Data Trace Editor – See: Rickets: – Discussion: – this is the most frequently encountered form of rickets and consists of a genetic or acquired fault in the handling of phosphate in the proximal tubule; – patholophysiology: – decreased reabsorpion of phosphate by the renal tubule (causing hypophosphatemia) (otherwise the … 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
– 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
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
– 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
– 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: – Antihypertensive Meds – GMO Manual – Iowa Family Practice Handbook – 1 – Iowa Family Practice Handbook – 2 – Merck Manual – Management: * Goal: Reduction of the DBP to 100-110; note: excessive reduction is avoided to minimize the risk stroke, MI; * In the absence of encephalopathy or acute vascular … Read more
– Discussion: – hyperthyroidism produces high turnover type osteopenia from increased activity of the remodeling system; – high turnover osteopenia occurs in both hyperthyoidism & hyper-parathyroidism, although abnormalities of calcium homeostasis seen in hyperparathyroidism do not occur in hyperthyroidism; – Thyroid Panel – Medical Management: – Propylthiouracil
– 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
– 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