Metabolic Flashcards
night blindness
deficiency of vitamin A (retinoids)
neuropathy, heart failure, wernicke korsakoff
deficiency of vitamin B1 (thiamine)
deficiency of vitamin B3 (niacin)
pellagra (dementia, dermatitis, diarrhoea, death)
anaemia, irritability, seizures, peripheral neuropathy
deficiency of vitamin B6 (pyridoxine)
dermatitis, seborrhoea
deficiency of vitamin B7 (bitoin)
megaloblastic anaemia, neural tube defects
deficiency of vitamin B9 (folic acid)
megaloblastic anaemia, peripheral neuropathy
deficiency of vitamin B12 (cynocobalamin)
deficiency of vitamin C (ascorbic acid)
SCURVY (gingivitis, bleeding)
rickets, osteomalacia
deficiency of vitamin D (calciferol)
mild haemolytic anaemia in newborns, ataxia, peripheral neuropathy
deficiency of vitamin E
haemorrhagic disease of newborn, bleeding
deficiency of vitamin K
headaches, lethargy, dizziness, vomiting, confusion, cramps
hyponatremia
3 ways to categorise hyponatremia
acute or chronic (48hrs)
severity (mild 130-134) (moderate 120-130) (severe below 120)
aetiology
which class of hyponatremia is caused by dehydration, diuretics, addisonian crisis
hypovolemic
which class of hyponatremia is caused by SIADH, hypothyroidism
euvolemic
which class of hyponatremia is caused by heart/liver failure, metabolic syndrome
hypervolemic
treatment of hyponatremia
hypovolemic: isotonic saline
euvolemic/hypervolemic: fluid restrict (500-1000mls) ? vaptan
what type of saline do you use in acute/severe/symptomatic hyponatremia
hypertonic saline
if untreated, what can hyponatremia cause
cerebral oedema/herniation
if overcorrected, what can hyponatremia cause
central pontine myelinolysis (osmotic demyelination)
causes irreversible locked in syndrome after 2 days
what are SCLC, stroke, subdrual, subarachnoid, TB, pneumonia, SSRI, tricyclics, sulph, carbemazepine causes of
SIADH
management of hypercalcaemia
rehydrate with normal saline then give bisphosphonates
perioral paraesthesia is a sign of what
hypocalcaemia
what is trousseaus sign
carpal spasm when brachial occluded in hypocalcaemia
what is chvosters sign
tapping the parotid causes facial muscle twitching in hypocalcaemia
how do you find the cause of hypocalcaemia
measure the PTH
management of hypocalcaemia
IV calcium gluconate
ECG change in hypocalcaemia and hypercalcaemia
prolonged QT interval in hypo
shortened QT interval in hyper
ACEi, ARB, AKI, metabolic acidosis, rhabdomyelosis, massive blood transfusion, addisons and compartment syndrome are causes of what
hyperkalaemia
ECG changes in hypokalaemia
prolonged QT and PR
U waves
sine shaped T waves (flat)
cushings, conns and beta hydroxylase deficiency are causes of what
hypokalaemia with hypertension
diuretics, D+V and renal tubular acidosis are causes of what
hypokalaemia without hypertension
what would renal tubular acidosis show on an ABG
hyperchloraemic metabolic acidosis
what are the four types of renal tubular acidosis and what is the potassium level
- DISTAL (low K)
- PROXIMAL (low K)
- MIXED (low K)
- Hyperkalaemic (high K)
familial hypercholesterolaemia - which gene is mutated
mutated gene for LDL receptor
dose for primary and secondary prevention with atorvastatin
primary: 20mg
secondary: 80mg
should you replace the phosphate in DKA if phosphate levels are low
yes
maximum potassium transfusion if no cardiac monitor
10mmol/hr
most common cause of hypopituitism
non secretory pituitary adenoma
urea increased disproportionately to creatinine means
dehydration
raised ALP with normal LFTs
bone mets
osteomalacia and renal failure
raised ALP with low calcium
hyperparathyroid and bone mets
raised ALP with high calcium
3 physiological causes of raised ALP
pregnancy
children growing
healing fractures
ECG in hyperkalaemia
sine wave
management of hyperkalaemia
calcium gluconate THEN calcium resonium