Test 17 - IM Flashcards
Why would a patient with weakness, cough, decreased appetite and a history of smoking have a low sodium concentration?
SIADH from small cell lung cancer. Excess ADH causes increased water volume which dilutes out the sodium.
Sequele of small cell lung cancer?
SIADH, ACTH production and Lambert- Eaton Syndrome
Symptoms and MOA of Lambert-Eaton Syndrome
MOA: Lambert–Eaton myasthenic syndrome (LEMS, also Lambert–Eaton syndrome, or Eaton–Lambert syndrome) is a rare autoimmune disorder that is characterized by muscle weakness of the limbs. It is the result of an autoimmune reaction in which antibodies are formed against presynaptic voltage-gated calcium channels, and likely other nerve terminal proteins, in the neuromuscular junction
Sx:The weakness of LEMS typically involves the legs and arms. Leg involvement is more striking than in myasthenia gravis. The proximal muscles (those closest to the trunk) are predominantly affected; this leads to difficulties climbing stairs and rising from a sitting position. Physical exercise and high temperatures can worsen the symptoms. Weakness of the eye muscles is uncommon.
Sequele of squamous cell lung cancer?
Hypercalcemia and cavitary lung lesions
Most common cause of mitral valve prolapse?
myxomatous degeneration of the mitral valve leaflets an chordae and causes a mid systolic click followed by mid to late systolic murmur
displaced apical impulse, holosystolic murmor, third heart sound
mitral valve prolapse
Pt px with fatigue, dyspnea, hx mono, splenomegaly, mild icterus and Hg 7.8. What does he have? What test will be positive?
Autoimmune hemolytic anemia, + direct coombs test
What is autoimmune hemolytic anemia?
Seen in lymphoproliferative disorder, viral infections, autoimmune conditions, and drugs. RBC lysis occurs when antibodies against a person’s own blood cells cause them to burst. Normocytic anemia with high reticulocyte count usually seen.
What is a coombs test? What are the different types? How do they help you distinguish etiology of AIHA?
Coombs test: test that detects antibodies against one’s own RBCs
What is paroxysmal supra ventricular tachycardia (PSVT)?
Random episodes of rapid heart beat that start in the atria and are due to a accessory conduction pathway that depolarizes faster than the SA node, causing electrical impulse to bypass SA and increase heart rate.
How do you trt PSVT?
You can’t slow down the accessory pathway, so instead, focus on slowing down the AV node. Vagal maneuvers such as valsalva, carotid sinus massage and immersion into cold water increases vagal tone. These increase parasympathetic thus decrease AV conductivity. You can also use adenosine.
