High-Yield Rapid-Review Notes: Electrolyte
Imbalances, Pulmonary Emboli, Splenectomy
Precautions & More| Well Revised
Description:
These bite-sized notes cover critical concepts and
associations frequently tested in exams like NCLEX and
USMLE Step 2 CK. Topics include metabolic and respiratory
derangements in DKA and pulmonary embolism, recognition
of acanthosis nigricans, congenital pyloric stenosis,
serotonin syndrome treatment, key genetic translocations in
hematologic cancers, and common side effects of
cardiovascular and endocrinologic medications. Ideal for a
quick yet comprehensive refresh before test day.
DKA metabolic derangements hyperkalemia hyponatremia
ketonemia”
“pulmonary embolism V/Q mismatch respiratory alkalosis
NCLEX prep”
“t(15;17) APL translocations WIth Nimodipine vasospasm
SAH review”
Heterophile ab NEGATIVE Mono-like syndromes
-Solution
*CMV
HHV-6
HIV
Toxoplasmosis
Wernicke's Aphasia
-Solution
-word salad: well-articulated, nonsensical speech paired with lack
of lang comprehension
-aud association cortex: post part of sup temporal gyrus
- supplied by MCA
Congenital Deficiency of Propionyl CoA Carboxylase
-Solution
-prevents conversion of propionyl CoA to methylmalonyl CoA
1
,-propionyl CoA derived from= val, ile, met, thr, odd # FA,
cholesterol side chains
-Propionic Acidemia: poor feeding, vomiting, hypotonia, lethargy,
dehydration, anion gap acidosis
Down Synd Comorbidities
-Solution
Neuro: MR, early onset Alzheimer's
Cardio: complete AV septal defect, VSD, ASD
GI: duodenal atresia, hirschprung disease
Endo: hypothyroid, DM1, obesity
Heme: ALL (> 5 yo) and AML (<5 yo)
Rheumatology: atlantoaxial stability
MCC of Hypoglycemia in EtOH-ics
-Solution
Thiamine def= suppression of GNG (pyruvate DH) and TCA cyle
(alpha-KG DH)
MCC of Hypoglycemia in advanced renal insuff
-Solution
impaired clearance of insulin
Avoid Nitrates in Hypertrophic Cardiomyopathy bc...
-Solution
Nitrates decrease preload, which will increase the LV outflow
tract... BUT since the ventricle is abnormally shaped, there is an
outflow obstruction
Mets through BM
-Solution
Clonal proliferation of cells can invade/ metastasize*
1. malignant cells to lose their cell-to-cell adhesion molecules
(cadherins)
2. cell receptors to attach to laminin (a glycoprotein) in the
basement membrane and to release metalloproteinases (e.g.,
collagenases, stromelysins, gelatinases) to degrade the basement
membrane and other enzymes to degrade the interstitial
connective tissue- tissue inhibitors of metalloproteinases neutralize
these tumor-produced enzymes and limit the degree of invasion
3. cell receptors to attach to bronectin and other proteins in the
extracellular matrix (ECM) and to break it down
2
,4. malignant cells to produce cytokines that stimulate locomotion,
so that they can move through basement membranes and the
intracellular and extracellular matrices
Bicuspid Aortic Valve
-Solution
Commonly presents in young, asymptomatic patient with soft
systolic ejection at right 2nd ICS
-can cause aortic regurg
MCC of Vaginal Candidiasis
-Solution
1. Abx use= reduces lactobacilli pop
2. High estrogen levels- preg
3. System corticosteroid therapy
4. Uncontrolled DM
5. Immunosuppression, including HIV
Drug causes of SIADH
-Solution
-Carbamazepine
-Cyclophosphamide
-SSRI
MC Ankle Sprain due to inversion of plantar-flexed foot
-Solution
-Ant Talofibular Lig dmg
-ecchymosis at the ant-lat aspect of the ankle
Upper Brachial Plexus Injury
-Solution
- Musculocutaneous and Suprascapular N.
- dystocia mc in neonates; severe trauma mc in adults
- should adduction, elbow extension, and forearm pronation
Patent foramen ovale
-Solution
-failure of septum primum and septum secundum to fuse after
birth
-can lead to paradoxical emboli
Ventricular Septal Defect
-Solution
3
, -MC occurs in membranous septum
-Acyanotic at birth bc of L to R shunt
Coronary Blood Flow Peak
-Solution
-at Early Diastole
-coronary perfusion driven by diastolic pressure
-tachycardia will decrease coronary perfusion
Right Dom Heart
-Solution
majority of people
-PDA comes off RCA
-SA and AV nodes supplied by RCA
Left Dom Heart
-Solution
-PDA comes off of LCX
- SA and AV node supplied by LCX
Increased Pulse Pressure
-Solution
hyperthyroidism, aortic regurgitation, aortic stiffening (isolated
systolic hypertension in elderly), obstructive sleep apnea
( sympathetic tone), exercise (transient)
Decreased Pulse Pressure
-Solution
aortic stenosis, cardiogenic shock, cardiac tamponade, advanced
heart failure (HF)
Causes of Spontaneous Depol causing Tachyarrhythmias
-Solution
Hypokalemia, Hypermagnesemia, or prolonged QT interval
= all cause spontaneous depol of ventricles in phase 3 or 4 and it
will cause an extra AP in heart
Direct alpha 1 agonist mediated effects
-Solution
- vasc smooth muscle contraction= increased afterload and
venous return= increased DBP + SBP causes reflexive increase in
vagal tone= dec HR and slowed AV conduction
- mydriasis
4
Imbalances, Pulmonary Emboli, Splenectomy
Precautions & More| Well Revised
Description:
These bite-sized notes cover critical concepts and
associations frequently tested in exams like NCLEX and
USMLE Step 2 CK. Topics include metabolic and respiratory
derangements in DKA and pulmonary embolism, recognition
of acanthosis nigricans, congenital pyloric stenosis,
serotonin syndrome treatment, key genetic translocations in
hematologic cancers, and common side effects of
cardiovascular and endocrinologic medications. Ideal for a
quick yet comprehensive refresh before test day.
