Clin Lab Med Exam II Flashcards
1
Q
Epithelial cells
A
contaminated specimen
2
Q
Oval fat bodies
A
Nephrotic syndrome
3
Q
Hyaline cast
A
Normal, most common
4
Q
RBC cast
A
Glomerulonephritis
5
Q
WBC cast
A
Acute pyelonephritis
6
Q
Renal tubule cast
A
Acute tubular necrosis
7
Q
Specific gravity (UA)
A
Acute kidney failure
8
Q
Glucose (UA)
A
Diabetes
9
Q
Ketones (UA)
A
Acidosis (DKA)
10
Q
Protein (UA)
A
Kidney dz
11
Q
Moderately increase Albumin (UA)
A
Early Kidney dz
12
Q
Bilirubin/ Urobilinogen (UA)
A
Liver dz
Hemolysis
Biliary obstruction
13
Q
Uric acid crystals
A
Hyperuricemia
Gout
14
Q
Struvite crystals
A
Alkaline urine
Infection by urease producing bacteria
15
Q
Hypokalemia
Low K
A
Causes: Vomiting/gastric suction Thiazide//loop diuretics Alkalosis Insulin
16
Q
Kyperkalemia
A
Causes:
ACE-I, ARB
Aldosterone antagonist
K-sparing diuretics
Acidosis
17
Q
Tx for Hyperkalemia
A
Insulin/Ca/Bicarb administration
Loop/Thiazide diuretics
Dialysis
18
Q
Normal range of sodium
A
135-145
19
Q
Solutes that determine ECF osmolality
A
Sodium
Glucose
Urea
20
Q
Sx occur if osmolality is out of whack by this much
A
<265
>320
21
Q
Substances that are active but not included in calculated osmolality (lead to Osmolol Gap)
A
Mannitol Other proteins Ethanol Methanol Ethylene glycol (antifreeze)
22
Q
Tonicity
A
ability of all solutes to make Osmotic Driving Force that causes water mov from one compartment ot another
23
Q
Examples of solutes unable to cross from ECF to ICF that influence tonicity
A
Sodium
Glucose
Mannitol
24
Q
What is a substance that crosses freely and therefore does NOT contribute to tonicity?
A
Urea
25
Major determinant of the size of ECF volume
(Na) Sodium
26
Increase Na in ECF
Hypervolemia
27
Serum [Na+]
refers to amt of water relative to sodium in ECF
| not the total body Na+ amt
28
Abnormal Serum [Na+] means
disorder of water regulation
| not necessarily a messed up sodium level
29
Abnormal ECF volume
marker of abnormal (Na) sodium control
30
Causes of Hypovolemia
```
GI loss
Renal loss (diuretics, Diabetes Insipidus)
Skin loss (sweat, burn)
Intestinal obstruction, pancreatitis, Rhabdo
```
31
Hypovolemia sx
```
Weakness
Muscle cramps
Decreased BP
Postural hypotension
Increased pulse
```
32
Causes of HYPERvolemia
```
Renal failure
Nephrotic synd
Primary Hyperaldosteronism
Cushing's synd
Liver dz
Heart failure
Pregnancy
```
33
3 main causes of HYPER volemia
Kidney failure
Liver failure
Heart dz
34
Signs of HYPERvolemia
```
Edema
SOB
Orthopnea (PND)
JVD
Hepatojugular reflux
Crackles
```
35
Water retention influenced by:
Thirst
| ADH
36
Salt retention influenced by:
RAAS
ANP
Catecholamines
Renal fx (GFR, BF)
37
Aldosterone actions
Increase Na absorption
| Kicks K out of body
38
Severe Hyponatremia (sodium so low, in danger zone)
below 125
39
Most common electrolyte abnormality in hospitalized pts
Low sodium
40
Hyponatremia is assoc/ with
Pulmonary dz
| CNS disorder
41
Signs of low sodium
```
HA, dizzy
N/v
Lethargy
Weakness
Confusion
Severe: Hypoventilation, Resp arrest, Seizure, Coma, Death
```
42
Pseudohyponatremia
Falsely low serum sodium, <135 BUT osmolality is normal
43
Pseudohyponatremia (falsely low sodium) occurs with:
Hyperlipidemia
| Hyperprotein
44
Redistributive or Hyperosmolar Hyponatremia
Osmotically active particles in the ECF are concentrating stuf out there and drawing water out of the cell as a result, diluting the Na concentration outside of the cell
