General Medical Flashcards
List
Types of Diabetes
- Insulin Dependant Diabetes Mellitus
- Non-Insulin Dependant Diabetes Mellitus
- Gestational Diabetes Mellitus
Gestational Diabetes is typically resovled after birth, but can remain
Define
DKA vs HHNK
- DKA - Diabetic Ketoacidosis: Neuro deficits rare, Metabolic Acidosis, Glucose typically <800
- HHNK - Hypersomolar Hyperglycemic Non-Ketonic Syndrome: Profound Dehydration, Neuro changes, Glucose 1000+, No acidosis usually
List
Treatment for DKA
- Isotonic crystalloids
- Insulin (bgl goal <300)
- Potassium Replacement
Also the treatment for HHNK
Insulin Infusion
0.1 units/kg/hr
titrate for a change in bgl of 50-100/hr
Monitor K+ as well
List
Myxedema Coma Symptoms
- AMS/Lethargy
- Thermoregulatory Failure
- Precipitating event (stress, sudden cold exposure, trauma, illness)
Chronic, untreated hypothyroidism
What is
Myxedema Coma Care
- Keep warm
- Monitor BGL
- Don’t reduce HR, BP, or temp with medications
Medications such as fentanyl and versed can reduce HR and BP - Avoid
Define/List
Thyroid Storm
- Critical Hyperthyroidism
- Known hyperthyroidism with acute changes
- New Onset Afib
- New onset dilated cardiomyopathy
- New onset psychosis with abnormal labs
- Hyperthermia
Mimics signs of sepsis without focus of infection
What is a
Sepsis Mimic
Thyroid storm
Define
Addison’s Disease
- Deficiency of steroid hormones - chronic
- Improper regulation of Sodium, Potassium, and Water
Define/List Symptoms
Addisonian Crisis
- Sudden onset exacerbation of Addison’s symptoms
- Shock, AMS, hyperthermia, n/v leading to dehydration
- Can be caused by TBI in patients w/o hx of Addison’s
- Iatrogenic causes of prescribed steroids not taken on taper
Define
Diabetes Insipidus
Insufficient Antidiuretic Homrone (ADH) leading to huge amounts of dilute urine, hypernatremis, and hemoconcentration
This medication is
Chemically identical to ADH (Antidiuretic Hormone)
Vasopressin
Define
SIADH
Syndrome of Inappropriate Antidiuretic Hormone
Too much ADH
Treatment of
SIADH
3% Hypertonic Saline or Lasix to reduce serum somolality and correct hyponatremia
Signs of
Anaphylaxis
- Respiratory Distress
- Hypotension
- Skin Signs (urticaria)
- Gastrointestinal (abd pain and diarrhea)
True/False
Sepsis is when infection has spread to the blood
False
Sepsis is a system response to local infection
What is
qSOFA
Acronym and criteria
- GCS < 13
- SBP < 100
- Respirations >22
Define
“Sepsis Bundle”
Treatment for Sepsis
* Fluids of 30ml/kg LR Preferred
* Early Pressors
* Antibiotics (Broad spectrum)
To a MAP goal of >65mmHg
Which
Vasopressors for Septic Shock
in order of preference
- Norepinephrine
- Epinephrine
- Vasopressin
- Phenylephrine
