-
D. In a patient with a consciousness
change, electrolyte imbalance (hypercalcemia, hyponatremia,
hypernatremia), glucose (hypoglycemia, hyperglycemia), metabolic
factors (hepatic encephalopathy, uremic encephalopathy), brain
(seizure or cerebral vascular attack) and heart (arrhythmia)
should be considered.
-
C. Both the use of losartan (an
angiotensin II antagonist) and renal insufficiency can cause
hyperkalemia. Diarrhea usually leads to hypokalemia.
-
D. The managements of hyperkalemia
include calcium gluconate (for heart protection), bicarbonate,
insulin and glucose water (intracellular shifting), resin (to
remove gastrointestinal K+), and hemodialysis. Remove predisposing
factor is also important.
-
D. Conditions that are associated with
hypoglycemia include drugs (insulin, sulfoureas, sulfonamides,
alcohol), critical illness (liver failure, renal failure, sepsis),
endocrine deficiencies (adrenal insufficiency, hypothyroidism),
and poor intake. (Harrison's principles of internal medicine 15th
edition, table 334-1)
-
B. Multiple myeloma and thyrotoxicosis
can induce hypercalcemia. (Harrison's principles of internal
medicine 15th edition, table 341-1)
-
A. Hypercalcemia can be classified
into two types by the level of intact PTH: high iPTH (due to
parathyroid gland) and low iPTH (others). (Harrison's principles
of internal medicine 15th edition, chapter 341)
-
A. About 80% of primary
hyperparathyroidism is due to parathyroid adenoma. (Harrison's
principles of internal medicine 15th edition, chapter 341)
-
B. The level of intact PTH is low in
Vit D intoxication. The other conditions are associated with high
levels of intact PTH. (Harrison's principles of internal medicine
15th edition, chapter 341)
-
C. Thiazide can induce hypercalcemia.
(Harrison's principles of internal medicine 15th edition, table
341-1)
-
D. Surgical intervention should be
considered in the following conditions: elevation of serum calcium
(> 1 to 1.6 above upper limit of normal); history of
life-threatening hypercalcemia, reduction of age-matched
creatinine clearance by 30% without a known cause, kidney stones,
24-h urinary calcium excretion > 400mg, reduction of bone mass
more than 2 standard deviation below before using one of several
noninvasive methods. (Harrison's principles of internal medicine
15th edition, chapter 341)
Top of Page
| |