Classic Cases 2

Question 1

Predominate Cation intracellular

Answer 1

Potassium

Question 2

Predominate cation extracellularly

Answer 2

Sodium

Question 3

Normal pH

Answer 3

7.35-7.45

Question 4

Normal Na+ value

Answer 4

135 - 145 mmol

Question 5

Normal K+ value

Answer 5

3.0- 5.0 mol

Question 6

Normal H+ concentration

Answer 6

0.0004 mmol

Question 7

Effect of acid on protein

Answer 7

Acid causes protein denaturing

Question 8

Predominate extracellular buffer

Answer 8

Bicarbonate Buffer System

Question 9

Formula for bicarbonate buffer system

Answer 9

CO2+H2O = H2CO3 = H+HCO3

Question 10

What are hormones?

Answer 10

Amines & amino acids
Peptides, polypeptides, glycoproteins & proteins
Steroids
Fatty acid derivatives

Question 11

Anterior Pituitary Hormones

Answer 11

FSH
LH
Adrenochorticotropic(ACTH)
Thyroid Stimulating (TSH)
Growth Hormone(GH)
Melanocyte Stimulating Hormone(MSH)
Prolactin

Question 12

Posterior Pituitary Hormones

Answer 12

Oxytocin
Antidiuretic hormone(ADH)

Question 13

Characteristics of adrenal insufficiency

Answer 13

• decreased adernal cortex function

- decreased cortisol and aldosterone

Question 14

What is Addison’s disease and symptoms

Answer 14

• Primary adrenal insufficiency
• Bronze pigmentation of skin
• Hypoglycemia
• Postural hypotension
• weight loss
• weakness
• GI disturbances

Question 15

what does decreased aldosterone result in

Answer 15

Increased urinary loss of sodium, chloride and water

Decreased excretion of potassium

Question 16

what does decreased cortisol do in the body

Answer 16

Poor tolerance of stress
Hypoglycemia, lethargy, weakness, fever
Anorexia, nausea, vomiting and weight loss

Question 17

What is secondary adrenal insufficiency

Answer 17

A lack of ACTH secretion from the pituitary, leading to a reduced production of cortisol

Question 18

What is addisonian crisis

Answer 18

Acute onset or worsening of primary adrenal insufficiency

Question 19

What is cushing’s syndrome

Answer 19

Hypercortisolism

Question 20

What are the 3 forms/causes of Cushing’s syndrome

Answer 20

Pituritary
Adrenal
Ectopic Cushing’s

Question 21

Symptoms of Cushing’s syndrome

Answer 21

Moon Face
HTN
Cardiac Hypertrophy
Buffalo Hump
Obesity
Abdominal Striae
Amenorrhea
Muscle Weakness

Question 22

Myxedema Coma and symptoms

Answer 22

- Profound hypothyroidism
ALOC
Hypothermia
Hypoventilating
Hypoglycemia
Bradycardia
Decreased inotropy
Hyponatremia

Question 23

Hypothyroidism symptoms

Answer 23

Hair loss
Enlarged thyroid
Dry, coarse skin
Cold extremities and swelling of limbs
Poor appetite
Slow heartrate

Question 24

Congenital Hypothyroidism

Answer 24

Can result from lack of thyroid gland, abnormal synthesis or deficient TSH

Question 25

Hyperthyroidism

Answer 25

Excessive delivery of T3 and T4 to tissues | Manifests as increased O2 consumption and use of metabolic fuels

Question 26

Thyroid Storm

Answer 26

- Develops in a patient with longstanding untreated hyperthyroidism - Precipitated by infection, DKA or trauma

Question 27

What 3 things does insulin do

Answer 27

- Promotes glucose uptake by target cells & provides for glucose storage as glycogen - Prevents fat and glycogen breakdown and inhibits gluconeogenesis - Increases protein synthesis

Question 28

What does glucagon do?

Answer 28

Initiates glycogenolysis to raise glucose levels Also increases transport of amino acids into the liver and stimulates conversion to glucose

Question 29

DKA

Answer 29

Occurs when ketone production exceeds cellular use and renal excretion May often be the sentinel event leading to a diagnosis of Type 1 Diabetes

Question 30

DKA presentation

Answer 30

Polyuria & polydipsia over 2 days is common Nausea/vomiting Abdominal pain and tenderness without co-occurring disease Fatigue, progressing to unconsciousness Hypotension and tachycardia Kussmaul’s respirations

Question 31

Hyperglycemic Hyperosmolar Non-Ketotic Syndrome(HHNK) Causes

Answer 31

May occur in: T2DM Acute pancreatitis Severe infection

Question 32

HHNK presentation

Answer 32

Dehydration Neurologic Compromise Seizures, hemiparesis, aphasia, nystagmus, hallucinations Excessive thirst Generally progressive over days and may be mistaken for a stroke

Question 33

Causes of Seizures

Answer 33

``` Vascular Infection Trauma/toxins AV malformation Metabolic Idiopathic Neoplasm ```