Misc - Medical

Front 1

G# P2112

Back 1

G = # pregnancies

P:
2 = 2 live births
1 = 1 preemie
1 = 1 miscarriage/abortion
2 = 2 children living

(so in this case, G=3)

Front 2

COMMON LABS:

Albumin

Back 2

3.2 - 5
g/dL

made by liver

negative acute phase reactant (levels will be lower in pt's suffering systemic inflammation, e.g. from infection or malignancy)

LOW: hepatic impairment, poor nutrition, systemic inflammation, IV fluids

HIGH: severe dehydration (high levels due to volume loss), pts on anabolic steroids may have actual hyperalbuminemia

Symptoms:
LOW - very low albumin may be accompanied by ascites & peripheral or pulmonary edema
HIGH - asymptomatic

Front 3

COMMON LABS:

ALP

Back 3

Alkaline Phosphatase

33 - 131
IU/L

HIGH:
all forms of cholestasis (particularly obstructive jaundice)
skeletal system disorders that involve hyperactive osteoblast activity, such as Paget's, fractures & malignant tumors

MODERATE ELEVATION:
Hodgkin's disease
CHF
intra-abdominal bacterial infections

Front 4

Alkaline Phosphatase & biliary tree obstruction

Back 4

the response of the liver to any kind of biliary tree obstruction is to synthesize more Alkaline Phosphatase

Front 5

COMMON LABS:

Ammonia

Back 5

10 - 80
mcg/dL

HIGH - may be present in cases of hepatic encephalopathy, particularly when due to acute liver failure (e.g. viral hepatitis), but may not always be elevated in hepatic encephalopathy

Front 6

COMMON LABS:

bilirubin

Back 6

0.1 - 1.2
mg/dL

Usually reported as total bilirubin, may be broken down into conjugated & unconjugated (conjugated is soluble & eliminated, unconjugated in insoluble and highly bound to albumin). Usually 90% unconjugated, 10% conjugated. High bilirubin with 90% or greater unconjugated is never from liver disease. May indicate excessive hemolysis or Gilbert's Syndrome (inherited inability to conjugate bilirubin)

HIGH conjugated: liver disease

Front 7

COMMON LABS:

arterial pH
venous pH

Back 7

ARTERIAL pH:
7.41

acidosis: 1 - 7.4
neutral: 7.41
alkalosis: 7.42 - 14

VENOUS pH:
7.36

acidosis may be from respiratory (lung disease, neuromuscular/diaphragm weakness) or metabolic (complicated, discussed elsewhere) sources

alkalosis may be respiratory (hyperventilation) or metabolic (vomiting, burns, ingestion of base)

Front 8

COMMON LABS:

respiratory acidosis

Back 8

low pH (1 - 7.4 arterial)
high pCO2 (45+ arterial)
normal or high-normal bicarb

CAUSES:
neuromuscular/diaphragm weakness
lung disease (e.g. COPD)

Front 9

low pH
high pCO2
normal bicarb

Back 9

respiratory acidosis

CAUSES:
neuromuscular/diaphragm weakness
lung disease (e.g. COPD)

Front 10

COMMON LABS:

respiratory alkalosis

Back 10

high pH (7.42 or greater)
low pCO2 (<35)
normal or high-normal bicarb

CAUSES:
hyperventilation from any cause

Front 11

high pH
low pCO2
normal bicarb

Back 11

respiratory alkalosis

CAUSES:
hyperventilation from any cause

Front 12

metabolic alkalosis

Back 12

high pH (7.42 or greater)
normal pCO2
high bicarb

CAUSES:
vomiting
burns
ingestion of base

Front 13

high pH
normal pCO2
high bicarb

Back 13

CAUSES:
vomiting
burns
ingestion of base

Front 14

COMMON LAB VALUES:

metabolic acidosis

Back 14

low pH (7.4 or less)
normal or low-normal pCO2 (35 - 45)
low bicarb

CAUSES when anion gap is normal (hyperchloraemia):
loss of bicarb or ingestion of acid, e.g.:
- diarrhea
- renal tubular acidosis
- Addison's disease
- drugs (carbonic anhydrase inhibitors, e.g.)

