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FINALS - ENDOCRINE > metabolic > Flashcards

metabolic Flashcards

1
Q

causes hyperK

A

AKI // meds // met acidosis // addisons // rhabdo // massive blood transfusion

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2
Q

drugs that cause hyperK

A

ACEi // ARBs // sprinolactone // ciclosporin // heparin // (BB in kidney failure)

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3
Q

ECG hyperK

A

tented T waves // loss of p // broad QRS // sinudoidal wave // v fib

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4
Q

mild, moderate, severe hyperK

A

mild 5.5-5.9 // moderate 6-6.4 // severe >6.5

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5
Q

mx hyperK

A

IV calcium gluconate (stabilise cardiac membrane) // IV dextrose+insulin (shift K from ECF –> ICF) // calcium resonium, diuretisc, dialysis (remove K)

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6
Q

relationship with K ions and H ions

A

they compete with each other - high K means less H can enter cells and vice versa

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7
Q

causes hypoK alkalosis

A

vomiting // thiazide + loop diuretics // cushings // conn’s

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8
Q

causes hypoK acidosis

A

diarrhoea // renal tubular acidosis // acetazolamide

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9
Q

what other deficiency can cause hypoK

A

hypoMg

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10
Q

symptoms hypoK

A

weakness, hypotonia

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11
Q

ECG hypoK

A

U wave // small T wave // prolonged PR // St depression

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12
Q

hypoK with hypertension

A

Cushings // conns // liddles

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13
Q

hypoK w/o hypertension

A

diuretics // GI loss (diarrhoea or vomitting) // renal tubular acidosis // Bartters

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14
Q

inheritance Liddle’s

A

dominant

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15
Q

features liddles

A

hypertension + hypoK alkalosis

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16
Q

mx LIddles

A

amiloride or triamterene

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17
Q

inheritence Bartters

A

autosomal recessive

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18
Q

mechanism Bartters

A

defective Cl absorption from NaKCl transporter (work like loop diuretics)

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19
Q

most common cause hypercalcaemia in non-hospital patients

A

primary hyperparathyroid

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20
Q

most common cause hypercalcaemia in hospital patients

A

malignancy

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21
Q

how does malignancy cause hyperCa

A

PTHrP from tumour eg squamous cell lung cancer // bone mets // myeloma

22
Q

invx hyperCa

A

PTH

23
Q

other key causes hyperCa

A

sarcoid // vit D intoxication // acromegaly // thyrotoxicosis // thiazides // dehydrated // addisons // pagets

24
Q

symptoms hyperCa

A

bones, stones (kidney), groans , psychic moans // corneal calcification // HTN

25
Q

ECG hyperCa

A

short QT

26
Q

initial mx hyper Ca

A

rehydration with saline (3/4L per day)

27
Q

secondary mx hyper Ca

A

bisphosphonates // calcitonin // loops (can worsen U+Es)

28
Q

causes hypo Ca

A

vit D def (osteomalacia) // CKD // hypoparathyroud // rhabdo // mg deficiency // blood transfusion // acute pancreatitis

29
Q

invx hypo Ca

A

history + PTH

30
Q

symtoms hypo Ca

A

tetany - muscle twitch or spasm // perioral parasthesia // depression // cataracts

31
Q

hypo Ca ECG

A

prolonged QT

32
Q

trousseaus sign hypo Ca

A

blood pressure cuff –> occlude brachial artery (above systolic) –> carpal spasm

33
Q

chvoteks sign hypo Ca

A

tapping parotid –> facial twitch

34
Q

mx hypo Ca

A

IV calcium gluconate + ECG monitoring

35
Q

indications urgent mx hypo Ca

A

carpal spasm, tetany, seizure, prolonged QT

36
Q

Mg relationship with Ca

A

Mg required for PTH secretion and action on targets // so low Mg –> low Ca and little response to Ca or Vit D mx

37
Q

causes hypo mg

A

diuretics and PPI // parenteral nutrition // diarrhoea // alcohol // hypoK and hyperCa // metabolic disorders

38
Q

how does hyperCa cause hypo Mg

A

hyperparathyroid ism

39
Q

symptoms hypoMg

A

(similar to hypoCa) // paraesthesia, tetany, seizure, arrhythmia, decreased PTH, ECG –> hypoK, digoxin toxicity

40
Q

mx hypo Mg if <0.4

A

IVmagnisium (if tetany, arrythmia, seizure)

41
Q

mx hypoMg >0.4

A

oral mg salts

42
Q

se mg salts

A

diarrhoea

43
Q

relationship between Na, K, H

A

sodium exchanged for K and H (reduces them both)

44
Q

causes hyper Na

A

dehydrated // osmotic diuresis eg HONK // diabetes insipidus // too much saline

45
Q

risk of correcting hyperNa too quickly

A

cerebral oedema –> seizure, coma, death

46
Q

rate to give saline hyperNa

A

no more 0.5 mmol/hr

47
Q

inheritence and defect liddles syndrome

A

autosomal dom // disorder Na channels in distal tubule –> increased Na

48
Q

symptoms Liddles

A

HTN + hypoK alkalosis

49
Q

mx LIddles

A

amiloride or triamtrene (K sparing diuretic)

50
Q

causes of hypoNa with urinary Na >20 (5)

A

Na depletion = diuretic, addisons, renal failure // others = SIADH, hypothyroid

51
Q

causes hypoNa with urinary Na <20

A

FINALS - ENDOCRINE (14 decks)

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