45
Common cause of Redist/Hyperosmolar Hyponatremia (low sodium)
Hyperglycemia
46
Hyperglycemia is often seen with
Hyponatremia
| type: Hyperosmolar/Redistributive
47
Hypervolemic Hyponatremia
too much volume
| too little Na
48
Cause of Hypervolemic Hyponatremia
| too much fluid, too little sodium
Liver, Heart, or Kidney failure
| Tx: diuretics, dialysis, fluid restrict
49
Hypovolemic Hyponatremia
| low volume, low sodium
Check Urine Na
50
If urine Na >20 in Hypovolemic Hyponatremia
Cerebral salt wasting
Renal tubular acidosis
Diuretics (thiazide)
51
If urine Na <20 in Hypovolemic Hyponatremia
Vomiting/diarrhea
| Third space loss (burn, pancreatitis)
52
Tx of Hypovolemic Hyponatremia (low everything)
Replace with fluids
| Tx underlying cause
53
Euvolemic Hyponatremia
SIADH
Psychogenic polydipsia
Hypothyroid
Adrenal insuff
54
Tx of Euvolemic Hyponatremia
Fluid restriction
| Tx underling cause
55
SIADH
too much ADH
retaining water
TOO MUCH ADH activity
Keeps water in
but lets Na out
Serum diluted
Urine concentrated
56
Determine cause of SIADH
CT/MRI head (CNS disorder)
CXR (lung tumor/inf)
Review pt meds
57
SIADH dx criteria (5 things)
1. diluted plasma <275
2. concentrated urine >100
3. elevated urine Na >20
4. euvolemic
5. normal cortisol and thyroid levels
58
Dx Hyponatremia, First look at
Serum: Na, osmolality
59
Dx Hyponatremia, 2nd look at
Urine Na and osmolality
60
Dx Hyponatremia, 3rd look at
TSH, Serum Cortisol
61
When to admit a pt to hospital for Hyponatremia?
If sodium is below 125 OR symptomatic
62
Common use for tx of Chronic Hyponatremia
"Vaptans" and
| Demeclocycline
63
Correcting Low Sodium
4-6 in first 24 hours
definitely less than 8
64
How often to check sodium when you are correcting levels
every 2 hours
65
CPM- Central Pontine Myelinolysis
Aka osmotic demyelination synd
Focal demyelination in the pons
Irreversible!
66
Sx of CPM- Central Pontine Myelinolysis
Dysarthria, dysphagia, seizures, AMS, quadriparesis, hypotension
1-3 days after over-correction
67
Hypernatremia
too little water relative to salt
| >145
68
Clinical features of Hypernatremia d/t
brain shrinkage
69
Clinical sx of Hypernatremia (if any, often asymptomatic)
```
Thirst
AMS, weakness
Neuromusc irritability
Focal neuro deficits
Seizure/coma
```
70
Causes of Hypernatremia
```
GI loss (elderly or infants w diarrhea)
Sweating, fever
Renal loss
Diuretics
Osmotic diuresis
```
71
Vast majority of Hypernatremia are d/t:
Water loss
| GI, skin, renal
72
Body's normal response to Hypernatremia
Thirst and fluid intake
73
Diabetes Insipidus
dilute urine
concentrated blood
Losing a bunch of dilute water
(collecting ducts are impermeable to water and cannot reabsorb it)
Concentrated serum Na
74
Causes of DI
Central: impaired secretion of ADH
tx: desmopressin
Nephrogenic: lack of kidney response to normal amts of ADH
75
SIADH
too much ADH!
76
Diabetes Insipidus
not enough ADH or impaired response to ADH!
77
Tx of Nephrogenic DI
| we want to get rid of Na
when kidneys aren't responding to normal amts of ADH
- Thiazide diuretics (cause you to get rid of Na)
- Amiloride
- Chlorpropamide
- NSAIDs
78
Tx of Hypernatremia
Stop water loss
Replace water deficit
Hospitalize (if severe)
79
Water deficit
Normal TBW- current TBW
80
3 parts to UA
Gross examination
Dipstick
Microscopic analysis
81
What can cause urine to be red or red-brown
Beets and Rhubarb
82
What can cause urine to be brown-black?
