Block 32 Week 8 Flashcards

Question

CT in acute panc?

Answer 1

used to confirm diagnosis when uncertainty remains and to exclude complications of disease.

Answer 2

most commonly indicated in suspected gallstone pancreatitis to help evaluate for CBD stones.

Answer 3

- supportive - IV fluids - Analgesia - Nutritional support

Answer 4

in mild cases low fat diet reintro

Answer 5

- enteral feeding is preferred to total parenteral nutrition (TPN). - It is thought enteral feeding helps maintain the mucosa and prevents translocation of bacteria. Nasojejunal feeding is commonly used.

Answer 6

- NOT for acute panc - should be used for suspected cholangitis

Answer 7

- Gallstone panc - stone extraction

Answer 8

- continued inflammation -> local thrombosis, haemorrhage and necorsis in the panc - high infection risk - major cause of mortality

Answer 9

- CT guided fine needle aspiration and culture

Answer 10

- present 4+ weeks after an episode - psudo means epithelial lining around the cyst rather than granulation tissue

Answer 11

- pseudoaneurysm - venous thrombosis

Answer 12

- rare but life threatning haemorrhages - often seen in splenic and hepatic arteries - normally occur in association w pancreatic pseudocysts

Answer 13

- venous thrombosis may affect the portal, splenic and superior mesenteric veins - requires AC

Answer 14

- Acute respiratory distress syndrome - Renal failure - Shock - disrtibutive

Answer 15

- 1% in mild panc - sterile pancreatic necrosis: 10% - infected panc necrosis: 25% mortality

Answer 16

chronic, irreversible, inflammation and/or fibrosis of the pancreas.

Answer 17

Endocrine dysfunction: damage to the islet cells result in lack of insulin and development of diabetes mellitus

Answer 18

Exocrine dysfunction: damage to the acinar cells results in lack of pancreatic enzymes and malabsorption

Answer 19

T (toxic/metabolic): alcohol, smoking, high triglycerides, hypercalcaemia, chronic kidney disease

Answer 20

- idiopathic - may be late onset, early onset or tropical

Answer 21

- genetics - mutation in PRSS1

Answer 22

- type 1 - type 2

Answer 23

- IgG4 disease

Answer 24

limited to the pancreas and associated with inflammatory bowel disease

Answer 25

- recurrent and severe acute panc - patients with a severe episode of necrotising pancreatitis or those with acute recurrent pancreatitis can progress to chronic pancreatitis due to tissue destruction

Answer 26

- chronic obstruction of the main pancreatic duct can lead to tissue damage and chronic pancreatitis upstream. - Typical causes of obstruction include strictures, stones, cysts, and tumours

Answer 27

- PRSS1 mutation - encodes cationic trypsinogen

Answer 28

- mutation in CTFR gene - spink 1 gene

Answer 29

- epigastric discomfort - worse post-prandially and on lying down

Answer 30

- nausea - vomiting - anorexia

Answer 31

- destruction of acinar cells -> loss of digestive enzymes -> malabs - inability to digest fatty foods due to lack of lipase

Answer 32

- Weight loss - Bloating - Flatulence - Abdominal pain/discomfort - Loose stools - Steatorrhea - > 90% of the pancreatic exocrine function needs to be lost before patients develop steatorrhea - consq of long standing panc damage

Answer 33

- Type 3c DM - Polyuria, polydispsia, weight loss

Answer 34

- CT or MRI with MRCP

Answer 35

- CT is excellent at looking for calcification changes within the pancreas. - Features of chronic pancreatitis include atrophy, calcification, and ductal changes (e.g. dilatation, strictures).

Answer 36

- indirect marker of panc function - used to assess for panc exocrine insufficiency - low levels suggest PEI

Answer 37

- FBC, U&Es, LFTs - lipid profile - bone profile - mag - hbalc

Answer 38

- nutritional assessment - alcohol cessation - smoking cessation - vitamin replacement e.g. vitamin D

Answer 39

- basic first: paracetamol and NSAIDs - then weak opiods: tramadol, codeine

Answer 40

- pancreatic enzyme replacement therapy - abs can be improved using a PPI

Answer 41

- Pancreatic pseudocysts - Pancreatic stones - Main pancreatic duct strictures - Other complications (e.g. biliary strictures, duodenal obstruction)

Answer 42

- PEI - DM - osteoporosis - panc cancer - duodenal and biliary obst

Answer 43

HBsAg = ongoing infection, either acute or chronic if present > 6 months anti-HBc = caught, i.e. negative if immunized

