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ABEM board exam > Equations > Flashcards

Equations Flashcards

1
Q

Anion gap

A

Na - (Cl + HCO3) <= 12
MUDPILES
Methanol, Uremia, DKA/AKA, Paraldehyde/phenformin, Iron/INH, Lactic acidosis, Ethylene glycol, Salicylates

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2
Q

Osmolar gap

A

2Na + BUN/2.8 +glucose/18 + ETOH/4.6 = 285-295

>10: toxic alcohols, mannitol, lorazepam drip

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3
Q

Total body water (L)

A

Wt (kg) x 0.6

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4
Q

Parkland formula

A

4 mL x Wt (kg) x %BSA
1st 1/2 in 8 hours
2nd 1/2 in 16 hours

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5
Q

MAP

A

1/3 SBP + 2/3 DBP or DBP + (SBP - DBP)/3

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6
Q

Pediatric ETT size

A

Age/4 + 4 (uncuffed) and age/4 + 3 (cuffed) (or minus 0.5)
2 x ETT = NG/OT/foley
3 x ETT + depth of ETT
4 x ETT = chest tube
Neonate: premature 2.5 uncuffed, full-term 3.0 uncuffed

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7
Q

A-a gradient

A

140 - (PaO2 + PaCO2)

normal = (age +10)/4

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8
Q

Corrected Na in hyperglycemia

A

Na + 2.4 (glucose-100)/100

Or use 1.6

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9
Q

Winters formula (expected pCO2)

A

1.5 x HCO3 + 8 (+/- 2)
To assess respiratory compensation in metabolic acidosis
“Rule of 15” - if there’s a metabolic acidosis
HCO3 + 15 (+/-2) = pCO2 + last 2 digits of pH (non mixed)

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10
Q

GCS

A

Eye (spontaneous 4, verbal 3, pain 2, none 1)
Voice (oriented 5, confused 4, inappropriate 3, moaning 2, none 1)
Movement (obeys 6, localize pain 5, withdraws 4, flex 3, extend 2, none 1)

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11
Q

Fluid maintenance

A

“4 - 2 - 1”
0-10 kg: + 4 ml/kg/hr
10-20 kg: + 2 ml/kg/hr
>20 kg: 1 ml/kg/hr

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12
Q

Ranson criteria

A

On admission - GLOWS
Glucose >200, LDH >350, older age >55, WBC >16k, AST (SGOT) >250
At 48 hours - BOB CHF
Base deficit (24 - HCO3) > 4, O2 < 60, BUN increase >5, Ca < 8, Hct drop > 10%, fluid deficit > 6L

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13
Q

Jones criteria

A

2 major or 1 major + 2 minor
Major: polyarthritis, carditis, subcutaneous nodules (wrist/elbow/knees), erythema marginatum, syndeham chorea
Minor: fever, arthralgia, h/o RF, prolonged PR, elevated CRP/ESR, GBS infection

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14
Q

Diabetes diagnosis

A

Fasting blood glucose > 126
Random blood glucose > 200 + symptoms
Blood glucose > 200 after glucose tolerance test
Hgb A1c > 6.5%

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15
Q

DKA diagnosis

A 
Serum glucose > 250
pH < 7.3
Serum bicarb < 12
AG > 10
\+ serum/urine ketones
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16
Q

Water deficit

A

0.6 x wt (kg) x [Na/140 - 1]
50% in first 12 hours, rest over next 24 hours
Hypernatremia goal, decrease 1-2 meq/hour

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17
Q

Hypercalemia symptoms

A

Bones, stones, moans, thrones, and psychic overtones
Bone pain, urinary/biliary stones, abdominal pain, N/V, polyuria (porcelain throne), depression, anxiety, insomnia
Shortened QT
< 12 no treatment, 12-14 symptoms based, >14 treat
Lithium causes hypercalcemia

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18
Q

Hypocalcemia symptoms

A 
Tetany
Trousseau's sign (BP cuff)
Chvostek sign (cheek)
Seizure
QT prolongation
19
Q

Pituitary hormones

A

GOATFLAPS
Growth hormone, Oxytocin, Antidiuretic hormone, TSH, FSH, LH, ACTH, prolactin
FLAT PiG - FSH, LH, ACTH, TSH, prolactin, GH and ADH and oxytocin (posterior pituitary)
Prolactinomas = treated with bromocriptine

20
Q

Scarbossa criteria in LBBB (>=3 points)

A

> 1 mm concordant ST elevation = 5 points
1 mm ST depression in V1-V3 = 3 points
5 mm discordant ST elevation = 2 point

21
Q

Causes of infant cyanosis

A

1,2,3,4,5 truncus arteriosus, transposition of the great vessels, tricuspid atresia, tetralogy of Fallot, total anamolous pulmonary venous return

22
Q

Salter-Harris

A

I: straight/slip through
II: metaphysis –> physis (above - *think femur)
III: epiphysis –> physis (low)
IV: both metaphysis and epiphysis (through)
V: crush/ram

23
Q

Indication for thoracotomy in traumatic hemothoraces

A 
Initial output > 1.5L
250mL/hour x 4 hours
Worsening hemothorax
Hemodynamic instability
Cardiac arrest
24
Q

APGAR

A 
Activity (active 2, flexed 1)
Pulse (>100 2)
Grimace (strong cry 2, whimper 1)
Appearance (pink 2, peripheral cyanosis 2)
Respiration (normal 2, slow 1)
25
Q

Most common cause of death in sickle cell anemia?

