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Alveolar Gas Eq - Answer PAO2 = (760 - 47) FIO2 - PaCO2 (1.25) CO - Answer SVx HR SV - Answer Preload x contractility DO2 - Answer Cardiac output (hemoglobin x Sat%) Fick's Law of Diffusion - Answer Diffusion = Pressure gradient x area/ Wall thickness Ohm's Law - Answer MAP= COx SVR Metabolic tissue demand - Answer CO x (arterial O2= venous O2) Excessive CO2 - Answer PaCO2 = CO2 produced - minute ventilation Minute ventilation = respiratory rate x tidal volume (1 - dead space %) Fluid Flow (Starling) - Answer Fluid flow = K [ (Pin - Pout) - (Oncin - Oncout) ] Wall tension (force) on heart chambers - Answer Pressure x Rad^4 / Wall thickness Side effects of Loop Diuretics - Answer Hypokalemia, metabolic alkalosis, pre-renal AKI. (cirrhotic pt with volume issue) hearing loss! Succinylcholine - Answer Depolarizing neuromuscular blocker used in rapid sequence intubation. dont use in hyperkalemia Osmolal gap - Answer Serum osmo- calc osmo Cal osmo= 2Na + gluc/18 + BUN/2.8 =ethylene glycol, methanol, propylene glycol with gapped acidosis Crystal Renal Tubular Obstruction (AKI) - Answer Causes: acyclovir, sulfonamide, MTX, ethylene glycol, protease inhibitors 2 | P a g e S/S: asymptomatic, inc cre, hematuria/ pyruria/ crystals Tx: stop drug, fluids Primary Nephrotic syndrome - Answer FSGS: AA, hispanic, obese, HIV, heroin Membranous: adeno, NSAIDs, Hep B, SLE Membranoprolif: Hep B/C. dense C3 deposits Minimal change: NSAID, lymphoma, kids IgA: URI, asian Uric Acid Stones - Answer -Radiolucent (need CT) -can cause ileus -needle shaped crystals in urine Acid-base disorders and compensations - Answer Metabolic acidosis: PaCO2= 1.5 (bicarb) +8 +/-2 Metab alk: inc PaCO2 0.7 per 1 in HCO3 Acute Resp acid: inc HCO3 by 1/ 10 rise PCO2 Acute Resp Alk: Dec HCO3- by 2/ 10 dec PaCO2 Compensation will never bring pH to normal Aspirin acid base disturbance - Answer respiratory alkalosis with metabolic acidosis Acute management of Hypernatremia - Answer Free water if euvolemic 3 | P a g e 5% dextrose if hypovolemic/ asymptomatic 0.9% NS if hypovolemic/ symptomatic Adrenal Insuff - Answer Cause: autoimmune, TB (other infections), hemorrhagic, cancer S/S: shock, fever, N/V, hypoNa, HyperK, hyperCa Chronic- fatigue, weight loss, anemia Non-anion gap metab ascidosis! Dx: ACTH/ cortisol Uncomplicated Cystitis - Answer S/S: dysuria, frequency, suprapubic tenderness Tx: nitrofurantoin, trimeth/ sulfameth, fosfomycin -culture if not responding Antiphospholipid syndrome - Answer False (+) VDRL, long PTT, thrombocytopenia. Clots- abortions Tx: LMWH Reversible causes of urinary incontinence in eldery - Answer DIAPPERS D: delirium I: infection A: atrophic vaginitis/ uretheritis P: pharm P: psych E: excessive urine (CHF) 4 | P a g e R: restricted mobility S: stool impaction Tdap - Answer At 11, then every 10 yrs Common Screening Tests - Answer Mammogram: 2 yrs, 50-75 Pap: 3 yrs, 21-65 Colon: 10 yrs, 50-75 HIV: 1 time 15-65 Hyperlipid: 5yrs, Men 35+ HTN: 18+ every 2 yrs Osteoporosis: women 65 When to suspect primary polydipsia - Answer Hyponatremia 100 u osmo psych issues First step in managing hyperkalemia - Answer insulin and glucose if cardiac stable Calcium gluconate if cardiac not stable change meds/ causes if stable Preventing calcium stones - Answer 1. increase fluid intake 2. THIAZIDES First generation antihistamines side effects - Answer URINARY RETENTION! oropharyngeal dryness 5 | P a g e SLE - Answer Gradual onset, rash, easy sunburn, joint/ renal/ neuro Lab: ANA, anti-dsDNA, low complement, anemia, leukopenia, thrombocytopenia UTI dipstick - Answer Leukocyte esterase- pyuria nitrites- E coli urge incontinence - Answer bladder training, pelvic floor muscle. antimuscarinic (oxybutinin) if do not work CO2 retention - Answer can lead to acidosis and CO2 narcosis- AMS Cryoglobinuria - Answer Purpura, glomerulonephritis, arthralgia, hepatosplenomegaly, peripheral neuropathy. HepC Refractory hypokalemia - Answer hypoK that is hard to correct with hypoMg. Not associated with high Phos. Alcoholics/ malnourished side effect of rifampin - Answer red to orange discoloration of body fluids- urine! Hypokalemia - Answer Causes 1. K into cell (insulin, beta agonist) 2. Gi loss 2. Renal waste (hyperaldosteronism, diuretics) S/S 1. weakness, fatigue 2. muscle cramps 3. U waves, flat/ broad T waves, PVCs ATN - Answer -cause hypovolemic shock -Uosmo 300-350 -UAn 20 -Fe/Na 2.....