A 27-year-old male with primary sclerosing cholangitis and u…

A 27-year-old male with primary sclerosing cholangitis and ulcerative colitis presents with high ileostomy output and abdominal pain for last few weeks associated with a 9-kg weight loss. He has no other medical history. Despite fluid resuscitation and pharmacologic therapy, his symptoms persist. He develops fever to 39.7°C and is transferred to the ICU with concerns for sepsis. On admission to the ICU, he is somnolent and lethargic, heart rate is 160 beats/min, blood pressure is 156/80 mm Hg, respiratory rate is 25/min, and his pulse oximeter reads 98% on room air. His sepsis workup is negative, but his laboratory work is remarkable for a low TSH level.  What is the diagnosis?

A 54-year-old female is admitted to the intensive care unit…

A 54-year-old female is admitted to the intensive care unit (ICU) with a subarachnoid hemorrhage due to a left middle cerebral artery aneurysm rupture. Early external ventricular drain was placed because of a poor neurological examination. Over the course of 7 days, there have been ongoing issues with refractory elevated intracranial pressure and poor neurologic examination, progressing to no cranial nerve responses. Her examination is as follows: pupils 5 mm and nonreactive, absent oculocephalic reflexes, absent corneal reflexes, absence of facial grimace, absent gag, and absent cough. The only evoked motor response is minimal triple flexion in the bilateral legs. An apnea test was completed and there were no spontaneous respirations with an increase in pCO2 20 mm Hg more than baseline.  Which of the following is MOST true?

An elderly patient is brought to the emergency department af…

An elderly patient is brought to the emergency department after being found on the floor after a fall. The patient has unilateral sagging of the face, marked slurring of the speech, and paralysis on one side of the body. The patient’s blood pressure is 220/109 mm Hg. What is the likely treatment for this patient?