Surgical Recall Flashcards
1
Q
Ballance’s sign
A
Constant dullness to percussion in the L flank/LUQ & resonance to percussion in the R flank - splenic rupture/hematoma
2
Q
Beck’s triad
A
Cardiac tamponade:
1) JVD
2) Dec/muffled heart sounds
3) Dec BP/Pulsus paradoxus
3
Q
Bergman’s triad
A
Fat embolism syndrome:
1) Mental status change
2) Petechiae (axilla/thorax)
3) Dyspnea
4
Q
Blumer’s shelf
A
Metastatic disease to rectouterine (pouch of Douglas) or rectovesical pouch, creating a palpable sehlf on rectal exam
5
Q
Boas’ sign
A
R subscapular pain from cholelithiasis
6
Q
Borchardt’s triad
A
Gastric volvulous:
1) Emesis followed by retching
2) Epigastric distention
3) Failure to pass NGT
7
Q
Carcinoid triad/syndrome
A
W/carcinoid syndrome:
1) Flushing
2) Diarrhea
3) R-sided HF (2ndary to chemicals released by tumor)
4) Bronchospasm
8
Q
Charcot’s triad
A
W/cholangitis:
1) Fever/chills
2) Jaundice
3) RUQ pain
9
Q
Courvoisier’s law
A
Enlarged nontender GB seen with obstruction of the CBD, common with pancreatic CA
10
Q
Cushing’s triad
A
Inc ICP:
1) HTN
2) Bradycardia
3) Irregular respirations
11
Q
Dance’s sign
A
Empty RLQ in children w/ileocecal intussusception
12
Q
Fothergill’s sign
A
Intra-abd mass vs mass in abd wall: mass felt while tension in mm (sitting up) –> mass in abd wall
13
Q
Fox’s sign
A
Ecchymosis of inguinal ligament w/ retroperitoneal bleeding
14
Q
Hamman’s sign
A
Crunching sound on auscultation of heart - from emphysematous mediastinum (Boerhaave’s syndrome, pneumomediastinum)
15
Q
Howship-Romberg sign
A
Pain along inner thigh - obturator hernia compressing nn
16
Q
Kehr’s sign
A
L shoulder pain from splenic rupture (referred pain from diaphragmatic irritation)
17
Q
Kelly’s sign
A
Visible peristalsis of ureter in response to squeezing or retraction - ID ureter during surg
18
Q
Mittelschmerz
A
LQ pain d/t ovulation
19
Q
Obturator sign
A
Pain w/int rot of leg, hip and knee flexed - pts with appendicitis/pelvic abscess
20
Q
Pheochromocytoma
A
1) Palpitations
2) HA
3) Episodic diaphoresis
10% b/l, malig, children, extra-adrenal, multiple tumors
21
Q
Reynold’s pentad
A
1) Fever
2) Jaundice
3) RUQ pain
4) Mental status change
5) Shock/sepsis
in suppurative cholangitis
22
Q
Saint’s triad
A
1) Cholelithiasis
2) Hiatal hernia
3) Diverticular disease
23
Q
Sister Mary Joseph’s sign/node
A
Met tumor to umbilical LNs
24
Q
Virchow’s node
A
Met tumor to L supraclavicular node (d/t gastric CA)
25
Valentino's sign
RLQ pain from perforated peptic ulcer d/t succus/pus draining into RLQ
26
Westermark's sign
Dec pulm vascular markings CXR in a pt w/PE
27
Whipple's triad
Insulinoma:
1) Hypoglycemia (<50)
2) CNS and vasomotor symp (Syncope, diaphoresis)
3) Relief of symp w/ glucose
28
Afferent loop syndrome
Obstruction of affarent loop of Billroth II gastrojejunostomy (greater curvature of the stomach connected to the first part of the jejunum in end-to-side anastomosis.)
