Author: Sultan Chaudhry
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Hyperglycemic emergencies: diabetic ketoacidosis and hyperosmolar hyperglycemia state
Definition Diabetes Spectrum. January 2002 vol. 15 no. 1 28-36 CMAJ. 2003 Apr 1;168(7):859-66. Diabetic ketoacidosis (DKA), the hallmark of type 1 diabetes mellitus (T1DM), and hyperglycemic hyperosmolar state (HHS), primarily seen in type 2 diabetes (T2DM), are hyperglycemic emergencies that may lead to death if untreated. They are both associated with: Insulin deficiency (absolute…
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Introduction to immunology
Overview N Engl J Med. 2000 Aug 3;343(5):338-44. Trends Immunol. 2001 May;22(5):235-6. Nat Immunol. 2012 Feb 16;13(3):214-22. Medicine. 2009 Oct 37(10): 510-517 Jpn J. Infec Dis. 2004 57: 236-247. Microorganisms that cause disease in humans and animals enter the body at different sites and produce disease symptoms by a variety of mechanisms. Microbial invasion is…
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Diuretics and renal hormones
Physiologic hormones affecting the kidney Hormone Trigger and pathway Site of action in the nephron (see figure) Net effect Angiotensin II (Ang II) Synthesized in response to hypotension. (See AKI and CKD chapters for details of Ang II production pathway) Afferent and efferent arteriole Afferent and efferent (higher degree) arteriolar constriction leading to a rise in…
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Oncologic emergencies
Definition Complications due to active malignancies or chemotherapy. Metabolic, cardio-respiratory, neurological, structural, or mechanical in nature. Requires active monitoring and immediate management. Metabolic N Engl J Med. 2011 May 12;364(19):1844-54. Endocrinol Nutr. 2010 May;57 Suppl 2:30-40. Cleve Clin J Med. 2004 Aug;71(8):639-50. Humoral hypercalcemia of malignancy (HHM) Etiology and pathophysiology Three major mechanisms lead to elevated serum calcium levels.…
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Chronic kidney disease (CKD)
Chronic kidney disease is the progressive loss of renal function over time, based on a gradual decline in the GFR and creatinine clearance.
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Acute kidney injury (AKI)
Overview of acute kidney injury, including causes and treatment.
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Chronic obstructive pulmonary disease (COPD)
COPD is a characterized by persistent airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory response in the airways and lung to noxious particles or gases.