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85 Cards in this Set
- Front
- Back
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IDA - MCV and RDW
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MCV low
RDW high |
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THAL - MCV and RDW
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MCV - low
RDW - nml |
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THAL - dx
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electrophoresis
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IDA - the lower the ferritin
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the higher the probability of Fe deficiency
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IDA - Iron and TIBC relevance
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not important tests
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IDA - TIBC
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high
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IDA - transferrin sat
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low
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IDA - ferritin sx when
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< 20, stores depleted
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IDA - ferritin also
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acute phase reactant
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IDA - ferritin nml
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30-160
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IDA - transferrin sat nml
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20-50%
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HEMA - transferrin sat
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> 60%
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anemia - 2 forms iron
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heme - animal fat, easy absorption
non-heme - veggie, less easily absorbed |
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anemia - role of stomach acid
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changes heme and non-heme to ferrous forms
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anemia - role of transferrin
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take and give iron to RBC precursors
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anemia - role of ferritin
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iron storage
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anemia - TIBC
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indicators of how many receptors are not occupied
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anemia - transferrin sat indicates
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home many transferrin have iron
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anemia - micro
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Pb poisoning
IDA thalassemia sideroblastic anemia |
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anemia - macro
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B12
folate EOH hypothyroid |
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anemia - normocytic
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ACD
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anemia - RBC lives
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120 days
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anemia - fe excretion
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VERY low
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IDA - etiologies
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non-heme
acid reducers gastric surgery tea/coffee Ca++ def celiac dz |
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IDA - replacement oral
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FeSO4 - 65 meq
gluconate - 33 meq |
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IDA - replacement regimen
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once daily and see how tolerated
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IDA - replacement duration
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6 months of treatment to correct stores
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IDA - replacement response
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increased ret count in 3-5 days
peak at 4-10 days improvement in HgB at 4 weeks |
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folate - leads to
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B12 deficiency
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folate - if low
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give 4 weeks of folate and retest for folate and B12
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folate - can be caused by
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decrease in B12
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B12 - def test
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increased MMA (methylmyolonic acid)
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B12 - requires
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intrinsic factor which is produced by parietal cells
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folate - etiologies
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ETOH - poor diet
methotrexate dilantin metformin |
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B12 - etiologies
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pernicious anemia
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IDA - TIBC
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high
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IDA - tsat
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low
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IDA - transferrin receptor
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high (bc it's upregulated during deficiency)
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IDA - ferritin
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low
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IDA - iron
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low
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ACD - iron
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low
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ACD - ferritin
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incr
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ACD - TIBC
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decr
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ACD - TSAT
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nml
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ACD - transferring receptor
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nml
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IDA - IV replacement
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gluconate
sucrose feromoxytal |
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ACD - test to differentiate
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CRP
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folate - replacemet
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1 mg/day
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B12 - replacement
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1000-2000 mcg/day oral OR
1 mg daily/7 days injection 1 mg weekly for month injection 1 mg/month thereafter |
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B12 - replacement considerations
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absorption issues, cost is same
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ACD - ferritin stores increase
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during chronic inflammation
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ACD - ferritin stores nml bc
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ferritin stores are not mobilized
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SS - SIRS
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sytemic inflammatory response syndrome
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SS - SIRS criteria
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> 2 of:
HR > 90 temp < 36 or > 38 WBC < 4k or > 12k RR > 20 or PaCO2 < 32 |
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SS - sepsis
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any systemic inflammatory response to infection
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SS - severe sepsis
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any organ dysfunction
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SS - septic shock
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dysfunction with no response to fluid resuscitation
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SS - MODS
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multiorgan dysfx syndrome with >1 affected
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SS - MOF
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> 1 organ system failure
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SS - ABC
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intubate GCS < 8
breathing - hi flow o2 circulation - restore volume, vasoconstrict |
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SS - 6 hour targets in order of attack
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MAP > 65
Central venous pressure > 8-12; 15 if intubated SVO2 > 70% urine > .5 ml/kg/hr |
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SS - MAP equation
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(2D+S)/3, bc we spend twice as long in diastole
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SS - MAP tx
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fluid bolus
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SS - central venous pressure tx
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vasopressor
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SS - SVO2 tx
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measure with central line - add O2
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SS - urine tx
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dialysis
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SS - O2 delivery compromise
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O2 carrying capacity is diminished
O2 is not utilized by cells |
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SS - O2 return
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lack of venous pressure, d/t venous dilation
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SS - impact of intubation
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increase in pressure on chest, decreasing venous return
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SS - management
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2 lines
2 blood cultures abx fluids pressors |
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SS - abx coverage
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pseudomonas and MRSA
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SS - abx
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imipinem (greater seizure risk) or meropinem + vanco
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SS - fluids
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normal saline
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SS - pressors
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norepi
dopamine - don't confuse with dobutamine |
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SS - norepi moa
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simulate alpha (veins) *****
stimulate beta (heart) |
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SS - norepi dose
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.3-1.2 mg/kg/min
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SS - dopamine dose dependencies
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< 3 increases kidney perfusion
3-10 works like dobutamine > 10 alpha agonist |
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SS - norepi alternative
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vasopressin
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SS - vasopressin dose
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.01-.04 units/min
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SS - dobutamine don't use in
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septic shock OR
low BP CHF |
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SS - dubutamine moa
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B1 and B2 agonist; increases rate, but relaxes vessels
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SS - dobutamine dose
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3-15 mg
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SS - dobutamine v. dopamine cardiac output
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dop - incr dose -> incr CO until a certain point b/c of constriction of the aorta
dob - incr dose -> incr CO constantly |
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SS - dobutamine v. dopamine fill pressures
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dop - incr dose -> incr fill pressures bc of vasoconstriction
dob - incr dose -> decr fill pressures bc of vasodilation |
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SS - pressor considerations
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inactive in alkalotic states, so no bicarb
can promote arrhythmias has sulfite base, so may provoke anaphylactic runs |
