I n t e r n a L medicine questions Bank

Labs :
Na 138 meq/L, K 4.6 meq/L , HCO3 25 meq/L , Cr 2 mg/dl stable for 2 years , 5 days later Blood pressure remained stable 135/85 mmHg , but labs became :
glucose 225mg/dl, Na 135 meq/L , k 7 meq/L , HCO3 21 meq/L , Cr 2.4 mg/dl , TTKG 4 .
What is the most likely cause of hyperkalemia ?
A ) Acute adrenal hemorrhage B ) Acute Renal failure
C ) Hyperglycemia
D ) Pulmonary embolus
E ) Hypoaldosteronism xxx

5. 
   ) 30 year old woman , 34 weeks pregnant developed PET , as part of her treatment was given Mg SO4 , a check on her deep tendon reflexes were decreased and she started to be confused .
   

Labs :
BUN : 40 mg/dl , Cr 1.7 mg/dl , Ca 8.3 mg/dl , CO2 23 meq/L , Cl 97 meq/l , K 4.3 meq/l , Na 137 meq/l , Mg 10.5 meq/L
The patient urine output is 30 cc / hour for the last few hours
What is the first step in management of this patient hypermagnesemia :
A ) Placement of a dialysis catheter and initiation of hemodialysis B ) Administration of furosemide , Iv 100 mg
C ) Administration of 10 % Ca gluconate , Iv , 10-20 ml xxx
D ) Discontinuation of Mg containing antacids followed by observation
E ) Gastric lavage alternating with Kayexalate ( Na polysterene sulfonate ) enemas .

6. 
   ) A 66 year old man with ESRD secondary to hypertension has been receiving maintenance hemodialysis for 15 years . He is hospitalized for evaluation of neck and bilateral shoulder pain associated with pain and parasthesias in both hands . Nerve conduction studies show bilateral median nerve entrapment .
   

He undergoes a bilateral carpal tunnel release procedure . A skeletal survey shows numerous periarticular lytic lesions in both humeral heads , the right acetabulum , & right scaphoid . Diffuse osteopenia , and subperiosteal erosion of the medial aspects of the middle phalanges of the hands .