Revision Flashcards
Effect of ACEi on potassium
increases potassium in body through decreasing excretion
Normal urine output
0.5 mL/kg/hr
Obstructive jaundice mechanism
Obstruction of the excretion of conjugated bilirubin into the gut for elimination into the feces
(bile salts accumulation doesn’t contribute to jaundice because bile salts are colorless)
Plan regarding meds for diabetic having surgery the next day
give dextrose-potassium-insulin before surgery to avoid hyperglycemia, hypoglycemia and hypokalemia
Desired glucose: 10mmol/L (above normal 5 because better in state of surgery)
Relation between obstructive jaundice and increased INR
bile is not reaching the gut, so fat soluble vitamins are not absorbed like vit K which is essential in prothrombin formation
Txt: Start regular vit K injections
Liver failure + high protein meal
mimics alcohol intoxication, altered mental status, tremor, can lead to coma
Liver deals with toxic products from protein digestion
Also, liver failure causes esophageal varices bleeding, gut absorption of this blood is toxic, same effect as high protein (impaired consciousness)
PTLKB
Particular Tumors Like Killing Bone
Prostate, thyroid, lung, kidney, breast
Fluid volume given over 24 hours for electric burns
4 mL x weight (kg) x %burn
Half of volume given over 8 hrs then other half over 16 hrs
Fluid volume given over 24 hours for flames and scalds
2 mL x weight (kg) x %burn
Malignant otitis externa
Erosive inflammatory process that happens in immunocompromised people
Presents with ear pain, headache and facial nerve palsy
Glue ear
otitis media with effusion
MEN1
Pituitary, pancreas, parathyroid
MEN2 A
Pheochromocytoma, thyroid, parathyroid
Superficial abscess organisms
Staph aureus, Strep pyogenes
Deep abscess organisms
E coli (gram neg), Bacteroides (anaerobe)
MEN2 B
Pheochromocytoma, thyroid, neuronal tumors
When are liver hemangiomas dangerous
when larger than 5 cm, they can rupture and cause intra-abdominal bleeding
De Quervain’s thyroiditis
Associated with viral infection, painful swelling of thyroid, pain exacerbated by coughing or swallowing
Inflammation initially causes release of T3/4 for 4 to 6weeks then hypothyroid state happens due to depletion
Riedel’s thyroiditis
Progressive fibrosis of thyroid, patient can become hypothyroid
Position of thoracic duct relative to esophagus
posterior and left of esophagus, passes diaphragm at T5
Which thoracic ganglion for sweating
T1 for facial sweating
T2,3 for palms
T4 for axilla
Can do intradermal botox or topical aluminum chloride
Wilm’s tumor
mutation or deletion of both copies of WT1 tumor suppressor gene on chrom 11p, “nephroblastoma”, accounts for 80% of GU tumors in kids <15 yrs, good prognosis
osteosarcoma xray sign
sunray sign
ewing’s sarcoma xray sign
onion ring sign, multiple concentric rings