Bel Flashcards
Túl alacsony albumin
Ascites Burns Glomerulonephritis Liver disease (hepatitis or cirrhosis) Malabsorption syndromes (eg, Crohn disease, celiac disease, or Whipple disease) Malnutrition
Nephropathy Hepatic encephalopathy Hepatorenal syndrome Sprue Wilson disease
Túl magas albumin
Dehydration
A surplus of magnesium or a deficiency of calcium may cause …
inhibition of acetylcholine release.
Transzplantált/immunsuppr. betegnèl tüdő infiltrarum jelenik meg. Vizsgálatok:
HRCT, BAL
Herediter angioödémában mi mediálja a folyamatot?
Bradykinin, ezért nincs viszketés és kiütés sem, ellentétben a hisztamin mediált ödémákkal (antihisztamin és steriod nem fog hatni)
Herediter angioödéma legfontosabb tünetek
Subcutan szövetek ödémája, viszketés, kiütés nélkül
- arc, végtagok, stb.
- laryngealis életveszélyes lehet
- hasi görcsök, hasmenés, hányás
Herediter angioödéma teszt
C4 szint alacsony szokott lenni
Ok: C1 inhibitor hiányzik, vagy rossz funkció
Herediter angioödéma - gondolni kell rá:
Visszatérő subc. szövet duzzanat, viszketés, és kiütés nélkül; visszatérő megmagyarázhatatlan hasi görcsök, hányinger, hasmenés.
Herediter angioödéma mikor jelentkezik, meddig tart
Élet első két évtizedében kezdődik. Tünetek 3-5 napon belül javulnak.
Pulsus paradoxus
decrease in the systolic blood pressure during inspiration
Pulsus paradoxus in status asthmaticus results from…
decrease in cardiac stroke volume with inspiration due to greatly increased left-ventricular afterload. This increase is generated by the dramatic increase in negative intrapleural and transmural pressure in a patient struggling to breathe against significant airways obstruction. Pulsus paradoxus of greater than 20mm Hg correlates well with the presence of severe airways obstruction (ie, forced expiratory volume in 1 second [FEV1] < 60% predicted).
The 4 stages of blood gas progression in persons with status asthmaticus are as follows:
Stage 1 - Characterized by hyperventilation with a normal partial pressure of oxygen (PO2)
Stage 2 - Characterized by hyperventilation accompanied by hypoxemia (ie, a low partial pressure of carbon dioxide [PCO2] and low PO2)
Stage 3 - Characterized by the presence of a false-normal PCO2; ventilation has decreased from the hyperventilation present in the second stage; this is an extremely serious sign of respiratory muscle fatigue that signals the need for more intensive medical care, such as admission to an ICU and, probably, intubation with mechanical ventilation.
Stage 4 - Characterized by a low PO2 and a high PCO2, which occurs with respiratory muscle insufficiency; this is an even more serious sign that mandates intubation and ventilatory support.
Factors that decrease theophylline clearance (increase levels) include
cimetidine, erythromycin and other macrolide antibiotics, viral infections, cirrhosis, fever, propranolol, and ciprofloxacin.
Factors that increase theophylline clearance (decrease levels) are
IV isoproterenol, phenobarbital, smoking, phenytoin, and rifampin.
Causes of QRS prolongation
- Ventricular ectopy
- BBB (LBBB or RBBB)
- paced rhythm
- Pre-excitation (WPW)
- Metabolic/Electrolytes (acidosis, hyperkalemia)
- Medication toxicity (Na ch blocker)
- Nonspecific intraventricular conduction delay (eg. LVH, CMPY, IVCD)
- hypothermia?
Treatment for WCT
- Shock
- Ca
- bicarb
- antiarrhythmics
Antiar. meg is ölheti (ha pl tox van a háttérben). Ca és bicarb-al nem lehet sokat ártani, viszont megmentheti (ha hyperK v acidosis van a háttérben)
Status asthmaticus stage 1
? - no hypoxemia
- hyperventilation
- normal PO2.
Data suggest that to possibly facilitate hospital discharge, these patients may benefit from ipratropium treatment via a handheld nebulizer in the emergency setting as an adjunct to beta-agonists.
Status asthmaticus stage 2
? - hyperventillation
- hypoxia
- may be discharged from the emergency dep. depending on the response to the bronchodilator
- syst. corticosteroids required