Answer 44

- faecal-oral

Answer 45

- self limiting - doesn't cause chronic disease

Answer 46

* flu-like prodrome * abdominal pain: typically right upper quadrant * tender hepatomegaly * jaundice * deranged liver function tests

Answer 47

double standed DNA hepadanvirus

Answer 48

- exposure to infected blood or body fluids - mother to child

Answer 49

6-20 weeks

Answer 50

- fever - jaundice - elevated LFTs

Answer 51

ground glass hepatocytes

Answer 52

- HCC - glomerulonephritis - fulm liver failure

Answer 53

- faecal oral - Can be transmitted by seafood

Answer 54

- central and south asia - mexico - north and west africa

Answer 55

- pregnancy - causes sig mortality

Answer 56

does not cause chronic disease or an increased risk of hepatocellular cancer

Answer 57

- IV drug users - patients who receive a blood transfusion

Answer 58

- Needle stick injury - mother to child - sexual intercourse

Answer 59

breastfeeding

Answer 60

- Sjogren's syndrome - cirrhosis - HCC - glomerulonephritis

Answer 61

- single stranded RNA virus - transmitted parenterally (blood and body fluids)

Answer 62

- requires hep B surface antigen to repllicate

Answer 63

transmitted in a similar fashion to hepatitis B (exchange of bodily fluids) and patients may be infected with hepatitis B and hepatitis D at the same time.

Answer 64

Co-infection: Hepatitis B and Hepatitis D infection at the same time. Superinfection: A hepatitis B surface antigen positive patient subsequently develops a hepatitis D infection.

Answer 65

Superinfection is associated with high risk of fulminant hepatitis, chronic hepatitis status and cirrhosis.

Answer 66

- infection of the biliary ducts - caused by obstruction

Answer 67

Charcots triad: fever, jaundice, RUQ pain

Answer 68

- Ascending cholangitis - fever, jaundice, RUQ pain, septic shock and mental confusion

Answer 69

choledocholithiasis (gallstones) and strictures of the biliary tree.

Answer 70

inc risk of septic shock -> medical emergency

Answer 71

hyperbilirubinaemia and elevated serum alkaline phosphatase

Answer 72

- ERCP: when history of biliary disease - transabd US: CBD dilatation

Answer 73

- pieracillin/ tazobactam - IV fluids - analgesia - sepsis 5

Answer 74

- biliary decompression - ERCP or surgery

Answer 75

- RUQ pain - intermittent - usually begins abruptly and subsides gradually - attacks often occur after eating

Answer 76

- female - forties - fat - fair

Answer 77

- similar to biliary colic but more severe and persistent - pain may radiate to back or right shoulder

Answer 78

- pyrexial - murphy's sign positive: arrest of inspiration on palpation of the RUQ

Answer 79

- SBO - secondary to impacted gallstone

Answer 80

Abdominal pain, distension and vomiting

Answer 81

- persistent biliary colic symptoms - anorexia - jaundice - weight loss

Answer 82

- Courvoiser's sign - sister mary joseph nodes - virchow node

Answer 83

palpable mass in the right upper quadrant

Answer 84

periumbilical lymphadenopathy

Answer 85

left supraclavicular adenopathy

Answer 86

alcohol or gallstones

Answer 87

- Severe epigastric pain - Vomiting is common - Examination may reveal tenderness, ileus and low-grade fever

Answer 88

- painless jaundice - anorexia - weight loss

Answer 89

* Biliary colic --> pain * Acute cholecystitis --> pain + fever * Ascending cholangitis --> pain + fever + jaundice

Answer 90

In Mirizzi syndrome the stone may compress the bile duct directly- one of the rare times that cholecystitis may present with jaundice

Answer 91

Typically painless jaundice with palpable gallbladder (Courvoisier's Law)

Answer 92

- Fat - Female - Fertile - pregnancy - Forty

Answer 93

- diabetes - chrons - rapid weight loss - drugs - fibrates, oral contraceptive

Answer 94

- colicky right upper quadrant abdominal pain worse postprandially, worse after fatty foods - the pain may radiate to the right shoulder/interscapular region - N and V

Answer 95

in biliary colic there is no fever and liver function tests/inflammatory markers are normal

Answer 96

gallstones in common bile duct

Answer 97

Cholelithiasis (gallstones) refers to the development of a solid deposit or ‘stone’ within the gallbladder.

Answer 98

They are more common in women and tend to affect those of caucasian, Native American and hispanic backgrounds more.

