Love Your Liver
The ratio of spironolactone to furosemide used for the management of ascites
5:2
Name the acute indications for hemodialysis
Acidosis, Electrolytes (potassium), Ingestion, Fluid Overload (pulmonary edema), Uremia (pericarditis)
A physical exam sign that you can smell in a patient with liver disease
Fetor hepaticus
HbA1c target for most adults living with diabetes
<= 7.0%
Medications given for a suspected variceal hemorrhage
Pantoprazole, octreotide, ceftriaxone
Name 3 types of hemodialysis access
Most sensitive - shifting dullness
Most specific - fluid wave
CD4 count at which you should start PJP prophylaxis in HIV
CD4 count < 200
Name 3 peripheral stigmata of liver disease which can be found on the hands
Terry's nails/leukonychia, clubbing, Dupuytren's contracture, palmar erythema, asterixis
Describe how you would calculate a potassium bath
Patient's serum potassium + potassium bath = 7
Name three skin/nail findings of infective endocarditis
Osler nodes, Janeway lesions, splinter hemorrhages, petechiae, clubbing
Name the Atlanta criteria for the diagnosis of acute pancreatitis
1. Typical abdominal pain
2. Lipase/amylase 3x the ULN
3. Typical imaging findings
Name 3 indications for a TIPS procedure
Hepatorenal syndrome, hepatopulmonary syndrome, refractory ascites, refractory hepatic hydrothorax, Budd Chiari, secondary prevention of variceal hemorrhage
Your patient is experiencing intradialytic hypotension. What are three things you could optimize?
Remove offending medications, add medications (midodrine), IV fluid bolus, Trendeleburg position, decrease temperature of dialysate, decrease flow speeds (minimal setting).
Most sensitive physical exam sign for meningitis
Jolt accentuation
Name 5 cancers that metastasize to bone
Breast, kidney, lung, multiple myeloma, lymphoma, prostate, thyroid
Name the 1000s club members (7)
Acute viral hepatitis, shock liver, toxin induced (acetaminophen), autoimmune, Budd Chiari, Wilson's Disease, acute bile duct obstruction (stones)
Your patient with CKD stage 5 had his first hemodialysis treatment today. Near the end of his treatment, he becomes acutely confused. What is the most likely diagnosis?
Dialysis disequilibrium syndrome
A drop in SBP by 10 mmHg with inspiration
Name 7 causes of a cavitary lung lesion
Bacterial (gram positive and negative), tuberculous mycobacterium, non-tuberculous mycobacterium, fungal, septic emboli, parasitic infection, primary lung cancer, lymphoma, solid organ metastases, GPA, rheumatoid nodule, SLE, sarcoid, congenital, pulmonary infarct