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Pass Med > Metabolic > Flashcards

Metabolic Flashcards

1
Q

Vit A def

A

Retinoids

Night blindness

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2
Q

Vit B1

A

Thiamine

Polyneuropathy
Wernicke/ Korsakoff
Heart failure

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3
Q

VIT b3

A

Niacin

Pellagra

  • dermatitis
  • diarrhea
  • Dementia
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4
Q

Vit B6

A

Pyridoxine

Anemia, irritability, seizures

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5
Q

Vit B7

A

Biotin

Dermatitis, seborrhoea

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6
Q

B9

A

Folic acid

Megaloblasitc anaemia
NTD

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7
Q

Vit C

A

Ascorbic acid

Scurvy

  • gingivitis
  • bleeding
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8
Q

Vit D

A

Rickets, osteomalacia

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9
Q

Vit E

A

Mild hemolytic Anaemia in newborn infants, ataxia and peripheral neuropathy

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10
Q

Vit K

A

Haemorrhagic disease of the newborn,

Bleeding, diathesis

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11
Q

SIADH def

A

Syndrome of inappropriate ADH secretion

Characterized by hyponatraemia secondary to the dilutional effects of excessive water retention

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12
Q

Causes SIADH

A

Malignancy- small cell lung cancer, pancreas, prostate
Neurological- stroke, SAH, Subdural haemorrhage, meningitis, abscess
INfection- TB, pneumonia
Drugs- sulfonylurea, SSRI- citalopram, TCA, carbamazepine, vincrisine, cyclophosphamide,

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13
Q

Mgmt SIADH

A

Correction must be done slowly to avoid precipitating central pontine myelinolyisis
Fluid restriction
Demeclocycline- reduces the responsiveness of the collecting tubule cells to ADH
ADH receptor antagonisits

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14
Q

Secondary causes of hyperlipidaemia

A 
Causes of elevated TAG
DM 1&2
Obesity
Alcohol
CKD
Drugs- thiazides, beta blockers, unopposed oestrogen 
Liver disease

Causes of elevated cholesterol
Nephrotic syndrome
Cholestasis
Hypothyroidism

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15
Q

Hyponatraemia

A

May be caused by water excess or sodium depletion.

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16
Q

Causes of pseudohyponatraemia

A

Hyperlipaedmia

Taking blood from a drip arm

17
Q

Urinary sodium >20mmol/l

A

Sodium depletion, renal loss (patient often hypovolaemic)

Diuretics
Addison’s
Diuretic stage of renal failure

Patient often euvolaemic
SIADH
Hypothyroidism

18
Q

Urinary sodium <20mmol/l

A

Sodium depletion moo, extra renal loss
Diarrhea, vomiting, sweating
Burns, Adenoma of the rectum

Water excess (patient often hypervolaemic)
Secondary hyperaldosteronism; heart failure, cirrhosis
Reduced GFR renal failure
IV DEXTROSE, Psychogenic polydipsia

19
Q

ECG change sin hypocalcamia

A

Corrected QT interval prolongation

Rare; a fib or tornado de pointes

20
Q

Hypocalcaemia features

A

Extra cellular calcium conc are important for muscle and nerve function - features of low ca seen as a result of neuromuscular excitability

Tetany; muscle twitching, cramping, spasm 
Perioral paraesthesia 
If chronic; depression and cataracts
ECG prolonged QT
Trousseau sign 
Chovstek’s sign
21
Q

Trousseasu’s sign

A

Carpal spasm of the brachial artery occluded by inflating the BP cuff and maintaining pressure above systolic

Wrist flex ion and fingers drawn together
Seen in 95% with hypocal

22
Q

Chvostek’s sign

A

Tapping over the parotid causes facial muscles to twitch

Seen in 70% with hypocal

23
Q

Mgmt of hypercalcaemia

A

Rehydration with normal saline 3-4L/day

Following rehydration use bisphosphates
Typically take 2-3 days to work- max effect at 7days

Other options
Calcitonin- quicker effect than bisphos
Steroids in sarcoidosis

Loop diuretics sometimes used in hypercalcaemia - particularly if patients cant tolerate aggressive fluid rehydration

24
Q

Mgmt of hypercalcaemia at home

A

Rehydration at home
Don’t need a low calcium diet as small intestine abs is already reduced
Avoid drugs and vitamin supplements that could exacerbate hypercal
Mobilization

25
Q

Hyperkalaemia

A

Associated with metabolic acidosis

26
Q

Causes of hyperkalaemia

A 
AKI
Drugs- potassium sparing, ACEi, ARB’s, spironolactone, cyclosporine, heparin, *beta blockers
Metabolic acidosis 
Addison’s 
Rhabdomyolysis 
Massive blood transfusion
27
Q

Foods high in potassium

A

Salt substitutes

Bananas, kiwi, oranges, avocado, spinach, tomatooe

28
Q

ECG changes in hyperkalaemia

A

Broad QRS

Tall tented t waves

Pass Med (8 decks)

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