General/Metabolic Flashcards
causes of high anion gap, high osmolar gap acidosis?
methanol, ethylene glycol, and ethanol poisoning
how do you calculate osmolar gap?
calculated osmolarity-measured osmolarity
normal
risk factors for foot ulceration?
diabetic neuropathy (most important) — monofilament testing is key
vascular disease
previous foot ulceration
foot deformity
Exertional heat stroke
- risk factors
- presentation
- treatment
risk factors: strenuous activity in the heat/humidity, dehydration, poor physical fitness, obesity, meds (anticholinergic, antihistamine, phenothiazine, TCAs)
presentation: core body temp >40/104 AND CNS dysfunction AND end-organ damage
treatment: rapid cooling, fluid resuscitation, electrolyte correction, managing end-organ damage
NO ROLE FOR ANTIPYRETICS
Possible effects of oral glycemic agents:
- metformin
- sulfonylureas
- thiazolidinediones
- GLP-1 agonist
- DPP-4 inhibitors
- metformin: lactic acidosis, CI in renal failure
- sulfonylureas (glyburide, glipizide): weight gain & hypoglycemia
- TZDs (rosi/pioglitazone): weight gain, can induce CHF, okay in CKD
- GLP-1 (exenatide/liraglutide): assoc. w/ pancreatitis, weight loss
- DPP-4 (sitagliptin): weight neutral, okay in CKD, not that great in lowering A1C
Drugs that cause erosive esophagitis
- tetracyclines
- bisphosphonates
- potassium chloride
Hashimoto’s thyroiditis
- Anti-thyroperoxidase (TPO) antibodies
- Hypothyroid or Euthyroid
- 60X more likely to develop LYMPHOMA of the thyroid
- Enlarged, smooth, rubbery thyroid gland with no nodularities
Findings in hyperparathyroidism?
Stones, bones, groans, and psychiatric overtones
- kidney stones
- hypercalcemia
- bone pain
- GI symptoms
- neuropsychiatric symptoms
- can be a cause of secondary hypertension
- can be associated with MEN II
Presentation of carcinoid syndrome?
FLUSHING, diarrhea (secretory), bronchospasm, murmur (tricuspid preferentially affected)
