http://lccn.loc.gov/2015040586
9 8 7 6 5 4 3 2 1
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Preface
There are a limited number of critical care review books on the market. The books
that exist are arranged almost exclusively in 1 of 2 formats: a traditional chap-
ter book, with an organ- system format based on physiology and pathophysiol-
ogy, or a review book in question- and- answer format that is also organized by
organ systems. These are adequate for general review or board review by the
practicing physician or physician-i n- training; however, the presentation is dry
and there is little to differentiate 1 book from another. In contrast, Mayo Clinic
Critical Care Case Review, a new and unique critical care textbook, is based on
cases presented by critical care medicine faculty and fellows at the Mayo Clinic
Clinical Pathological Case (CPC) Conference. The CPC Conference is a twice-
monthly meeting where interesting cases are presented in an “unknown” format:
The presenter leads the audience through a patient’s hospital course, highlight-
ing clinically important facts and pearls in a question-a nd- answer format. The
presentation concludes with take- home points relevant to clinical practice. The
CPC Conference is unique and highly rated by fellows and faculty alike because
of its brevity (3 cases are presented in 1 hour), style of presentation (diagnostic
dilemmas and question- and- answer format), and clinical relevance. Our goal is to
capture these CPC Conference attributes in text and illustrations by reproducing
the best of these presentations in book form. We hope this unique style proves as
valuable to our readers as it has to our residents, fellows, and faculty.
Rahul Kashyap, MBBS
John C. O’Horo, MD, MPH
J. Christopher Farmer, MD
v

Contents
SECTION I: CASES
1. Dyspnea and Edema  2
Blair D. Westerly, MD, and Hiroshi Sekiguchi, MD
2. An Electrical Problem  6
Ronaldo A. Sevilla Berrios, MD, and Erica D. Wittwer, MD, PhD
3. Hypertension  10
Srikant Nannapaneni, MBBS, Lisbeth Y. Garcia Arguello, MD,
and John G. Park, MD
4. A Rare Cause of Liver Failure  14
Alice Gallo de Moraes, MD, Sarah A. Narotzky, MD,
and Teng Moua, MD
5. Shortness of Breath  18
Carlos J. Racedo Africano, MD, and Darlene R. Nelson, MD
6. Acute Respiratory Failure in a Young Smoker  22
Mazen O. Al-Qadi, MBBS, and Bernardo J. Selim, MD
7. Shock  26
Mazen O. Al-Qadi, MBBS, John C. O’Horo, MD, MPH,
and Larry M. Baddour, MD
vii
viii CONTENTS
8. Diffuse Abdominal Pain in a 45- Year- Old Woman  32
Mazen O. Al-Qadi, MBBS, Jasleen R. Pannu, MBBS,
and Teng Moua, MD
9. An Over- the- Counter Intoxication  36
Ronaldo A. Sevilla Berrios, MD, and Kianoush B. Kashani, MD
10. An Over- the- Counter Overdose  42
Mazen O. Al-Qadi, MBBS, Sarah B. Nelson, PharmD, RPh,
and Bernardo J. Selim, MD
11. A Post– Myocardial Infarction Complication  48
Mazen O. Al-Qadi, MBBS, and Eric L. Bloomfield, MD
12. Massive Hemoptysis  52
Mazen O. Al-Qadi, MBBS, and Mark E. Wylam, MD
13. Hypotension Following a Broken Hip  58
Joseph H. Skalski, MD, and Daryl J. Kor, MD
14. Extubation Failure  62
Muhammad A. Rishi, MBBS, and Nathan J. Smischney, MD
15. Hypotension and Right- Sided Heart Failure After Left Pneumonectomy  66
Misty A. Radosevich, MD, W. Brian Beam, MD, and Onur Demirci, MD
16. More Than Meets the Eye  70
Sumedh S. Hoskote, MBBS, Shivani S. Shinde, MBBS,
and Nathan J. Smischney, MD
17. Reverse Apical Ballooning Syndrome Due to Clonidine Withdrawal  74
Pramod K. Guru, MBBS, Dereddi Raja S. Reddy, MD,
and Nandan S. Anavekar, MB, BCh
18. A Well- Known Cardiac Condition With a Unique Presentation  80
Sumedh S. Hoskote, MBBS, Muhammad A. Rishi, MBBS,
and Nathan J. Smischney, MD
19. Electrolyte Abnormalities During Continuous Renal
Replacement Therapy  84
Sumedh S. Hoskote, MBBS, Fouad T. Chebib, MD,
and Nathan J. Smischney, MD
CONTENTS ix
20. A Disease Masquerading as Septic Shock  90
Muhammad A. Rishi, MBBS, and Nathan J. Smischney, MD
21. A Respiratory Infection  94
Kelly A. Cawcutt, MD, and Cassie C. Kennedy, MD
22. Infection in a Patient With Chronic Myeloid Leukemia  98
Michelle Biehl, MD, Lisbeth Y. Garcia Arguello, MD,
and Teng Moua, MD
23. Torsades de Pointes  104
Andrea B. Johnson, APRN, CNP, and Thomas B. Comfere, MD
24. The Kidneys Can See When the Eyes Cannot  108
Sarah J. Lee, MD, MPH, and Floranne C. Ernste, MD
25. An Upper Airway Crisis  114
Mazen O. Al-Qadi, MBBS, and Mark T. Keegan, MD
26. An Endocrine Emergency  118
W. Brian Beam, MD, and Ognjen Gajic, MD
27. Acute Renal Failure  124
Mazen O. Al-Qadi, MBBS, and Amy W. Williams, MD
28. Hypoxia and Diffuse Pulmonary Infiltrates in
an Immunosuppressed Patient With Vasculitis  130
Matthew E. Nolan, MD, and Ulrich Specks, MD
29. A Paraneoplastic Syndrome  136
Andres Borja Alvarez, MD, and Emir Festic, MD
30. Complicated Diarrheal Illness  142
Arjun Gupta, MBBS, and Sahil Khanna, MBBS
31 Persistent Shock With Hemorrhagic Complications  146
Sangita Trivedi, MBBS, Rahul Kashyap, MBBS,
and Michael E. Nemergut, MD, PhD
32. An Unusual Presentation of Disseminated Histoplasmosis  150
Lokendra Thakur, MBBS, and Vivek Iyer, MD, MPH