IM-2

Question 1

Even if pH is normal, what should you always check?

Answer 1

anion gap
Na - (HCO3+Cl)
>12 means there is a gapped metabolic acidosis

Question 2

If a gapped metabolic acidosis is found, what is the next calculation to make?

Answer 2

A delta-delta
AG-12+HCO3

If > of = 31, that indicates a concurrent metabolic alkalosis

Question 3

What acid-base disturbance does Addison’s disease usually cause?

Answer 3

non-gapped metabolic acidosis because of aldosterone deficiency

Question 4

What acid-base disturbance does diarrhea cause?

Answer 4

non-gapped metabolic acidosis

Question 5

What acid-base disturbance does multiple myeloma cause

Answer 5

RTA I

non gapped metabolic acidosis

Question 6

What acid base disturbance does NG suction cause?

Answer 6

metabolic alkalosis

Question 7

What acid-base disturbance does Acetozolamide use cause?

Answer 7

RTA II

non gapped metabolic acidosis

Question 8

Heavy alcohol use causes what to the testicles? Why?

Answer 8

Testicular atrophy

• prone to EtOH damage
• EtOH users have elevated estrogen due to decreased hepatic degradation of that hormone

Question 9

Retro-orbital pain and blurry vision, red conjuctiva and hazy cornea. Worse at night. What is dx? Underlying pathology?

Answer 9

Acute angle (closed) glaucoma

• decreased ability to allow aqueous humor to exit the eye
• why? Iris and cornea make a small or “acute” angle
• With pupil dilation, it, folds into the outer areas of the iris where the cnals of Schlemm are blocking those canals from aqueous humor escape.

Question 10

Increased aqueous humor production happens in what dz?

Answer 10

open angle glaucoma

Question 11

Why are cataracts formed in diabetic patients?

Answer 11

In diabetics, glucose enters the lens drawing water with it.
- glucose is converted to sorbitol which along with water never leaves the lens causing osmotic water accumulation and lens buldging –> cataract forms.