Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
38 Cards in this Set
- Front
- Back
Replacement IV Fluids
|
1. Fever (150 ml/day per 1 degree over 37 C)
2. Tachypnea 3. 3rd Spacing 4. Burns |
|
IV Fluids
|
Normal = 154 mmol/L (286 osm/L)
1/2 Normal = 77 mmol/L (143 osm/L) D5W (278 osm/L) |
|
IVF Infusion Rate
|
4-2-1 Rule
1st 0-10 kg: 4 cc/kg/hr Next 10-20 kg: 2 cc/kg/hr Subsequently 1 cc/kg/hr |
|
Maintenance / Replacement IVF
|
Pre-OP: D5 1/2 NS + 20 mEq KCl at 110 cc/hr
Gastroenteritis: NS + 20 mEq KCl at 175 cc/hr |
|
Calcium
|
Total Ca: 8.7 - 9.5 mg/dL
iCa (46%) = 1.09-1.29 (corrected to pH 7.4) Protein Bound (40%) Organic Anion Bound (phosphate, citrate) = 14% |
|
Mg
|
1.3 - 1.9 mEq/L (Critical < 1 or > 4)
|
|
Phos
|
2.2 - 4.7 mg/dL (critical < 1)
|
|
Cl
|
98-108
|
|
CO2
|
20-29
|
|
BUN
|
7-23
|
|
Hemoglobin
|
Males: 12.3 - 16.3 g/dL
Females: 11.5 - 14.6 g/dL |
|
HCT
|
Male: 37.4% to 47%
Female: 34% to 42.1% |
|
Platelets
|
143-398
|
|
WBC Count
|
3.28-9.29 x 10^3/μL
|
|
Hyperkalemia
|
1. EKG (flat P, peaked T)
2. Calcium Gluconate 1-2 amps 3. Insulin 10 U + Glucose - Bicarb 1 amp - Albuterol 10-20 mg inhaled or 0.5 mg IV 4. Kayexalate 30-45 g PO/PR 5. Diuretics |
|
Hypokalemia
|
- 1 mEq increases K+ by 0.1
KCl Replacement: Desired [K] - Measured [K] / Cr x 100 |
|
Hypomagnesemia
|
1 g MgSO4 increases by 0.1
If Cr x 2 -- > 50% MgSO4 dose Goal 1.5 - 2 (> 2 if cardiac patient) |
|
K+
|
3.6-5.4
|
|
Non-ICU CAP Treatment
|
Standard Empiric:
1. Ceftriaxone 1g IVPB STAT then qd 2. Azithromycin 500mg IVPB STAT then qd Alternative Empiric (failed outpatient Rx, suspected resistant orgs, beta-lactam allergy): 1. levofloxacin 750mg qd x 5 days |
|
Complicated Female UTI
|
1. ampicillin 1-2g IV q6hrs x 7-14d + gentamicin 3-5 mg/kg/day x 7-14d
2. Ceftriaxone 1g IV qd x 7-14d 3. Zosyn 3.375 g IV q6-8hrs x 7-14d |
|
Short Acting Insulin
|
Regular insulin (novolin/humulin)
Onset 0.5-1 hr Peak 2-4 hrs Duration 4-8 hrs |
|
Long-Acting Insulin
|
1. Detemir (Levemir)
- Onset 1 hr, duration 12-24 hrs 2. Glargine (Lantus) - Onset 1 hr, duration > 24 hrs |
|
VTE Prophylaxis
|
Standard:
1. Enoxaparin 40mg SC daily BMI > 30 or high VTE risk: 1. Enoxaparin 40mg SC bid GFR < 30 1. Enoxaparin 30mg SC qd *Caution if GFR < 15 |
|
Stress Ulcer Prophylaxis
|
Mechanical ventilation, home PPI/H2 blocker Rx, coagulopathy + 1 risk factor, or at least 3 risk factors
1. Pantoprazole 40 mg PO/IV qd or 2. Famotidine 20 mg PO/IV bid |
|
Inpatient Diverticulitis Treatment
|
- Unable to tolerate PO
- Requiring narcotic analgesia - Complicated diverticulitis - Make NPO - NGT if obstruction / ileus - Flagyl + cipro/ceftriaxone |
|
Hypernatremia Management
|
1. Treat Underlying Cause
- Stop GI losses - Control pyrexia - Normalize glucose - d/c diuretics, lactulose, Li - Treat hyperCa, hypoK 2. Correction of HyperNa - Rapid correction (1 mmol/L per hour) if developed over period of hours - Slow correction (0.5 mmol/L per hour) w/ goal decrease in serum Na of 10 mmol/L per day --- > 145 mmol/L - Pure water, D5W, one-quarter normal saline, half normal saline (decr infusion rate req'd for lower tonicity of fluid) 3. Anticonvulsant Rx, airway management if seizures |
|
TBW
|
TBW = ECF (40%) + ICF (60%)
Nonelderly men = 0.6 x body wt Nonelderly women = 0.5 x body wt Elderly men = 0.5 Elderly women = 0.45 |
|
DM Diagnosis
|
1. HbA1c >/= 6.5
2. Random glucose > 200 3. Fasting glucose > 125 4. 2 hr OGTT > 200 After diagnosis: lipid panel, BP, lytes, urinalysis, EKG |
|
Rapid Acting Insulin
|
Lispro (Humalog), Aspart (Novolog)
- Onset 10-15 min - Peak -2 hrs - Duration 3-5 hrs |
|
Intermediate Acting Insulin
|
NPH
- Onset 1-3 hrs - Peak 4-10 hrs - Duration 10-18 hrs |
|
Goal LDL
|
0-1 Risk Factors: < 160
Risk factors = smoking, HTN, HDL<40, fam hx early CAD Moderate Risk (> 1 risk factors): < 130 High Risk (CAD or CAD equivalent): < 100 |
|
Metabolic Syndrome
|
1. Abdominal Obesity (> 35-40 in)
2. Hypertriglyceridemia (> 150) 3. HDL < 40 in men < 50 in women 4. HTN 5. Fasting glucose > 110 |
|
Fibrates
|
Gemfibrozil, fenofibrate
Decrease VLDL synthesis (decr TG by 50%) |
|
Niacin
|
- Most effected Rx to raise HDL (25-35%)
- Decr LDL, TG (10-30%) Rx of choice for combined hyperlipidemia or low HDL ASA to minimize flushing |
|
HgbA1c
|
~ 30 mg/dL glucose per 1% HgbA1c
5% = 100 mg/dL 7% = 150 mg/dL 9% = 200 mg/dL 12% = 300 mg/dL |
|
Celsius
|
98.6 = 37
99.5 = 37.5 100.4 = 38 101.3 = 38.5 102.2 = 39 |
|
Acute Interstitial Nephritis
|
- Rash
- Pruritis - Eosinophilia - Fever - Urine sediment w/ pyuria, leukocyte casts, microscopic hematuria, proteinuria |
|
Nephrotoxic Agents
|
- Contrast
- IV aminoglycosides - Cisplatin |