Answer 99

- age - female - obesity - rapid weight loss/ prolonged fasting - diabetes - crohns

Answer 100

oestrogen replacement therapy, ceftriaxone, octreotide

Answer 101

- intermittent RUQ/ epigastric pain - nausea and vomiting

Answer 102

- USS - can also assess for CBD dilation - LFTs

Answer 103

- analgesia - paracetamol and NSAIDs - diet - low fat

Answer 104

- elective cholecystectomy

Answer 105

Cholelithiasis (gallstones) refers to the development of a solid deposit or ‘stone’ within the gallbladder.

Answer 106

gallstones within the biliary tree.

Answer 107

refers to a self-limiting pain in the RUQ/epigastrum associated with gallstones.

Answer 108

refers to the acute inflammation of the gallbladder, most commonly caused by gallstones.

Answer 109

refers to the acute inflammation of the gallbladder, most commonly caused by gallstones.

Answer 110

- most common type - occur due to crystalisation of cholesterol in bile due to supersaturation of cholesterol

Answer 111

- dark stones composed primarily of calcium bilirubinate - They occur in people with increased amounts of bilirubin in their bile - hyperbilirubinbilia - occurs w inc haemolysis

Answer 112

- mix of calcium bilirubinate and a calcium salts of fatty acids - mostly occur in association with infection

Answer 113

- normal - BTs normal

Answer 114

RUQ pain, fevers, malaise

Answer 115

- fever - haemodynamic instability

Answer 116

- tenderness - localised guarding may be present

Answer 117

- gallstones - inflamed, thickened GB - pericholesytitic fluid

Answer 118

fever and haemodynamic instability

Answer 119

- jaundice - tenderness

Answer 120

CBD stone, duct dilatation

Answer 121

- epi pain radiating to back - fever and tachy - epigastric tenderness - raised amylase

Answer 122

- Lower back or bone pain. - Lethargy. - Erectile dysfunction. - Haematuria. - Anorexia/weight loss. - Lower urinary tract symptoms (LUTS), such as frequency, urgency, hesitancy, terminal dribbling, and/or overactive bladder.

Answer 123

- SGLT2 inhibitors: cardiovascular and renal benefits - e.g. CREDENCE trial - GLP-1 analogues -> CV benefit

Answer 124

people with diabetes experience disproportionately high rates of mental health problems such as depression, anxiety and eating disorders.

Answer 125

- diabulimia involves the deliberate manipulation of insulin doses to control weight -> poor glycaemic control and ketosis

Answer 126

- Diabetes disress - constant vigilance -> stress - depression and anxiety - stress of a chronic condition, stress about a hypo - increased risk of EDs - condition called diabulimia - Chronic hyperglycemia and fluctuations in blood sugar levels can affect cognitive function in individuals with type 1 diabetes

Answer 127

- Insulin omission/ manipulation - Fear of hypos -> restrictive eating - Food rules and rituals - only eating at certain times and developing strict meal plans - Body image concerns - focus on weight

Answer 128

- eGFR and ACR - Smoking - BP control - full lipid profile - age - FHx of CVD - abd adiposity

Answer 129

- Stop smoking - BB for those who have had a stroke or MI

Answer 130

- are older than 40 years or - have had diabetes for more than 10 years or - have established nephropathy or - have other CVD risk factors.

Answer 131

Consider statin treatment for the primary prevention of CVD for people aged 18 to 40 with type 1 diabetes, including those who have had diabetes for 10 years or less.

Answer 132

- for adults w T1D who have recurrent severe hypoglycaemia that has not responsed to other treatments - consider referral to for islet and/or pancreas transplantation - Consider islet or pancreas transplantation for adults with type 1 diabetes with suboptimal diabetes control, if they have had a renal transplant and are currently on immunosuppressive therapy.

Answer 133

- in the hypothalamus - arcuate nucleus -> appetite controle

Answer 134

- Excitatory neurons release NPY -> hunger - Inhibitory neurons release -> POMC

Answer 135

- Ghrelin is a peptide hormone produced in the pancreas and released from the stomach wall when the stomach is empty. - This stimulates the excitatory primary neurones, and therefore stimulates appetite. When the stomach is full, ghrelin release is inhibited, thus the appetite stimulus is also inhibited

Answer 136

from the ileum in response to feeding. Causes appetite suppression

Answer 137

- leptin is produced by fat cells - stimulates inhibitory neurones and inhibits excitatory neurons in the arcuate nucleus -> appetite suppression

Answer 138

- Insulin is a hormone released from beta cells in the islets of Langerhans of the pancreas. This suppresses appetite in a similar way to leptin.

