DSP Flashcards
typical urine output
600-2000 mL/day
urine glucose false pos
SGLT2 inhib
urine glucose false neg
Vit C
urine bili pos
conjugated/direct hyperbili
urine bili false pos
red urine
urine bili false neg
light exposure
urine ketones pos
lipid metab
urine ketones pos and glucosuria pos
DKA
urine ketone false pos
highly pigmented urine
urine spec gravity normal
<1.010
urine blood pos
hematuria or hematoglobinuria
urine blood false pos
menses, strenuous exercise
urine blood false neg
red urine, beets
urine pH acidic
high protein diet, diabetic acidosis, severe diarrhea, dehydration, fever, bacteria
urine pH alkaline
high veg/milk/citrus diet, vomiting, resp alkalosis, UTI, CKD
urine protein pos
glomerular damage, nephrotic syndrome, preeclampsia
urine protein false pos
pH 9+
urobilinogen increased
unconjugated/indirect bili
urobilinogen absent
conjugated/direct bili
urobilinogen false pos
red urine
urobilinogen false neg
old urine
hemolytic dz bili and urobili
reg bili, inc urobili
hepatic dz bili and urobili
inc bili, inc urobili
extrahep dz bili and urobili
inc bili, absent urobili
urine nitrate pos
enterobacteria present
urine nitrate false neg
<4-6 hrs since last urination
urine leukocytes pos
UTI or inflammation
urine leukocytes false neg
conc urine, proteinuria, glucosuria, viral infection
RBC microscopy values
<5 normal, >=2 microscopic hematuria
neutrophil microscopy
bacteria
eosinophil microscopy
interstitial nephritis
transitional epithelial cells microscopy
renal pelvis -> prox urethra
squamous epithelial cells microscopy
distal urethra -> ext genitalia
RBC cast
glomerulonephritis
WBC cast
interstitial nephritis
granular casts
acute tubular necrosis or AKI
renal tubular casts
acute tubular necrosis
hyaline casts
oliguria with conc urine
broad waxy casts
CKD
fatty casts
nephrotic syndrome
calcium oxalate mono
dumbbell; kidney stone
calcium oxalate di
square envelope; kidney stone
calcium phosphate
circle with spikes; alkaline urine
uric acid crystals
rhomboid; acidic urine
cystine crystals
cuboidal; acidic urine
struvite crystals
long envelope; alkaline urine (common in bact)
oval fat bodies
maltese cross, nephrotic syndrome
bladder scan direction
3 cm above pubic symphysis; 15 degree caudal
bladder scan pos number
> 300 mL is urinary retention
bladder scan inaccurate if
body habitus, edema, scar, vol >1000mL
bladder scan equation
transverse x AP x length x 0.52
urine culture positive number
> =100,000 or if woman with pyuria, >= 1000
Gram pos color
purple
Gram neg color
pink (red)
gamma hemolytic bacteria
MRSA, Staph epidermis, Group D strep (boris, viridans)
alpha hemolytic bacteria
Strept pneumoniae, Enterococcus faecalis
tetanus prone wound
> 6 hrs old, >1 cm deep, stellate/avulsion, associated with devitalized tissue, contam with soil/feces/saliva, from gun/puncture/crush, associated with frostbite/burn
absorb mono
Gut, monocryl, PDS
absorb multi
vicryl
nonabsorb mono
prolene, nylon
nonabsorb multi
silk, nylon
growth hormone increase
gigantism, acromegaly, anorexia/starvation, hypoglycemia, stress/surgery, exercise
growth hormone decrease
pituitary insuff, GH deficient, hyperglycemia
growth hormone stim test
give insulin to cause hypoglyc, if GH >10x => positive for excessive response
growth hormone suppress test
give glucose to cause hyperglyc, if GH does not change => positive for insufficient regulation
GH effects
increase skeletal growth, increase free FA, increase gluconeogen, increase blood to kidneys
prolactin effects
milk secretion in females
prolactin increase
pharm (SSRI, anticonvulse), physio (stress, exercise), patho (acromegaly, hypothy, SLE)
ACTH secreted in resp to
dec cortisol, inc stress, hypoglycemia
ACTH effects
stim adrenal cortex to release mineralcorticoids, glucocorticoids, and androgens
normal stimulation test for ACTH
give ACTH, if <2x rise in cortisol => deficient
