boards 12

Question 1

cause sof SIADH

Answer 1

CNS tumors pituirtary, Lung infxn (TB fungal) drugs *chloropropamide, vasopressin, diaurtics, cyclophos,

Question 2

dilute urine with concertrated serum hyperna ahd hyper osm

Answer 2

DI - central and nephrogenic cause

Question 3

does central or renal DI responds to ADH

Answer 3

responding is central - txDDAVP, neprhogenic tx HCTZ

Question 4

tumor of adenal medulla, dx

Answer 4

pheo, dx catechol and ureina VMA

Question 5

gi tumor secreting serotinin, PG - flushing, watery stool, wheezing

Answer 5

Carcinoid- attacks can last minuts to days- tx with somoatoatatic analogiies - octreotide

Question 6

goal in tx hyponatremia

Answer 6

raise to >120, rise 1 meq/hr

Question 7

what do you need to consider when replacing low K

Answer 7

Mg needed for NaK pump- needs MG

Question 8

what metabolic state causes hypo K

Answer 8

alkalosis LOW

Question 9

which intubatin drug rasies K

Answer 9

succinlycholine- worse in BURNS, patients with muscular dystrophy, paralyzed

Question 10

when dont you use calcium in hyperkalemia

Answer 10

if dig toxicity- will cause cardiac arrest - use digibind

Question 11

EKG changes in hypo hyper ca

Answer 11

high ca SHORT qt low ca LONG qt

Question 12

tx hypercalcemia

Answer 12

tx IV NS- will pee out Ca, calcitonin/bisphosphonates- not in ED ypitcally

Question 13

kids born withoit parathyroid gland

Answer 13

digeorge- low Ca

Question 14

big 3 that affect Cacliu levels

Answer 14

PTH, vitamind D, kidneys

Question 15

etiology of hyperMg

Answer 15

renal failure - causes weakness, resp depression, hearr blocks- tx IV calcium

Question 16

etiology of low mg

Answer 16

malnutiritoins, etoh, diuretics - tx IV mag

Question 17

PTH effect on phosphate

Answer 17

Ca up, Phos down

Question 18

casues of high phos

Answer 18

low PHT, renal fialure - tx oral binding gels - associated hypo Ca hypo mg

Question 19

low phos sxs

Answer 19

weakness (no ATP), hemolytic anemia, rhabdo - cause hyper PTH, hyper Ca

Question 20

MUD PILES -anion gap

Answer 20

methanol, Uremia, DKA AKA keotiss, Paralydehyde, Iron INH, lactic acidosis, Ethylene glycol, salicylates

Question 21

meds causing lactic acidosis

Answer 21

toxic ethol, metformin, antiretrovirals

Question 22

non gap acidosis- losing NAa nd bicarb at the saem time

Answer 22

RENAL or GI - hypoaldos (adrenals) acetazolamide, RTA, diarrhea, pancreatic fistula-

Question 23

normal osm

Answer 23

280-295, > 10 diff between calculated and measured is OSM gap - presence of other soulte like ethanol, ethylene glycol, methanol, isopropyl etoh

Question 24

what is coombs test

Answer 24

globulin ab on surface of RBC - use in transfusion rxn mismatch

Question 25

mc transfusion rxn

Answer 25

ferile transfusion rxn, no hemolysis, fever, chills, must STOP to exclude hemolysis

Question 26

transfusion plus erytema hives wheezing hypotension

Answer 26

allergic rxn, plasma protein, does not need to d/c

Question 27

transfusion rxn after 7 days

Answer 27

delayed hemolytic- antigen antibody- more mild than acute hemolytic

Question 28

electrolyte imbalance from transfusion rxn

Answer 28

hyperkalemia from lysed RBC, low CA - long QT- hypo K from citrate casusing metabolic alkalosis

Question 29

palpable vs nonpalpable purpura

Answer 29

nonpalpable- low plateletes or dysfnx, palpable is angiopathy or vasculiitis

Question 30

when to give platelets ITP

Answer 30

20-30, or 30-50 with active bleeding

Question 31

treatment ITP

Answer 31

suppress immuse repsonde with prednisone, replace platelts with 2-3x calculated amount to get to 50k,

Question 32

what prolongs aPTT

Answer 32

heparin, hemophilia, VWD, lupus anticoag

Question 33

mcc DIC

Answer 33

sepsis, meningitis, truama, retained POC

Question 34

coags in DIC

Answer 34

prolonged PT, low pt, low fibrinogen, HIGH d dimer

Question 35

TTP managmenet pearl

Answer 35

do not give platelets- makes them clot more

Question 36

fever, renal failure, neuro deficits, hemolytic anemia w/ shistocytes, decreased platelets

Answer 36

TTP - causes idiopathic, drug, pregnagny, infx

Question 37

treatment TTP

Answer 37

steroids, FFP, plasmephereisi, NOT PLATELETS

Question 38

difference between TTP and Hus

Answer 38

HUS is kids vs adults, HUS has anemia but no TCP, HSU is more renal and TTP is more CNS with clots, tx HUS suppotive tx TTP plasmpheresis and steroids

Question 39

does heparin closs the placenta

Answer 39

no, not even LMWH

Question 40

direct thrombin inhbitors what coag do you check

Answer 40

dabigatran like pradaxa- aPTT

Question 41

mcc sickle cell death

Answer 41

acute chest - new pulm infiltrate, chest pain, fever, tachypnea/wheeze-

Question 42

2nd mcc death sickle cell

Answer 42

splenic sequestration- kids- blocks splenc outflow- hypovolemic shock, HSM, tx RBC and exchange trasnfusion

Question 43

mc preciptiating aplastic crisis SCD

Answer 43

parvvovirus infxn

Question 44

how is hemophilia inherited

Answer 44

x linnked recessive- more in guys

Question 45

mc inherited bleeding disorder

Answer 45

VWD- activtaes platelet activation and carries factor VII - PTT prolonged- tx desmopressin (DDAVP) induces release of VWD from endothielium - vactor VIII concentrate has VWF

Question 46

PEP

Answer 46

2-3 drugs, within 72 hours, risk < .3%, SE GI upset

Question 47

SE HIV drugs

Answer 47

lactic acidosis, tx bicarb, kidney stones (indinavir, stones are radiolucent), SJS

Question 48

HIV w/ CD4< 50, blind spots, flashes, floaters, retina yellow white lesions starting in peripheray

Answer 48

CMV retinites, imw itht he gang, gangclycovir

Question 49

complications with HIV plsu VZV

Answer 49

retinitis and necrosis and detarchemnt - tx acyclovir

Question 50

mc sysemic fungal infxn HIV

Answer 50

cryptococcus- meiningitis, look for antigen in CSF

Question 51

hiv, CD4< 50, ha, confusions, AMS, seizures, strokes

Answer 51

toxo- prozoan in cat litter and meats, ring enchaing lesions, postitive IGG