13.

Neuro-Sarcoidosis

Pathophys-sarcoidosis with cardiac involvement can cause neuro s/s. noncaseating granulomas form in
heart heart which causes inflammation and can cause conduction block (Av block), restrictive
cardiomyopathy, dilated cardiomyopathy, and heart failure.

Incidence- usually <55 years

14. Endocrine-Amiodarone

s/s- hypothyroid such as weight gain, lethargy, constipation, dry skin.

Diff dx- digoxin (no thyroid / liver), verapamil- more impaired conduction and contractility.

15. Endocrine-hypercalcemia

Risk f- malignancy can cause hypercalc

s/s- volume depleted due to polyuria and decreased oral intake

tx- saline hydration to restore volume in vessels and to promote calcium excretion….also can administer
calcitonin currently.

Vs. bone marrow biopsy- preferred as next stpe, first step is always fluids

Diff dx – giving glucocort- may herlp b/c inactivate 1,25 vit d formation. Only used for excessive vit d
uptake.

17. Renal-Hematuria

Diff dx- glomerular vs nonglomerular. Glomerular in adults after uri- iga nephropathy (most common
GN)

Labs- proteinuria, dysmorphic rbc, rbc cast

s/s of glomerular- microscopic hematuria, glomerulonephritis or BM disease.

19. CV- Nitrates complication

MI-inferior leads and clear lungs (clear lungs suggest the RVentricular MI)
s/s- JVD due to cardiogenic shock due to impaired rv preload.

Pathophys- RV MI- so we get impaired filling to RV and so high sensitivity to low volume in vessels. Do
not give anything that further reduces RV preload or bp will dip.

Tx- bolus with saline to increase rv preload to improve CO

Vs synthetic cannibinoids- no proven efficacy in weight gain and anorexia …only proven in HIV
cachexia.

21. Neoplasm-Cachexia

Tx- nutrional supplement or enteral do little to help with cancer-related anorexia/cachexia. Pharm
intervention with progesterone (megesterol) or corticosteroids is affective in increasing appetite. prog
preferred b/c less side effects

22. CV-Supraaortic stenosis

s/s- associated is coronary artery stenosis.

Pathophys- changes cause subendocardial ischemia, responsible for pt angina s/s.

Risk f- exercise increases o2 demand

23. Resp-Emph

Imaging- lower lungs see bilateral basilar lucency.

s/s- productive cough

risk f- alpha 1 antitrypsin=lower lobe destruction whereas smoking is upper lobe.

Incidence- Low age person.

Diff dx-Sweat chloride- would more see GI, endocrine, and fertility problems. Vs. trances echo – used for
cardiac causes sources of dyspnea.

24. Resp-Atherosclerosis

Imaging – on x ray most likely linked to thoracic aneurism. Showing mediastinal widening and thick
aorta., increased trachial deviation.
2. Endo-Prim aldosteronism

dx- adrenal suppression after saline fluid load.

Tx- unilateral=surgery…ibilateral=pharmacotherapy

3. Primary aldosteronism