Data Trace Editor – Discussion: – determine volume status of the patient; – SIADH (Normovolemic) – Volume Excess Hyponatremia – Volume Depleted Hyponatremia; – may be seen endurance athletes, military, and marathoners after prolonged exertion; – due to excess free water intake that fails to replete massive sodium losses that … Read more
– Differential Diagnosis: – Malabsorption, Steatorrhea, Diarrhea, Laxitive, ETOH/withdrawl, Alcoholism and Cirrhosis, Hyperthyroidism, Aldosteronism, Diuretics, – RTA, Acute Pancreatitis Hyperparathyroidism, Hyperalimentation, NG suctioning, Chronic Dialysis, RTA, Hungry Bone syndrome, – Hypophosphatemia, Intracellular shifts w/ respiratory acidosis or metabolic acidosis; – Meds (Cis Platinum, Amphotericin B, Aminoglycosides Cisplatin, Ifosphamide, Insulin, … Read more
– See: Glucose Decreased: Pancreatic d/o (Pancreatitis, Islet cell tumor), Extrapancreatic tumor (Adrenal ca, Gastric Ca, mesothelioma) Hepatic dz (Hepatitis, Cirrhosis, Tumor), Endocrine dz (Early DM, Hypothyroidism, Hypopituitarism), functional d/o (after gastrectomy) Ketotic Hypoglycemia, Exogenous Insulin, Oral hypoglycemic agents, Malnutrition Sepis; Meds: ETOH, Pentamidine, Disopyramide MAOI, Adrenal Insufficiency
Decreased: Vomiting Diabetes mellitus w/ ketoacidosis, Mineralocorticoid Excess Renal dz w/ Na loss; – also is commonly associated with loss of body potassium: – as potassium is lost from diuretics, hyperaldosteronism, DKA, TPN, diarrhea, or vomiting, the potassium deletion is accompanied by a concomitant loss of chloride and is manifested by hypokalemia, and metabolic alkalosis
– Diff Dx: – factitious levels 2nd to low protein and albumin (malabsorption, intestinal bypass surgery); – causes related to calcium deficiency: – osteomalacia (most common) – vitamin D defficiency; – rickets … Read more
– See: respiratory alkalosis: – Discussion: – induction of hypocapnia is probably the most frequently used technique to reduce intracranial pressure; – lowering partial pressure of CO2 to 26-28 mm Hg (3.5-3.7 kPa) reduces cerebral blood flow & thus lowers intracranial pressure; – even w/o ability to measure intracranial pressure, inducing … Read more
– Discussion: – hypertrophic non unions are rich in callus and have a rich blood supply in the ends of the fragments; – they result from insecure fixation (inadequate stability) or premature wt bearing in a reduced fracture whose fragments are viable; – fracture is capable of mounting a healing response … Read more
– Male 4.5-8.2 mg/dL; Female 3.0-6.5 mg/dL; Child 2-5.5 mg/dL; Increased: Gout Renal Failure, Increased DNA degredation (Leukemia, Anemia, Chemotherapy, Toxemia of Pregnancy), Meds (Diuretics), Lactic Acidosis PolyCystic Kidneys Sarcoidosis (50% will have hyperuricemia); Multiple Myeloma Decreased: Uricosuric Meds (Salicylates, Probenecid, Allopurinol), Wilson’s dz, Fanconi’s syndrome
– Discussion: – finding include hypertrophy of bone ends & sclerosis at 6 months post injury; – these non unions theoretically have sufficient vascularity to heal but stability is lacking or normal axial alignment has not been restored; – it is important to point out, however, that even with … Read more
– See: – Thyroid Panel – Ortho Changes – Thyroid Storm – Hyperthyroidism, Chronic Rx: – Long term Rx: – PTU: initially: 150mg PO q8hr; (max 1200mg/day) – Methimazole (Tapazole) in PO form; … Read more