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54 Cards in this Set
- Front
- Back
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most common cause nephritic syndrome
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membranous nephropathy
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what are Kimmelstiel-Wilson lesions
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kidney damage due to longstanding dm
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which lab test determines whether or not dka pat can be switched from IV to sub cut insulin
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anion gap
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Waterhouse-Friedrichson syndrome
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bilateral adrenal hemorrhage from dic
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addisons disease and response to ACTH stimulation
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present with tan, hypokalemia, hypernatremia with low cortisol and ACTH
response to ACTH challenge is minimal change in plasma cortisol (known as primary adrenal insufficiency) |
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distinguish primary and secondary adrenal deficiency
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Addison's (primary) adrenal gland doesn't work, little if any response to ACTH stimulation. in secondary, pituitary doesn't work to produce ACTH, so normal increase in cortisol production with addition ACTH
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calculated osmolality
normal level |
2x (glucose+urea+sodium)
normal = 10 |
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parathyroid production and ionized Ca
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Low ionized Ca dirtily stimulates parathyroid to produce PTH, which acts to increase ionized Ca
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secondary hypoparathyroidism
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deficit in vit d causing low ca and high pth
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diGeorge syndrome
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aplasia of parathyroids at birth causing undetectable pthand critical low ca
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another name for pseudohypoparathyroidism
phenotypic lab |
Albright's hereditary osteodystrophy syndrome characteristic phenotype with stocky build, irregular length of metacarpal and metatarsal bones, and hyper pigmentation
hypocalcemia and hyperphosphatemia are noted on laboratory evaluation. |
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ricketts
cause appearance |
low ca due to vit d deficiency
low ca, vit d, phosphorous (400Iu daily vit d!) present with craniotabes, rickettic rosary |
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what 2 med classes antagonize vit d
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glucocorticoids
anti-convulsants |
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vit d genesis in 3 steps
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cholesterol -> d3 at skin
d3 -> 25(OH)d3 at liver 25)OH)dc -> 1,25(OH)d3 at liver |
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ada screening for dm
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anyone with vmi >= 25 or any adult over 45
hga1c, random glucose, or 2 hr gtt |
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A1C or w hour gtt diagnostic crit for dm
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2 hour gtt over 200mg/dl
A1C over 6.5 |
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what screen for metabolic disorder is needed in child dx of dm1
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screen celiac disease with ttg or anti-endomysial
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drug class leading to hypoglycemia in elderly
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sulfonylureas (glimeperide et al)
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drug class leading to fluid overload and exacerb of chf
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thiazolidinedones (pioglitazone et al)
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nonproliferative diabetic retinopathy
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microvascular disease at retina
hard exudates no new vessel formation |
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proliferative diabetic retinopathy
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advanced microvascular disease at retina
new bloood vessel formation covers optic disc |
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average fluid deficit in dka
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100ml/kg
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calculate serum osmolality
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2Na+glucose/18+BUN/2.8
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5 causes of osmolality decrease
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SIADH, hyponatremia, overhydration, Addison's disease, hypothyroidism
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raiu increased
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Graves
Toxic adenoma toxic multinodular goiter |
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raiu decreased
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exogenous thyroxine source
thyroiditis iodine toxicity |
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1st line tx of subacute thyroiditis
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NSAIDS
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what does HcG do to tsh
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suppression tsh with normal or near normal t4 by cross-reacting with tsh receptor
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which antiviral can precipitate hypoglycemia
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pentqmidine
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pro-insulin and c-peptide lefels in native insulin production
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elevate c-peptide and pro-insulin
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2 sources of non insulin-mediated hypoglycemia
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adrenal insufficiency
liver disease |
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what does igf level do in pituitary adenoma producing hypoglycemia
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high
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what is igf level if hypoglycemia is caused by islet-cell tumor
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low
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what is most common cause hypothyroidism in US
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Hashimoto's
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tx of myxedema coma
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levothyroxine 500mcg iv
hydrocortisone 100mg iv |
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3 classes drugs inhibiting levothyroxine absorption
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1: divalent cations (ferrous sulfate, magnesium)
2: acid suppressors (omeprazole, pantoprazole, cimetidine et al) 3: cholesterol binding resins (cholesterimine) |
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type A and type B lactic acidosis
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Type A lactic acidosis is most commonly caused by tissue hypoperfusion or hypoxia resulting in a decrease production of tissue ATP, resulting in anaerobic metabolism and production of lactic acid.
Type B lactic acidosis results from overproduction of lactate from muscle exertion or malignancies with heavy tumor burdens. |
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initial labs for ed
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morning testosterone
tsh lipid profile |
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6 absorption deficiencies after gastric bypass
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copper
folate iron B12 vit d calcium |
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who's at greatest risk for thyroid storm
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women 30's-40's
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1st drug tx in thyroid storm
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betablocker for tachycard
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2/3 of adrenal insufficiency have what resulting comorbidity
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hypoglycemia
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tx of choice for unconfirmed adrenal insufficiency
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dexamethasone
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three signs of vit B12 deficit
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macrocytic anemia
posterior column deficits decreased pinprick |
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three signs of porphyria attack
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progressive neuro
hematuria without RBC's abd pain |
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10kg wt loss associated with what % decrease CV, ca, and all-cause mortality
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25% decrease in cardiovascular, cancer, and all-cause mortalityq
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most common abnormality in primary adrenal insufficiency
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hypoglycemia
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TOC Graves
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Radioactive thyroid ablation
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TOC Graves in preg
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PTU
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Nodule low tsh workup
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RAIU scan
cold=>FNA hot=>endocrinology or surg |
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Nodule high tsh workup
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FNA
if positive think papillary ca |
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serum osmolality calculation
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2Na + glucose/18 + BUN/2.8
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what is associated with decreased osmolality
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SIADH
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causes of elevated anion gap metabolic acidosis
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MUDPILES
Methanol Uremia DKA Paraldehyde Iron Lactate Ethanol Salycylates |
