Monday, April 20, 2015

WILTIMS #288-90: Ol' Blue Eyes

ThursdayIL: You may need to give sugar-water to a diabetic because DKA takes longer to treat than hyperglycemia. One of the more serious acute reactions to diabetes is diabetic ketoacidosis (DKA), where the body makes energy from protein because it can't get the plentiful glucose in the blood into the cells without abundant insulin and functional insulin receptors. This produces ketone bodies and lower the pH of the blood to unhealthy levels. Now when you're treating this condition, you need to give saline fluids, give insulin and monitor potassium. But when the hyperglycemia has been stabilized, you need to switch the fluids to dextrose (a slightly sugary solution) to prevent a deadly hypoglycemic overcorrection while you wait for the dawdling DKA to resolve.

FridayIL: Osteogenesis imperfecta (OI) is an interesting, if awful, disease caused by a defect in either the structure or quantity of collagen, leading to brittle bones, skeletal abnormalities, and one particularly interesting symptom: blue sclera - in other words, the whites of the eyes turn blue. This blueness is caused by the lack of collagen that normally makes the sclera white, allowing you to see the blue mini-veins behind it.


Osteopetrosis (not osteoporosis), which literally means "bone of stone," is a rare bone disease that causes the bone to grow too densely. Somewhat counter-intuitively, the bones become both harder and more brittle. This is the same reason you don't make swords out of the hardest metals and why those ceramic knives you see on late night infomercials are not the greatest investment - they are prone to shattering. One of the signs you may find with this disease is an Erlenmeyer flask deformity.

Stolen and drawn on w/o the permission of: www.ncbi.nlm.nih.gov/pmc/articles/PMC2836257/
Brown tumors are not tumors. They are bone lesions caused by hyperparathyroidism where the osteoclasts, cells that break down bone, proliferate to the point that they eat away a hole in the bone. On X-ray this looks exactly like a bone cancer or metastasis. Treating the underlying parathyroid gland overproduction will allow the bone to reform.

Sunday: Today, I had the companion experience to the practice gynecological exam we had a couple months ago: the GU exam. We learned and practiced examining the kidneys, male genetals, potential hernias and the rectum/prostate. All in all, it was so much simpler than the female version.

TIL: What a prostate feels like through gloves and some large intestine.

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