Biliary dz
Alkaptonuria
Malignant melanoma
83
Maple syrup urine dz and Phenylketonuria
Amino acid disorder
84
Normal pH for Urine
4.5-8.0
85
Urine is water containing dissolved:
Urea, Na, and Cl (some other stuff)
86
Normal Spec Gravity of Urine
1.003-1.035
87
Spec Grav reflects kidney's ability to
Concentrate and dilute the urine
88
In kidney dz, Spec Grav may be fixed at
1.01
| "Isothenuria"
89
Urine volume normal
500-2000
Olig: <500
Anuria: <100
90
False negatives for Glucose in urine
Absorbic acid
| ASA
91
Ketones
product of incomplete fat metabolism, occur when carbs diminished
92
Ketones in urine
Acidosis
| DKA, rapid weight loss, fasting, starvation, pregnant
93
Albumin
indication of Renal endothelial dysfx
| Early sign of kidney dz
94
False positive Albuminuria test
Pyridium can cause false positive
95
Limit to Albuminuria test
Low levels: 30-300 usually not detectable with dipstick
96
Alb to Cr ratio used for screening for Kidney Damage in high risk pts
Diabetes
HTN
Cardiovascular dz
97
Persistently positive dipstick for protein should:
also have Albuminuria quantified
98
Blood in urine can mean 3 things:
RBC
Hemoglobin
Myoglobin
99
False negative to blood can be d/t
Ascorbic acid
100
High power field
WBC
| RBC
101
Low power field
Casts
102
RBC
>3 in urine is abnormal
103
If sediment is red
Hematuria (RBC)
104
If supernatant is red, do a dipstick heme
if negative, red color is d/t something else
105
If supernatant is red, do a dipstick heme
if positive, centrifuge again and determine color
Clear: myoglobin
Red: hemoglobin
106
WBC
lobed nuclei
refractile cyto granules
>5 is abnormal
10-20 suspicious
>20 probably UTI
107
Tubular and transitional epithelial cells
tubular degeneration if high numbers
108
Oval fat bodies
"Maltese cross"
| Nephrotic syndrome
109
"Maltese cross"
seen by Polarized light microscopy
| Nephrotic synd
110
Where are casts formed?
Distal tubule or Collecting duct
111
Red cell casts
Glomerulonephritis
112
White cell casts
Pyelonephritis
113
Renal tubular casts
Acute tubular NECROSIS
114
Cystine crystals
"sisteine chapel genetically caused stones"
rare Genetic cause of kidney stones
115
Struvite
Urease producing bacterial infection
116
Calcium oxylate
kidney stones
117
crystals that cause Kidney stones
Cystine (rare genetic)
| Calcium oxylate
118
Regulation of Renal K excretion occurs in
Distal nephron
119
Too much K
| Hyperkalemia
Serum level >5
120
Causes of too much K
| Hyperkalemia
Pseudo
Inadequate kidney excretion
Redistribution
Excess administration
121
Aldosterone leads to low K levels
so anything that antagonises Aldosterone will ---> too much K (Hyperkalemia)
122
Causes of Hyperkalemia (too much K)
Aldosterone antagonist
K sparing diuretic
ACE-I/ ARB
Adrenal insuff (Addison's dz)
Congenital Adrenal Hyperplasia
Renal tubular dysfx
123
When to clinical features of Hyperkalemia generally appear?
7 or greater
"It's
A F A C T"
124
A F A C T
Arrhythmia
Flaccid paralysis
Asc muscle weak
Conduction abn
T waves (tall and peaked)
125
Tx for Too much K
| Hyperkalemia
```
ER/ICU if >6.5
Correct levels (rapid or slow)
```
126
Rapid correction of Hyperkalemia
IV Calcium Chloride
Maneuver to shift K from ECF to ICF
127
Birmingham lecture
| treat for too much K
Sodium bicarb IV
| D50W + Insulin IV
128
Slow correction of Hyperkalemia
Loop or thiazide diuretic
| Hemodialysis
129
Med cause of too much K
ACE-I and ARBs
K-sparing diuretic
Aldo Antag
130
Tx of Hyperkalemia
Thiazide or Loop diuretic
131
Not enough K
| Hypokalemia
<3.5
132
When does low K become dangerous?
below 3.0
133
Causes of Not enough K
| Hypokalemia
Inadequate intake
GI tract loss
Kidney loss
Redistribution
134
When does a person usually suffer from Hypokalemia d/t inadequate intake?