Answer 139

vagus nerve

Answer 140

- Empty stomach senses by stretch receptors in the stomach -> signal to BS - Ghrelin -> arcute nucleus of hypothalamus - Ghrelin -> paraventicular nucleus to increase food intake and decrease energy expenditure

Answer 141

- distension of stomach stops ghrelin production - Gut peptides like GLP-1 and CCK are released which then act on the BS and hypothalamus - suppressing appetite and increasing energy expenditure

Answer 142

- High fat -> stop feeding and spend energy - Low fat -> feed more, preserve more energy

Answer 143

- Leptin release is dependent on insulin and is released from adipose tissue - Increased leptin -> stop eating and spend energy - Inhibit food intake at hypothalamus

Answer 144

- results from disregulation of this system - assoc w chronic low leptin - makes the body think its starved which leads to obesity

Answer 145

- high fat diet -> saturated fats -> inflammation -> leptin resistance -> starvation response - Leptin deficiency or mutations leading to leptin resistance

Answer 146

- Insulin -> GLUT4 insertion -> glucose enters cell - Causes glycogen production, inhibits glucogonegenesis

Answer 147

- Glucagon - released when all the glucose - inactivates glycogen synthesis - inc glucogenolysis - Adrenaline acts the same as glucagon but faster

Answer 148

- screening tool - quick and easy way to assess weight - health risk assessment - Individuals with higher BMI values are generally at increased risk of developing these conditions compared to those with lower BMI values. - population health monitoring - clinical decision making

Answer 149

- Doesn't distinguish between fat and lean body mass - not applicable to different age and ethniticities - BMI does not account for distrubution of body fat - not suitable for pregnancy

Answer 150

- healthy weight: BMI 18.5 kg/m2 to 24.9 kg/m2 - overweight: BMI 25 kg/m2 to 29.9 kg/m2 - obesity class 1: BMI 30 kg/m2 to 34.9 kg/m2 - obesity class 2: BMI 35 kg/m2 to 39.9 kg/m2 - obesity class 3: BMI 40 kg/m2 or more

Answer 151

Men: ≥ 102 cm (40 inches) Women: ≥ 88 cm (35 inches)

Answer 152

- dietary changes - lifestyle interventions - reducing calories - increasing fruit and veggies - physical activity - behavioural strategies - goal setting, self monitoring - education - nutrition, exercise. weight management

Answer 153

- complexity of disease - multifactorial so won't address underlying genetic factors - indiv variability - sustainability - challenging to do long term

Answer 154

Emotional eating, stress, depression, and other psychological factors can undermine efforts to adopt healthier lifestyles. Lifestyle interventions may need to incorporate strategies to address these psychological barriers effectively.

Answer 155

- least restrictive - first line - less weight loss but less comps

Answer 156

reduces size of stomach

Answer 157

= Metal ions + Folate (first)

Answer 158

- Jejunum = all vitamins except - Ileum = B12

Answer 159

Na, K, water

Answer 160

- ACTH - FSH/ LH - TSH - GH - prolactin

Answer 161

- autoimmune response against an autoantigen, possibly the TSH receptor → retro-orbital inflammation - the inflammation results in glycosaminoglycan and collagen deposition in the muscles

Answer 162

- most imp: smoking - radiodine treatment - predinoslone can reduce risk

Answer 163

- the patient may be eu-, hypo- or hyperthyroid at the time of presentation - exophthalmos - conjunctival oedema - optic disc swelling - ophthalmoplegia - inability to close the eyelids may lead to sore, dry eyes. If severe and untreated patients can be at risk of exposure keratopathy

Answer 164

- smoking cessation topical lubricants may be needed to help prevent corneal inflammation caused by exposure - steroids - radiotherapy - surgery

Answer 165

- the typical symptoms of pregnancy often emulate symptoms of thyroid dysfunction, creating a significant diagnostic challenge during this time - during pregnancy, thyroid gland enlarges and TFTs change - T3 and T4 increases but TSH decreases

Answer 166

- due to human chorionic gonadotropin (hCG) cross-reacting with TSH receptors; total T4 (TT4) levels increase while free T4 (FT4) levels remain unchanged.

