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I have tried putting the following scenario to a number of consultant physician colleagues over the last couple of days: "On take on Friday evening at about 10 pm you admit a 23 year old woman, unconscious, with a body temperature of 32 degree centigrade. What clinical chemistry tests are you going to want ready for the post take ward round at 8 am on Saturday morning?" All mentioned thyroid function, cortisol and "ideally" a drug screen as well things like U/E LFTs, glucose & amylase on the usual on call repertoire. The neurosurgeon listening in (whom I was a neuro SHO with more years ago than I care to remember) reply was "Give her a shot of steroids and MRI her head urgently". Fine if you get the bloods off before giving the steroids. We both vividly remembered the same hypothermic young woman with a hypothalamic glioma. Robert Forrest BTW I was amused to note that my spell checker wanted to substitute "gloom" for "glioma" %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%