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Good morning guys once again welcome to usmle videos dotnet and thank you for visiting our website again this evening tonight i want to discuss a few questions and let us start with delirium what is the leading cause of delirium i will give you some choices yeah alcohol abuse be depression say dementia the malnutrition is stroke what is your answer think about it
And give an answer the answer is c dementia dementia is the leading risk factor for delirium you see delirium is the acute confusional state it is typically multifactorial there is an interaction between delirium development of delirium and on the exposure to the precipitating factors now delivering effects like up to thirty percent of hospitalized patients who
Are medically ill and in some patients like cancer patients like twenty-five percent of them develop delirium hav infection like forty percent of them develop delirium and the post-operative patients like fifty percent of them develop delirium in the hospitalization and the nursing home residents especially people were than 75 years up to sixty percent of them
Can develop delirium but you see the this cofactor is dementia because fully two-thirds of delay neum occurs in patients with dementia and dementia is predisposes the brains for the formation of delirium that’s why you should identify delirium in patients with dementia whenever you see confusion and agitation you should help these patients because unless you
Recognize pyridium in these patients you are not going to play them and many of these patients dementia patients the develop underlying medical problems and latter develop delirium and there are many many models go for the next question what is the initial step in the management of hypercalcemia of malignancy yay aggressive rehydration be fluid restriction say
Phosphate depletion the iv bisphosphonates ii iv lasix so what is the initial step in the management of hypercalcemia of malignancy what do you do as the first step do you fluid restrict or do you phosphate definition or do you use i needa sparseness that the use iv lasix are do you do aggressive rehydration the answer is yeh aggressive rehydration whenever you
See a patient with the hypercalcemia you should first start aggressive rehydration there is a very first step and then other things should be contemplated like viruses with the phase my and the phosphorus replacement afore i pop acidemia is present and you can also use iv bisphosphonates you can actually give phosphorus replacement if i profile so timmy is present
So i will be sworn as you see we use any displays fonuts in the treatment and usually we use bisphosphonates in the treatment of osteoporosis why because this was erroneous they increase the deposition of calcium in the bones that is the reason so by using ie bisphosphonates we are decreasing the serum calcium level the same way highly lasix lasix it increases
The renal excretion of calcium so you are actually rehydrating patients giving lot of water then you are also using iv bisphosphonates to remove the calcium from the blood and the deposit into the bones then you are using iv lasix in order to increase the renal excretion of calcium so the initial step is aggressive rehydration let us go to the next question we’ll
Give the next question what is the leading cause of death from bariatric surgery bariatric surgery as you know is for obesity and what is the leading cause of death yeh infection be pulmonary embolism see ischemic bowel d pneumothorax e myocardial infraction so what is the leading cause of death after bariatric surgery choose your answer the answer is b pulmonary
Embolism according to the international bariatric surgery registry the leading cause of death following bariatric surgery is pulmonary embolism that’s a thing you need to remember it’s not infectious not ischemic bowel it’s not nemeth alexis or myocardial infraction it is pulmonary embolism now what are the indications for bariatric surgery bmi body mass index
Should be more than 40 kg per meter square it is more than 40 or bmi more than 35 kg per meter square with serious comorbid factors such as diabetes obstructive sleep apnea our culinary artery disease so those are the indications and the other passing we can also actually review the medications for obesity what are the main medications we have for obesity so you
Can discuss them like this sympathomimetic drugs like sibert remind center of mine under diethylpropion second group is drugs that alter the fat digestion like orlistat third class antidepressants like fluoxetine underboob propia fourth class anti-epileptic drugs like popeye roommates and zonisamide fifty rupees diabetes drugs like metformin pram lynn tide and eggs and tide you
Transcribed from video
USMLE Review Questions: Delirium, Obesity, Hypercalcemia By USMLEVideoLecturesCK
