Subspeciality Prep Flashcards
T1DM Diagnosis (same as adults)
a1c 6.5
FBG 126
2h OGT 200
RBG 200 + classic symptoms
Microvascular T1DM complications
retinopathy, neuropathy, nephropathy
EUVOLEMIC Hypernatremia
Renal Losses: DI, Hypodipsia
Extra-Renal: Sweating, respiratory
HYPERVOLEMIC
Hypernatremia
Primary Aldosteronism
Cushing Syndrome
Salt Tablets/NaBicarb
HYPOVOLEMIC
Hypernatremia
w/ urine sodium less than 20
GI losses including diarrhea, NG secretions, fistula
Burns
Sweating
HYPOVOLEMIC
Hypernatremia
w/ urine Na more than 20
Osmotic Diuresis
Loop Diuretics
Intrinsic Renal Disease
Post-obstruction
Sodium- homeostasis basics
pumped OUT of cells, so in EXTRAcellular fluid
Hypertonicity plasma =
> 295 Osm
Stimulates receptors in hypothalamus and causes secretion of ADH
Central DI=
low ADH secretion by posterior pituitary
Nephrogenic DI=
tubules cannot respond to ADH
Urine in DI
low specific gravity and low osmolality
Plasma in DI
Normal/High
280-310
Normal Plasma Osm
250-290
Water Deprivation Test
-Withhold fluids
measure urine osm every hour
- no increase in urine osm
- can give desmopressin to assess if kidneys respond
Central DI Treatment
Desmopressin
Nephrogenic DI treatment
sodium restriction and thiazide diuretics (deplete body of sodium)
Hypervolemic HYPOnatremia
Non renal: CHF, Ascites, Cirrhosis
Renal: ARF, NS, CRF
Renin =
comes from juxtomegular cells of kidneys in response to decreased BP –> increase angiotensin
How does aldosterone system get activated
dehydration, hyponatremia –> decrease in BV –> decrease in BP
Angiotensinogen comes from
liver
Factor ii def
Prothrombin def
Can be acquired due to liver disease
