jep 1

Hem/onc

100

After a vessel becomes injured, what does it do next?

Constricts

200

DIC can be characterized as what?

Consumptive coagulation

300

What is the priority action for someone in HIT?

Stop heparin

400

What are the 3 characteristics of tumor lysis syndrome?

Hyperuricemia, hyperkalemia, Hyperphophatemia/hypocalcemia

500

What alternative medication should you use for someone in HIT?

Argatroban 

SIADH

100

What is a typical sodium for one of these patients?

less than 135

200

What is the priorty treatment for SIADH

fluid restriction

300

what labs would you expect

Low serum osmo, high urine osmo, high urine specific 

400

Which clinical manifestations are indicative of thyroid storm?

•  Hypotension, elevated TSH and T4, and subnormal T3
•  Tachycardia, hyperthermia, subnormal TSH, and elevated T3 and T4 Incorrect
•  Hyperthermia, diarrhea, elevated TSH, and normal T3 and T4 Correct
•  Bradycardia, hypothermia, normal TSH, and elevated T3 and T4

C

500

Which patient with a fasting blood sugar of 110 mg/dL has the highest risk for development of metabolic syndrome?

•  African American woman with a 40-inch waist, blood pressure of 140/90 mm Hg, triglycerides of 180, and high-density lipoprotein (HDL) of 25Correct
•  Asian American man with a 30-inch waist, blood pressure of 130/60 mm Hg, triglycerides of 140, HDL of 45
•  Native American man with a 28-inch waist, blood pressure of 120/50 mm Hg, triglycerides of 130, HDL of 50
•  Hispanic American woman with a 34-inch waist, blood pressure of 130/50 mm Hg, triglycerides of 145, HDL of 40

A

DI

100

What are the different classifications for DI?

dipsogenic, nephrogenic, central

200

What labs would you expect for a patient?

Serum osmo low, urine osmo high urine specific low

300

What is priority treatment?

desmopressin

400

The presence of hyperglycemia in critical illness is associated with an increased mortality rate. Which statement best describes the mechanism(s) responsible for increased glucose levels?

•  The liver releases glucagon in response to the body’s increased energy needs, resulting in gluconeogenesis. Correct
•  The pancreas decreases insulin production, resulting in increased glucose available to the tissues.
•  The tissues are unable to use circulating glucose secondary to increased serum potassium levels. Incorrect
•  Increased secretion of antidiuretic hormone (ADH) results in diuresis, causing increased glucose levels in the serum.

A

500

Which laboratory finding would suggest a differential diagnosis of hyperosmolar hyperglycemic state (HHS)?

•  Serum glucose of 500 mg/dL Incorrect
•  Serum potassium of 3.4 mEq/L
•  Absence of serum ketones Correct
•  Serum osmolality of 350 mOsm/L

C

DKA

100

What abg are patients in DKA most commonly in?

Metabolic acidosis

200

What are the characteristics/criteria of people in dka 

pH, bicarb, ketones, glucose

300

What are the 3 treatments in order for the patient in DKA

Fluids, Insulin, Electrolytes 

400

Why does a patient in DKA require fluids so desperately? need exact term 

Osmotic diuresis 

500

7.05, hco3 15 co2 44 - what level of dka is this?

moderate

HHS

100

What patient population most likely to get HHS?

DM 2

200

Which electrolyte is of most concern?

potassium

300

What is the order of treatment for a patient in HHS

fluids, insulin, electrolytes 

400

What are 3 classifications of HHS

bicarb, ph, ketones

500

a patient in HHS would have a serum osmolality of what?

greater than 320