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boards 12 Flashcards

1
Q

cause sof SIADH

A

CNS tumors pituirtary, Lung infxn (TB fungal) drugs *chloropropamide, vasopressin, diaurtics, cyclophos,

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2
Q

dilute urine with concertrated serum hyperna ahd hyper osm

A

DI - central and nephrogenic cause

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3
Q

does central or renal DI responds to ADH

A

responding is central - txDDAVP, neprhogenic tx HCTZ

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4
Q

tumor of adenal medulla, dx

A

pheo, dx catechol and ureina VMA

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5
Q

gi tumor secreting serotinin, PG - flushing, watery stool, wheezing

A

Carcinoid- attacks can last minuts to days- tx with somoatoatatic analogiies - octreotide

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6
Q

goal in tx hyponatremia

A

raise to >120, rise 1 meq/hr

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7
Q

what do you need to consider when replacing low K

A

Mg needed for NaK pump- needs MG

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8
Q

what metabolic state causes hypo K

A

alkalosis LOW

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9
Q

which intubatin drug rasies K

A

succinlycholine- worse in BURNS, patients with muscular dystrophy, paralyzed

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10
Q

when dont you use calcium in hyperkalemia

A

if dig toxicity- will cause cardiac arrest - use digibind

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11
Q

EKG changes in hypo hyper ca

A

high ca SHORT qt low ca LONG qt

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12
Q

tx hypercalcemia

A

tx IV NS- will pee out Ca, calcitonin/bisphosphonates- not in ED ypitcally

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13
Q

kids born withoit parathyroid gland

A

digeorge- low Ca

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14
Q

big 3 that affect Cacliu levels

A

PTH, vitamind D, kidneys

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15
Q

etiology of hyperMg

A

renal failure - causes weakness, resp depression, hearr blocks- tx IV calcium

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16
Q

etiology of low mg

A

malnutiritoins, etoh, diuretics - tx IV mag

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17
Q

PTH effect on phosphate

A

Ca up, Phos down

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18
Q

casues of high phos

A

low PHT, renal fialure - tx oral binding gels - associated hypo Ca hypo mg

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19
Q

low phos sxs

A

weakness (no ATP), hemolytic anemia, rhabdo - cause hyper PTH, hyper Ca

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20
Q

MUD PILES -anion gap

A

methanol, Uremia, DKA AKA keotiss, Paralydehyde, Iron INH, lactic acidosis, Ethylene glycol, salicylates

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21
Q

meds causing lactic acidosis

A

toxic ethol, metformin, antiretrovirals

22
Q

non gap acidosis- losing NAa nd bicarb at the saem time

A

RENAL or GI - hypoaldos (adrenals) acetazolamide, RTA, diarrhea, pancreatic fistula-

23
Q

normal osm

A

280-295, > 10 diff between calculated and measured is OSM gap - presence of other soulte like ethanol, ethylene glycol, methanol, isopropyl etoh

24
Q

what is coombs test

A

globulin ab on surface of RBC - use in transfusion rxn mismatch

25
Q

mc transfusion rxn

A

ferile transfusion rxn, no hemolysis, fever, chills, must STOP to exclude hemolysis

26
Q

transfusion plus erytema hives wheezing hypotension

A

allergic rxn, plasma protein, does not need to d/c

27
Q

transfusion rxn after 7 days

A

delayed hemolytic- antigen antibody- more mild than acute hemolytic

28
Q

electrolyte imbalance from transfusion rxn

A

hyperkalemia from lysed RBC, low CA - long QT- hypo K from citrate casusing metabolic alkalosis

29
Q

palpable vs nonpalpable purpura

A

nonpalpable- low plateletes or dysfnx, palpable is angiopathy or vasculiitis

30
Q

when to give platelets ITP

A

20-30, or 30-50 with active bleeding

31
Q

treatment ITP

A

suppress immuse repsonde with prednisone, replace platelts with 2-3x calculated amount to get to 50k,

32
Q

what prolongs aPTT

A

heparin, hemophilia, VWD, lupus anticoag

33
Q

mcc DIC

A

sepsis, meningitis, truama, retained POC

34
Q

coags in DIC

A

prolonged PT, low pt, low fibrinogen, HIGH d dimer

35
Q

TTP managmenet pearl

A

do not give platelets- makes them clot more

36
Q

fever, renal failure, neuro deficits, hemolytic anemia w/ shistocytes, decreased platelets

A

TTP - causes idiopathic, drug, pregnagny, infx

37
Q

treatment TTP

A

steroids, FFP, plasmephereisi, NOT PLATELETS

38
Q

difference between TTP and Hus

A

HUS is kids vs adults, HUS has anemia but no TCP, HSU is more renal and TTP is more CNS with clots, tx HUS suppotive tx TTP plasmpheresis and steroids

39
Q

does heparin closs the placenta

A

no, not even LMWH

40
Q

direct thrombin inhbitors what coag do you check

A

dabigatran like pradaxa- aPTT

41
Q

mcc sickle cell death

A

acute chest - new pulm infiltrate, chest pain, fever, tachypnea/wheeze-

42
Q

2nd mcc death sickle cell

A

splenic sequestration- kids- blocks splenc outflow- hypovolemic shock, HSM, tx RBC and exchange trasnfusion

43
Q

mc preciptiating aplastic crisis SCD

A

parvvovirus infxn

44
Q

how is hemophilia inherited

A

x linnked recessive- more in guys

45
Q

mc inherited bleeding disorder

A

VWD- activtaes platelet activation and carries factor VII - PTT prolonged- tx desmopressin (DDAVP) induces release of VWD from endothielium - vactor VIII concentrate has VWF

46
Q

PEP

A

2-3 drugs, within 72 hours, risk < .3%, SE GI upset

47
Q

SE HIV drugs

A

lactic acidosis, tx bicarb, kidney stones (indinavir, stones are radiolucent), SJS

48
Q

HIV w/ CD4< 50, blind spots, flashes, floaters, retina yellow white lesions starting in peripheray

A

CMV retinites, imw itht he gang, gangclycovir

49
Q

complications with HIV plsu VZV

A

retinitis and necrosis and detarchemnt - tx acyclovir

50
Q

mc sysemic fungal infxn HIV

A

cryptococcus- meiningitis, look for antigen in CSF

51
Q

hiv, CD4< 50, ha, confusions, AMS, seizures, strokes

A

toxo- prozoan in cat litter and meats, ring enchaing lesions, postitive IGG

boards (17 decks)

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