Endocrine Anatomy, Human Anatomy, USMLE Step 1 - Full Vignette with Extended Explanations скачать в хорошем качестве

Endocrine Anatomy, Human Anatomy, USMLE Step 1 - Full Vignette with Extended Explanations

Three patients arrive simultaneously during a regional power outage in winter, severely limiting hospital resources and access to advanced medications. Each presents with an acute, potentially life-threatening condition affecting neurological, endocrine, or cardiac systems. What critical clinical features should guide your immediate bedside management decision using only crash cart medications while you await restoration of full hospital services? VIDEO INFO Category: Endocrine Anatomy, Human Anatomy, USMLE Step 1 Difficulty: Hard - Advanced level - Challenges experienced practitioners Question Type: Emergency Priorities Case Type: Multi Patient Explore more ways to learn on this and other topics by going to https://endlessmedical.academy/auth?h... QUESTION A winter ice storm causes a regional power failure. The hospital is on generator power; the pneumatic tube system and smart infusion pumps are offline for an estimated 20 minutes, and transfers are delayed 30-60 minutes due to road closures reported by emergency management. Crash carts and the trauma bay medication drawer are immediately available.... OPTIONS A. Administer intravenous hydrocortisone 100 mg now to Patient A for suspected pituitary apoplexy with secondary adrenal insufficiency and acute chiasmal compression, then continue 50 mg IV every 6 hours once systems resume. B. Administer intravenous dexamethasone 10 mg now to Patient A as the sole immediate therapy to avoid interfering with cortisol assays; defer hydrocortisone until laboratory access is restored. C. Administer intravenous esmolol bolus and titration to Patient B first to control atrial fibrillation with rapid ventricular response in thyroid storm; postpone other treatments until pumps and telemetry return. D. Administer intravenous phentolamine 5 mg immediately to Patient C for presumed catecholamine crisis as the first action while deferring other interventions during the outage. CORRECT ANSWER A. Administer intravenous hydrocortisone 100 mg now to Patient A for suspected pituitary apoplexy with secondary adrenal insufficiency and acute chiasmal compression, then continue 50 mg IV every 6 hours once systems resume. EXPLANATION "Administer intravenous hydrocortisone 100 mg now to Patient A for suspected pituitary apoplexy with secondary adrenal insufficiency and acute chiasmal compression, then continue 50 mg IV every 6 hours once systems resume." The foundational priority in a constrained, single-action window is to prevent irreversible harm: Patient A has vision-threatening chiasmal compression, cranial nerve III involvement, hyponatremia, and biochemical risk of secondary adrenal insufficiency-an endocrine emergency in which immediate hydrocortisone 100 mg IV is guideline-endorsed. Steroids can improve hemodynamics, treat adrenal failure, and may reduce edema compressing the optic apparatus while urgent perimetry and neurosurgical/ophthalmologic assessment are arranged when systems return. "Administer intravenous dexamethasone 10 mg now to Patient A as the sole immediate therapy to avoid interfering with cortisol assays; defer hydrocortisone until laboratory access is restored." This is less appropriate because the priority is physiologic cortisol replacement and vision protection; hydrocortisone is recommended first-line in apoplexy emergencies.... --------------------------------------------------- Our cases and questions come from the https://EndlessMedical.Academy quiz engine - multi-model platform. Each question and explanation is forged by consensus between multiple top AI models (GPT, Claude, Grok, etc.), with automated web searches for the latest research and verified references. Calculations (e.g. eGFR, dosages) are checked via code execution to eliminate errors, and all references are reviewed by several AIs to minimize hallucinations. Important note: This material is entirely AI-generated and has not been verified by human experts; despite stringent consensus checks, perfect accuracy cannot be guaranteed. Exercise caution - always corroborate the content with trusted references or qualified professionals, and never apply information from this book to patient care or clinical decisions without independent verification. Clinicians already rely on AI and online tools - myself included - so treat this book as an additional focused aid, not a replacement for proper medical education. Visit https://endlessmedical.academy for more AI-supported resources and cases. This material can not be treated as medical advice. May contain errors. ---------------------------------------------------