CAUSES when anion gap is HIGH:
DKA
lactic acid (e.g. shock or infection)
drugs (metformin, salicylates, methanol)

Front 15

low pH
normal pCO2
high bicarb

Back 15

metabolic acidosis

Front 16

anion gap

Back 16

Useful in isolating cause of metabolic acidosis. In plasma, the sum of cations (Na + K) should be greater than anions (Cl + bicarb) by 6 - 18 mmol/L.

CAUSES when anion gap is HIGH (too much acid):
M = methanol
U = uremia
D = DKA
P = paraldehyde
I = infection/ischemia/isoniazid
L = lactic acidosis
E = ethylene glycol, ethanol
S = salicylates, starvation

Front 17

MUDPILES

Back 17

pnemonic for causes of raised anion-gap metabolic acidosis

CAUSES when anion gap is HIGH (too much acid):

M = methanol
U = uremia
D = DKA
P = paraldehyde
I = infection/ischemia/isoniazid
L = lactic acidosis
E = ethylene glycol, ethanol
S = salicylates, starvation

Front 18

COMMON LABS:

pCO2

Back 18

35 - 45 (arterial)
mmHg

partial pressure of blood CO2
the balancing comoponent of the respiratory system (whereas the balancing component of the renal/metabolic system is bicarb/HCO3)

higher pCO2: acidosis
(remember, slow/shallow breathing retains CO2, so it makes sense that respiratory acidosis is caused by neuromuscular weakness or lung disease)

lower pCO2: alkalosis
(remember, faster/deeper breathing blows off CO2, and hyperventilation causes alkalosis)

Front 19

COMMON LABS:

pO2

Back 19

80 - 100 arterial
mmHg

NOT THE SAME as O2 sat

LOW: hypoxemia

Front 20

COMMON LABS:

O2 Sat

Back 20

O2 Sat (arterial):
90 - 100%

LOW: hypoxemia

Front 21

COMMON LABS:

HCO3

Back 21

bicarb

19 - 26
mEq/L

LOW: acidosis (metabolic)
HIGH: alkalosis (metabolic)

Front 22

COMMON LABS:

BUN

Back 22

7 - 20
mg/dL

Blood Urea Nitrogen: urea is the product of protein degradation; this is the most important catabolic pathway for elminating excess nitrogen

HIGH:
- Prerenal (cardiac decompensation, dehydration, high protein diet, muscle breakdown)
- Renal (acute glomerulonephritis, chronic nephritis, tubular necrosis, kidney disease)
- Postrenal (all types of obstruction of the urinary tract, such as stones, enlarged prostate, tumors)

Usually interpreted based on a BUN:SCr ratio, normally 10 - 20. High ratio with normal SCr usually denotes prerenal causes. High ratio with high SCr is usually renal or postrenal.

Front 23

COMMON LABS:

Hemoglobin

Back 23

g/dL

MALE:
13.5 - 16.5

FEMALE:
12 - 15

Front 24

COMMON LABS:

Hematocrit

Back 24

%

MALE:
41 - 50

FEMALE:
36 - 44

Front 25

COMMON LABS:

RBC's

Back 25

million/uL

MALE:
4.5 - 5.5

FEMALE:
4 - 5

Front 26

COMMON LABS:

Platelets

Back 26

100,000 - 450,000

Front 27

COMMON LABS:

RDW

Back 27

(measure of the amount that RBC's vary in size)

10% - 15%

HIGH: liver disease, anemia, B12 or folic acid deficiency
LOW: macrocytic or microcytic anemia

Front 28

COMMON LABS:

MCV

Back 28

(Mean Corpuscular Volume: amount of space occupied by a RBC)

80 - 100

Front 29

COMMON LABS:

CK

Back 29

(creatinine kinase: can detect rhabdomyolysis, serious muscle damage, or inflammation of the muscles)

CK-MB (found primarily in heart muscles):
0% - 3.9%

CK-MM (found primarily in skeletal muscle):
96% - 100%

CK-BB (found in brain, but when in blood it's primarily from smooth muscles including intestines, uterus, placenta):
0%

