Thyroid
High TSH, Low T3 and T4
Hypothyroidism
Hypoglycemia occurs in which adrenal patient
Addison's crisis
When blood sugar gets to 60-80, an SNS response is activated with Sx: such as restlessness, shaking, tingling of the lips. What is released in the body causing such symptoms
Epinephrine
For which type of renal failure would you administer oxygen, fluids, inotropes, and/or vasopressors as indicated?
PRE-renal failure - results from decreased/or inadequate blood flow to the kidneys (the problem often lies BEFORE the kidney in pre)
1) Diabetes Insipidus (DI) is a result of ____ levels of ADH
2) SIADH is a result of _____ levels of ADH
1) Low - hypovolemic and hypernatremic due to increased urine output
2) High - water intoxication and cerebral edema due to decreased urine output
What comes first PTU (Propylthiouracil) or Iodine (Lugol's Solution)
PTU; Iodine 1hr after
Potassium level in an Addison's crisis patient
High Potassium Level
The brain requires what to extract oxygen (why you see symptoms such as weakness, HA, staggering gait, blurred vision)
Glucose; cannot extract with blood glucose levels less than 40
What is the term for climbing BUN and Cr levels?
Azotemia
For which imbalances might you see Chvostek's and Trousseaus' signs?
Hypocalcemia and Hypomagnesemia
You cannot give this one medication in a Thyroid Storm
ASA (Aspirin) - known for releasing thyroid hormone
Discontinuing this medication in a Cushing's patient may produce an Addison's crisis response
Prednisone (or abrupt steroid discontinuation)
List the electrolyte/fluid imbalances in DKA/Hyperglycemia
-Hypovolemic shock (low Na+, low Cl)
-Metabolic Acidosis (Low bicarb)
-Hyperkalemia
-Hyperglycemia
For which type of renal failure can you utilize diuretics?
INTRA-renal failure - will try to maximize remaining functioning of glomerulus
1) What 2 pairs of electrolytes increase and decrease together?
2) Calcium and phosphorus have a ____ type of relationship
1)
- Sodium and Chloride
- Potassium and Magnesium
2) Inverse
Intubation may be required for which patient
Myxedema coma - hypoventilation
Maldistribution of fat of face (Moon)
Cushingoid
Drops in blood sugar greater than this value can cause what?
List the causes of intra-renal failure (35-40% of AKIs)
-Renal tubule damage
-Nephrotoxic agents (Metformin/aminoglycosides, contrast dye, rhabdomyolysis, NSAIDs)
-Damage to renal vascular tissue (HTN, diabetes, lupus)
Explain the correlation between hypomagnesemia and prolonged alcoholism/alcoholics
-Alcohol is hypertonic and suppresses ADH (therefore is a diuretic)
-Majority of Mg comes from food and alcoholic are often not eating/getting adequate amounts
-Diarrhea can cause since a lot of Mg is in your intestines
Prolonged ileus may occur in which thyroid patient
Hypothyroid
What glucocorticoids and mineralocorticoids do you replace during an Addison's Crisis?
Aldosterone (retaining Na+ and water) and cortisol - Hydrocortisone and Decadron
What percent of dextrose do you give to pediatric patients and what does the normal % cause?
25% - greater than can cause severe osmotic dehydration
List the electrolyte imbalances associated with an AKI
*Ps are high
- Potassium | elevated
-Phosphorus | elevated
-Positive Ions (Hydrogen) | Elevated
-Sodium | low
-Calcium | low
List the order of arrhythmias you might see in a Hyperkalemic patient
Peaked T- waves > AV Node/1st Degree block (prolonged PR interval) > Absent P waves > Sine Wave > Asystole