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Questions and Answers

What is a common dietary restriction for someone with hyperuricemia?

Fruits and vegetables

Legumes

Organ meats (correct)

Whole grains

What symptom is commonly associated with hyperuricemia?

Diarrhea

Hair loss

Frequent urination

Joint redness and swelling (correct)

Which of the following best describes Cushing Syndrome?

Excess production of corticosteroids from adrenal glands (correct)

A deficiency of glucocorticoids due to adrenal dysfunction

An autoimmune disease affecting the pituitary gland

Tendency towards hyperkalemia and hypoglycemia

Which gender is more susceptible to urinary tract infections (UTIs)?

Young adult females Signup and view all the answers

What is the primary cause of Cushing Disease?

Pituitary tumor causing high ACTH levels Signup and view all the answers

What is a potential effect of adrenal insufficiency (Addison's Disease)?

Severe hypotension and weight loss Signup and view all the answers

Which symptoms are associated with Cushing's Syndrome?

Moon face and buffalo hump Signup and view all the answers

What is a likely consequence of untreated hyperuricemia?

Nephropathy and nephrolithiasis Signup and view all the answers

What is the gold standard for diagnosing diabetes mellitus?

Fasting plasma glucose levels greater than 126 on two separate occasions Signup and view all the answers

Which condition is more commonly associated with Diabetic Ketoacidosis (DKA)?

Type 1 diabetes Signup and view all the answers

What level of HgbA1c is indicative of diabetes mellitus?

6.5% or greater Signup and view all the answers

What is the first-line treatment for a patient who is unconscious due to severe hypoglycemia?

Dextrose IV or glucagon Signup and view all the answers

What is the primary distinguishing symptom between diabetes mellitus (DM) and diabetes insipidus (DI)?

Hyperglycemia Signup and view all the answers

How does the Rule of 15's guide the treatment of hypoglycemia?

Give 15 grams of carbohydrates, then recheck in 15 minutes Signup and view all the answers

Which condition is more commonly associated with Hyperglycemic Hyperosmolar Syndrome (HHS)?

Type 2 diabetes Signup and view all the answers

To diagnose prediabetes using the Oral Glucose Tolerance Test (OGTT), what postprandial BG level indicates a diagnosis?

Between 140 mg/dL and 200 mg/dL Signup and view all the answers

What defines metabolic syndrome in terms of elevated fasting glucose levels?

Equal to or greater than 100 mg/dL Signup and view all the answers

Which of the following is a characteristic feature of appendicitis?

Pain in the lower right quadrant Signup and view all the answers

What role do goblet cells play in the body?

They produce mucous Signup and view all the answers

Which statement accurately contrasts ulcerative colitis and Crohn's disease?

Crohn's disease lesions extend deeper than ulcerative colitis Signup and view all the answers

What symptom can be caused by liver dysfunction due to portal hypertension?

Caput medusa Signup and view all the answers

What is the function of intrinsic factor in the digestive system?

To help absorb vitamin B12 Signup and view all the answers

Which condition is characterized by reduced HDL cholesterol levels?

Metabolic syndrome Signup and view all the answers

What is a potential consequence of hepatic encephalopathy?

Severe confusion and seizures Signup and view all the answers

Which sign is indicative of acute pancreatitis?

Cullen sign Signup and view all the answers

What is a common symptom of kidney stones?

Pain radiating down to the groin Signup and view all the answers

In acute pancreatitis, which symptom is typically experienced when the patient lies supine?

Increased abdominal pain Signup and view all the answers

What diagnostic criterion is used to assess the severity of acute pancreatitis?

Ranson Criteria Signup and view all the answers

Which of the following symptoms does NOT typically indicate acute pancreatitis?

Severe constipation Signup and view all the answers

What is a possible treatment approach for kidney stones?

Pain relief and fluid therapy Signup and view all the answers

Which demographic is typically not affected by kidney stones?

Children under five Signup and view all the answers

What symptom is a classic feature of acute pancreatitis?

Severe back pain Signup and view all the answers

Which of the following is NOT one of the four primary symptoms of Parkinson's disease as characterized by the acronym TRAP?

Anxiety Signup and view all the answers

What is the purpose of the Tensilon test?

To assess muscle weakness in myasthenia gravis Signup and view all the answers

During a seizure, what is one of the primary interventions that should NOT be performed?

Hold the person down to prevent movement Signup and view all the answers

What indicates a positive Babinski reflex test in adults?

Big toe bends back and other toes fan out Signup and view all the answers

What is an expected symptom of osteoporosis?

Fractures from minimal trauma Signup and view all the answers

How does osteoarthritis differ from rheumatoid arthritis?

Osteoarthritis typically affects weight-bearing joints; rheumatoid arthritis affects multiple joints Signup and view all the answers

What is the main purpose of encouraging independence in activities of daily living (ADLs) for a patient with bradykinesia?

To improve self-esteem and confidence Signup and view all the answers

What is the reversal agent given after the Tensilon test if stabilization is required?

Atropine Signup and view all the answers

Which type of arthritis is characterized by the immune system attacking the joints?

Rheumatoid arthritis Signup and view all the answers

What is primarily building up in the body of a patient with gout?

Uric acid Signup and view all the answers

Which anticoagulant is monitored using the activated partial thromboplastin time (aPTT)?

Heparin Signup and view all the answers

What dietary change should a patient with gout consider to manage their condition?

Avoid organ meats Signup and view all the answers

Which pathway is evaluated by the Prothrombin time (PT) test?

Extrinsic pathway Signup and view all the answers

What is the most significant goal when treating a patient on Heparin?

Achieve controlled aPTT Signup and view all the answers

What should the INR level ideally be for a patient on Warfarin therapy?

