Lab Flashcards
NA+
Sodium 135-145
Primary extracellular cation
Helps nerves and muscles contract
K+
Potassium 3.5-5.0
Primary intracellular cation
Most dangerous abnormality
Cell excitability
CL-
Chlorine 96-106
Extracellular anion
Tends to shift with NA+
Hypochloremia impending renal dysfunction
CO2
22-26
Helps maintain acid-base balance
BUN
Blood urea nitrogen
8-23 mg/dl
Provides picture of renal clearance
Tends to increase with age
Creatinine (CR)
.7- 1.4 mg/dl
High levels = permanent kidney damage
Glucose
70-110
High levels = coma/death
Calcium
8.5-10.2
Most essential electrolyte in body
Hypercemia
Kidney transplant, hyperparathyrodism, tb
Hypocalcemia
Alcoholism, pancreatitis, renal failure
Cvosteks sign
Cheek muscle spasms with facial nerve
Trousseaus sign
Forearm tetany with no cuff
Treat with calcium glucanate
Ionized calcium
4.5-5.6
Decreased levels from receiving blood transfusions
Sepsis and low albumin
Anion gap
Poor man’s abg
Sodium, chloride and bicarbonate factored together
Normal = 12 (+-4)
Large number is bad
Replacement formula
.1 x (-be) x kg = bicarbonate required
Therapy for anion gap trt with bicarbonate
RBCS,hmglobin, hematocrit
5/15/45
WBCs
4500-11000 ul
Low = seen in sepsis destroyed at rate that exceeds production
High= inflammation, infection and trauma
Platelets
150-400k ul
Total protien
6-8 g/dl
Albumin and immunoglobulins
Albumin
3.5-5.5 g/dl
Produced by liver, transport protein
Coagulation intrinsic pathway
Triggered by endothelial dmg
Platelets activate
Initiates clotting
Formation of clot
Dissolves 7-10days
Coagulation panel
PT 10-13 sec (prothrombin time extrinsic)
PTT 25-40 sec (partial thromboplastin time intrinsic)
INR .9-1.3 sec (international normalized ratio)
“Pt do outside”
Heparin/lovenox
Affects intrinsic pathway
Overdose trt with Protamine Sulfate
Coumadin (warfarin)
Affects extrinsic pathway
Overdose with vitamin k
Extrinsic pathway
Damaged tissue
Release tissue thromboplastin
Highest in Brain and placenta
Platelets arrive
Initiate clotting
Form clot
7-10 days dissolve
ALT
Alanine transaminase
7-55 units per liter
AST
Aspartame transaminase
8-48 u l
Increase indicate liver damage or disease
Alkaline phosphotase
45-115
Increase indicates damage
Albumin
Decrease levels indicate liver damage
Lactate
.5-1 mmol/L
Hyper= 2-4
Lactic acidosis 4-5
Most commonly caused by decrease blood flow to cells
Amylase
25-125
Test used for pancreatitis
>300
Lipase
5-60
Test used to detect pancreatitis
Urine 2/1/.5
Infant 2ml/hr
Child 1 ml/hr
Adult .5 ml/hr
Average output is 30/50ml/hr
Electrical burs/ rabdo 100ml/hr
DKA
Common in type 1
Glu>350 occasionally exceeds 800
Ella Ted ketones, metabolic acidosis
Kussmal respirations
DKA TRX
Bolus insul .1
Inufusion .1
Do not lower glucose <100
Hhnk
Common type 2
Extremely elevated glu> 600
Non ketonix, non acidotic and no kussmal
Hhnk trx
7-10 liter deficient
Insulin bolus and infusion
Glu not <100
DI
Kidneys are unable to conserve water
Central/neuro DI
ADH no longer produced by pituitary gland
Nephrgenic DI
Kidneys do not respond to AHD
Caused by Dilantin Od and head injuries
DI trx
Fluid resuscitation and DDAVP
Siadh
Syndrome of inappropriate ADH
Too much ADH in body
Central pontine myelinolysis can occur if sodium corrected to quickly
