causes of hypokalemia・decreased intake
・intracellular translocation
insulin, β-adrenargic activity(dobutamine, ☆stress-induced(eg. alcohol withdrawal, acute MI)), alkalosis
・GI loss
diarrhea, vomiting, hyperaldosteroeism
・urinary loss
hyperaldosteroeism, diuretics, RTA (type Ⅰ, Ⅱ)
・sweat loss renalendocrinologyUWorld HirotoShishido
diagnosis/ causes of rhabdomyolysis☆Positive blood on urine dipstick (a reaction that detects the heme pigment in both hemoglobin and myoglobin) in the absence of red blood cells on microscopic urinalysis suggests myoglobinuria.
contrast agent nephropathyDirect cytotoxicity of intravenous contrast on tubular cells
→ diffuse necrosis of the ☆proximal tubular cells visible on histologic specimens and muddy brown casts on urinalysis
Renal vasoconstriction
→ Renal vasoconstriction causing medullary ischemia and a prerenal injury pattern (ie, fractional excretion of sodium <1%), even in the absence of clinical volume depletion renalUWorld HirotoShishido
closed angle glaucoma vs migrane with auraclosed angle glaucoma
→ typically older (> 60yo),
severe pain and conjunctival erythema are common, and vision would not be expected to improve without intervention
H pylori induced GDUantrum
→cause both ↓D cells(somatostatin) and ↓G cells
→overall gastrin production from stomach increases
→☆↑duodenal ulcer
body (corpus)
→ reduction in the number of parietal cells
→ acid prduction decreases (or normal)
→ associated with metaplasia and malignancies(eg gastric lymphoma, adenocarcinoma) gastrointestinalUWorld HirotoShishido
cellulitis, impetigo, erysipelas, necrotizing fasciitisimpetigo
epidermis, S aureus, S pyogenes
(☆bullous impetigo→ S aureus)
erysipelas
dermis, S pyogenes
cellulitis
deeper dermis+ subcutaneous tissue, S aureus→ prulent, S pyogenes→ nonpurulent
primary membranous nephropathyantibodies to ☆phospholipase A2 receptor
(highly specific for MN)
titers correlate with disease activity, and serial mesurments can be used to determine the efficacy of immunosuppressive therapy renalUWorld HirotoShishido
radiation-induced lung injuryacute(1-3months)
impaired gas exchange due to exudative alveolitis → ☆hyaline membrane formation, pneumocyte sloughing(slúː)
chronic(6-12months)
radiation fibrosis(dense fibrous bands) results in decreased lung volume and dilated bronchi and bronchioles(ie traction bronchiectasis)
(predisposition to chronic infections) respiratoryradiologyUWorld HirotoShishido
GI manifestations of diabetic autonomic neuropathygastroparesis, GERD, ☆diabetic diarrhea
Loss of autonomic input to the GI tract results in abnormal peristalsis, leading to ☆disordered small-bowel and colonic motility, which can result in rapid intestinal transport.
→painless, secretory-like diarrhea that persists with fasting(eg ☆nocturnal diarrhea)
Fecal incontinence is particularly common in patients with long-standing diabetes, resulting from both a large volume of watery diarrhea and decreased anorectal sensation. endocrinologygastrointestinalUWorld HirotoShishido
relative high lympholyte count in BAL (bronchoalveolar lavage)(normally, 85% alveolar macrophage, 10% lymphocytes, small percentages of neutrophils and eosinophils)
