Diagnosis of Diabetes is done using one of the following criteria:

1) glucose lvl of 125mg/dL or higher after an 8 hour fast.  Have to see this on two separate occasions.

2)  Random glucose of >200 mg/dL

3) HgA1C >6.5 %.  Have to see this on two separate occasions.  Although you can still use the 8 hour fast, using the HgA1C is now becoming preferred.

4)  Glucose tolerance test  >200mg/dL within 2 hours of giving 75g oral glucose.

 Appearance of Red Blood cells on a peripheral smear can give clues regarding the pathology in a patient:

Allergic reactions to fulvic acid

Fulvic acid is derived from the microbial degredation of plant an animal tissues.  There is very little evidence of health benefits, allergies, side-effects related to its ingestion.

Diagnosis and symptoms of vasculitis.

There are 3 main categories of vasculitis.  In all types, the blood vessels get inflammed and the organ supplied by that blood vessel can get necrosed (so you can even have tongue necrosis in something like Temporal arteritis if the blood vessels).   Symptoms are based on the endorgans affected.  Diagnosis usually requires measuring lvls of ESR, certain antibodies (p-ANCA, c-ANCA) and most importantly biopsy of effected tissue.

1 small box = 1 mm = 40ms = .1mV amplitude

1 large box = 5 mm = 200ms = .5mV amplitude

Normal PR = 120-200 ms (3 to 5 small boxes)
.... prolonged in incrased K or Mg, first degree heart block (AV node block)
.... shortened in pre-excitation via accessory pathway (Wolff-Parkinson-White sydnrome)

Normal QRS = 60-100ms (3 small squares or less)
...widened in increased K or Mg,

Q wave should be less than 1/3 the height of the R wave.  If its higher.... think Myocardial Infarction.

We normally experience symptoms of hyponatremia when sodium levels fall below 120 mEq/L.  However, an exception to that is during states of increased intracranial pressure (as in a head injury). 

Chronic renal failure--> decreased clearance of phosphate --> hyperphosphatemia --> decreased production of activated vitamin D (1,25 dihydroxy) --> hypocalcemia --> hyperparathyroidism --> hypercalcemia, renal osteodystrophy

hyperphosphatemia --> vascular calcifications --> calciphylaxis (necrotic skin lesions)

Men:  decreased testosterone
Women: amenorrhea, infertility, hyperprolactinemia

Pruritis

Cushing’s syndrome

Syndrome: increase in glucocorticoids (primarily cortisol).