DKA metabolic derangements hyperkalemia hyponatremia
ketonemia”
“pulmonary embolism V/Q mismatch respiratory alkalosis
NCLEX prep”
“t(15;17) APL translocations WIth Nimodipine vasospasm
SAH review”
Heterophile ab NEGATIVE Mono-like syndromes
-Solution
*CMV
HHV-6
HIV
Toxoplasmosis
Wernicke's Aphasia
-Solution
-word salad: well-articulated, nonsensical speech paired with lack
of lang comprehension
-aud association cortex: post part of sup temporal gyrus
- supplied by MCA
Congenital Deficiency of Propionyl CoA Carboxylase
-Solution
-prevents conversion of propionyl CoA to methylmalonyl CoA
1
,-propionyl CoA derived from= val, ile, met, thr, odd # FA,
cholesterol side chains
-Propionic Acidemia: poor feeding, vomiting, hypotonia, lethargy,
dehydration, anion gap acidosis
Down Synd Comorbidities
-Solution
Neuro: MR, early onset Alzheimer's
Cardio: complete AV septal defect, VSD, ASD
GI: duodenal atresia, hirschprung disease
Endo: hypothyroid, DM1, obesity
Heme: ALL (> 5 yo) and AML (<5 yo)
Rheumatology: atlantoaxial stability
MCC of Hypoglycemia in EtOH-ics
-Solution
Thiamine def= suppression of GNG (pyruvate DH) and TCA cyle
(alpha-KG DH)
MCC of Hypoglycemia in advanced renal insuff
-Solution
impaired clearance of insulin
Avoid Nitrates in Hypertrophic Cardiomyopathy bc...
-Solution
Nitrates decrease preload, which will increase the LV outflow
tract... BUT since the ventricle is abnormally shaped, there is an
outflow obstruction
Mets through BM
-Solution
Clonal proliferation of cells can invade/ metastasize*
1. malignant cells to lose their cell-to-cell adhesion molecules
(cadherins)
2. cell receptors to attach to laminin (a glycoprotein) in the
basement membrane and to release metalloproteinases (e.g.,
collagenases, stromelysins, gelatinases) to degrade the basement
membrane and other enzymes to degrade the interstitial
connective tissue- tissue inhibitors of metalloproteinases neutralize
these tumor-produced enzymes and limit the degree of invasion
3. cell receptors to attach to bronectin and other proteins in the
extracellular matrix (ECM) and to break it down
2
,4. malignant cells to produce cytokines that stimulate locomotion,
so that they can move through basement membranes and the
intracellular and extracellular matrices
Bicuspid Aortic Valve
-Solution
Commonly presents in young, asymptomatic patient with soft
systolic ejection at right 2nd ICS
-can cause aortic regurg
MCC of Vaginal Candidiasis
-Solution
1. Abx use= reduces lactobacilli pop
2. High estrogen levels- preg
3. System corticosteroid therapy
4. Uncontrolled DM
5. Immunosuppression, including HIV
Drug causes of SIADH
-Solution
-Carbamazepine
-Cyclophosphamide
-SSRI
MC Ankle Sprain due to inversion of plantar-flexed foot
-Solution
-Ant Talofibular Lig dmg
-ecchymosis at the ant-lat aspect of the ankle
Upper Brachial Plexus Injury
-Solution
- Musculocutaneous and Suprascapular N.
- dystocia mc in neonates; severe trauma mc in adults
- should adduction, elbow extension, and forearm pronation
Patent foramen ovale
-Solution
-failure of septum primum and septum secundum to fuse after
birth
-can lead to paradoxical emboli
Ventricular Septal Defect
-Solution
3
, -MC occurs in membranous septum
-Acyanotic at birth bc of L to R shunt
Coronary Blood Flow Peak
-Solution
-at Early Diastole
-coronary perfusion driven by diastolic pressure
-tachycardia will decrease coronary perfusion
Right Dom Heart
-Solution
majority of people
-PDA comes off RCA
-SA and AV nodes supplied by RCA
Left Dom Heart
-Solution
-PDA comes off of LCX
- SA and AV node supplied by LCX
Increased Pulse Pressure
-Solution
hyperthyroidism, aortic regurgitation, aortic stiffening (isolated
systolic hypertension in elderly), obstructive sleep apnea
( sympathetic tone), exercise (transient)
Decreased Pulse Pressure
-Solution
aortic stenosis, cardiogenic shock, cardiac tamponade, advanced
heart failure (HF)
Causes of Spontaneous Depol causing Tachyarrhythmias
-Solution
Hypokalemia, Hypermagnesemia, or prolonged QT interval
= all cause spontaneous depol of ventricles in phase 3 or 4 and it
will cause an extra AP in heart
Direct alpha 1 agonist mediated effects
-Solution
- vasc smooth muscle contraction= increased afterload and
venous return= increased DBP + SBP causes reflexive increase in
vagal tone= dec HR and slowed AV conduction
- mydriasis
4
