Data Trace Editor – 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: – 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
– See: antihypertensive agents – Outside Links: Flight Surgeon Manual GMO Manual Hospital Corpsman 1&C Sickcall Screener’s Handbook Sickcall Screener’s Handbook LTG Iowa Family Practice Handbook – Hypertension Iowa Family Practice Handbook – Hypertensive Crisis Merck Manual – Young Hypertensive Patient: – consider ACE, combined … Read more
– Discussion: – hyperpronation refers to the inward rotation of the foot during gait; – the term is vague and probably should be replaced by precise descriptions of the relative positions of the hindfoot and forefoot during gait; – w/ hyper-pronation, there is an inability of the foot to supination … Read more
– Discussion: – hyperpronation, by virtue of its mechanics, inevitably results in hallux being forced into valgus even in absence of RA dz in first metatarsal joint; – in this situation fusion of first MP joint is preferred option; – this does not apply when there is severe forefoot … Read more
– Diff Dx: – Renal Failure – Secondary Hyperparathyroidism – Hypoparathyroidism (surgical, psuedo) – Immobilization – Addison’s dz – Bone dz (Healing frx) – Factitious increase (hemolysis of specimen) – Vit D toxicity – Tumoral Calcinosis – … Read more
(see also: Renal Osteodystrophy; Remodeling of Bone) Discussion caused by excessive production of parathyroid hormone which leads to hypercalcemia, recurrent nephrolithiasis, pancreatitis, peptic ulcers, and mental changes; incidence of approx 5 /10,000 pts per year; usually affects adults over 50 yrs & occurs more commonly in females; causes: in most cases is due to single … Read more
– Treatment of Hyperosmolar Non Ketotic Coma: – Infusion of Normal Saline to restore volume – Reg Insulin 10-25 units IV – Insulin drip 5-10 units/hr until Serum Glucose < 500 mg/dl; – Insulin given IV has plasma t 1/2 of 5 min and a biologic effect for about 20 min; – thus, even brief … Read more
Increased: Renal Failure: Hypothyroidism Mg containing Antacids Addison’s dz Diabetic coma Severe Dehydration Lithium intoxication Signs and Symptoms: – Generalized Neuromuscular Depression – Decreased Deep Tendon Reflexes (Early) > 7.0 – Weakness – PR lengthening if > 8.0 – Flaccid quadriplegia (w/ severe HyperMg) – Hypotension – MS Changes & Coma
– See Treatment of – Diff Dx: – Diabetes Mellitus / Inadequate Insulin dosing – Infection – GI upset – TPN administration – MI / Stroke – Cushing’s, Acromegaly – Increased Epinephrine (Injection, Pheochromocytoma), Stress, Burns, Surgery) – Acute Pancreatitis; – Meds: Corticosteroids Thiazides – Spurious result caused by drawing blood from a site above … Read more