medicine i should know Flashcards
Abx with MRSA coverage
Clinda, vanc, bactrim, ceftaroline, dapto, linezolid
abx with pseudomonal coverage
Meropenem, zosyn, levaquin, aminoglycosides, cephalosporins
COPD diagnosis
FEV1/FVC less than 0.7
sodium quantity of IV fluids
NS = 154 meq/L 1/2NS = 77 meq/L LR = 130 meq/L
meds that improve mortality in HF
1) BB 2) Statin 3) ACE/ARB 4) Aldosterone antagonists 5) Hydralazine/isosorbide in AA’s
normal PCO2 on ABG
35 to 45 mmHg (4.7 to 6 kPa)
normal pO2 on ABG
> 80
normal PO2 on VBG
30-40
anytime you make someone NPO you should reflexively
think whether they’re on insulin
any procedure think
1) NPO at midnight
2) hold DVT PPX
3) check PT/INR
every time you make someone NPO think
1) NPO EXCEPT MEDS
2) are they on insulin
3) Accuchecks
every time you order a PICC think
SINGLE LUMEN
any time you order an MRI think
1) Claustrophobic? Need to premedicate?
2) Metal devices or metal cardiac stents
vanc trough goal for skin and soft tissue infections
10-15
intraabdominal infection abx duration if source control
5 days
when changing diuretic dose always
confirm whether patient is compliant
when consulting nephrology give them
K, bun, cbc, creatinine, phosphorus, volume status
when a person tries to AMA always ask
whether they have capacity
when you need contrast
1) Vascular structures
2) Solid organs, and malignancy/tumor evaluation
3) Abscess
4) CT abdomens, commonly
DIC panel
PT/PTT + d-dimer + fibrinogen + smear + CBC (platelets)
SIRS criteria
Temp >38°C (100.4°F) or < 36°C (96.8°F)
Heart rate > 90
Respiratory rate > 20 or PaCO₂ < 32 mm Hg
WBC > 12,000/mm³, < 4,000/mm³, or > 10% bands
Reasons to have an elevated d-dimer
any acute or inflammatory process (eg, age >50 years, recent surgery or trauma, acute illness, pregnancy or postpartum state, rheumatologic disease, renal dysfunction [estimated glomerular filtration rate <60 mL/min/1.73 m2]), sickle cell disease, pulmonary disease
every time you order contrast study you need to
check for recent creatinine
positive orthostatics
- Pulse rate increases >20; OR
- Systolic blood pressure decreases by 20-30 mmHg; OR
- The patient has an increase in dizziness, weakness, nausea, or other symptoms.
Left heart catheterization generally means
coronary angiography
what are esbl producing organisms and to what are they resistant
ESBLs are beta-lactamases that hydrolyze extended-spectrum cephalosporins with an oxyimino side chain. These cephalosporins include cefotaxime, ceftriaxone, and ceftazidime.
Options for treating ESBL organisms
typically carbapenem (possibly zosyn too)
strength grading
5- normal 4- some weakness 3- can lift against gravity 2- no lift against gravity 1- no contractions
