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Barts Final Year > Metabolic medicine > Flashcards

Metabolic medicine Flashcards

1
Q

What is the criteria called used to diagnose Familial Hypercholesterolemia?

A

Simon-Broome

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2
Q

What is the mutation in that causes Familial Hypercholesterolemia?

A

LDL-receptor protein

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3
Q

How is familial hypercholesterolemia inherited?

A

Autosomal Dominant

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4
Q

How can Hypercalcemia be treated?

A
  • Normal saline
  • Bisphosphonates, calcitonin
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5
Q

What can hyponatremia cause?

A

Cerebral oedema

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6
Q

How is hyponatremia treated?

A
  • Normal saline
  • Hypertonic 3% saline if acute and severe
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7
Q

How is hypernatremia usually treated?

A

Normal saline
- diuretics possibly considered

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8
Q

How can hypomagnesium be treated?

A
  • Oral Magnesium (MG citrate) or IV magnesium (sulfate)
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9
Q

How can hypermagnesium technically be treated?

A
  • IV Calcium gluconate (works in opposite direction)
  • Loop diuretic
  • Haemodialysis
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10
Q

How can hypocalcemia be treated?

A
  • IV calcium gluconate (10 ml 10% solution over 10 mins) (ECG monitoring required), often 50 mL/hour
  • Asymptomatic: PO calcium gluconate
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11
Q

HYPOKALEMIA: iv PREPS

A
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12
Q

If both magneisum and potassium are low what is given first?

A

Magnesium

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13
Q

How can central diabetes insipidus be treated?

A

Desmopressin

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14
Q

How can nephrogenic DI be treated?

A
  • Thiazides
  • Low salt / protein diet
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15
Q

What can be used in the treated of SIADH? (3)

A
  • Fluid restriction
  • Demeclocycline (reduces responsiveness of CT to ADH)
  • ADH (vasopressin) receptor antagonists
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16
Q

What can happen if SIADH is treated too quickly?
- Or any hyponatremia for that matter?

A

Osmotic demyelination syndrome (Central pontine myelinolysis)

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17
Q

How does ezetimibe work?

A

Inhibits cholesterol receptors on enterocytes, decreasing cholesterol absorption in the small intestine

18
Q

SIADH causes what electrolyte abnormality?

A

Hyponatremia

19
Q

Metformin in dehydration may cause what?

A

Lactic acidosis

20
Q

Sodium bicarbonate is used in what?

A

Metabolic acidosis

21
Q

what is a normal anion gap?

A

10 to 18

22
Q

Acetazolamide ca cause what electrolyte abnormalities?

A

Hypomagnesemia
Hypokalemia

23
Q

Max infusion rate of K+

A

10mmol per hour

24
Q

Asymptomatically elevated uric acid is treated how?

A

With nothing

25
Q

What is Chvostek sign and Trousseau sign associated with?

A

Hypocalcemia

26
Q

Vasopressin receptor antagonist example

A

Tolvaptan (may be used in ADPKD, SIADH w. hyponatremia)

27
Q

What are the electrolyte abnormalities in Refeeding syndrome?

A
  • Low Mg
  • Low K+
  • Low Phosphate
  • May cause low Ca2+
  • Thiamine deficiency also
  • ?Oedema
28
Q

What are the electrolyte abnormalities in Tumour-lysis syndrome?

A
  • High K+
  • High Urate
  • High Phosphate
  • Low Ca2+
  • Low LDH
29
Q

Heparin and Beta blockers both cause what electrolyte abnormality?

A

Hyperkalemia

30
Q

What type of RTA is associated with hyperkalemia?

A

Type 4 (decreased aldosterone)

31
Q

What RTA is associated with bone conditions (osteomalacia, multiple myeloma)?
- Also hypokalemic

A

Type 2 RTA

32
Q

What is the risk of giving too much 0.9% saline?

A

Hyperchloraemic metabolic acidosis

33
Q

Maintenance electrolytes:

A

Approximately 1 mmol/kg/day of potassium, sodium and chloride

34
Q

Sum up pediatric fluid prescribing in terms of how much water to give per kg for each weight?

A
  • 1st 10kg of weight: 100ml/kg
  • 2nd 10kgs (10 - 20 kg): 50ml/kg
  • Over 20kgs: 20ml/kg

REMEMBER 100 -> 50 -> 20

35
Q

Maintenance fluid/water per kg per day:

A

25-30 ml/kg/day of water

36
Q

Maintenance glucose per day:

A

50-100 g/day

37
Q

2 main potassium fluids (percentages) and mmol etc

A
  • 0.3% potassium chloride in 0.9% NaCl = 40mmol / L (max rate is over 4 hrs)
  • 0.15% potassium chloride in 0.9% NaCl = 20 mmol/L (max rate is over 2 hours)
38
Q

Max rate at which 0.3% potassium chloride in 0.9% NaCl can be given? (1 litre)

A

4 hrs per Litre (as 40mmol per Litre)

39
Q

Max rate at which 0.15% potassium chloride in 0.9% NaCl can be given? (1 litre)

A

2 hrs per Litre (as 20 mmol per Litre)

40
Q

What RTA is associated with renalstones and the distal tubule also hpokalemic and fails to excrete H+

A

Type 1

Barts Final Year (13 decks)

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