2 to 3 Signup and view all the answers

In severe chest pain management, what condition differentiates angina from a myocardial infarction?

Duration of pain Signup and view all the answers

Study Notes

10-20 GFR Starting Dialysis

Causes of high BUN (blood urea nitrogen) include decreased GFR, dehydration, extremely muscular persons, and high protein diets.
A blood urea nitrogen (BUN) test measures urea nitrogen levels in the blood, which indicates how well the kidneys are working.

Comparing Acute Kidney Injury (AKI) and Chronic Renal Failure

AKI occurs quickly and is often treatable, while chronic renal failure develops slowly, usually requiring long-term dialysis.

Acute Kidney Injury (AKI) (Acute Renal Failure)

Prerenal: Renal ischemia (inadequate blood flow), hemorrhage, or shock.
Intrarenal: Nephrotoxic drugs (NSAIDs, aminoglycosides, radiopaque dyes), infections, excess hemoglobin or myoglobin, and purine breakdown.
Postrenal: Kidney stones, prostatic hyperplasia.

Acute Kidney Injury (AKI) Phases

Initial insult: Prerenal, intrarenal, or postrenal condition disrupts kidney function.
Oliguria: Low GFR, lack of urine output, fluid overload.
Diuresis: Large unconcentrated urine outflow; kidney not concentrating urine properly.
Recovery: Healthy nephrons take over function of damaged nephrons; kidney function resumes.

Chronic Renal Failure (CRF)

Progressive gradual loss of kidney function.
Stage 1: Kidney damage with normal or increased GFR (greater than 90 mL/min).

Gout Pathophysiology

Uric acid (byproduct of protein metabolism) accumulates, forming crystals in subcutaneous tissue and synovial fluid.
Hyperuricemia triggers inflammation.
May be primary metabolic disorder or secondary to alcoholism, certain drugs, or chemotherapy.
Symptoms include redness, warmth, swelling of joints, possible fever.
Avoid organ meats, red wine, aged cheese/steaks, shellfish, etc. (high in purines.)

UTIs

Young women are more susceptible to UTIs than their male counterparts.

Adrenal Glands

Cushing's disease: Hypercortisolism, often due to a pituitary tumor secreting excessive ACTH.
Addison's disease: Hypoadrenalism, insufficient secretion of cortisol and aldosterone, typically due to adrenal gland destruction or insufficient ACTH.

Diabetes Insipidus

Posterior pituitary insufficient ADH (antidiuretic hormone), causing excessive urination and dehydration.
Can be central (lack of ADH) or nephrogenic (kidney not responding to ADH).

Hyper/HypoPituitarism

Hyperpituitarism: Excessive hormone secretion (e.g., growth hormone, ACTH).
Hypopituitarism: Insufficient hormone secretion (e.g., growth hormone, ACTH).

Thyroid Disorders

Hyperthyroidism: Excessive thyroid hormone production (e.g., Graves' disease).
Hypothyroidism: Insufficient thyroid hormone production (e.g., Hashimoto's thyroiditis).

Diabetes Mellitus (DM) vs. Diabetes Insipidus (DI)

DM: Elevated blood glucose levels.
DI: Excessive urination.
Crucial to differentiate DM from DI to ensure accurate diagnosis and treatment.
Measure BG (blood glucose)* to differentiate DM from DI. DI does not have high BG.

Clinical Manifestations of Diabetes

Three Ps: Polyuria, polydipsia, and polyphagia
Hypoglycemia: Low blood glucose.
Hyperglycemia: High blood glucose.

DKA and HHS

DKA (Diabetic Ketoacidosis): Commonly in type 1 diabetes, high blood glucose, insulin deficiency, and the breakdown of fats cause ketone production.
HHS (Hyperglycemic Hyperosmolar State): Mainly in type 2 diabetes, severe dehydration and very high blood glucose; without ketone production.

Arterial Blood Gases (ABG)

Assess respiratory and metabolic acidosis and alkalosis.

Seizures

Status epilepticus: Series of 3 or more tonic-clonic seizures.
Tensilon test: For myasthenia gravis.
Interventions: Airway management, oxygen.

Osteoporosis

Bone density loss, resulting in increased fragility.
Symptoms include pain, fractures, and altered posture.

Appendicitis

Inflammation of the appendix, typically in the lower right quadrant of the abdomen.
Symptoms include pain, nausea, and vomiting.

Crohn's Disease and Ulcerative Colitis

Chronic inflammatory bowel diseases.
Crohn's: Inflammatory lesions throughout the bowel.
Ulcerative colitis: Lesions limited to the colon and rectum and are superficial to the bowel wall.

Liver Dysfunction

Causes (e.g., liver disease, toxins).
Symptoms (e.g., abnormal laboratory results like high ammonia, coagulation abnormalities), and encephalopathy, bleeding issues (coagulopathy), ascites, neurological changes, etc.

Neuro

Lobes of the Brain: Frontal (cognition, movement), Parietal (sensation), Temporal (memory, language), Occipital (vision)
Multiple Sclerosis: Progressive autoimmune disorder, causing demyelination of nerve fibers in the brain and spinal cord.

Myasthenia Gravis

Autoimmune disorder targeting acetylcholine receptors at the neuromuscular junction, leading to muscle weakness.
Symptoms often include fluctuating muscle weakness and fatigue, particularly in the face and neck.

Guillain-Barré Syndrome

Autoimmune disorder often following an infection.
Characterized by ascending paralysis and weakness of the limbs.

Parkinson's Disease

Progressive neurodegenerative disorder affecting dopamine-producing neurons in the brain.
Symptoms often include tremors, rigidity, bradykinesia, and postural instability.

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