Multiprofessional Critical Care Review: Adult 2024 (MCCRCA24ON)-Board Review Questions: Kidney, Acid-Base Disorders, Electrolytes and Endocrine

Board Review Questions: Kidney, Acid-Base Disorders, Electrolytes and Endocrine

Video Transcription

Video Summary

Dr. Connor and I addressed renal and metabolic questions for a 65-year-old woman with hypertensive urgency and signs indicating pheochromocytoma. Initial management with a short-acting alpha blocker like doxazosin was recommended over options like furosemide or morphine.<br /><br />For a patient with elevated glucose after a TBI, it was noted that intensive insulin therapy increases hypoglycemic risks without improving mortality. Instead, maintaining glucose levels between 140-180 is preferred.<br /><br />A case of a 26-year-old IV drug user with AKI, elevated CK, and positive urine dipstick was managed with aggressive hydration using balanced crystalloids.<br /><br />A 34-year-old man with severe Cushing's was best managed with etomidate to rapidly reduce cortisol levels.<br /><br />Lastly, a septic patient benefitted from continued lactated Ringer’s solution for resuscitation, while an 18-year-old's alkalotic urine indicated type 1 RTA following a large ingestion of naproxen.

Keywords

hypertensive urgency

pheochromocytoma

intensive insulin therapy

acute kidney injury

Cushing's syndrome

type 1 RTA

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