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Hippos > Endocrine, metabolic, nutrition > Flashcards

Endocrine, metabolic, nutrition Flashcards

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1
Q

With respiratory acidosis, the increase in HCO3 is how much for an acute vs chronic insult respectively?

A
  • If acute, HCO3 increases by 1 for every increase of pCO2 of 10
  • if chronic, 3 for every 10 of pCO2
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2
Q

With respiratory alkalosis, the decrease in HCO3 is how much for an acute vs chronic insult respectively?

A
  • If acute, decrease is 2 for every 10 pCO2

- if chronic decrease by 5

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3
Q

What is the compensatory increase in pCO2 for every 1 increase in HCO3 for metabolic alkalosis?

A

0.7

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4
Q

What is the rule of 15s for metabolic acidosis?

A

HCO3 + 15 should equal pCO2 and last 2 digits of pH (+/-2)

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5
Q

What are the components of the HARDUPS mnemonic for Non-anion gap metabolic acidosis?

A 
Hyperalimentation
Acetazolamide
Renal tubular acidosis
Diarrhea
Ureteral diversion
Pancreas
Spironolactone
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6
Q

What are the fast acting insulins?

A

Aspart
Lispro
Glulisine

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7
Q

What are the two long acting insulins?

A

Glargine

Detemir

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8
Q

What is the treatment for correcting hyponatremia in a patient who is actively seizing, in a coma, or who has AMS?

A

100 cc of 3% over 10 minutes followed by 100cc over 50 minutes

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9
Q

What is the calculation of free water deficit?

A

0.6(kg)([current Na /140] -1)

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10
Q

What are the s/sx of hypercalcemia?

A 
Stones
Bones
abd Groans
Thrones
Psych overtones
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11
Q

At what level(s) is hypercalcemia treatment indicated?

A

Over 14 always
12-14, symptom based
Less than 12, not indicated

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12
Q

What is the deficiency in beriberi?

A

Vitamin B1 (thiamine)

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13
Q

What is the deficiency in korsakoff’s psychosis?

A

Vitamin B1 (thiamine)

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14
Q

What is the vitamin deficiency in Wernicke’s encephalopathy?

A

Vitamin B1 (thiamine)

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15
Q

What is the classic triad for Wernicke’s encephalopathy?

A

AMS
Ataxia
Ocular

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16
Q

What is the treatment for Wernicke’s encephalopathy?

A

500 mg IV thiamine QD

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17
Q

What are the s/sx of Korsakoff’s psychosis?

A

Memory loss (primarily short term) with confabulation

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18
Q

What are the s/sx of wet beriberi?

A

Vasodilation, fistula formation leading to high output heart failure

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19
Q

What causes pellagra? What are the s/sx?

A
  • Vitamin B3 (niacin) deficiency

- Diarrhea, dermatitis, dementia, death

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20
Q

What sort of rash occurs with pellagra?

A

Scaling photosensitive rash that is bilateral and symmetric

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21
Q

What medication for GERD is associated with decreased B12 absorption?

A

PPIs

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22
Q

What GI diseases can cause B12 deficiency?

A

Crohn’s disease

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23
Q

What type of anemia can cause B12 deficiency?

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A

Pernicious anemia–(abs against IF) megaloblastic anemia with hypersegmented PMNs

24
Q

Which AED is known for causing folate deficiency?

25
What is the major difference in s/sx between B12 deficiency vs folate deficiency?
Folate does not have neurologic changes, whereas B12 does
26
Why can folate deficiency manifest in months compared to B12 which takes years?
Large store of B12 in liver
27
What are the s/sx of vitamin A toxicity?
n/v vertigo, blurred vision
28
What are the s/sx of vit D excess?
Hypercalcemia s/sx (stones, bones, groans, psych)
29
Which two hormones come from the posterior pituitary?
Oxytocin | ADH
30
What is Sheehan syndrome?
Pituitary apoplexy after pregnancy
31
How/when is ACTH measured?
Morning serum cortisol
32
True or false: if ACTH is deficient, then aldosterone will also be deficient
False
33
What size differentiates a macro vs microadenoma of the pituitary?
1 cm
34
What is the medication that can be used to treat a prolactinoma?
Bromocriptine
35
True or false: prolactin levels correlate with the size of a prolactinoma
True
36
What is the lab value to diagnose a GH tumor?
IGF-1
37
What is the only pituitary tumor that is managed medically, and not surgically?
Prolactinoma
38
What is the term for the physical features that are found in patient with GH pituitary tumors?
Acromegaly
39
What are the three zones of the adrenal glands, and what do they produce?
Glomerulosa - aldosterone Fasciculata - cortisol Reticularis - sex hormones
40
Which has skin darkening and why: primary vs secondary addison's disease?
Primary since ACTH secreted more and this has a subunit that controls skin pigmentation
41
Kid with a mass in one side of their abdomen and HTN = ?
Neuroblastoma
42
How do you diagnose a pheo without imaging?
Urinary catecholamines
43
Which is the active form of thyroid hormone, T3 or T4?
T3
44
What is the difference between thyrotoxicosis and hyperthyroidism?
Thyrotoxicosis is any condition that results in increased thyroid hormone, whereas hyperthyroidism is hyperfunctioning of the gland itself
45
True or false: size of the thyroid gland does not matter in terms of severity of thyroid disease
True
46
What is the role of corticosteroids in hyperthyroidism?
Prevent conversion of T4 to T3
47
What is the preferred antipyretic in thyroid storm? Why?
Acetaminophen since NSAIDs cause release of thyroid hormone from TBG
48
What is Hashimoto's thyroiditis? Is it painful?
Autoimmune attack against thyroid gland. Is generally painless
49
What is subacute (de Quervain's) thyroiditis?
Painful infection of thyroid gland
50
What is the diagnostic modality of choice for thyroid nodules?
FNA
51
What are the s/sx of hyperparathyroidism?
Hypercalcemia: stones bones groans, thrones, psych overtones
52
What is the role of lasix in the treatment of hypercalemia?
Inhibits Ca reabsorption in the distal nephron.
53
What levels of Ca require treatment?
Less than 12 nothing Over 14 immediate Between is symptom based
54
What is the initial treatment for hypercalcemia?
IVFs
55
What are the medications the can be given to treat hypercalcemia?
Bisphosphonates Calcitonin Glucocorticoids
56
What is the role of glucocorticoids in the treatment of hyperparathyroidism?
Decreases Ca absorption from intestines and increases urinary excretion
57
What is the treatment for hypoparathyroidism?
Ca and Vit D supplementation

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