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Flashcards in 7/19 Deck (52)
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1

what is central DI

ADH deficiency

you diurese and urinate too much,
loss of free water

polyuria and polydipsia with life-threatening dehydration
Hypernattremia (concentrating Na in blood from straight water/volume loss)
dilute urine (straight water loss)

water deprivation test does not concentrate urine

treat with desmopressin, ADH analog

2

what is nephrogenic DI

impaired response to ADH

could be 2/2 lithium, antibiotics

clinical features are similar to central DI
(polyuria, polydipsia, hypernatremia, dilute urine)
but NO RESPONSE to desmopressin

3

what is SIADH

excessive ADH secretion
you don't pee, you're holding on to all free water

retention of free water will cause:
hyponatremia (diluted blood)
mental status changes, seizures (neuronal swelling)

treatment: water restriction, or demeclocycline, which blocks ADH effect

4

what is hyperaldosteronism

high aldosterone

aldosterone normally acts on collecting duct to:
retain Na, and therefore retain H2O
dump K
dump H+

presents:
HTN (high Na, high water in blood)
hypokalemia (dump)
metabolic alkalosis (dumped H+ in urine)

5

what is hyperaldosteronism

high aldosterone

aldosterone normally acts on collecting duct to:
retain Na, and therefore retain H2O
dump K
dump H+

presents:
HTN (high Na, high water in blood)
hypokalemia (dump)
metabolic alkalosis (dumped H+ in urine)

6

what are the buzzwords for asbestos

shipyards
roofing
plumbing

"ivory white" calcified supra diaphragmatic and pleural plaques are pathognomic

also ferruginous bodies (golden-brown fusiform rods resembling dumbbells) with Prussian blue stain

7

what are the buzzwords for berylliosis

aerospace and manufacturing

8

what are the buzzwords for coal workers pneumoconiosis

coal dust exposure

anthracosis is what normal city-dwellers probably have

9

what are the buzzwords for silicosis

foundries
sandbalsting
mines
"eggshell calcifications" on hilar lymph nodes

10

where do the pneumoconiosis present in the lung

Lower lobes:
asbestos

Upper lobes:
beryllium
Coal
Silicosis

"asbestos is from the roof, but affects the floor"
"silica and coal are from the earth, but affect the roof"

11

what are Calcium oxalate stones

most common
from hypocitraturia
radiopaque

shaped like envelope or dumbbell- square with an X

12

what can cause Calcium oxalate stones

can result from ethylene glycol (antifreeze)

vitamin C abuse
hypocitraturia
malabsorption (Crohn's!)

13

what are calcium phosphate stones

radiopaque (like calcium oxalate)

wedge-shaped prisms

14

what are ammonium magnesium phosphate stones

radiopaque
AKA Struvite
associated with high pH

urease positive organisms!!! (NH3 spray bottles)

shaped like coffin lids

commonly form the stag horn calculi

15

what are uric acid stones

radiolucent

shaped like yellow/brown rhombus

strong association with hyperuricemia/gout or high cell turnover (leukemia)

16

what are cysteine stones

radiolucent

shaped like hexagons- flat, may be clear or yellow
(sounds like 6) "CYSTINE stones have 6 sides"

associated with hereditary condition where Cysteine-Reabsorbing PCT transporter loses function, causing Cysteinuria and COLA

17

how does Cystinuria present

defect in renal PCT and intestinal transporter that cannot reabsorb COLA:
Cystine
Ornithine
Lysine
Arginine

recurrent hexagonal "six-tine" stones

treat by alkalizing the urine and proper hydrating

18

what is adenomyosis

extension of endometrial tissue into uterine myometrium

presents w/ dysmenorrhea, menorrhagia, and uniformly enlarged, soft, GLOBULAR UTERUS (bulky/tender)

19

what is leiomyoma of endometrium

AKA Fibroid

most common tumor of females

presents w/ multiple discrete tumors
benign smooth muscle
estrogen sensitive- so it grows/shrinks

"irregular uterine enlargement" that may lead to constipation or urine problems, or asymptomatic

histo shows whorled pattern of SM bundles with well-demarcated borders

20

what is endometrial hyperplasia

abnormal endometrial gland proliferation,
usually 2/2 excess estrogen

presents:
postmenopausal bleeding, or irregular bleeding premenopausal

increased risk for endometrial carcinoma

21

what's the greatest risk for endometrial hyperplasia to turn into carcinoma

nuclear atypia

(not complex architecture)

22

what is endometritis

inflammation of endometrium- an infection of decidua

associated with retained products of conception, miscarriage, abortion, or foreign bodies/IUDs.

23

what is endometriosis

non-neoplastic endometrial tissue OUTSIDE THE ENDOMETRIAL CAVITY

most commonly found in ovary (CHOCOLATE CYST),
pelvis
peritoneum

presents:
cyclic pelvic pain, bleeding, dysmenorrhea, dyspareunia, dyschezia, infertility
normal-sized uterus

24

distinguish RA from OA joint findings

RA:
symmetric joints
"soft, spongy, warm joints"
systemic symptoms
soft tissue swelling and inflammation (WBCs)
involves MCP, PIP, wrist
NOT DIP OR CMC

OA:
asymmetric
"hard, bony enlarged joints"
weight bearing joints
osteophytes/bone spurs
no swelling (no/low WBCs)
involves DIP and PIP and CMC
NOT MCP

25

what is the buzzword for white parchment-like skin over vulva

lichen sclerosis

thinning of epidermis, fibrosis/sclerosis of dermis

26

what is the buzzword for thick, leathery vulvar skin

lichen simplex chronicus

27

what are MUDPILES

anion gap metabolic acidosis

Methanol (formic acid)
Uremia
DKA
Propylene glycol
Iron or Isoniazid
Lactic acidosis
Ethylene glycol (antifreeze, oxalic acid)
Salicylates (late, aspirin)

28

how do you calculate anion gap

Na - (Cl + HCO3)

greater than 12 = anion gap

29

what are the normal-gap metabolic acidosis

HARDASS

Hyperalimentation
Addison
Renal tubular acidosis
Diarrhea
Acetazolamide
Spironolactone
Saline infusion

30

what is Winters formula used for

calculates the predicted respiratory compensation for a simple metabolic acidosis.