Micellaneous Flashcards
Hyperkalemia
- Definition
- Causes
K+ levels >5.5mmol/L, with 6.5 needing urgent treatment.
Causes
- Acute kidney injury (urinary obstruction, hypovolemia, pyelonephritis)
- K+ sparing diuretics/ aldosterone antagonists
- Rhambdomyolosis
- Metabolic acidosis
- Addisons’
Hyperkalaemia treatment
- Do ECG and Protect the myocardium membrane
- 10 mL of 10% Calcium gluconate - Insulin dextrose IV
- Drives K+ into cells - Nebulized Salbutamol
- Drives K+ entry into cells - Consider Dialysis
ECG changes with Hyperkalemia
Peaker tall T waves
Broad QRS
Ventricular tachycardia
Bradycardia
Absent/ flattened P waves
Hypokalemia
- Definition
- Causes
K+ levels < 3.5, <2.5= urgent
Causes
- Vomiting and diarrhoea
- Diuretics
- Cushings/ Steroids
- Conn’s syndrome
- Metabolic alkalosis
Hyperkalemia
- Signs and symptoms
Signs
- Arrhythmias. ECG changes: Tall tented T waves, VF, broad QRS
- Palpitations
- Hyperventilation (in acidosis)
Hypokalemia
- Treatment
- Check Mg and correct
- If hypomagnesaemic, give MgSO4 - Oral K+ supplement if mild
- SandoK - If severe, K+ (KCl) given IV, slowly (20-40mmol/h)
Hypokalemia
- Signs and symptoms
Weakness
Constipation
Cramps
SoB
Arrhythmias
Hypokalemia
- ECG changes
U waves
T wave flattening
Depressed ST
Prolonged PR
Toursard de pointes
Thiamine deficiency
- Description
- Causes
- Presentation
Thiamine is important for catabolism of sugars and amino acids
- Deficiency manifests first in highly aerobic tissue
Causes
- Alcoholism
- Malnutrition
Presentation
- Wernicke’s encephalopathy (nystagmus, ophthalmoplegia and ataxia)
- Korsakoff’s syndrome: Amnesia, confabulation, psychosis
- Dilated cardiomyopathy
- Peripheral neuropathy
Amyloidosis
- Description
- Classification
- Pathophysiology
Diseases that involve the build up of amyloid fibrils in tissue.
Types
- Light chain= AL amyloidosis/ multiple myeloma. Ig light chains= most common
- Inflammation amyloidosis (AA): serum Amyloid A produced due to inflammation
- Dialysis (AB2M)
- Hereditary
- Old age
Pathophysiology
- Protein fragments produced misfold and form oligomers.
- Oligomers aggregate and form amyloid fibrils.
Goodpasture syndrome
- Description
- Pathophysiology
- Presentation
- Treatment
Autoimmune disease
- Anti-basement membrane antibodies produced to attach lungs and kidneys
Presentation
- General: malaise, weight loss, fatigue, fever
- Lung symptoms usually predates kidney: haemoptysis,, chest pain, cough, SOB
- Kidney: haematuria, oedema, HTN
Treatment
- Plasmapheresis
- Immunosuppression
Kartagener’s syndrome
- Description
- Pathophysiology
- Presentation
- Treatment
Primary ciliary dyskinesia
- Genetic, autosomal recessive
- Immotile cilia leading to inability to clear out mucus effectively in lungs.
Features - Bronchiectasis - Recurrent sinusitis - Subfertility -
Cystic fibrosis
- Description, genetics
- Presentatation/ features
Autosomal recessive genetic condition
- Mutation in CFTR protein , chromosome 7= abnormal chloride channel
- Can also be autosomal dominant
Presentation
- Destruction of exocrine pancreas= malabsorption
- Intestinal blockage
- Lungs: chronic infection, mucus retention (increases brochiectasis risk)
Complications of a large goitre (5)
Upper airway obstruction
Dysphagia
Recurrent laryngeal palsy
Jugular compression
Horner’s
Autoimmmune polyendocrine syndromes
- Type 1
- Description
Autosomal recessive syndrome of endocrine disorders
- rarer than type 2
- Due to mutation of AIRE gene on chromosome 21
Includes
- Addison’s
- Chronic mucocutaneous candidiasis
- Hypoparathyroidism
- Vitiligo, alopecia, pernicicous anaemia, AI hyperparathyroidism
