Internal Credit

List at least three causes for metabolic acidosis with anion gap.

KETOACIDOSIS, LACTIC ACIDOSIS, KIDNEY FAILURE, TOXIC INGESTION, UREMIC ACIDOSIS, ALCOHOLIC KETOACIDOSIS

What does the term "Bence-Jones protein" mean?

PARAPROTEIN COMPOSED OF MONOCLONAL Ig LIGHT CHAIN (MULTIPLE MYELOMA). PRODUCE CRYSTALS DEPOSITED IN TUBULES

What laboratory abnormalities are typical of secondary hyperparathyreoidism ?

normo or hypocalcemia, hyperphosphatemia and elevated level of parathormon in plasma

What is the most frequent cause of dehydration associated with lab abnormalities: hypokalemia, hypochloremia and metabolic alkalosis?

VOMITING

What is the laboratory definition of parathyreoid gland adenoma ?

Hypercalcemia, hyperparathyroidism (elevated parathormon in blood), hypophosphatemia, high or normal amt of vitD

List at least three therapeutic measures used for correction of hyperphosphatemia.

Reduction of phosphate intake, furosemide, PHOSPHATE BINDERS (calcium acetate, calcium carbonate)

What is the sodium deficit in patient with body weight=74kg and serum concentration of Na=115mmol/l.?

Sodium deficit (meq) = Normal TBW * (140 - sNa) Normal TBW (L) = fractionWater * wtKg Where wtKg = Weight in kg Where fractionWater Child: 0.6 for males, 0.6 for females Adult: 0.6 for males, 0.5 for females Elderly: 0.5 for males, 0.45 for females. THEREFORE Sodium deficit (meq)= (74*0.6)*(140-115) = 1110 mmol for males (925 if female)

What is volume (in litres) of the total body water in a patient whose body weight is 75kg.

75 x 0.6 = 45L IN MALE (60%), 41L IN FEMALES (55%)

What is the definition of polyuria?

INCREASED DIURESIS PER 24H (>2,5L/D)

What is the definition of oliguria?

DECREASED DIURESIS PER 24 H (< 500MG/D)

How we classify polyuria ?

OSMOLALITY OF URINE

What is the formula for calculation of base deficit?

Base deficit  = 0.4 x weight (KG) x (24- serum HCO3) 

How many liters ECT has a person weighing 70 kg ?

ECF is 1/3 of TBW. So 14L for males and 11.7L for females

What EFNa is in patient with renal failure of prerenal etiology?

LOW FeNa < 1%

What is typical concentration of natrium in patient with isotonic dehydration ?

Normal serum sodium (135-145 mmol/L)

What is the treatment of thoracic empyema? List at least two methods.

Empiric ATB (ceph+metronidazole) and later adjust accordingly + chest tube drainage 

What is the definition of nosocomial pneumonia?

Pneumonia acquired in a Hospital setting, more than 48h post admission and within 2 weeks of hospital discharge.

List the two most frequent locations of the extra-thoracic tuberculosis, occured in the Czech Republic

LN, joints, skeleton

What way of drug administration is preffered in the astma bronchiale treatment?

Long term - inhaled BA, muscarinic antagonist, Leukotriene R antagonists, inhaled CS 

How long (how many months) should the patient have a productive cought to consider such disorder to be chronic?

3m each year in 2 consecutive years