Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PathY5 > Diabetes CPC > Flashcards

Diabetes CPC Flashcards

1
Q

48 yo Unconscious woman with recent Hx of vomiting, polyuria and polydipsia. Obese, dehydrated and ++++glycosuria on dip. Likely diagnosis?

A

HHS/ HONK coma - hypooperfusion (hypotension) causes unconsciousness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What test should we do first?

A

ABG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

pH 7.65
PCO2 = 6.1 kPa (N 4.7-6.0)
PO2 = 15 kPa

What is the acid/ base abnormality?

A

Metabolic alkalosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the causes of metabolic alkalosis?

A

H+ loss (e.g. vomiting)
Hypokalaemia
Ingestion of Bicarbonate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the formula for osmolality?

A

2(Na+K) + U + G

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the causes of hypokalaemia?

A

Intestinal loss- Diarrhoea, vomiting, fistula
Renal loss- mineralocorticoid excess, diuretics, renal tubular
Redistribution- Insulin, alkalosis
Rare causes: Renal tubular acidosis type 1& 2, hypomagnesaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What does hypokalaemia lead to?

A

Alkalosis- Low K means shift of H+ into cells and causes extracellular alkalosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What does alkalosis lead to?

A

Hypokalaemia- more K+ into cells instead of H+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

KIDNEY
Lack of intracellular potassium leads to:
Increased excretion of H+ in exchange for sodium
The production of an acid urine
Generation of bicarbonate

A

KIDNEY
Lack of intracellular potassium leads to:
Increased excretion of H+ in exchange for sodium
The production of an acid urine
Generation of bicarbonate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Longstanding hypertension and diabetes
Previous fractured hip
Slowly worsening obesity.
Wound on shin that did not heal
What is the diagnosis?

A

Cushing’s syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the causes of Cushing’s?

A

Pituitary
Ectopic ACTH
Adrenal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Dexamethasone failed to suppress
Low dose dex: cortisol = 3100 nM
High dose dex: cortisol = 2990 nM
(totally failed to suppress).

A

Ectopic ACTH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Why does Cushing’s cause hypokalaemia?

A

Because VERY high levels of cortisol bind to the aldosterone receptor.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the causes of Ectopic ACTH?

A

Lung cancer
Other cancers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Examination reduced on RIGHT
Percussion: dull on RIGHT
Vocal resonance: increased on RIGHT
Diagnosis?

A

Collapse and consolidation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Patient very hypotensive
Patient hypokalaemic

Osmolality : 380 mosm/kg
Management?

A

Rehydrate cautiously
Reduce potassium

17
Q

She does not pass any urine.
Na 145 K 4.0
U 45 Creat 450.

What is the differential diagnosis ?

A

Acute renal failure (dehydration)
Chronic renal failure (diabetes)

18
Q

BP recovers to 130 / 80
JVP starts to rise
Risk of pulmonary oedema

Remains anuric for 24 h
Na: 145, K: 5.2, U 50, creat 500, Glucose 34.0

What now?

A

Acute renal failure ? (ATN)
Chronic renal failure ? (diabetic renal disease)

19
Q

Acute renal failure ? (ATN)
Chronic renal failure ? (diabetic renal disease)

How can we distinguish them ?

A

Renal Biopsy

20
Q

What is the treatment of ATN and Diabetic glomerular kidney disease?

A

If ATN, then dialyse for 3 weeks (will recover)

Diabetic glomerular kidney disease is end stage renal failure and will need lifelong dialysis

21
Q

What is this?

A

ATN

22
Q
A

Ectopic ACTH adrenal

23
Q
A

Pituitary Cushing’s Adrenal

24
Q

What this?

A

Inferior STEMI

25
Q

Whats the treatment of a STEMI?

A
  • Aspirin
  • GTN
  • Beta blocker
  • Pain relief
  • thrombolysis / primary angioplasty
26
Q

New onset difficulty walking.

Tone increased on right

Power reduced on right

Brisk reflexes on right

Diagnosis ?

  • A. Right Upper Motor Neurone Signs
  • B. Right Lower Motor Neurone Signs
  • C. No idea
A

A. Right Upper Motor Neurone Signs

27
Q

What this?

A

LVH post MI

There is lighter part that is a scar

28
Q

What’s this?

A

Coronary thrombus

29
Q

How do you diagnose Diabetes?

A

Fasting Gluucose- 7 mmol

OGTT 2hr- 11.1 mmol

HbA1c- 48 mmol/ml

30
Q

How do you calculate anion gap?

A

Na + K - Cl - bicarb

31
Q

With a midline shifting mass, what do you do?

A

Refer to neurosurgeons

Dexamethason to reduce swelling

May die

32
Q

What is this in lung cancer?

A

ACTH producing cells (Stained brown) in lung cancer

PathY5 (98 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions