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Flight Paramedic Certification > Endocrine and General Medical > Flashcards

Endocrine and General Medical Flashcards

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1
Q

Cause of Diabetic Ketoacidosis

A

Lack of Insulin or Insulin Resistance.

Excess blood sugar causes increased water in body which diuresis fluid, Potassium, and Phosphorus. (Causing Metabolic Acidosis)

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2
Q

Treatment of Diabetic Ketoacidosis

A 
Aggressive fluid hydration
K+ and Pho4 replacement
Insulin dosing at 0.1 u/kg
Consider D5w once CBG <300 mg/dl
Do not drop glucose >100 mg/dl/hr
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3
Q

Hyperglycemic Hyperosmolar Non-ketonic Coma (HHNK/HHNC)

A

Excessive sugar but body is still making and using insulin

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4
Q

Presentation of HHNK

A 
Severe dehydration
Hyperglycemia (>800 common)
Elevated BUN /Creatine
Hypernatremia
No Ketones
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5
Q

Treatment of HHNK

A

Aggressive fluid replacement
Insulin
Anticipate hypokalemia

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6
Q

Cause of Diabetes Insipidus (DI)

A

Lack of anti-diuretic hormone caused by Head injury or Dilantin

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7
Q

Presentation of Diabetes Insipidus

A

Extreme urinary output with low osmolarity and specific gravity.
Hypernatremia

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8
Q

Treatment of Diabetes Insipidus

A

Aggressive fluid replacement
Vasopressin
dDavP

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9
Q

Syndrome of Inappropriate Antidiuretic Hormone (SIADH)

A

Excessive production of ADH

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10
Q

Causes of SIADH

A

Small cell / oat cell carcinoma

Head injury

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11
Q

Presentation of SIADH

A

Dilutional Hyponatremia
Seizures
Cerebral edema
Elevated Urine osmolarity / specific gravity

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12
Q

Treatment of SIADH

A

Restrict fluids
Diuresis
Demeclocycline (ADH receptor antagonism)

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13
Q

GI Hemorrhage Treatment

A

Treat shock with 3:1 Crystalloid/Blood
NG/OG
Octreotide (Sandostatin) 25-50 mcg IVP then drip
Vasopressin

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14
Q

Causes of Grave’s Disease / Thyrotoxicosis (Thyroid storm / Hyperthyroid)

A

Increased Thyroid production due to surgery Uncontrolled DM
AMI
Toxemia

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15
Q

Presentation of Grave’s Disease (Hyperthyroid)

A

Any new tachycardia/A Fib in otherwise healthy females
Dramatic weight loss
CP /SOB/ Palpitations
Tremors / Nervousness

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16
Q

Treatment of Grave’s Disease (Hyperthyroid)

A

Anti-thyroid Meds
Anti-pyretics
Consider Iv glucocorticoids (Dexmethasone)
Fluids / Electrolytes

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17
Q

Thyroid controls _____.

A

Metabolic rate (Body Idle Speed)

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18
Q

Causes of Hypothyroid / Myxedema Coma

A

Autoimmune disorder most commonly triggered by infection.

Officially Myxedema Coma upon any change in LOC.

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19
Q

Presentation of Hypothyroid

A

Primarily women, almost exclusively over age 60.
>90% of cases in winter.

Fatigue, weight gain, deep voice, coarse hair

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20
Q

Treatment of Hypothyroid

A

Levothyroxine

Supportive care

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21
Q

Cause of Addison’s Disease / Adrenal Insufficiency

A

Not producing enough steroids caused by Autoimmune disease (Primary Addison’s)

Low levels of ACTH (Secondary Addison’s)

22
Q

Presentation of Addison’s Disease / adrenal Insufficiency

A

Poor catecholamine production
Failure to respond to exogenous pressor agents
Inadequate aldosterone, cortisol, and androgens

