A patient comes to emergency opd with feeling of impending doom, intense anxeity and palpitations. All of the following investigations should be done in emergency except?
**Core Concept**
The patient's presentation of impending doom, intense anxiety, and palpitations is suggestive of a panic attack, which is a common manifestation of anxiety disorders. In such cases, the primary concern is assessing for potential life-threatening causes of these symptoms, such as cardiac arrhythmias or hypoglycemia, rather than investigating for underlying endocrine or hematological disorders.
**Why the Correct Answer is Right**
Hemoglobin levels are not immediately relevant in the acute management of a panic attack, as the primary concern is assessing for cardiac instability or hypoglycemia. The other options (T3, T4, TSH, glucose levels, and ECG) are all relevant in the emergency assessment of a patient presenting with symptoms suggestive of a panic attack, as they help to rule out potential life-threatening causes such as thyroid dysfunction, hypoglycemia, or cardiac arrhythmias.
**Why Each Wrong Option is Incorrect**
**Option A:** T3, T4, and TSH levels are relevant in the assessment of thyroid dysfunction, which can mimic or exacerbate anxiety symptoms.
**Option B:** Glucose levels are crucial in the emergency assessment of a patient with symptoms suggestive of a panic attack, as hypoglycemia can cause similar symptoms.
**Option D:** ECG is essential in the emergency assessment of a patient with palpitations, as it can help diagnose or rule out cardiac arrhythmias.
**Clinical Pearl / High-Yield Fact**
In the emergency assessment of a patient with symptoms suggestive of a panic attack, it's essential to remember the "ABCs" of assessment: Airway, Breathing, Circulation, and then consider potential life-threatening causes such as cardiac arrhythmias or hypoglycemia.
**✓ Correct Answer: C. Hemoglobin**