Test 3 Flashcards
what does oncogene activation do?
leads to excessive amounts of cyclins and uncontrolled cell growth
labs for dehyration
BUN will be elevated, creatinine won’t
fever in cancer patients
99.0
SIADH happens commonly in which cancer?
lung
treatment of spinal cord compression
- often palliative
- high dose corticosteroids decrease swelling and reduce compression
- high-dose radiation
- surgery
- external back or neck braces
s/s of hypercalcemia
fatigue, loss of appetite, n/v, constipation, polyuria, severe muscle weakness, loss of deep tendon reflexes, paralytic ileus, dehydration, ECG changes
treatment of hypercalcemia
- oral hydration is usually adequate
- glucocorticoids, calcitonin…
Tx of superior vena cava syndrome
- O2, corticosteroids, diuretics
- high-dose radiation therapy, rarely surgery, stent placement
tumor lysis syndrome
large numbers of tumor cells are destroyed rapidly, resulting in intracellular contents being released into the blood stream faster than they can be eliminated
-potassium and purines
Tx of tumor lysis syndrome
- prevention through hydration
- drug therapy: allopurinol, diuretics, kayexalate
albumin level that shouldn’t go to surgery
lower than 3.8
A1C normal level
4-6.5… definitely should be lower than 7
diabetes insipidus originates in the
posterior pituitary gland
diagnostics for diabetes insipidus
vasopressin test: when given, symptoms go away
diagnostics for diabetes mellitus
- fasting 8 hr glucose of 126 or more
- random or casual glucose of 200 or more
rapid acting name
aspart
lispro
short acting name
regular
intermediate acting name
NPH
lente
long acting name
glargine
what does A1C measure?
- the amount of glycosylated hemoglobin as a percentage of total hemoglobin
- e.g., A1C of 7% means that 7% of the total hemoglobin has glucose attached to it
labs for hypoparathyroidism
-serum PTH
treatment of hypoparathyroidism
- increase serum Ca+ to 9 to 10 mg/dL
- calcium gluconate IV
- Pentobarbital to decrease neuromuscular irritability
- administration of parathormone
- quiet environemnt, low draft, no sudden movement
- high Ca+ diet and low in phosphorus
- Vitamin D
secretion of growth hormone happens where?
anterior pituitary gland
disease if excess GH is secreted before the epiphesial plates close
gigantism
disease if excess GH is secreted after epiphesial plates close
acromegaly
steriostatic radiation
occlude blood vessels feeding the tumor, thereby starving it
disease of hyposecretion of growth hormone
dwarfism
treatment of dwarfism
-biosynthetic GH at bedtime until they are 14 or 16
Cushings disease is caused by
hyperfunction of adrenals… too much steroid release
labs for cushings
-dexamethasone suppression test
Addisonian crisis s/s
shock; hypotension; rapid, weak pulse; rapid resp rate; pallor; extreme weakness
Tx of Addisonian crisis
immediate IV administration of fluids, glucose, and electrolytes, especially sodium; replace missing hormones; vasopressors; recument position with legs elevated
tx of graves disease
- radioactive 131I therapy
- PTU and methimazole
- Na+ and potassium iodine solutions
- dexamethasone
- beta blockers
thyroid storm s/s
- high fever
- extreme tachy
- altered neuro: delirium psychosis, somnolence, coma
tx of thyroid storm
- reduce temp and HR and recent ventricular collapse
- O2
- IV fluids containing dextrose
- PTU or methimazole
- hydrocortisone to treat shock
- iodine to decrease output of T4
- Propanolol and dig to reduce CV symtoms
s/s myxedema coma
diminished LOC, hypothermia without shivering, hypoventilation, hypotension, hypoglycemia, lactic acidosis
tx of myxedema coma
- ventilatory support
- thyroid and adrenocortical hormones, fluids, and glucose
- gradual rewarming
hypercalcemic crisis
- serum Ca+ >13 mg/dL
- neuro, CV, and kidney symptoms that can be life threatening
tx of hypercalcemic crisis
- rapid rehydration with isotonic fluids to maintain output of 100-150 mL/hr
- Calcitonin
DKA is characterized by…
- hyperglycemia
- ketosis (fruity breath)
- acidosis (respirations)
- dehydration (BUN abnormal, creatinine normal)
s/s DKA
- early: lethargy/weakness
- late: dehyration, abdominal pain, vomiting, kussmaul respirations
Tx of DKA
- hydration with NS
- insulin drip (always regular)
- K+ replacement (ONLY when they’re hydrated)
- O2
- check glucose q30 min x2 or 4 when hanging drip, then qh
- change IV to contain D5NS or D5 1/2NS when BG reaches 250
- stop IV when insulin drip reaches 200
dif between HHS and DKA
in HHS:
- increased serum osmolality
- absent/minimal ketone bodies
tx of HHS
- same as DKA but greater fluid replacement:
- IV fluids, insulin therapy, electrolytes
- once stable, attempt to detect underlying cause
what interferes with sensing hypoglycemia
beta blockers
treatment of hypoglycemia
- Always treat ABC’s first
- them 15mg CHO once able to swallow (orange juice, soda, lifesavers, lowfat milk)
- repeat if BG is still
