Endocrine & Hematology Flashcards
The measure of particles in a solution
Osmolality of body fluids
- Expressed in milliosmoles
- Normal is 275-295
What are the components to serum osmolality?
Sodium, BUN, glucose
-An increase in theses values will increase serum osmolality
Is the endocrine monitoring center and regulates temperature, intake drives, and ANS (sympathetic and parasympathetic)
Hypothalamus
-Only the pancreas and parathyroid releasing hormones are not controlled by it
Works on distal convoluted and collecting tubule of kidney to reabsorb water
- Formed in the hypothalamus and stored in posterior pituitary
- Concentrates urine
ADH
What is the most common causes of SIADH
- Oat cell carcinoma
- Viral pneumonia
- Head problems
- Other: thiazide diuretics
What is the biggest danger go hyponatremia?
Seizures
Inhibits ADH secretion
Phenytoin (Dilantin)
Not enough ADH
Diabetes insipidus
What are common causes of diabetes insipidus?
- Head problems
- Phenytoin
Meds with ADH?
Pitressin, DDAVP
-Use caution with patients with heart failure because it can cause coronary artery ischemia
What is the relationship of pH and K?
For every 0.1 decrease in pH, the serum K will increase by 0.6.
What medication masks early signs of hypoglycemia?
Beta blockers
-Especially in type 1 diabetes
- Smallest of blood cells
- Made in bone marrow
- 200 billion produced per day
- White
- Live 7-10 days
Platelets
What activates platelets?
The presence of injury
Measures platelet quantity
Platelet count
Measure platelet function, how well platelets work
Bleeding time
Stimulated by vascular endothelium injury
Such as: cell trauma (valve, IABP), sepsis, shock, ARDS, hypoxemia, academia, cardiac arrest.
Intrinsic coagulation pathway
Stimulated by tissue injury, releases “tissue thromboplastin”
Such as: extensive trauma, OB emergencies, malignancies, dissecting aortic aneurysm, extensive MI
Extrinsic coagulation pathway
What reverses heparin?
Protamine
Deposition of thrombi in microvasculature (microembolism) and consumption of clotting factors (hemorrhage)
- Is primarily a clotting problem, no a bleeding
- Is aways secondary to another problem
DIC
What causes abnormal factor K activation?
Acute pancreatitis and liver disease
What do lab values look like for DIC?
- Decrease PLT, fibrinogen, hematocrit
- Increase in FSP, PT, INR, bleeding time, D-dimer, antithrombin III
- **Elevated FSP is the definite lab test for presence of DIC (normal is <10)
- Due to IgG immune response
- Results in thrombosis (white clots) that consumes platelets
- S/S: PLT <150 or drop by 30-50%, petechiae (early sign)
HIT
- Tested by testing for heparin antibodies using the ELISA test
- Start thrombin inhibitor (argatroban)
Only decrease in platelets is present. The rest of the CBC is normal.
Idiopathic thrombocytopenia purport (ITP)