A

Sepsis (especially pneumonia) – asplenia –> infection due to encapsulated organisms (ie strep pneumoniae, e coli, H flu)
Stroke also common > aplastic crisis > splenic sequestration

26
Q

Non-anion gap

A

HARDUP - GI and renal causes

Hypoaldosteronism, Acetazolamide, Renal tubular acidosis, Diarrhea, Ureterosigmoidostomy, Pancreatic fistula

27
Q

Criteria for anaphylaxis

A

1) acute onset derm/mucosal reaction + respiratory compromise or hypotension
2) acutely at least 2 of the following with known allergen: derm/mucosal involvement, respiratory compromise, hypotension, GI symptoms
3) hypotension in setting of unknown allergen

28
Q

Indications for perimortem C-section

A

> 24 weeks (or 4 finger breaths above umbilicus)

Witnessed arrest and can be done in 4-5 minutes

29
Q

DIC lab findings

A

Hemolytic anemia –> decreased haptoglobulin, increased indirect bili, increased LDH, schistocytes
Increased thrombin generation –> decreased fibrinogen, elevated coags
Increased fibrinolysis –> elevated Ddimer and fibrin degradation products
Moderate-severe thrombocytopenia

30
Q

Kocher criteria for septic arthritis in pads

A 
Fever > 101.3F
non-weight bearing
ESR > 40
serum WBC > 12K
All 4 --> 99% specific
31
Q

Sudden unexplained infant death risks

A

3rd leading cause of infant death
Most common at age 2-4 months
Prone sleeping, sleeping on soft surface, maternal smoking during or after pregnancy, overheating from heavy bedding/clothing, late or no prenatal care, long maternal age, prematurity, low birth weight, male sex

32
Q

EKG findings in PE

A

Sinus tach
Twave inversions V1-V3
RBBB
S1Q3T3

33
Q

Endocarditis pathogens

A

Prosthetic valves: < 2 months, staph aureus, coag-neg staph, staph epidermis –> late: strep viridans, serratia pseudomonas
Native valve: staph aureus, older patients strep viridian’s

34
Q

Encapsulated bacteria

A

Klebsiella (gram neg bacilli), Neiserria (diplococci), Salmonella, Gp B strep (gram pos cocci in pairs), H flu

35
Q

Ectopic pregnancy risk factors

A

Prior ectopic, h/o PID, h/o tubal surgery, presence of IUD, assisted reproductive therapy

36
Q

Causes of neonatal jaundice

A

Non-serious: physiologic, breast milk (substances in milk inhibit glucuronyl transferase), breast feeding (inadequate feeding)
Serious: sepsis, biliary atresia (elevated direct bilirubin), metabolic dysfunction, blood disorder –> check CBC, bilirubin, Coombs, T & S

37
Q

ABCD2 score in TIA (likelihood of stroke in 2 days

A

Age > 60 = 1 pt
BP: SBP >140 or DBP > 90 = 1 pt
Clinical feature: unilateral weakness = 2 pts, speech disturbance without weakness = 1 pt
Duration: 10-59 minutes = 1 pt, >60 minutes = 2 pts
History of DM = 1 pt
Low risk = 0-3 –> discharge
4-5 moderate risk, 6-7 high risk

38
Q

Mechanical complications after MI

A

Rupture of LV free wall –> cardiac tamponade, check echo, pericardiocentesis, fluids, inotropes, surgical repair
Septal rupture –> holosystolic murmur best at left sternal border, check echo, afterload reduction, inotropes, intraaortic balloon pump, surgical repair
MV regurgitation –> early/mid/holosystolic murmur best at apex, check echo, afterload reduction promotes forward flow, surgical repair

39
Q

Murmurs

A

mitral stenosis - loud S1, opening snap, diastolic murmur heard best at apex
mitral prolapse - early/mid click, high-pitched late systolic murmur heard best at left lateral border
Aortic stenosis - crecendo-decrecendo murmur radiating to neck
Aortic regurgitation - high-pitched diastolic murmur heard best at left sternal border

40
Q

Well’s score

A 
Low < 2, moderate 2-6, high > 6
Clinical S/s DVT = 3 pts
Heart rate > 100 = 1.5 pts
Immobilization >=3 days or surgery in last 4 weeks = 1.5 pts
Previous DVT/PE = 1.5 pts
Hemoptysis = 1 pt
Malignancy = 1 pt
Likely PE = 3 pts
41
Q

Causes of late decelerations

A

Uteroplacental insufficiency: abruption, excessive uterine contractions/hyperstimulation, materal hypotension
NOT cord compression (variable decels)

42
Q

Indications for HBO

A

Neuro deficits, AMS, cardiovascular compromise, MI, syncope, dysrhythmia, COHb level > 25%, pregnant with COHb level > 15%

43
Q

Encapsulated orangisms

A

“Some Nasty Killers Have Some Capsule Protection”

Strep pneumo, Neiserria meningitidis, Klebsiella, H flu, Salmonella, Cryptococcus, Pseudomonas

44
Q

Fluid analysis in SBP

A

PMN > 250
Total leukocyte count > 500-1000
Tx: 3rd generation cephalosporin

ABEM board exam (3 decks)

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