Renal, Endocrine, and Metabolic Flashcards

1
Q

Electrolyte abnormalities in tumor lysis syndrome

A

Hyperuricemia, hyperkalemia, hyperphosphatemia

Hypocalcemia

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2
Q

Lithium level requiring hemodialysis

A

> 4 or > 2.5 with signs of impaired mentation or renal failure making clearance not likely

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3
Q

Aspirin level requiring dialysis

A

> 100 or signs of volume overload preventing bicarbonate drip

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4
Q

Is there a difference in effects on serum potassium between all the various balanced crystalloids?

A

No
(SALT-ED and SMART trials)

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5
Q

Labile htn hx with headache and chest pain following abdominal surgery suggests what

A

Pheochromocytoma

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6
Q

TTM effect on glucose

A

Hypothermia causes increased insulin resistance. Glucose rises requiring higher insulin doses, and then patient’s can become hypoglycemic during rewarming.

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7
Q

KDIGO criteria for AKI (3 things)

A

> 0.3 mg/kL risk in creatinine in 48 hours or
rise 1.5 x baseline in 7 days or
urine output < 0.5 ml/kg/h for 6h

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8
Q

7 findings in propofol infusion syndrome

A
  1. Metabolic acidosis
  2. fever
  3. rhabdo
  4. AKI
  5. Shock
  6. Arrhythmias
  7. HLD (triglycerides)
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9
Q

Dose of 3% for use in symptomatic hyponatremia

A

100 ml of 3% repeated to a total of 300 ml to increase sodium by up to 6 (1-2 per dose)

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10
Q

Urine anion gap in normal functioning kidneys with a NAGMA

A

very negative

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11
Q

Passive leg raise in a fluid responsive patient will change what parameter

A

> 5% change in the ETCO2

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11
Q

Saline compared to LR has what effect on mortality and renal function in septic shock

A

Higher mortality and worsening AKI

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11
Q

Hyperthyroid medication used in 1st trimester of pregnancy

A

PTU

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11
Q

Whipple’s triad

A

Symptoms consistent with hypoglycemia
Low glucose on lab test or finger stick
Relief of symptoms with administration of glucose

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12
Q

Hyperthyroid medication that causes birth defects if given in the first trimester

A

Methimazole

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13
Q

Is there any regimen shown to be superior to another in preventing contrast induced nephropathy

A

No

14
Q

Treatment protocol for thyroid storm

A
  1. Propranolol or esmolol (Stop symptoms)
  2. PTU or Methimazole (Stop new hormone production)
  3. Steroids (block conversion of T4 to T3)
  4. Iodine solution 1 hour after the PTU (to block release of hormone from thyroid)
15
Q

Administering iodine (either solution or amiodarone) to a person in thyroid storm before PTU/methimazole is given will cause what?

A

Higher levels of thyroid hormone as the iodine is used to create new hormone

16
Q

Stopping vasopressin can cause what transient condition

A

Diabetes insipidus due to rise in sodium

17
Q

Retinal edema is suggestive of which toxic alcohol ingestion

A

Methanol

18
Q

2 toxic alcohols that cause elevated osmolar gap WITHOUT an anion gap

A

Ethanol and isopropanalol

19
Q

Acute respiratory acidosis cause how much change in bicarb for every 10 of CO2?

A

1

20
Q

Acute respiratory alkalosis causes how much change in bicarb for every 10 of CO2?

A

2

21
Q

Chronic respiratory acidosis causes how much change in bicarb for every 10 of CO2?

A

3-4

22
Q

Chronic respiratory alkalosis causes how much change in bicarb for every 10 of CO2?

A

5

23
Q

Metabolic acidosis causes how much change in CO2 for every 10 of bicarb?

A

10

24
Q

Metabolic acidosis causes how much change in CO2 for every 10 of bicarb

A

10

25
Q

Low levels of what electrolyte can cause bronchospasm?

A

Calcium

26
Q

Immune checkpoint inhibitor that can cause a loss of function of the pituitary gland

A

Ipilimumab

27
Q

Enzyme that is produced from tylenol due to glutamine deficiency seen in ETOH or critical illness and causes HAGMA

A

5-oxoproline

28
Q

Treatment for severe metformin toxicity

A

Dialysis

29
Q

Treatment for refeeding syndrome

A

Decrease nutrition rate and replace electrolytes until 3 days have gone without need for replacement

30
Q

Urinary sodium and osmolarity in SIADH

A

> 20 and > 100

31
Q

Acid base disturbance in aspirin toxicity

A

Respiratory alkalosis with HAGMA