Endocrine & Hematology

Question 1

The measure of particles in a solution

Answer 1

Osmolality of body fluids

• Expressed in milliosmoles
• Normal is 275-295

Question 2

What are the components to serum osmolality?

Answer 2

Sodium, BUN, glucose

-An increase in theses values will increase serum osmolality

Question 3

Is the endocrine monitoring center and regulates temperature, intake drives, and ANS (sympathetic and parasympathetic)

Answer 3

Hypothalamus

-Only the pancreas and parathyroid releasing hormones are not controlled by it

Question 4

Works on distal convoluted and collecting tubule of kidney to reabsorb water

• Formed in the hypothalamus and stored in posterior pituitary
• Concentrates urine

Answer 4

ADH

Question 5

What is the most common causes of SIADH

Answer 5

• Oat cell carcinoma
• Viral pneumonia
• Head problems
• Other: thiazide diuretics

Question 6

What is the biggest danger go hyponatremia?

Answer 6

Seizures

Question 7

Inhibits ADH secretion

Answer 7

Phenytoin (Dilantin)

Question 8

Not enough ADH

Answer 8

Diabetes insipidus

Question 9

What are common causes of diabetes insipidus?

Answer 9

• Head problems

- Phenytoin

Question 10

Meds with ADH?

Answer 10

Pitressin, DDAVP

-Use caution with patients with heart failure because it can cause coronary artery ischemia

Question 11

What is the relationship of pH and K?

Answer 11

For every 0.1 decrease in pH, the serum K will increase by 0.6.

Question 12

What medication masks early signs of hypoglycemia?

Answer 12

Beta blockers

-Especially in type 1 diabetes

Question 13

• Smallest of blood cells
• Made in bone marrow
• 200 billion produced per day
• White
• Live 7-10 days

Answer 13

Platelets

Question 14

What activates platelets?

Answer 14

The presence of injury

Question 15

Measures platelet quantity

Answer 15

Platelet count

Question 16

Measure platelet function, how well platelets work

Answer 16

Bleeding time

Question 17

Stimulated by vascular endothelium injury

Such as: cell trauma (valve, IABP), sepsis, shock, ARDS, hypoxemia, academia, cardiac arrest.

Answer 17

Intrinsic coagulation pathway

Question 18

Stimulated by tissue injury, releases “tissue thromboplastin”
Such as: extensive trauma, OB emergencies, malignancies, dissecting aortic aneurysm, extensive MI

Answer 18

Extrinsic coagulation pathway

Question 19

What reverses heparin?

Answer 19

Protamine

Question 20

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

Answer 20

DIC

Question 21

What causes abnormal factor K activation?

Answer 21

Acute pancreatitis and liver disease

Question 22

What do lab values look like for DIC?

Answer 22

• 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)

Question 23

• 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)

Answer 23

HIT

• Tested by testing for heparin antibodies using the ELISA test
• Start thrombin inhibitor (argatroban)

Question 24

Only decrease in platelets is present. The rest of the CBC is normal.

Answer 24

Idiopathic thrombocytopenia purport (ITP)