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Bones, Groans…

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No Mens Land INXS

Got my number?

Bones, Groans…

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300

400

500

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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

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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)

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