Oct 28, 2019 Flashcards
When should immunizations be administered for splenectomy?
Non-Emergent
Start 10-12 weeks prior so vaccines can be completed 14 days prior to splenectomy
Autosplenectomy
As soon as recognized
Emergent/Urgent
Start 14 days post splenectomy
What are EKG and lab findings in Stress Cardiomyopathy?
~50% have ST elevation in anterior leads
Deep T wave inversions, Q waves or prolonged QT in some pts
Mild elevation of troponin
Apical ballooning with akinesis or dyskinesis with basal hyperkinesis
No evidence of culprit CAD
Demographics in stress cardiomyopathy?
Post-menopausal women
Stressful emotional or physical situation
Time course of stress cardiomyopathy?
Most recover LVEF in 1-4 weeks, some can take up to 2-3 months
Treatment of stress cardiomyopathy?
Supportive
Diuretics
ACEi
B-Blockers
Repeat echo in 3-6mo
If recovered continue therapy ~1yr (no clear evidence)
How do you calculate and interperet a urinary anion gap?
AGU=NaU+KU-ClU
Negative urinary gap (-20 to -50) indicates significant amount of unmeasured + charged cation in the urine. ie increased NH4(Normal response to acidosis)
Positive gap (20-90) low normal NH4. (Distal RTA)
-20 to 20 not reliable
What does a negative urinary anion gap in light of non-gap metabolic acidosis indicate (DDx)?
Diarrhea
Laxative abuse
Enteric fistula
What does a positive urinary anion gap in light of non-gap metabolic acidosis indicate (DDx)?
Renal bicarb wasting
RTA (Distal) ie 1 or 4
Carbonic anhydrase inhibitors
low aldosterone state
How does serum osmolality help differentiate between AGMA with negative ketones?
Normal serum osm
Paraldehyde
Salicylates
High serum osm
Methanol
Ethylene glycol
Statin therapy for secondary prevention with age?
<=75 High intensity
>75 moderate intensity
LDL cutoff for statin therapy
High intensity statin if >=190
Statin in Diabetes?
Age 40-75
ASCVD >=7.5 High intensity
ASCVD <7.5 Moderate intensity
