Myxedema coma

Today we discussed the case of a young woman with history of hypothyroidism who was unhoused and not taking medications for 2 months, presenting with subacute onset fatigue, with periorbital and bilateral lower extremity edema and lower extremity hyperpigmentation, found to have profound hypothyroidism vs mild myxedema coma.

We also discussed a MKSAP question on management of intracranial hemorrhage, as review of American Heart Association’s guidelines for management of hypertensive emergency.

Acute Severe Asthma

Today we discussed the case of a young man with history of well controlled asthma who presented with subacute dyspnea, and productive cough with respiratory distress, thought to have severe acute asthma with likely triggers of smoking as well as poor air quality due to the California fires. Finally we discussed that his living in a neighborhood that was redlined throughout the mid to late 20th century contributes to his likelihood of ED presentations with asthma exacerbation.