Metabolic medicine Flashcards
Heparin and K+ concentration
**both unfractionated and low-molecular weight heparin can cause hyperkalaemia. This is thought to be caused by inhibition of aldosterone secretion
Metabolic acidosis and potassiun=m
metabolic acidosis causes hyperkalaemia
ECG changes in hyperkalaemia
tall-tented T waves,
small P waves,
widened QRS leading to a sinusoidal pattern
and asystole
Key features of hypocalcaemia
perioral paraesthesia,
cramps,
tetany
and convulsions
ECG sign + examination findings in hypocalcaemia?
Prolonged QTc
Chovsteks
Trousseaus
Causes of raised ALP
liver: cholestasis, hepatitis, fatty liver, neoplasia
Paget’s
osteomalacia
bone metastases
hyperparathyroidism
renal failure
physiological: pregnancy, growing children, healing fracture
Vitamin deficiency causing pellagra? (dermatitis, diarrhoea, dementia)
Niacin (B3)
Vitamin deficiency causing bleeding gums?
C
Vitamin deficiency causing night blindness?
A
Vitamin deficiency causing anaemia, seizures and irritability?
Pyridoxine
Offer a statin to people with a QRISK10 score of what?
> = 10%
Atorvastatin 20mg first line
Statins and pregnancy?
Stop before trying to conceive
No other Rx during pregnancy
Aim to adjust lifestyle during this period
Inheritance of familial hypercholestorlaemia?
Autosomal dominant
Dx criteria for familial hypercholesterolaemia
Clinical diagnosis is now based on the Simon Broome criteria:
in adults total cholesterol (TC) > 7.5 mmol/l and LDL-C > 4.9 mmol/l or children TC > 6.7 mmol/l and LDL-C > 4.0 mmol/l, plus:
for definite FH: tendon xanthoma in patients or 1st or 2nd degree relatives or DNA-based evidence of FH
for possible FH: family history of myocardial infarction below age 50 years in 2nd degree relative, below age 60 in 1st degree relative, or a family history of raised cholesterol levels
BMI 40 or above
morbidly obses
