Medicine Flashcards
Hyperkalemia ECG changes
- peaked T waves
- shortened QT
-absent p waves
-lengthened PR
-widened QRS
-sinusoidal
treatment for 6.5< or ecg changes
calcium gluconate
it stabilizes myocardial excitability
inc threshold potential
- normalize
insulin
causes intracellular movement of potassium
given with glucose
multiple sclerosis
chronic demyelinating disease
affecting central nervous system
tissue hardening -> sclerosis
multiple sclerosis
immune mediated destruction of oligodendrocytes
partial remyelination
scar tissue forms -> plaques
mostly on white matter
after infections -> BBB can become injured, and permeable -> allow immune cells through it
symptoms of MS
motor deficits -> weakness, spasticity , tremors
sensory disturbance -> paraesthesia, hypoethesia
bulbar dysfunction -> dysphagia, dysarthria
vision disturbance -> central monocular loss, diplopia, pain
also - depression, anxiety, urinary symptoms, cog impairment (optic neurtitis)
uhthoff phenomenon -> detritaton of symptoms
lhermitte’s sign - electric shock sensation in neck flexion
epidemiology of MS
3:1 f to m
ages 20-40s
infection exposure
EBV risk
smoking and adolescent obesity
europe/america
management
corticosteroids iv
long term - disease modifying
interferon beta -> modify t and b cells (inflam response)
Nephrotic syndrome
high protein loss (more than 3.5 g)
leads to hypoalbuminemia (<30)
nephritic syndrome
moderate proteinuria
and evidence of hematuria
rbc/wbc casts in urine
hypertensions and oliguria
types of nephrotic syndrome
minimal change disease
focal segmental glomeruloscloerosis
membranous nephropathy
diabetic nephropathy
amyloidosis
types of GN
RPGN or crescentic
a. anti glomerular membrane (goodpastures)
b. immune complex mediated
iga
post strep
diffuse prolif
pauci immune
anca vasculitis
iga vasculitis (henoch schloein purpura)
PSGN
2-3 weeks following infection
positive ASO
lumpy bumpy - granular deposits
diffuse proliferative
most common in lupus
anti dsDNA immune complexes
and ANA
thickening of wall (wire loop)
pauci immune
no anti gbm or immue complexes
anca vasculitis
inflam-> fibrosis
ANCA positive
wegeners, churg strauss, microscopic
Alport syndrome
defects in type 4 collagen
x linked
triad - hematuria, sensorineural hearing loss, cataracts
lamelation of GBM
courvoiser’s law
painless ruq lesion = malignancy until proven otherwise
symptoms of afib
fatigue, dizziness, palpitations, chest pain and dyspnea
virchow’s triad
blood stasis, hypercoagulabilty and endothelial injury
uc
psc
MEN (multiple endocrine tumor)
MEN1 -> menin gene
pituatary, parathyroid, pancreas
MEN 2A -> RET
MEN2B -> RET
cushings triad
hypertension, bradycardia and irregular respirations
