Renal, Endocrine, and Metabolic Flashcards
Electrolyte abnormalities in tumor lysis syndrome
Hyperuricemia, hyperkalemia, hyperphosphatemia
Hypocalcemia
Lithium level requiring hemodialysis
> 4 or > 2.5 with signs of impaired mentation or renal failure making clearance not likely
Aspirin level requiring dialysis
> 100 or signs of volume overload preventing bicarbonate drip
Is there a difference in effects on serum potassium between all the various balanced crystalloids?
No
(SALT-ED and SMART trials)
Labile htn hx with headache and chest pain following abdominal surgery suggests what
Pheochromocytoma
TTM effect on glucose
Hypothermia causes increased insulin resistance. Glucose rises requiring higher insulin doses, and then patient’s can become hypoglycemic during rewarming.
KDIGO criteria for AKI (3 things)
> 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
7 findings in propofol infusion syndrome
- Metabolic acidosis
- fever
- rhabdo
- AKI
- Shock
- Arrhythmias
- HLD (triglycerides)
Dose of 3% for use in symptomatic hyponatremia
100 ml of 3% repeated to a total of 300 ml to increase sodium by up to 6 (1-2 per dose)
Urine anion gap in normal functioning kidneys with a NAGMA
very negative
Passive leg raise in a fluid responsive patient will change what parameter
> 5% change in the ETCO2
Saline compared to LR has what effect on mortality and renal function in septic shock
Higher mortality and worsening AKI
Hyperthyroid medication used in 1st trimester of pregnancy
PTU
Whipple’s triad
Symptoms consistent with hypoglycemia
Low glucose on lab test or finger stick
Relief of symptoms with administration of glucose
Hyperthyroid medication that causes birth defects if given in the first trimester
Methimazole
Is there any regimen shown to be superior to another in preventing contrast induced nephropathy
No
Treatment protocol for thyroid storm
- Propranolol or esmolol (Stop symptoms)
- PTU or Methimazole (Stop new hormone production)
- Steroids (block conversion of T4 to T3)
- Iodine solution 1 hour after the PTU (to block release of hormone from thyroid)
Administering iodine (either solution or amiodarone) to a person in thyroid storm before PTU/methimazole is given will cause what?
Higher levels of thyroid hormone as the iodine is used to create new hormone
Stopping vasopressin can cause what transient condition
Diabetes insipidus due to rise in sodium
Retinal edema is suggestive of which toxic alcohol ingestion
Methanol
2 toxic alcohols that cause elevated osmolar gap WITHOUT an anion gap
Ethanol and isopropanalol
Acute respiratory acidosis cause how much change in bicarb for every 10 of CO2?
1
Acute respiratory alkalosis causes how much change in bicarb for every 10 of CO2?
2
Chronic respiratory acidosis causes how much change in bicarb for every 10 of CO2?
3-4