Front 30

COMMON LABS:

CPK

Back 30

(creatinine phosphokinase: another name for CK - total; again, indicates some sort of stress or injury to heart or other muscles)

8 - 150 IU/L

Front 31

COMMON LABS:

SCr

Back 31

0.5 - 1.4
mg/dL

Front 32

COMMON LABS:

calcium

Back 32

8.6 - 10.6
mg/dL

Front 33

COMMON LABS:

chloride

Back 33

95 - 110
mEq/L

Front 34

COMMON LABS:

magnesium

Back 34

1.5 - 2.5
mEq/L

Front 35

COMMON LABS:

phosphate

Back 35

2.5 - 4.5
mg/dL

Front 36

COMMON LABS:

potassium

Back 36

3.5 - 5
mEq/L

Front 37

COMMON LABS:

sodium

Back 37

135 - 145
mEq/L

Front 38

Back 38

Na: 135 - 145
Cl: 95 - 110
BUN: 7 - 20
K: 3.5 - 5
HCO3: 19 - 26
Cr: 0.5 - 1.4

Glu (fasting): 60 - 110
Glu (2hrs postprandial): <140

Front 39

The body responds to metabolic acidosis by ________.

Back 39

trying to reduce the PCO2/[HCO3-] ratio, which is done by reducing the PCO2.

Reducing PCO2 is accomplished by increasing ventilation (which is characterized more by an increase in tidal volume than by an increase in respiratory rate).

In its most pronounced clinical manifestation, this increase in ventilation is called Kussmaul Respiration.

Front 40

Kussmaul Respiration

Back 40

The body responds to metabolic acidosis by trying to reduce the PCO2/[HCO3-] ratio, which is done by reducing the PCO2.

Reducing PCO2 is accomplished by increasing ventilation (which is characterized more by an increase in tidal volume than by an increase in respiratory rate).

In its most pronounced clinical manifestation, this increase in ventilation is called Kussmaul Respiration.

Front 41

The body responds to respiratory acidosis by ________.

Back 41

trying to increase serum [HCO3-], by 2 mechanisms:
1. rapid cell buffering (occurs within minutes) by intracellular buffers (Hemoglobin & proteins)
2. an increase in net acid excretion of NH4+ & carbonic acid (H2CO3), and bicarb resorption is increased (this response occurs over 3-5 days)

Front 42

In respiratory aacidosis, the elevation in PCO2 results from _____, never from ______.

Back 42

reduced alveolar ventilation
increase in CO2 production (never due to this)

Front 43

The body's response to metabolic alkalosis is _______.

Back 43

to increase PCO2, by lowering alveolar ventilation.

Front 44

The body's response to respiratory alkalosis is __________.

Back 44

to reduce the plasma HCO3, using 2 mechanisms:
1. rapid cell buffering (H+ ions from cells move into extracellular fluid, usually from intracellular hemoglobin, protein & phosphates) - response in minutes
2. decreasing renal acid excretion (ammonium & carbonic acid)

