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Hippos > Endocrine, metabolic, nutrition > Flashcards

Endocrine, metabolic, nutrition Flashcards

1
Q

With respiratory acidosis, the increase in HCO3 is how much for an acute vs chronic insult respectively?

A
  • If acute, HCO3 increases by 1 for every increase of pCO2 of 10
  • if chronic, 3 for every 10 of pCO2
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2
Q

With respiratory alkalosis, the decrease in HCO3 is how much for an acute vs chronic insult respectively?

A
  • If acute, decrease is 2 for every 10 pCO2

- if chronic decrease by 5

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3
Q

What is the compensatory increase in pCO2 for every 1 increase in HCO3 for metabolic alkalosis?

A

0.7

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4
Q

What is the rule of 15s for metabolic acidosis?

A

HCO3 + 15 should equal pCO2 and last 2 digits of pH (+/-2)

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5
Q

What are the components of the HARDUPS mnemonic for Non-anion gap metabolic acidosis?

A 
Hyperalimentation
Acetazolamide
Renal tubular acidosis
Diarrhea
Ureteral diversion
Pancreas
Spironolactone
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6
Q

What are the fast acting insulins?

A

Aspart
Lispro
Glulisine

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7
Q

What are the two long acting insulins?

A

Glargine

Detemir

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8
Q

What is the treatment for correcting hyponatremia in a patient who is actively seizing, in a coma, or who has AMS?

A

100 cc of 3% over 10 minutes followed by 100cc over 50 minutes

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9
Q

What is the calculation of free water deficit?

A

0.6(kg)([current Na /140] -1)

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10
Q

What are the s/sx of hypercalcemia?

A 
Stones
Bones
abd Groans
Thrones
Psych overtones
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11
Q

At what level(s) is hypercalcemia treatment indicated?

A

Over 14 always
12-14, symptom based
Less than 12, not indicated

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12
Q

What is the deficiency in beriberi?

A

Vitamin B1 (thiamine)

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13
Q

What is the deficiency in korsakoff’s psychosis?

A

Vitamin B1 (thiamine)

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14
Q

What is the vitamin deficiency in Wernicke’s encephalopathy?

A

Vitamin B1 (thiamine)

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15
Q

What is the classic triad for Wernicke’s encephalopathy?

A

AMS
Ataxia
Ocular

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16
Q

What is the treatment for Wernicke’s encephalopathy?

A

500 mg IV thiamine QD

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17
Q

What are the s/sx of Korsakoff’s psychosis?

A

Memory loss (primarily short term) with confabulation

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18
Q

What are the s/sx of wet beriberi?

A

Vasodilation, fistula formation leading to high output heart failure

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19
Q

What causes pellagra? What are the s/sx?

A
  • Vitamin B3 (niacin) deficiency

- Diarrhea, dermatitis, dementia, death

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20
Q

What sort of rash occurs with pellagra?

A

Scaling photosensitive rash that is bilateral and symmetric

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21
Q

What medication for GERD is associated with decreased B12 absorption?

A

PPIs

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22
Q

What GI diseases can cause B12 deficiency?

A

Crohn’s disease

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23
Q

What type of anemia can cause B12 deficiency?

A

Pernicious anemia–(abs against IF) megaloblastic anemia with hypersegmented PMNs

24
Q

Which AED is known for causing folate deficiency?

A

Phenytoin

25
Q

What is the major difference in s/sx between B12 deficiency vs folate deficiency?

A

Folate does not have neurologic changes, whereas B12 does

26
Q

Why can folate deficiency manifest in months compared to B12 which takes years?

A

Large store of B12 in liver

27
Q

What are the s/sx of vitamin A toxicity?

A

n/v vertigo, blurred vision

28
Q

What are the s/sx of vit D excess?

A

Hypercalcemia s/sx (stones, bones, groans, psych)

29
Q

Which two hormones come from the posterior pituitary?

A

Oxytocin

ADH

30
Q

What is Sheehan syndrome?

A

Pituitary apoplexy after pregnancy

31
Q

How/when is ACTH measured?

A

Morning serum cortisol

32
Q

True or false: if ACTH is deficient, then aldosterone will also be deficient

A

False

33
Q

What size differentiates a macro vs microadenoma of the pituitary?

A

1 cm

34
Q

What is the medication that can be used to treat a prolactinoma?

A

Bromocriptine

35
Q

True or false: prolactin levels correlate with the size of a prolactinoma

A

True

36
Q

What is the lab value to diagnose a GH tumor?

A

IGF-1

37
Q

What is the only pituitary tumor that is managed medically, and not surgically?

A

Prolactinoma

38
Q

What is the term for the physical features that are found in patient with GH pituitary tumors?

A

Acromegaly

39
Q

What are the three zones of the adrenal glands, and what do they produce?

A

Glomerulosa - aldosterone
Fasciculata - cortisol
Reticularis - sex hormones

40
Q

Which has skin darkening and why: primary vs secondary addison’s disease?

A

Primary since ACTH secreted more and this has a subunit that controls skin pigmentation

41
Q

Kid with a mass in one side of their abdomen and HTN = ?

A

Neuroblastoma

42
Q

How do you diagnose a pheo without imaging?

A

Urinary catecholamines

43
Q

Which is the active form of thyroid hormone, T3 or T4?

A

T3

44
Q

What is the difference between thyrotoxicosis and hyperthyroidism?

A

Thyrotoxicosis is any condition that results in increased thyroid hormone, whereas hyperthyroidism is hyperfunctioning of the gland itself

45
Q

True or false: size of the thyroid gland does not matter in terms of severity of thyroid disease

A

True

46
Q

What is the role of corticosteroids in hyperthyroidism?

A

Prevent conversion of T4 to T3

47
Q

What is the preferred antipyretic in thyroid storm? Why?

A

Acetaminophen since NSAIDs cause release of thyroid hormone from TBG

48
Q

What is Hashimoto’s thyroiditis? Is it painful?

A

Autoimmune attack against thyroid gland. Is generally painless

49
Q

What is subacute (de Quervain’s) thyroiditis?

A

Painful infection of thyroid gland

50
Q

What is the diagnostic modality of choice for thyroid nodules?

A

FNA

51
Q

What are the s/sx of hyperparathyroidism?

A

Hypercalcemia: stones bones groans, thrones, psych overtones

52
Q

What is the role of lasix in the treatment of hypercalemia?

A

Inhibits Ca reabsorption in the distal nephron.

53
Q

What levels of Ca require treatment?

A

Less than 12 nothing
Over 14 immediate
Between is symptom based

54
Q

What is the initial treatment for hypercalcemia?

A

IVFs

55
Q

What are the medications the can be given to treat hypercalcemia?

A

Bisphosphonates
Calcitonin
Glucocorticoids

56
Q

What is the role of glucocorticoids in the treatment of hyperparathyroidism?

A

Decreases Ca absorption from intestines and increases urinary excretion

57
Q

What is the treatment for hypoparathyroidism?

A

Ca and Vit D supplementation

Hippos (23 decks)

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