Thyroid storm:
Treatment for thyroid storm:
Target all individual organs effected:
- beta blockers to slow heart
- thionamides to block hormone synthesis from thyroid gland
- Steroids to block conversion of T4 -> T3
REMOVE THE THYROID GLAND!
After removal of thyroid gland in treatment of thyroid storm, how do you give the body necessary thyroid hormone?
A once a day pill containing T4 or T3
A woman came in with milky urine, what was found growing in it?
What was used to treat this?
What metabolite was found in the urine?
E. Coli
Sulfa drug
Lipids (which is highly abnormal)
Lipids in the urine indicated what?
Presence of lymphatic fluid in the urine
Chyluria:
- Define:
Milky urine laced with lipid rich lymphatic fluid. Represents a fistula between lymphatic vessels and the kidney
Fistula:
Abnormal connection between to hollow spaces
Name three other possible causes of chyluria:
Kidney cancer
Tuberculosis
Toxic insult
What is the name of the parasite which most often causes chyluria?
wuchereria bancrofti
How does wuchereria bancrofti cause chyluria?
What other condition can it cause related to the lymphatic system?
It blocks lymphatic vessels
Elephantiasis
Angina:
Severe pain in chest caused by inadequate oxygen to heart.
Often expressed by levine’s sign.
levine’s sign:
clenched fist held over the chest to describe ischemic chest pain.
Coronary Artery Disease (CAD):
- Risk factors:
Abnormal hardening of the arteries leading to heart, ischemia results.
- Risk factors:
Diabetes, inherited metabolic disorders, kidney failure or hypertension.
What can mimic the pain of a heart attack?
Esophageal spasm or acid reflux
Coronary angiogram:
Capillary tube inserted near heart, dye released, x-ray to confirm blood flow.
Sudden severe spasm of the coronary artery, causes obstruction of blood flow.
- Cause:
Related to capillary cell or nerve dysfunction
Often unprovoked
Smoking
Hyperventilation
Prinzmetal’s angina:
Prinzmetal’s angina:
- Treatment:
ABC for cardiac arrest:
Airway
Breathing
Compressions
Telephone booth syncope:
Preclampsia:
- Symptoms: Hypertension Protein in urine - Cause: Elevated levels of fetal cells in mother's circulation. Exposure to fetal cells and DNA. - Bright side/down side: Decreased chance of breast cancer Increased chance of cardiovascular disease later in life
What can chest pain often masquerade as?
Abdominal pain.
Takotsubo cardiomyopathy:
Hypertension redefined from:
> 140 systolic -> >130 systolic
>90 diastolic -> >80 diastolic
Prehypertension redefined from:
120 - 139 to 120 - 129 systolic
<80 diastolic