Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
23 Cards in this Set
- Front
- Back
|
lab abnormality a/w bacterial meningitis
|
incr'd WBCs
WITH POSSIBLE: left shift on CBC (bandemia) leukopenia mild hyponatremia |
|
|
RX for DKA
|
IVF's
IV insulin (until AG closes & NO ketones) IV glucose (prevent hypoglycemia) Replace electrolytes (Mg2+, Ca2+, K+, & phosphate) |
|
|
disorder a/w child who has history of theft, vandalism and violence
|
conduct disorder
|
|
|
How do you tx a px who has hyperPTH who refuses or cant have surgery
|
ADEQUATE HYDRATION (to avoid renal stones)
MINIMIZE BONE RESORPTION: exercise bisphosphonates Ca2+ (1000mg/day) Vit D (400 - 600 IU/day) PREVENT WORSENING HYPERCALCEMIA BY AVOIDING: thiazide diuretics lithium volume depletion prolonged bed rest Ca2+ ingestion (>1000mg/day) ROUTINE MONITORING: serum Ca2+ q6 mos serum Cr q12 mos BMD of hip, L-spine, & forearm q12 mos |
|
|
what are oral phosphate binders for px with hyperphosphatemia 2nd/2 hyperPTH
|
Ca2+ carbonate
Ca2+ acetate |
|
|
MCC's of hyperPTH
|
adenoma (single PT gland)
hyperplasia (x4 PT glands) |
|
|
how will vit D def affect Ca, PTH, P
|
decr'd Ca
incr'd PTH decr'd P |
|
|
why might PTH be increased in renal disease
|
renal ds --> decr'd vit D conversion --> decr'd Ca absorption (gut) --> incr'd PTH
|
|
|
what happens to phosphate in px with hyperPTH and renal disease
|
increases
|
|
|
likely cause of increased PTH, decreased Ca and increased P
|
renal failure
|
|
|
Ca2+, Phos, Alk phos, PTH in:
pagets |
Ca2+: normal
Phos: normal Alk phos: incr'd PTH: normal |
|
|
Ca2+, Phos, Alk phos, PTH in:
osteomalacia/rickets |
Ca2+: decr'd
Phos: decr'd Alk phos: nl/incr'd PTH: incr'd |
|
|
Ca2+, Phos, Alk phos, PTH in:
chronic renal failure |
Ca2+: decr'd
Phos: incr'd Alk phos: nl/incr'd PTH: incr'd |
|
|
Ca2+, Phos, Alk phos, PTH in:
osteoporosis |
Ca2+: normal
Phos: normal Alk phos: normal PTH: normal |
|
|
Ca2+, Phos, Alk phos, PTH in:
osteopetrosis |
Ca2+: normal
Phos: normal Alk phos: normal PTH: normal |
|
|
Ca2+, Phos, Alk phos, PTH in:
primary hyperPTH |
Ca2+: incr'd
Phos: decr'd Alk phos: incr'd PTH: incr'd |
|
|
Ca2+, Phos, Alk phos, PTH in:
hypoPTH |
Ca2+: decr'd
Phos: incr'd Alk phos: normal PTH: decr'd |
|
|
Ca2+, Phos, Alk phos, PTH in:
pseudohypoPTH |
Ca2+: decr'd
Phos: incr'd Alk phos: normal PTH: incr'd |
|
|
what is the disease a/w shortened 4th and 5th digits
|
albrights hereditary osteodystrophy
|
|
|
what are the indications for surgical parathyroidectomy
|
SYMPTOMATIC:
bones stones groans psychiatric overtones INCR'D [Ca2+]: > 1.0 mg/dl above upper limits of nl DECR'D Cr Cl (reduced by 30%) --> incr'd Cr AGE < 50 y/o BMD: T-score < -2.5 (at any site) |
|
|
If parathyroid adenoma is found & surgery is indicated, what is removed
|
REMOVAL of ONLY the gland containing adenoma
BIOPSY of 1 - 3 other glands |
|
|
If parathyroid hyperplasia is found & surgery is indicated, what is removed
|
REMOVAL of 3 & 1/2 glands
SURGICALLY "CLIP" the remaining 1/2 (or forearm autotrasplantation in cases of high recurrence e.g. Men type 1 & IIa) |
|
|
what happens to phosphate in pts with hyperPTH caused by renal ds
|
HYPERPHOSPHATEMIA
(2nd/2 kidney's inability to excrete phosphate) |
