House Rules This is With Host... Your No Mens Land.
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Transcript of House Rules This is With Host... Your No Mens Land.
House Rules
This
is
With
Host...
Your
No Mens Land
Bones, Groans…
INXS
Got my number?
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No Mens Land INXS
Got my number?
Bones, Groans…
100
200
300
400
500
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200
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200
300300
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Classically associated with LH/FSH ratio >2, it is the most
common cause of female infertility marked by
amenorrhea, hirsutism and insulin resistance
What is polycystic ovarian syndrome (Stein-Leventhal
syndrome)?
In addition to low-set ears, webbed neck and short stature, affected girls miss menses and
an X chromosome
What is Turner syndrome?
Non-pregnant women <40 years+ amenorrhea for 3 months
+ elevated FSH
What is premature ovarian failure?
Galactorrhea and amenorrhea in pre-menopausal women,
caused by pituitary adenomas, stress, drugs or simply, by
nipple stimulation
What is hyperprolactinemia?
An inherited cause of primary amenorrhea and anosmia, it is caused by GnRH deficiency and may present with cleft palate, cryptorchidism and
renal agenesis
What is Kallman syndrome?
Hypercalcemia,
hypercalcliuria and osteoporosis are indications
for surgical removal of a hypersecreting adenoma
What is hyperparathyroidism?
Caused by defective bone
mineralization due to Vit. D deficiency, this condition is
typically associated with pseudofractures
What is osteomalacia?
Parathyroid hyperplasia+ pheochromocytoma
+ medullary thyroid CA
What is MEN type 2A?(Sipple syndrome)
This hormone, produced by thyroid C cells, has been extracted from salmon to enhance bone mass and
provide mild analgesia in osteoporosis
What is calcitonin?
Suspect this in a patient with bone pain, osteolytic lesions,
headache, hearing loss, paralysis, high output HF, as
well as very high Alk phos and urinary hydroxyproline
What is Paget’s disease of bone?
MIBG scan for extra-adrenal lesions;
phenoxybenzamine for blocking catecholamine excess
What is pheochromocytoma?
Very high T4+ low TSH
+ normal ESR+low/normal throglobulin
+ painless gland
What is factitious hyperthyroidism?
Excess copper accumulation in the liver and brain lead to cirrhosis and personality
changes, along with decreased cerulopasmin and Kayser-
Fleisher rings
What is Wilson’s disease?
Gynecomastia and hypogonadism in the
presence of excess LH and FSH and X chromosomes
What is Klinefelter syndrome?
DM Q5
State of hormonal excess in the affected twin
NEJM 2004
What is acromegaly?
Standard deviations below a normal T score, indicating
osteoporosis
What is 2.5?
Multiple Endocrine Neoplasia (MEN) type
characterized by the 3Ps: pituitary, parathyroid and
pancreatic islet cell tumors
What is 1?
Chromosome # where the mutated HFE gene is located
in patients with hereditary hemochromatosis
What is 6?
Minimum % increase in urine osmolality in
response to desmopressin to diagnose central DI
What is 50?
In order to diagnose Vit. D deficiency, check this serum
level—the principal circulating form of this vitamin
What is 25-OH vitamin D?
Acid Base
Cast your Stone
KidneySyndromes
Trials
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Acid Base Trials
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Cast Your stone
KidneySyndromes
Overdose of these common substances can cause respiratory alkalosis and high anion gap metabolic acidosis
What are salicylates?
This condition can cause high anion gap metabolic acidosis
and elevated plasma creatine phosphokinase
What is rhabdomyolysis?
Renal tubular acidosis with hyporeninemic hypoaldosteronism
What is type IV RTA?
Hyperchloremic metabolic acidosisassociated with
urine pH > 5.5 despite plasma[HCO3] < 15 mmol/l
What is Type 1 or distal RTA?
Formerly used sedative and anticonvulsive drug whose overdose causes
high anion gap metabolic acidosis
What is paraldehyde?
Most common type of urinary stones
What are calcium oxalate stones?
An inborn error in the transport of dicarboxylic acids cystine, ornithine, lysine, and arginine (aka
“COLA”) causes the formation of these stones
What are cystine stones?
Urea splitting organisms
create alkaline urine that promotes the formation of
these stones
What are struvite stones?(triple phosphate)
Stones associated with Lesch-Nyhan syndrome
What are sodium urate stones?(uric acid stones)
Commonly associated with hyperparathyroidism
What are calcium phosphate stones?
This inherited kidney condition can cause brain
hemorrhage
What is polycystic kidney disease?
Proximal tubular defect marked by hypophosphatemia,
hypokalemia and hyperchloremic metabolic acidosis
What is Fanconi syndrome?
Low to normal BP,low serum potassium,
normal serum magnesiumhigh urine chloride, potassium
and calcium
What is Bartter syndrome?
Inherited disorder with hypertension,
hypokalemia, alkalosis and low aldosterone secretion
What is Liddle's syndrome?
Low to normal BP,hypokalemia, hypomagnesemia,high urine chloride, potassium
but low calcium
What is Gitelman syndrome?
Let me ask;Which trial showed that
Ramipril was superior in slowing progressive renal dysfunction among hypertensive African-
American patients?
What is the AASSK trial ?(African American Study
of Kidney Disease and Hypertension)
Landmark randomized trial of glycemic therapies for slowing
the progress of DM nephropathy,bearing the name of the host
country for the 2012 Olympics
What is the UKPDS?(United Kingdom
Prospective Diabetes Study)
Largest trial to date investigating the effect of protein
restriction on the progression of CKD.
The answer is in your creatinine clearance formula
What is the MDRD trial?(The Modification of Diet
in Renal Disease trial)
Better cooperate!It’s the only published study
examining the benefit of ACE/ARB combination in
non-diabetic patients with CKD
What is the COOPERATE trial (Combination Treatment of
ARB and ACE-I in Non-diabetic Renal Disease)?
Recent Canadian trial that showed intensive glucose control reduced
cardiovascular outcomes indiabetics, mainly due to decreasedincidence in nephropathy. If you
don’t know, you will still move onto the final question!
What is the ADVANCE (Action in Diabetes and Vascular Disease: Preterax and Diamicron
Modified Release Controlled Evaluation) trial?
New Kid on The Block
Direct Renin inhibitor FDA approved for
HTN but also under study for the treatment of diabetic nephropathy
What is Aliskiren? (Tekturna)
Thank you for playing