If they are already on Thiazide or Loop diuretic which enhances K excretion
135
Common cause for K los
GI loss
Upper GI: vomiting, NG suction (this causes Alkalosis which promotes Renal K loss, further worsening the problem)
136
Too much Aldosterone function can lead to
Low K
Hypokalemia
(i.e. Hyperaldosteronism and Cushing's syndrome)
137
Redistribution causes of Low K
Alkalosis
Insulin administration
B-adrenergic agonists
138
Hypokalemia sx
U CRAMP
139
U CRAMP with low K
U waves
```
Cramp
Rhabdo and Resp failure
Anorexia, n/v
Musc weakness
Paralysis
```
140
Having a hard time correcting low K?
check Mg level
141
Rapid correction of Low K
Cardiac monitor
IV Potassium Cl
(check K every 2-4 hrs)
142
Slow correction of Low K
orally
143
Causes of Hypokalemia
vomiting/gastric suction
Thiazide/loop
Alkalosis
Insulin
144
Alkalosis causes
Low K
145
KOH dissolves host cells and bacteria, sparing:
Fungi and elastin
146
Tzank Prep
Herpes Virus
Giemsa or Wright stain
Giant multinucleated cells
147
What is more commonly used to diagnose HSV than Tzanck smear?
Immunofluorescencse
148
India Ink
Cyrptococci
| large capsules that exclude the ink
149
Dark field microscopy
thin bacteria
| T. pallidum (Syphilis)
150
Diagnosing Syphilis (T. pallidum) We use dark field microscopy bc Syphilis is
cannot be cultured
gram (-) but too thin for staining
Dark stain reveals spirochetes
151
Extra testing for Syphilis (other than dark field)
Veneral Dz Research Lab (VDRL):
- CSF test
- Fluorescent Trep Antibody Absorption FTA-ABS
ALSO
Rapid Plasma Reagin (RPR)
-serum
152
Extra testing for Syphilis
VDRL (venereal)
| RPR (rapid plasma)
153
Latex agglutination
CSF for Meningococcal
| also serum, saliva, urine
154
Latex agglutination
detects pathogen specific antibodies/antigens
155
ELISA
| Enzyme Linked Immunoassay
Detects antibodies in serum
(used for many body fluids)
May need to repeat testing bc it takes up to 2 wks for some immune responses to kick in
156
IFA
| Indirect Immunofluorescence Assay
Detects antibodies
| Primary test for ANA
157
NAAT/PCR
Detects small quantities of bacterial/viral DNA or RNA
| faster than ELISA
158
AFD Acid Fast Bacilli stain
Tuberculosis
rapid and cheap
(mycobacterial culture is most sensitive and spec)
159
Only types of sterile C&S
CSF, pleural, pericardial, peritoneal, or synovial fluids
160
MIC Minimum Inhibitory Concentration
Lowest conc of Abx to inhibit the growth of an organism- achieved through microdilution
161
Intermediate results on Antimicrobial sensitivity mean
Organism is inhibited by MAXIMAL recommended Abx dose
162
Blood culture results
Prelim: 24 hours
| Identification of org: 48-72 hours
163
When should blood cultures be repeated within 48 hrs of starting Abx?
```
Staph Aureus bacteremia
Endocarditis
Infection site w/limited penetration
Persistent leukocytosis
Prosthetic vascular grafts
Pacemaker
Resistant pathogens
Unknown source of original bacteremia
```
164
Bacteremia
infection specifically in the blood
165
Thoracocentesis
Aspirate fluid from PLEURAL space
166
Paracentesis
Aspirate fluid from ABDOMINAL cavity
167
Transudative effusion
Intact vascular wall
| d/t Pressure differences
168
Transudative effusion usually d/t
CHF
Liver cirrhosis
Nephrotic synd
169
Is further testing usually needed for fluid from Transudative effusions?
NO
170
Exudative effusion
D/t inflammation and Vascular wall DAMAGE
171
Common causes of Exudative effusion
Infection
CA
Inflammatory disorder (RA, Lupus)
Trauma
172
Does fluid from exudative effusion usually require further testing?