Answer 167

amiodarone and immune checkpoint inhibitors in causing thyroid hormone excess

Answer 168

- normal T3 and T4 levels - TSH is low (suppressed)

Answer 169

MNG paticularly in elderly females

Answer 170

- AF - osteoporosis

Answer 171

- TSH levels often revert to normal - therefore levels must be persistently low to warrant intervention - a reasonable treatment option is a therapeutic trial of low-dose antithyroid agents for approximately 6 months in an effort to induce a remission

Answer 172

TSH raised T3 and T4 normal

Answer 173

- risk of progressing to overt hypothyroidism - higher in men - risk increased by presence of thyroid autoantibodies

Answer 174

- TSH >10 -> levothyroxine

Answer 175

- Incidentaloma - mass found upon imaging - was not carried out for sus of adrenal disease

Answer 176

- usually no typical findings - mild autonomous cortisol excess

Answer 177

- Have an increased incidence of metabolic disease like T2DM, HTN, osteoporosis, dyslipidemia

Answer 178

- CT for diagnostic uncertainty on whether it's a cancer - Urine metanephrines - > 4cm mass requires urgent assessment for malignancy

Answer 179

- Glucocorticoids - Dexamethasone suppression test - Urine and plasma metanephrines

Answer 180

- Benign and no hormone excess -> no follow up - Clinically overt cortisol excess or aldosterone or catecholamines -> surgery?

Answer 181

- chromaffin cells of the adrenal medulla -> catecholamine hypersecretion - may also develop at extra-adrenal sites -> paraganlionomas

Answer 182

episodic headache, diaphoresis, and tachycardia

Answer 183

- Plasma or urinary fractioned metanephrines - Followed by CT/ MRI for localisation

Answer 184

- MEN11 association - Von Hippel Lindau syndrome

Answer 185

- can be bilateral or unilateral - episodic - HTN - v high - headaches - palpitations - anxiety - sweating

Answer 186

- 24 hr urine metanephrines NOT catecholamines

Answer 187

- CT/ MRI - Functional imaging modalities like MIBG scintigraphy or PET scans may be employed in cases of metastatic or extra-adrenal disease. - genetic testing e.g. VHL

Answer 188

- Surgery definitive - but medically stabilise with BB or alpha blocker like phenyoxybenzamine first - pre-op

Answer 189

- bilateral idiopathic adrenal hyperplasia causes most cases followed by adrenal adenomas

Answer 190

1) bilateral adrenal hyperplasia 2) Conns = adrenal adenoma

Answer 191

- HTN - hypokalaemia - e.g. muscle weakness - metabolic alkalosis

Answer 192

- hypertension w hypokal - Tx resistant HTN

Answer 193

- first line: plasma A/R ratio - should show high aldosterone levels alongside low renin levels (negative feedback due to sodium retention from aldosterone

Answer 194

- High res CT abdo and adrenal vein sampling can be done to distinguish between unilateral and bilateral hyperplasia

Answer 195

caused by excessive renin stimulating the release of excessive aldosterone.

Answer 196

- Renal artery stenosis - Heart failure - Liver cirrhosis and ascites

Answer 197

- Renal artery stenosis (atherosclerosis of renal artery) is confirmed w Doppler US and CT angiogram oe MRA

Answer 198

- High aldosterone and low renin indicate primary hyperaldosteronism - High aldosterone and high renin indicate secondary hyperaldosteronism

Answer 199

- eplerenone and spironolactone - aldosterone antagonists

Answer 200

- Consider testing for hyperaldosteronism in patients with hypertension, who are younger, fail to respond to treatment or have a low potassium. - Be aware that potassium levels may be normal in hyperaldosteronism.

Answer 201

- Addisons is a complication of ICI - ACTH excess (lack of negative feedback) - T cells activated by ICIs may mistakenly recognize adrenal antigens as foreign and mount an immune response against them, leading to adrenal gland inflammation.

Answer 202

- fatigue weakness and lethargy - hypotension - dizziness, fainintg, lightheadedness - Nausea, vomiting, abdo pain - Hyponatreamia - Hypoglycaemia - cortisol deficiency

Answer 203

synthacten

Answer 204

- inflammation of PG -> inadequate production of one or more of the hormones secreted by the pituitary gland.