Hyperthyroidism
Avoid aspirin
Thyroid storm hr> 140
Hypothyroidism/myxedema coma
Fatigue, cold intolerance, weight gain, puffy eyelids
Trx with T4 or T3 levothyroxine
Adrenal insufficiency
Addison disease
No etomidate
Bronze skin
Cushings
Hypercortisol
BUFFULO hump
Rumor removed or steroids are stopped
Peptic ulcer
Upper gi bleed
Esophageal varices
Trx octreotide
Balloon tamponade: sengstaken blakemore tube
No NG tube
Mallory Weiss
Not life threatening
Forceful vomiting
Boerhaaves tears
Hammans sign: crunching sound upon auscultation
Sub cu emphasymea
Pancreatitis
ARDS
pain upper left
CULLEN SIGN
GREY TURNER
No morphine
Septic shock
Lactate > 4 mmol/l
No etomidate i rsi
DVT (virchows triad)
Virchow=venous
Homans sign: pain on dorsiflexion
Warm limb
Arterial occlusion
Cold limb
Sea level
760 torr
Compression loss
Windows fogging
90 seconds at 30k
If rapid decent then 45 sec
Boyle law
Alltitude ⬆️ pressure ⬇️ volume ⬆️
Charles law
Air expands when hot
Dalton’s law
As alltitude increases partial pressure decreases
O2 needed
Ficks law
Increase partial pressure = increase oxygenation
Gay lussac
Pressure decreases with temp
Graham law
Lower molecule weight can diffuse better
Henry’s law
Diving adds pressure when surfacing nitrogen comes out
Oxygen adjustment calc
Fio2(current torr) x new alt torr = oxygen requirement at new alt
Every 1k increase temp
Drop 2 c
Barodontalgia
Ascent
Boyce’s law air in tooth expand
Bartitis
Descent
Air trapped in middle ear
Barosinusitis
descent
Air in sinuses
Ground transfer preferred for dive inj
Can fly fixed wing at <1k
Atmosphere calc
Each is 33 feet
Stressors of flight self imp.
Dehydration
Exhaustion
Low freq vibrations
1-12 hz
Power plant
Hypemic
Hypoxia at the blood level
Histotoxic
Hypoxia at cellular level
Cyanide,
Stage of hypoxia
Indifferent: full reasoning most danger
Compensatory: incr hr, vent and slowe judgment
Disturbance: drunk
Critical: death
Consolidated omnibus budget reconciliation act
Protects uninsured pt
Emergency medical treatment and active labor act
250 yard rule for trt
Sending physician is responsible for pt until they arrive at next facility
Sterile cockpit
Take off
Landing
Refueling
Taxi
Flight following
15 min flying
45 min on ground
Activated after 2 missed checkin
Long range flight
> 3 hr
Rotary wing pilot in comand
2000 hr flight time
1000 pc/pic
Must be instrument rated for IFR
+ 100 hours at night got fixed wing
Area orientation
5hours total with 2 at night
Federal aviation regulation 91.17
No fly within 8hrs of alcohol
Higher than .04%
FAR 135
14 hour duty day
8hr total fly time
Weather min
Day 800’ 2 miles
Night 800 3 miles
Cross country fly
800 3 miles
1000’ 3 miles
Visual flight rules
See where u are flying
Instrument flight rules
Use instruments
HLZ
100x100’
1 approach and departure
2 passes one high/low
Approaching aircraft
11/1 o’clock
Hazmat zone
Land uphil and up wind
3 cross straps
Chest hip knee
Emergency locator transmitter
Self activated at 4gs
Freq 121.5/406
VHF
Line of sight
Long range
UHF
Short distances
Simplex
1 direction
Duplex
Two way and half duplex
Red light
Left wing
Green light
Right wing
White light
Rear
Performance temp
-33 to 122
Ambulance marking
3 inch high
Sirens
Audible >500 ft
Lights
> 500’ft