Endo/electrolytes/renal

Question 1

electrolyte abnormalities in rhabdo

Answer 1

hyperk, hyperPO4, hypocalcemia

Question 2

what is considered rhabdo in terms of CK level

Answer 2

CK>5 times upper limit of normal

Question 3

3 complications of rhabdo

Answer 3

1. DIC
2. ARF
3. compartment syndrome

Question 4

primary adrenal insufficiency

Answer 4

addison’s disease

Question 5

ACTH level in primary adrenal insufficiency

Answer 5

elevated

Question 6

2 other illnesses that mimic renal colic

Answer 6

1. renal vein thrombosis

2. aortic/iliac aneurysm

Question 7

uric acid renal stones on XR

Answer 7

translUcent

Question 8

MCC of HHS

Answer 8

infection

Question 9

hypocalcemia ECG

Answer 9

prolonged QTc

Question 10

hypocalcemia causing facial twitching- sign

Answer 10

Chvostek’s sign

Question 11

carpal spasm when BP cuff inflated for greater than 3 mins in hypocalcemia

Answer 11

trousseau’s sign

Question 12

hypoparathryoidism lab abnormalities

Answer 12

hypoCa, hypoPTH, hyperphosphatemia

Question 13

ECG hypercalcemia

Answer 13

shortened Qtc

Question 14

indications for dialysis in hypercalcemia

Answer 14

CHF, renal disease, level >18, altered mental status

Question 15

treatment of TTP

Answer 15

plasmapharesis

Question 16

what electrolyte should be repleted with thiamine

Answer 16

magnesium

Question 17

how should thiamine be replaced

Answer 17

thiamine before glucose

Question 18

phosphate levels in hyperPTH

Answer 18

decreased, PTH promotes renal excretion of phosphate

Question 19

problem with administering T3

Answer 19

can precipitate arrhythmias and SCD

Question 20

management of AKA

Answer 20

D5NS

Question 21

what electrolyte abnormality can cause hypocalcemia

Answer 21

hypoMg

Question 22

how to calculate true Na level when hyperglycemic

Answer 22

1.6mEq Na for every 100mEq BG>100

Question 23

urine Na and FeNA in ATN and post-renal

Answer 23

urine >20, FeNa>1% as is there is impairment of kidney’s ability to concentrate the urine

Question 24

treatment of acute uncomplicated pyelonephritis

Answer 24

oral FG (7d) or bactrim (10d)

Question 25

abx for UTI

Answer 25

bactrim or oral FQ (for cystitis and mild/mod ill complicated UTI)

Question 26

duration of treatment for complicated UTI

Answer 26

14d

Question 27

treatment for hospitalized pyelonephritis

Answer 27

IV FQ OR amp/gent OR third gen cephalosporin

Question 28

duration of treatment for uncomplicated cystitis

Answer 28

3-5 days

Question 29

duration of treatment for cystitis with comorbid conditions

Answer 29

7 days

Question 30

treatment of exogenous thyroid storm

Answer 30

propanolol and steroids

Question 31

what are the two mechanisms of amiodarone-induced hyperthyroidism

Answer 31

destructive thyroidtis and increased thyroid load

Question 32

possible complication of SBP

Answer 32

hepatorenal syndrome

Question 33

treatment for hyperCa from chronic granulomatous disease

Answer 33

steroids

Question 34

are symptoms of hypercalcemia due to absolute number or the rate of rise

Answer 34

rate of rise

Question 35

diarrhea, dermatitis, dementia- vitamin deficiency

Answer 35

niacin (B3)

Question 36

indications for dialysis in hypercalcemia

Answer 36

1. calcium>18 2. neuro symptoms 3. CHD 4. renal failure

Question 37

ACTH in primary vs secondary adrenal insufficiency

Answer 37

ACTH high in primary (trying to stimulate adrenals_ | ACTH low in secondary

Question 38

medications that cause hypercalcemia

Answer 38

lithium and thiazide diuretics

Question 39

Does treatment with ABx help prevent PSGN

Answer 39

No, does reduce risk of rheumatic fever, however

Question 40

What electrolyte should be monitored when patient is on bicarbonate drip

Answer 40

Potassium

Question 41

Seizure medicine that causes sodium blockage

Answer 41

Phenytoin

Question 42

inhibition of synthesis of thyroid hormone by blocking oxidation of iodine in the thyroid gland- medication

Answer 42

methimazole

Question 43

partially blocks peripheral conversion of T4 to T3- medication

Answer 43

propanolol

Question 44

compare methimazole to PTU

Answer 44

PTU blocks some peripheral conversion whereas methimazole does not

Question 45

medication that inhibits release of stored thyroid hormone

Answer 45

iodine

Question 46

why do you need to give iodine at least an hour after PTU, etc

Answer 46

because you don't want the thyroid to start producing more thyroid hormone once the iodine allows it to be released

Question 47

what is used as primary treatment of myxedema coma

Answer 47

thyroxine

Question 48

what finding of myxedema coma is most predictive of mortality

Answer 48

hypothermia on presentation

Question 49

Hypercalcemia indications for HD

Answer 49

Calcium >18 Neuro symptoms Presence of CHF Presence of renal failure