Hello Julian,
> If the argument continues along the line of a "...desperately
> ill patient..." should we not analyse catecholamines at night for
> patients with malignant hypertension?
>
Glad you brought this up. My advice re a suspect "phaeo" would be
very much along the lines you gave for Urgent TFTs. Take the samples
(urine and plasma) and treat with Alpha blockers (or whatever).
By the way I argue that every acute hypoglycaemia (except for the
very obvious insulin induced one) should have blood collected for
glucose, insulin, growth hormone, C-peptide, cortisol and ACTH
*BEFORE* glucose infusion. The samples may be separated and frozen
and stored but *not* analyzed till the cold sensible light of day
dictates the appropriate assay. Treatment would only be delayed for
minutes and one would not miss the one chance to make a diagnosis
of insulinoma or Addisons or hypopituitarism.
From: Dr Cyril Weinkove Tel: +44 (161)-787-4427
Clinical Sciences Building Fax: +44 (161)-787-4427
Hope Hospital, Salford Email: [log in to unmask]
M6 8HD, United Kingdom Internet:[log in to unmask]
Home Message and Fax Mail: +44 (171)-681-2373
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