Acid Base
Hyponatremia
AKI
Diuretics
Toxic
100
If delta AG > delta HCO3, think ?
What is high AG metabolic acidosis + metabolic alkalosis ?
100
Most serious consequence of rapid correction of hyponatremia
What is Central Pontine Myelinolysis or Osmotic Demyelination?
100
Muddy brown casts or corase granular casts in a UA is a clue towards which renal process?
What is ATN (acute tubular necrosis) ?
100
Where is the action of loop diuretics ? which transporter?
What is Na-K-2Cl transporter ?
100
High Osmolar gap, + ketones in urine, no acidosis
What is Isopropyl alcohol ?
200
HCo3 18, AG 10, K 2.8, Phos 2.0, Urine pH 5,Urine glucose +,
What is Fanconi`s syndrome ?
200
When considering a diagnosis of SIADH which 2 conditions need to be excluded ?
What is adrenal insufficiency and hypothyroidism ?
200
38 year old male admitted with fever, diarrhea, abdominal pain, LE edema, Hgb 8, Plts 25, Creat 3.6, BUN 45, HCO3 18, Na 142, K 5, Bili 4.0, LDH 1000. which organism is related to this condition?
What is O157:H7 E.coli ?
200
60 year old male with resistant HTN and with h/o CHF. You add spironolactone to his regimen. What side effect should you warn him about ?
What is gynecomastia ?
200
18 year old high school student presents with nausea, abdominal pain, confusion and difficulty seeing : feels like he is in a snowstorm. Na 140,K 5, HCO3 9, Cl 103, BUN 22, Creat 1.2, Serum osm 328.
What is Methanol ?
300
In patient with short bowel syndrome with altered mental status with high AG metabolic acidosis with normal ketone and normal lactate, think ?
What is D-Lactic acidosis?
300
19 year old female admitted with altered mental status. She was partying through the night prior to this episode. Labs : sodium 118, K 3.8, BUN 19, Creat 1.0, HCO3 28, Cl 110. Drug which was likely used by her ?
What is Ecstasy ?
300
Which one of these drugs is the most common culprit in acute interstitial nephritis ? Amoxicillin, Ciprofloxacin, Ibuprofen, Omeprazole
What is Omeprazole ?
300
A drug that acts on the proximal tubule, has a relatively low efficacy of blocking reabsorption of sodium but is useful in Rx of acute mountain sickness ?
What is Acetazolamide ?
300
78 year old male with HTN, CAD,DM< presents with confusion, tinnitus, vertigo, abd pain. ABG : pH 7.34, CO 32, Na 135, HCO3 19, Cl 102, BUN 19, Creat 1.1, Osm 290. What did he ingest?
What is Salicylate overdose ?
400
Na 140, K 4.0, Cl 110, PH 7.0, pCO2 35, pO2 75, HCO3 8. What is the acid base disorder ?
What is High AG + Normal AG metabolic acidosis + Resp acidosis ?
400
72 year old male with h/o ischemic cardiomyopathy admitted with acute decompensated CHF. Na on admission is 126 : started on Lasix IV BiD. Na continues to decline to 122. What can we add to correct hyponatremia ?
What is Vasopressin antagonist?
400
72 year old male s/p PCI 2 weeks back, now admitted with LE swelling, BUN 58, Creat 3.5, UA 1+ RBC, 1+ WBCs, trace protein, eosinophils, high ESR, low C4.
What is Atheroembolic disease ?
400
A diuretic that can decrease glucose tolerance, aggravate gout and produce small rise in LDL
What is HCTZ ?
400
56 year old amle with h/o ETOH, found lying on the street with impaired consciousness. Temp 97, P 92, BP 126/70, Exam : Resp distress , Pulm edema +, confused. Na 138, K 5.4, Cl 94, Bicarb 10, Osm 316, UA shows 2+ blood, no RBC, 1+ wbc, calcium oxalate crystals. ABG : Ph 7.16, pCO2 29. cause of the acidosis and treatment ?
What is Ethylene Glycol, Hemodialysis ?
500
55 year old male with ETOH abuse admitted for acute pancreatitis. His condition deteriorates and is transferred to ICU. on 3rd day he develops delirium tremens. Treatment started for etoh withdrawal. 2 days later he is doing better but with worsening acidosis. Na 138, K 5, Cl 100, HCO3 12, G 125, BUN 40, Creat 3, Osm 320. What is causing the acidosis?
What is IV Ativan ? Propylene glycol--> Lactic acid
500
27 year old female experienced hemorrhagic shock after delivery. One week later she was brought in obtunded. Na 121, BP 90/40, P 120. Diagnosis ?
What is Sheehan`s syndrome/Hypopituitarism
500
26 year old male injured in a homicide attempt when a liquid gas tank ignited in a closed room. Diagnosed with 80% burns. Admitted to ICU and required massive transfusions to maintain BP and u.o.p. Despite the enormous volume replacement (almost 18 L in first 12 hrs), he became hemodynamically unstable requiring 3 pressors, anuric, difficulty ventilating with increased peak airway pressures. cause of renal failure ?
What is Abdominal Compartment Syndrome ?
500
63 year old female admitted with altered mental status and urosepsis. h/o Schizophrenia and has been on lithium and olanzapine. Na 158, Uosm 200, normal Li levels. Diagnosis and which diuretic can be used for treatment?
What is Li induced DI and Amiloride
500
In ICU if you see cardiotoxicity, confusion, pancreatitis, rhabdomyolysis and renal failure, think of ?
What is Propofol Infusion Syndrome ?
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