Front 45

Cubicin

Back 45

daptomycin

Front 46

Factive

Back 46

gemifloxacin

Front 47

Vibativ

Back 47

telavancin

Front 48

Teflaro

Back 48

ceftaroline

Front 49

Dificid

Back 49

fidaxomycin

Front 50

Amikin

Back 50

amikacin

Front 51

Garamycin

Back 51

gentamycin

Front 52

Mycifradin

Back 52

neomycin

Front 53

Myciguent

Back 53

neomycin

Front 54

Netromycin

Back 54

netilmicin

Front 55

Nebcin

Back 55

tobramycin

Front 56

Duricef

Back 56

cefadroxil

Front 57

Ancef

Back 57

cefazolin

Front 58

Ceclor

Back 58

cefaclor

Front 59

Mefoxin

Back 59

cefoxitin

Front 60

Cefzil

Back 60

cefprozil

Front 61

Ceftin

Back 61

cefuroxime

Front 62

Zinacef

Back 62

cefuroxime

Front 63

Omnicef

Back 63

cefdinir

Front 64

Suprax

Back 64

cefixime

Front 65

Claforan

Back 65

cefotaxime

Front 66

Vantin

Back 66

cefpodoxime

Front 67

Rocephin

Back 67

ceftriaxone

Front 68

Cefobid

Back 68

cefoperazone

Front 69

Fortaz

Back 69

ceftazidime

Front 70

Tazicef

Back 70

ceftazidime

Front 71

Fortum

Back 71

ceftazidime

Front 72

Tazidime

Back 72

ceftazidime

Front 73

Ceptaz

Back 73

ceftazidime

Front 74

Mazipime

Back 74

cefepime

Front 75

Noroxin

Back 75

norfloxacin

Front 76

Zymaxid

Back 76

gatifloxacin

Front 77

Zymar

Back 77

gatifloxacin

Front 78

Vigamox

Back 78

moxifloxacin

Front 79

Factive

Back 79

gemifloxacin

Front 80

Ketek

Back 80

telithromycin

Front 81

Nallpen

Back 81

nafcillin (in dextrose_

Front 82

Bactocill

Back 82

oxacillin in dextrose

Front 83

Bicillin LA

Back 83

penicillin G benzathine

Front 84

Bicillin CR

Back 84

penicllin G benzathine + penicillin G procaine

Front 85

Pfizerpen

Back 85

penicillin G aqueous

Front 86

Doryx

Back 86

doxycycline

Front 87

Vibramycin

Back 87

doxycycline

Front 88

Adoxa

Back 88

doxycycline

Front 89

Oracea

Back 89

doxycycline

Front 90

Alodox Convenience

Back 90

doxycycline

Front 91

Monodox

Back 91

doxycycline

Front 92

Ocudox

Back 92

doxycycline

Front 93

Morgidox

Back 93

doxycycline

Front 94

Oraxyl

Back 94

doxycycline

Front 95

Dynacin

Back 95

minocycline

Front 96

Solodyn

Back 96

minocycline

Front 97

Minocin

Back 97

minocycline

Front 98

Tygacil

Back 98

tigecycline

Front 99

Rosadan

Back 99

metronidazole topical

Front 100

Vandazole

Back 100

metronidazole topical

Front 101

Flagystatin

Back 101

metronidazole + nystatin (vaginal)

Front 102

Tindamax

Back 102

tinidazole

Front 103

Furadantin

Back 103

nitrofurantoin (suspension)

QID

Front 104

Chloromycetin

Back 104

chloramphenicol

Front 105

Pentamycetin

Back 105

chloramphenicol

Front 106

Diochloram

Back 106

chloramphenicol

Front 107

Zyvox

Back 107

linezolid

Front 108

Rifadin

Back 108

rifampin

Front 109

Mycobutin

Back 109

rifabutin

Front 110

Xifaxan

Back 110

rifaximin

Front 111

Priftin

Back 111

rifapentine

Front 112

Lincocin

Back 112

lincomycin

Front 113

Synercid

Back 113

quinupristin/dalfopristin

Front 114

Which of the following medications would be an INAPPROPRIATE choice to sedate a patient with severe hypotension?

I. Haldol
II. Versed
III. Diprivan

a. I only
b. I and II
c. II and III
d. III only
e. ALL

Back 114

D: Diprivan

Diprivan (propofol) would be a poor choice because it's primary effect on the cardiovascular system is to cause hypotension. Use with caution in patients who are hypovolemic, have abnormally low vascular tone (e.g. in sepsis), or are hemodynamically unstable. Hypotensive effect may be substantial.

Front 115

Diprivan

Back 115

propofol

Front 116

Versed

Back 116

midazolam

Front 117

Rocephin is usually dosed at _____, except in meningitis, when it is dosed _____.

Back 117

Rocephin (ceftriaxone)

1g - 2g QD

2g BID in meningitis

Front 118

Rocephin

Back 118

ceftriaxone

Front 119

In which condition would Rocephin be dosed BID?

Back 119

meningitis