23
Q

Treatment of Addison’s Disease / Adrenal Insufficiency

A

Avoid abrupt discontinuation of chronic glucocorticoids

May need to initiate steroids

24
Q

Causes of Cushing’s Disease

A

Producing excessive steroids due to:
Chronic glucocorticoid use with abrupt discontinuation
Pituitary disorders (too much ACTH release)
Oat cell carcinoma (“fake” cortisol)
Adrenal carcinoma (too much produced)

25
Q

Presentation of Cushing’s Disease

A

Upper body obesity with thin arms and legs
Rounded face
Buffalo Hump
Fatigue, HTN, Hyperglycemia

26
Q

Treatment of Cushing’s Disease

A

Initiate or Reduce Glucocorticoids
Supportive
Surgery

27
Q

Causes of Pancreatitis

A

ETOH abuse
Biliary stone disease
Steroids and antibiotics
Infections

28
Q

Presentation of Pancreatitis

A

Low Calcium levels
Concomitant Sepsis and ARDS
Renal failure
Cullen’s sign

29
Q

Treatment of Pancreatitis

A 
Fluid resuscitation
NPO with OG/NG
Meperidine
Antibiotics for sepsis
Anticipate worsening progression
30
Q

Causes of Bowel Obstruction

A

Post operative adhesions
Malignancy
Crohn’s disease
Hernia’s

31
Q

Presentation of Bowel Obstruction

A

Bowel ischemia results in sepsis

Pancreatitis common

32
Q

Treatment of Bowel Obstruction

A

NPO with OG/NG
Aggressive fluid and pain control
Anti-emetics
Antibiotics

33
Q

Causes of Hepatic Encephalopathy

A

ETOH abuse
Liver Failure
Cirrhosis / Hepatitis (causing ammonia toxicity)

34
Q

Presentation of Hepatic Encephalopathy

A

Increased AST, ALT, BUN

“Coarse Muscle Flapping”

35
Q

Treatment of Hepatic Encephalopathy

A

Stop GI bleeding
NG / OG for blood evacuation in bowel
Stop protein intake
Correct K+ levels

36
Q

Cause of Splenic Disease / Rupture

A

Trauma (Most commonly affected organ in blunt trauma)

37
Q

Presentation of Splenic Disease / Rupture

A

Left shoulder pain (Kehr’s sign)

Shock

38
Q

Treatment of Splenic Disease / Rupture

A

Supportive care
Aggressive fluid replacement and PRBC’s
Surgery

39
Q

Brudzinski’s Sign

A

Flexion of knees on neck flexion
Possible bacterial meningitis (or subarachnoid bleed)
“Chin to chest will cause knees to flex”

40
Q

Kernig’s Sign

A

Inability to flex hamstring or leg due to pain. Indicative of Meningitis

41
Q

Cullen’s Sign

A

Periumbilical bruising indicative of Pancreatitis

42
Q

Grey-Turner’s Sign

A

Flank and groin bruising indicative of Pancreatitis

43
Q

Kehr’s Sign

A

Left shoulder pain indicative of Splenic injury

44
Q

Murphy’s Sign

A

Pain upon palpitation of RUQ while breathing in indicative of Gallbladder problems

45
Q

Levine’s Sign

A

Fist over chest indicative of Cardiac problems

46
Q

Define Hypertensive Crisis

A

Extremely elevated blood pressure WITH signs and symptoms of end organ damage

Headache, N/V, Visual changes, creatine/RBC in urine

47
Q

Treatment of Hypertensive Crisis

A

Lower BP no more than 25% per hour and no lower than patient’s “normal”

48
Q

Important dermatomes

A

T4: Nipples
T10: Umbilicus
C3/4/5: Innervates the diaphragm

49
Q

Meningitis

A

Inflammation of meninges
Disease carried in CSF
Triad of neck stiffness, photophobia, and headache

50
Q

6 P’s of Arterial Occlusion

A 
Pain
Pallor
Paresthesia
Poikilothermia
Pulselessness
Paralysis
51
Q

The most definitive assessment of shock is ____.

A

Lactic Acidosis (Lactate >4)

Flight Paramedic Certification (15 decks)

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