Friday, May 29, 2015

Regarding steroids

A 32 year old male is admitted in hospital being managed as a case of exacerbation of asthma. Consultant ordered Inj  Hydrocortisone (solucortef) 100mg 6 hourly. Nurse comes to you saying that pharmacy is short of Hydrocortisone but instead  has Dexamethasone. What will be the approximate equivalent dose of dexamethasone for 100 mg hydrocortisone?

A) 100 mg
B) 2mg
C)8mg
D)4mg
E)50mg


ANSWER:) D--4mg

http://www.uspharmacist.com/CMSImagesContent/2010/6/USP1006-Cushing-T2.gif

Regarding Hyperkalemia

A 42 year old male had an ankle strain 8 days back for which he was give Diclofenac sodium 50mg Bid. He presented to his GP with complaints of generalized weakness, his baseline workup was all normal except his serum potassium levels which was 5.9 .
What is the path-o-physiology of the drug most likely causing his Hyperkalemia ?
1) Diclofenac contains potassium
2) Diclofenac causes decreased cellular uptake of potassium
3) It induces a state of relative hyporenemic Hypoaldosteronism
4 ) Inhibits Na-Kt ATP ase pump
5) It does not cause hyperkalemia


ANSWER)
3) It induces a state of relative hyporenemic Hypoaldosteronism

Thursday, August 14, 2014

Correcting sodium of the Hyponatremic pt....

Provided the case before, what is the total amount of sodium in Meq's you need to replace if the pt weight is 70 kg's and your target sodium is 127 (from 118)?

a)378
b)315
c)500
d)269
e)300

ANSWER: a) 378 (Formula for sodium defecit is (desired-actual sodium) x body wt x 0.6 (male) or 0.5(Female)

Friday, August 1, 2014

Regarding Hyponatremia

A 70 year old  male is admitted with the complaints of confusion and irrelevant talking forthe last 3 days.
He was started on thiazide diuretic one week back for increased blood pressures. Labs showed serum sodium of 118.
What is the target sodium for replacement in the next 24 hours?

a)122
b)127
c)137
d)140
e)124

ANSWER : B)127 (In setting of acute hyponatremia,sodium is to be corrected by 9)

Monday, July 28, 2014

Image Challenge

Diagnosis

Ans:) A Large Bullae in left hemithorax: Pt with COPD.