Diabetes in the ER: The Big Three Presentations 1. Hyperglycemic Emergencies * Diabetic Ketoacidosis (DKA) * Common in type 1 but can occur in type 2. * Triad: Hyperglycemia, ketonemia/ketonuria, metabolic acidosis. * Presentation: Polyuria, polydipsia, abdominal pain, nausea/vomiting, Kussmaul respirations, fruity breath, AMS in severe cases. * Hyperosmolar Hyperglycemic State (HHS) * Typically

Hyperthyroidism * Weight loss despite increased appetite * Heat intolerance * Palpitations/tachycardia * Anxiety, tremor, insomnia Multinodular goiter/Toxic multinodular goiter * Hyperthyroidism and multiple palpable nodules Graves disease * most common cause of hyperthyroidism * Presence of thyroid-stimulating hormone receptor antibodies (anti-TSH receptor) * hyperthyroidism, pretibial myxedema, and thyroid ophthalmopathy * thyroid ophthalmopathy: diplopia, proptosis, and rest