Answer 205

- compression of the pituitary gland by non-secretory pituitary macroadenoma (most common)

Answer 206

- pituitary apoplexy - Sheehan's syndrome: postpartum pituitary necrosis secondary to a postpartum haemorrhage - hypothalamic tumours e.g. craniopharyngioma

Answer 207

- trauma - iatrogenic irradiation - infiltrative e.g. hemochromatosis, sarcoidosis

Answer 208

- tiredness - postural hypotension

Answer 209

- amenorrhoea - infertility - loss of libido

Answer 210

- feeling cold - constipation

Answer 211

- if occurs during childhood then short stature

Answer 212

- problems with lactation

Answer 213

- pituriary macroadenoma → bitemporal hemianopia - pituitary apoplexy → sudden, severe headache

Answer 214

- replacement of deficient hormones - Tx of underlying cause - e.g. surgery for removal of tumour

Answer 215

- high dose steroids - Checkpoint Inhibitors

Answer 216

- Prolonged use of glucocorticoids or drugs that inhibit steroidogenesis (e.g., ketoconazole) can suppress the hypothalamic-pituitary-adrenal (HPA) axis, leading to adrenal atrophy and insufficiency.

Answer 217

- Trauma, anticoagulation, and sepsis can lead to adrenal haemorrhage, resulting in acute adrenal insufficiency.

Answer 218

- stress - pregnancy - lactation - exercise - sexual intercourse

Answer 219

- AP - AD - SSRIs, MAO inhib, antienetics like domperidone and metoclopramide

Answer 220

prolactinomas

Answer 221

Compression of pituitary stalk due to meningiomas, craniphrayngiomas, GH secreting adenomas -> acromegaly

Answer 222

- CKD, cirrhosis, PCOS, hypothyroidism

Answer 223

* Serum prolactin: to confirm the diagnosis of hyperprolactinaemia * Pregnancy test: to exclude pregnancy, a common physiological cause of hyperprolactinaemia * Thyroid function tests: to identify hypothyroidism * Urea & electrolytes: to identify reduced renal function (chronic kidney disease) * Pituitary function testing: to assess pituitary function and possible hypopituitarism

Answer 224

- type of pituitary adenoma - macroadeoma >1cm - hormonal status: a secretory/functioning adenoma produces and excess of a particular hormone and a non-secretory/functioning adenoma does not produce a hormone to excess

Answer 225

amenorrhoea - infertility - galactorrhoea - osteoporosis

Answer 226

- impotence - loss of libido - galactorrhoea

Answer 227

- headache. - visual disturbances (classically, a bitemporal hemianopia (lateral visual fields) or upper temporal quadrantanopia) - symptoms and signs of hypopituitarism

Answer 228

- in the majority of cases, symptomatic patients are treated medically with dopamine agonists (e.g. cabergoline, bromocriptine) which inhibit the release of prolactin from the pituitary gland

Answer 229

- surgery is performed for patients who cannot tolerate or fail to respond to medical therapy. - A trans-sphenoidal approach is generally preferred unless there is a significant extra-pituitary extension

Answer 230

- Follow up every 6 -12 months - measurement of prolactin levels - visual fields

Answer 231

- headache - bilateral heminaopia - symptoms of hypopituitarism

Answer 232

- 1) Water deprivation - 2) desmopressin

Answer 233

- cranial DI: increase conc of urine after desmopressin - Nephrogenic: no change following desmopressin

Answer 234

- Increased release of ADH from PP - increases water reabs from the urine, causing dilution of the blood -> hyponatreamia

Answer 235

- DI: hypernatreamia - siADH: hyponatraemia

Answer 236

- ADH produced in the hypothalamus and secreted the PP - ADH stimulates water reabs in CDs diluting blood - causes hyponatreamia - extra water doesn't cause fluid overload so this is a euvolaemic hyponatreamia

Answer 237

- high urine osmolarity - high urine sodium

Answer 238

- Headache - Fatigue - Muscle aches and cramps - Confusion

Answer 239

seziures and reduced consciousness

Answer 240

- pre-op after surgery - transphenoidal surgery - lung infection - subarachnoid haemorrhage - Meds - SSRI and carbamazepine - small cell lung cancer - HIV

Answer 241

transsphenoidal surgery

Answer 242

- Euvolaemia - Hyponatraemia - Low serum osmolality - High urine sodium - High urine osmolality

Answer 243

- synacthen test - CKD - HF or liver disease

Answer 244

- primary polydipsia involves excessive water consumption. - Causes euvolaemic hyponatreamia but there is low urine sodium and low urine osmolality

Answer 245

- Stop med and treat underlying infection - Fluid restrict - Vasopressin antagonists - tolvaptan

Answer 246

- It is essential to correct the sodium slowly to prevent osmotic demyelination. The sodium concentration should not change more than 10 mmol/L in 24 hours.

Answer 247

Patients should be fluid restricted, to increase serum sodium and correct the hyponatremia

Block 32 Week 8 Flashcards

(287 cards)