Saturday June 14th 2008

1. The side effects of mannitol include headache, nausea, vomiting and the most severe is pulmonary edema. It is due to increase extracellular osmolality causing water extraction to extracellular space.
2. Constipation is due to inactivity, low-fiber diet, opiods and TCAs, hypercalcemia. Magnesium hydoxate, an osmotic laxative has similar effect to osmotic diarrhea in lactase deficiency.
3. Hypothyroid myopathy presentation:
1. Muscle fatigue, pain, cramping
2. Biopsy: pale muscle fibers, decreased striation and mucinous deposition.
3. atrophy of type II muscle fibers
4. increase in creatinine phosphokinase (CPK)
4. AV shunt bypasses capillary beds and is a major resistance in vascular system. On palpation; thrill pulsatile mass and bruits on auscultation. It increases preload (increase voluma and rate of blood flow back to the heart), thus increase diastolic volume, and prolong diastolic filling.
5. Hydroxyurea (for Sicke Cell Disease) increases HbF to protect sickle cells from polymerization.