Critical endocrine disorders (thyrotoxicosis, adrenal crisis)

1. Big picture

The two endocrine emergencies in this topic are:

1. Thyrotoxic crisis / thyroid storm = life-threatening decompensated thyrotoxicosis with fever, severe tachycardia, central nervous system disturbance, heart failure, and gastrointestinal/hepatic symptoms.
2. Adrenal crisis = life-threatening acute cortisol deficiency, usually with hypotension/shock, dehydration, vomiting, abdominal pain, hypoglycemia, hyponatremia, and hyperkalemia.

Both are clinical diagnoses first. Do not wait for confirmatory endocrine tests when the patient is unstable. Stabilize first, draw urgent blood if possible, and treat immediately.

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PART A — Thyrotoxicosis and thyroid storm