YES
173
Normal values for Pleural fluid (around lungs) AND Peritoneal fluid (around abdomen)
50 mL
Clear, serous, light yellow
NO RBC
WBC <300
174
Parapneumonic effusion (exudative) most common causes
Bacterial PNA
Lung abscess
Bronchiectasis
175
Second most common cause of Parapneumonic effusion (exudative)
Lung CA
Breast CA
Lymphoma
176
Hemothorax (exudative) effusion
RBCs in pleural space
>100,000
Main causes: trauma, CA, PE
177
PE can cause either
transudative or exudative effusion
178
Chylous effusion (exudative)
Lymphatic duct disruption or impairment
Cloudy, milky
+Triglycerides and lipids
179
Causes of Chylous effusion (exudative)
Trauma
| CA to induce lymphoma
180
CXR before Thoracocentesis
PA, lateral, lateral decubitus
Ensure fluid is accessible by needle
Check for fluidy (lays out when person lies down)
181
Parapneumonic effusion should be sampled if it meets any of the following
Layers out >25 mm
Loculated
Assoc w thickened parietal pleura on CT
Clearly delineated by US
182
Contra for Thoracocentesis
Significant thrombocytopenia
183
Rules for Thoracocentesis
Do not remove >1L
| Do not perform bilaterally
184
Pleural fluid- Transudative features
Protein ratio <0.5
LDH <0.6
Others: WBC <300, glucose levels equal, ph 7.4-7.4
185
Pleural fluid- Exudative features
Protein ratio >0.5
LDH ratio >0.6
Others: WBC >500, Glucose serum, pH lower
186
Pleural fluid analysis
Gross app, cell count, gram stain, protein, glucose, amylase, cytology, CEA carcinoembryonic, cultures, AFB
187
Why would pleural fluid have a pH of <7.3?
infection
esoph rupture
CA
188
Why would amylase be elevated in pleural fluid?
pancreatitis
esoph rupture
CA
189
Eisonophilia in pleural fluid
Parasite
CA
TB
190
Causes of Ascites
Liver cirrhosis
Alc Hepatitis
Acute Liver failure
191
Gold standard for dx Peritoneal Effusion
US
192
Abdominal paracentesis indication
New onset Ascites
with or without:
Fever, abd tender, AMS, hypotension, periph leukocytosis, worsening kidney fx, trauma, severe cirrhosis
193
Abdominal paracentesis contra
Coag abnormalities
Small amt fluid
Previous abd surgery
Massive ileus w bowel/distension
194
Peritoneal fluid- Transudative features
Albumin gradient >1.1
195
Peritoneal fluid- Exudative features
Albumin gradient <1.1
196
LDH ratio >0.6 regarding Peritoneal fluid
Bowel perforation
CA
Infection
197
Amylase elev with peritoneal fluid
Pancreatic
Bowel perforation
CA
Esoph rupture
198
Ammonia with peritoneal fluid
Ruptured or strangulated bowel
199
Bilirubin in peritoneal fluid
Bowel or biliary perforation
200
Urea/Cr
Possible bladder rupture
| trauma
201
Spontaneous bacterial peritonitis SBP
IMP to recognize and tx d/t high Mortality
Pts with Hepatic cirrhosis and Ascites
Sx: ACUTE ONSET fever, chills, abd pain, rebound tender
Labs: exudative effusion
202
Pericardial normal values
<50 mL
Clear, straw colored
NO RBC OR WBC
203
Overall diagnostic approach for Pericardial effusion
CBC, CMP, Trop, Thyroid fx, ANA/ESR/CRP, EKC, CXR, US, MRI or CT
Pericardiocentesis only if necessary
204
When to do pericardiocentesis
Pericardial effusion with TAMPONADE
| If fluid needed for dx and may change tx
205
Contra to pericardiocentesis
Coagulopathy
| Uncooperative pt
206
CSF located b/w
Pia and Arachnoid mater
in the Subarachnoid space
207
Lumbar puncture indications categories
Infection
CA
Multiple Sclerosis
Cerebral/Subarachnoid Hemorrhage
208
Subcategories of infection indications for LP
Meningitis
Encephalitis
Abscess
Neurosyphilis
209
Contraindications to LP
Increased intracranial pressure
Vertebral degenerative joint dz
Infection near LP site
Pts on anticoags
210
IDSA guidelines to do CT before LP!!!!
