The_Basics Flashcards
(33 cards)
Once glucose is greater than 200 mg/dL, sodium decreases by how many mEq/L for each rise of 100 mg/dL in glucose?
1.6 for every 100
Acidosis causes what effects on potassium? on calcium?
hyperkalemic acidosis = hypercalcemia
hypokalemic alkalosis = hypocalcemia
How do you correct calcium?
ca + 0.8 (4 - albumin)
How do you distinguish Wilm’s tumor from neuroblastoma?
neuroblastoma: arise from adrenal gland (not kidney), calcifications. Can use a CT to distinguish.
How do you distinguish Familial Hypocalciuric Hypercalcemia from Primary Hyperparathyroidism via urine studies?
UCa is < 100 in FHH, but > 250 in 1* PTH
Histologic findings for Reye syndrome:
microvesicular fatty infilration
List selection biases:
1) ascertainment: study population differs from target due to nonrandom selection
2) nonresponse
3) Berkson (only hospital patients in study population = not reflective of target)
4) Prevalence (Neyman): exposures that happen long before disease can miss those who recover or die early
5) attrition (loss of study participants to follow up)
List observational biases:
1) recall bias (negative outcomes more likely to report exposures)
2) observer bias (due to preconceived expectations will misclassify data)
3) reporting bias (due to social stimga)
4) surveillance (risk factor causes increased monitoring in exposed group)
What is the presentation of 17a-hydroxylase deficiency? Which hormones are elevated or depressed as a result? Are the levels of mineral corticoids, cortisol, and sex hormones increased or decreased?
HYPERtension, HYPOkalemia. Pregenolone and progesterone are elevated; 17-hydroxyprogesterone is decreased.
Ambiguous genitalia in geneitc males; externally phenotypical females with normal internal organs but no 2* sex characteristics
Increased mineralocorticoids, decreased cortisol, decreased sex hormones.
What is the presentation of 21-hydroxylase deficiency? Which hormones are elevated or depressed as a result? Are the levels of mineral corticoids, cortisol, and sex hormones increased or decreased?
most common CAH. HYPOtension and HYPERkalemia. Hyponatermia. Increased renin activity, volume depletion. 11-deoxycorticosterone and 11-deoxycortisol are decreased. 17-hydroxyprogesterone is increased.
Masculinization, leading to pseudohermaphroditism in females.
Decreased mineralocorticoids, decreased cortisol, increased sex hormones
What is the presentation of 11B-hydroxylase deficiency? Which hormones are elevated or depressed as a result? Are the levels of mineral corticoids, cortisol, and sex hormones increased or decreased?
HYPERtension. Masculinization. Decreased corticosterone, but increased 11-deoxycorticosterone (which is also a mineralocorticoid).
Masculinization.
Increased mineralocorticoids (11-deoxycortisone, but decreased aldosterone!!). Decreased cortisol. Increased sex hormones.
Tamoxifen and raloxifene are both estrogen receptor antagonists in the breast but agonists in the bone = SERMS. Which one increases the risk of endometrial cancer?
Tamoxifen! It is an endometrial AGONIST in the endometrium, too.
**raloxifene is an endometrial antagonist in the endometrium so does not increase endometrial CA risk
The obturator nerve is composed of which nerve roots?
What is a possible causes of injury?
What would be the motor deficit? Sensory deficit?
Obturator nerve = L2-L4
Injury: anterior hip dislocation
Motor deficit: thigh adduction
Sensory deficit: medial thigh
The femoral nerve is composed of which nerve roots?
What is a possible causes of injury?
What would be the motor deficit? Sensory deficit?
Femoral nerve = L2-L4
Injury: pelvic fracture
motor deficit: thigh flexion, leg extension
sensory deficit: anterior thigh and medial leg
The common peroneal nerve is composed of which nerve roots?
What is a possible causes of injury?
What would be the motor deficit? Sensory deficit?
common peroneal nerve: L4-S2
injury: trauma or compression of lateral aspect of leg. Fibula neck fracture.
motor deficit: foot EVersion and Dorsiflexion.
sensory deficit: anterolateral leg and dorsal aspect of foot
The tibial nerve is composed of which nerve roots?
What is a possible causes of injury?
What would be the motor deficit? Sensory deficit?
tibial nerve: L4-S3
injury: knee trauma.
motor deficit: foot INversion and PLantarflexion; toe flexion
sensory deficit: sole of foot
Can’t abduct thumb. When asked to make a fist, 2nd and 3rd digits remain extended/thumb unopposed.
Proximal median nerve lesion
Dislocation of the humeral head or a fractured surgical neck of the humerus might cause which motor deficits? which sensory deficits?
damage to axillary nerve (C5, C6)
motor deficit: inability to abduct arm at shoulder. sensory deficit over deltoid.
Compression of axilla by back of chair or crutches, or fracture at MIDSHAFT of humerus might cause which motor deficits/sensory deficits?
damage to radial nerve (C5-T1)
Inability to supinate, extend wrist and fingers, extend arm
sensory defict over posterior arm, dorsal hand, dorsal thumb
Fracture to the supracondylar humerus might cause what motor/sensory deficits?
median nerve (C5-T1)
motor: loss of opposition of thumb, lateral finger flexion, wrist flexion
sensory: loss of (the tip dorsal and) palmar aspects of lateral 3 1/2 fingers
Fracture of the medial epicondyle of the humerus might cause which motor/sensory deficits?
ulnar nerve (C8, T1)
motor: medial finger flexion, wrist flexion (will see a radial deviation). Claw hand (finger extensors, fed by radial nerve, will be unopposed)
sensory: medial 1 1/2 fingers, hypothenar eminence
Ammonium magnesium phosphate (or “struvite”) stones are caused by
infection with urease-positive bugs (Proteus mirabilis, Staph, Kelbsiella, ureaplasma, pseudomonas, morganella). They hydrolyze urea to ammonia, causing urine alkalinization.
Can form STAGHORN calculi
How does sensitivity affect PPV and NPV?
High sensitivity = low PPV, high NPV
Using the 4x4 table, how is Odds Ratio calculated? How is relative risk calculated?
odds ratio: (a x d) / (b x c)
relative risk: [a/(a + b)] / [c/(c+d)]