ACTH increase
Addison dz (adrenal failure), pituitary adenoma or other ACTH tumor
ACTH decrease
Cushing dz, Cushing syndrome, adrenal hyperplasia, hypopituitary
TSH secreted in resp to
decreased T3/T4
TSH increase
primary hypothyroidism, thyroditis, thryoid ablation, iodine toxicity, pituitary tumor
TSH decrease
secondary hypothyroidism, hyperthyroid, meds (synthyroid)F
GH hypothal
GHRH
ACTH hypothal
CRH
TSH hypothal
TRH
FSH/LH hypothal
GnRH
FSH effects
female: maturation of germinal follicle, produce estrogen
male: control spermatogenesis in Sertoli cells
LH effects
female: LH surge leads to ovulation, corpus luteum develop, produce progesterone
male: produce testosterone in Leydig cells
LH/FSH increase
ovarian/teste fail, pituitary neoplasm, drugs
LH/FSH decrease
hypo pituitary, hyper ovary/testes, drugs
ADH released in resp to
increased serum osmolarity, decreased blood volume
ADH effect
increased water reabsorb in the kidneys
ADH increase
SIADH, nephrogenic DI, tumor, severe phys stress, hypovolemia
ADH decrease
central DI, tumor, CNS trauma/infection, ablated pituitary, hypervolemia
oxytocin effect
milk letdown, uterine contractions
order of pituitary loss function
GLFTAP (GH, LH, FSH, TSH, ACTH, Prolactin)
T3/T4 effect
increase metab act, carotene into vit A, CNS development
hyperthyroid TSH, T3/T4
dec TSH, inc T3/T4
primary hypothyroid TSH, T3/T4
inc TSH, dec T3/T4
secondary hypothyroid TSH, T3/T4
dec TSH, dec T3/T4
increased T3
OCP, estrogen
increased T4
Synthyroid
decreased T3
steroids, ASA, phenytoin
decreased T4
iodine deficiency
PTH secreted in resp to
decreased Ca2+ or Mg2+
PTH effect
release Ca from bone, increase Ca reabsorb in kidney, increase vit D product
Increase PTH
primary hyperparathyroid, chronic renal failure, Ca malabsorb, vit D deficiency, drugs
decreased PTH
hypoparathyroid, bone malignancy, drugs
adrenal glands produce
cortex: mineralcorticoids, glucocorticoids, androgens
medulla: amphetamines
aldosterone secreted in resp to
decreased Na, decreased blood vol, increased K
aldosterone effect
stimulate kidney to reabsorb Na, increase K excrete, involved in RAAS
aldosterone increase
primary hyperaldo (adrenal adenoma), secondary hyperaldo (dec renal perfusion), drugs
aldosterone decrease
steroids, renin deficiency, hypernat, hypokal, drugs, Addison dz
epinephrine secreted in resp to
sympathetic stimulation, hypoglyc, hypotension
norepinephrine secreted in resp to
sympathetic stimulation
epinephrine effect
increase metab, inc HR, inc BP, inc glucose
norepinephrine effect
decreased HR, inc BP
IUD contraindic
pregnant, septic abortion, puerperal sepsis, postpartum endometriosis, uterine malformation, STD/PUD in last 3 mo, <4 wk postpartum, neoplasm
hormone only: migraine with FND, hx of VTE
gestation sac criteria
major: >= 25 mm and embryo inside, round
minor: fundus, thick echogenic ring, double ring sign
what eval on 2nd/3rd trimester scan
biparietal diameter
head circumference
femur length
abd circumference
amniotic fluid vol
fetal heart rate
head circumference equation
1.57 (BPD * occipt-front diameter)
best predic of growth restrict
abd circumference
oligoamnio and polyamnio
oligo: <2
poly: >8
breast US probe
high freq linear
breast US benign
well defined, hypoechoic, wider>deep, post acoustic enhance, no power to center
reassuring nonstress test
2+ FHR accelerations (15 bpm above baseline for 15+ seconds) in 20 mins
early decelerations
nadir of FHR is at peak of contract
cause: fetal head compression
variable decelerations
abrupt dec of FHR, not related to contraction
cause: umbilical cord compression
late decelerations
grad dec of FHR, nadir is after peak compression
cause: uteroplacental deficiency
cardinal tech of delivery
engage
descent
flexion
int rotate
extension
ext rotate
expulsion
thoracostomy safe area
lateral edge of pec major, base of axilla, 5th IC space, lateral edge of lat dorssi