P A N I C S
```
Papilledema
AMS
Neuro def
Immunocomp
CNS dz hx
Seizure within past week
```
211
Try to draw two separate blood cultures immediately if CNS infection is concern
before starting Abx if possible
212
CSF normal values
```
Clear
Pressure <20
RBC and WBC 0-5
Protein 15-45
Glucose 50-75
LDH <40
```
213
Xanthochromia (yellow) CSF
Bilirubin
| indicating lysis of RBC
214
Decreased pressure (hypovolemia)
dehyrdation
shock
nasal fracture w dural tear
215
Increased ICP
infection
intra-cranial bleed
tumor
hydrocephalus
216
Neutrophilia in CSF
Bacterial/TB meningitis
Abscess
Subarach bleed
Tumor
217
Macrophage in CSF
Fungal/ TB meningitis
Subarach bleed
Brain INFARCTION
218
Lymphocytosis in CSF
VIRAL, SYPHILIS, Fungal, or TB meningitis
Multiple Sclerosis
Guillian Barre synd
219
Multiple Sclerosis and Guillian Barre Syn
Lymphocytes in CSF
220
Eisonophilia in CSF
Parasitic meningitis
| Allergic rxn
221
Xanthochromia usually present with
Subarachnoid hemorrhage
but beware it takes 2-4 hours to occur
222
Oligoclonal gamma globulin bands in CSF
Multiple Sclerosis
223
Lymphocytes in CSF and
| Ologiclonal gamma
Multiple Sclerosis
224
What to order with CSF analysis
everything with others PLUS:
Lactic acid
VDRL
225
Is Lactic Acid elevated in viral meningitis?
NO
| only in bacterial/fungal
226
Glutamine in CSF
Hepatic failure
227
CRP C-reactive protein
bacterial meningitis
228
Syphilis test
VDRL or FTA-ABS
229
Toxoplasmosis eval for CSF
Geimsa/Wright stain
| also used for herpes
230
CSF Tubes
1: Chemistry- Protein and glucose
2: Microbio- Gram stain, Acid fast stain, C&S, PCR
3. Heme- Cell count and diff
4. Hold
231
Intracellular ions
K
phosphate and organic ions
protein
232
Extracellular iions
Mainly Na
| Cl also
233
Types of IVF
Crystalloids
Colloids
Blood
234
Types of Crystalloids (most commonly used)
Isotonic (often- dehydration and hypovolemia)
Hypertonic (emergency)
Hypotonic (maintenance)
Dextrose (sugar)
235
What is used for IV boluses in dehydration and hypovolemia?
CRYSTALLOIDS
NS (0.9%)
Lactated Ringer
Plasmalyte
236
Life threatening hyponatremia
CRYSTALLOID
Hypertonic 3% NS
life threat low Na with water excess
Caution: CPM
237
Maintenance fluids
CRYSTALLOIDS
Hypotonic
NOT good for replacing volume deficits like dehydration or hypovolemia
238
Hypoglycemia
CRYSTALLOIDS
| D5W/Dextrose
239
Colloids
more likely to expand Vascular compartment
Used when crystalloids fail to sustain plasma volume d/t low osmotic pressure
240
Colloids use (not often)
Pt with burn or peritonitis can't hold onto the Crystalloid fluid given
241
DexTRAN and Hetastarch
| Colloids, not often used
Operation room
242
Types of COLLOIDS
Albumin
DexTRAN
Hetastarch
243
Albumin (a Colloid)
Liver dz
Peritonitis
Burn
"third spacing"
244
PRBCs
used WITH Crystalloids to expand intravascular volume
245
What fluids can you bolus?
NS, LR, Plasma lyte, PRBCs
Hypovolemia (dehydration or acute blood loss)
246
What incriments do we bolus?
250mL,500mL, 1L
247
Maintenance IVD
maintain water and electrolyte balance in someone who isn't eating/drinking normally
248
What is generally used for Maintenance fluid?
D5/0.5 NS with 20 meq KCl
249
Maintenance IVF
"Kg method" for Normal adult patients
1500 for basically everybody, then once past 20kg, add 20 ml/kg/day
250
Children require less sodium than adults
Use 0.25 instead of 0.5 NS
251
NEVER BOLUS
K-containing IVF
252
Parkland formula
Burn patients
How much total fl to give them?
% burns x weight x 4 mL
8 hours: give 1/2 total amt
8 hours: 1/4
8 hours: 1/4
253
Parenteral means
not into mouth
into blood in this case
254
When to consider TPN for adults vs children with anticipated or current inadequate energy intake by mouth
adults 7-10 days
| children 3-7 days
255
Diuretics cause you to
lose K
256
ACE-I
| ARBs cause you to
retain K
| too much K
