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PCM IV Midterm > Endo CIS > Flashcards

Endo CIS Flashcards

1
Q

Polydipsia

A

-prolonged excessive thirst

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2
Q

Polyuria

A

-excessive urination

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3
Q

polyphagia

A

-my life

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4
Q

kussmaul respirations

A

-deep rapid respirations associate with acidosis

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5
Q

DDx of Anion Gap metabolic acidosis

A

MUDPILES

  • Methanol
  • Uremia
  • Diabetes
  • Paraldehyde
  • Infection/Iron
  • Lactic Acidosis
  • Ethylene glycol
  • Salicylates
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6
Q

How do you calculate anion Gap

A

Na- (Cl+HCO3)

-so, just take the positive ions (except potassium) and the negative ions and put them together!

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7
Q

GI ddx of abdominal pain

A
  • GERD
  • Gastritis
  • PUD
  • Obstruction of small or large bowel
  • Inflammation
  • Infectious
  • Vascular
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8
Q

GU ddx for abdominal pain

A

-Renal lithiasis
-blocked or torsed ureter, testicular torsion
-

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9
Q

Toxic causes of abdominal pain?

A

-Black widow spider bit

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10
Q

Metabolic causes of abdominal pain

A
  • Uremia
  • Hyperlipidemia
  • DKA!!! (this was the Diagnosis!!)
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11
Q

What was under DKA as a description?

A
  • Kussmaul breathing
  • unintentional wt loss over last 2 months
  • polyuria
  • polydipsia
  • polyphagia
  • hyperglycemia
  • positive ketones in urine and blood
  • low pH with anion gap
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12
Q

Where do we admit a patient with DKA?

A

-the ICU

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13
Q

What is the most important treatment for this diagnosis?

A
  • IV fluids

- FLUIDS/FLUIDS/FLUIDS-DEHYDRATED GIVE THEM FUCKING FLUIDS

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14
Q

What electrolyte do we have to watch when replenishing fluids?

A
  • K+

- initially, this is elevated, but when we give insulin/IVF, that will drive K+ into cells and they become hypokalemic

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15
Q

How do we correct the sodium when sugar is high?

A

-Na + ((glucose-100)* 0.016)

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16
Q

For fluid replacement, what do we use initially?

A

-Normal saline

17
Q

What do we have to swith to when the patient on insulin gtt when their glucose gets to 250 to prevent hypoglycemia?

A

-switch to D5 1/5 NS

18
Q

What is the goal of treatment of DKA?

A
  • Fix acid base disturbance!!

- do NOT answer bring sugar to normal level

19
Q

Why does the sugar level not matter as much to us in DKA?-

A

-they can have a “normal” sugar and still have an anion gap acidosis, they will go right back into DKA if you stop too soon

20
Q

What were the other notable findings/concerns for this diagnosis in this patient?

A

-DKA: diffuse abdominal pain, fruity breath, unintentional weight loss, ketonuria, hyperglycemia

21
Q

When can you end the protocol for DKA tx?

A
  • when dat gap is closed
  • switch to SQ insulin, stop gtt (glucose tolerance test) 2 hours after administration of SQ long acting (they will go right back into DKA if you stop too soon)
22
Q

Chapman point of the pancreas

A

-R 7th intercostal space tissue texture changes

23
Q

Sympathetics of pancreas

A

-T5-9

24
Q

Parasympathetics of pancreas

A
  • OA E RLSR

- AA RR

25
Q

When should we do OMM on the DKA patient?

A

-after they have stabilized

26
Q

Sympathetics of the pancreas and kidneys

A
  • Pancreas: T5-9 on R or B/l

- Kidneys: T9-L1 on R

27
Q

Parasymp of pancreas and kidneys

A

-both OA and AA

28
Q

Chapmans points for pancreas

A

-Right 7th intercostal space

29
Q

Chapman’s point for kidneys?

A

-1’ superior and 1’ lateral to the umbilicus

30
Q

What does the right lymphatic duct drain?

A
  • the right head and neck, right UE, all lung lobes except upper left
  • the rest is drained by the thoracic duct
31
Q

Sequence of lymphatic tx?

A
  • Thoracic inlet
  • Thoracic area
  • Abdominal area
  • UE or LE depending on which is more dysfunctional
  • UE or LE
  • Head and NEck
  • Thoracic inlet…. kind of a weird circle around the body

PCM IV Midterm (8 decks)

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