29
Blind loop syndrome
Bacterial overgrowth of intestine 2ndary to stasis
30
Budd-Chiari syndrome
Thrombosis of hepatic vein
31
Dumping syndrome
Delivery of large amount of hyperosmolar chyme into sm bowel after vagotomy and gastric drainage procedure (pyloroplasty, gasterojejunosotmy) --> autonomic instability, abd pain, and diarrhea
32
Fitz-Hugh-Curtis syndrome
Perihepatic gonorrhea infx
33
Gardner's syndrome
GI polyps assoc w/ Sebaceous cyst, Osteomas, Desmoid tumors. High malig potential
34
HIT syndrome
Heparin Induced Thrombocytopenia
Type I - Non-immune, 1-4 days after heparin, mild thrombocytopenia, 6-14 day tx
Type II - Immune mediated against Platelet Factor-4, 5-10 days after heparin, severe thrombocytopenia, min 6 mo tx
35
Leriche's syndrome
Iliac occlusive disease
1) Claudication of buttocks and thighs
2) Impotence
3) Atrophy of legs
36
Mendelson's syndrome
Chemical pneumonitis after aspiration of gastric contents
37
Mirizzi's syndrome
Extrinsic obstruction of CBD from gallstone in GB or cystic duct
38
Ogilvie's syndrome
Massive nonobstructive colonic dilatation (no mechanical cause)
39
Peutz-Jeghers syndrome
Benign GI polyps and buccal pigmentation
40
Plummer-Vinson syndrome
1) Esophageal web
2) Fe-deficiency anemia
3) Dysphagia
4) Spoon shaped nails
5) Atrophic oral and tongue mucosa
- Inc affinity for SqCC, Older female
41
RED reaction syndrome
Skin erythema from rapid vancomycin infusion (AEs red man syndrome, anaphylaxis)
42
Refeeding syndrome
HypoK, hypoMg, hypoP
43
Osler-Weber-Rendu syndrome
GI tract telangiectasia/AV malformations (Port Wine stain)
44
SVC syndrome
Obstruction of the SVC, associated Horner's (ptosis, miosis, anhydrosis)
45
Thoracic Outlet Syndrome
Compression of VAN between the clavicle and 1st rib
46
Tietze's syndrone
Costrochondritis, aseptic
47
Toxic Shck syndrome
S aureus toxin --> fever, hypotension, organ failure, rash (desquamation esp palms and soles)
48
MC indication for sug in Crohn's disease
SBO
49
MC Breast CA
Infiltrating ductal
50
MC vessel in bleeding duodenal ulcer
Gastroduodenal aa
51
MC bacteria in stool
B fragilis
52
MC site of GI carcinoids
Appendix
53
MC electrolyte deficiency causing ileus
HypoK
54
MC position of anal fissure
Posterior
55
MC type of colonic volvulus
Sigmoid volvulous
56
MC causes of post-op fevers
```
Wind - POD 1-3 - Atelectasis/pneumo
Water - POD 3-5 - UTI
Walk - POD 4-8 - DVT/PE
Wound - POD 5-7 - SSI
Wonder drugs - anytime - meds
```
57
MC organ damaged in blunt abd truama
Liver
58
MC organ damaged in penetrating abd trauma
Sm bowel
59
MC benign liver tumor
Hemangioma
60
MC cause of ICU pneumonia
Gr (-) bacteria
61
1 L of O2 via nasal cannula raises FiO2 by...?
3%
62
Suture sizes
By diameter: higher the O, the smaller the diameter (2-O >5-O) (ie the number of Os (zeros) in front of the number, so 0.00 >vs> 0.00000)
63
Catgut
- -Absorbable
- -Monofilament
- -Fibers from cow or sheep intestines.
- Chromic gut - tx with chromium salts --> more collagen crosslinking, the suture is more resistant to breakdown
- Plain - quicker dissolution
64
Vicryl
- -Absorbable
- -Braided/multifilamentous
- -Copolymer of lactide and glycoside
- ~10% strength after 4 wks
65
PDS (polydioanone)
- -Absorbable
- -Monofilament
- -Polymer of polydioxanone
- -complete absorption 6 mo
66
Silk
- -Non-absorbable
| - -Braided/multifilamentous
67
Prolene
- -Non-absorbable
| - Vascular anastomosis, hernias, abd fascial closure
68
Wound closure - Primary intention
Wound edges are approximated in a clean manner
69
Wound closure - Secondary intention
Wound remains open to heal via granulation, contraction, and epithelization - for dirty wounds, abscess
70
Wound closure - Tertiary intention
Wound remains open for a time and then closed, allows for debridement and wound care to reduce bacterial infx -->delayed primary closure
71
Taper point needle
Round body needle - spreads without cutting - suturing soft tissue (GI tract, mm, nn, peritoneum, fascia)
72
Conventional cutting needle
Triangle body needle - sharp edges - suturing skin
73
Vertical mattress use
For difficult to approximate skin edges - eversion of tissue
74
Retention suture
Large suture (#2) - full thickness through entire abd wall (except peritoneum) - used buttress and abd wound at risk for dehiscence
75
Time to remove sutures
```
Face - 3-5 d
Extremities - 10 d
Joints - 10-14 d
Back - 14 d
Abd - 7 d
```
76
Femoral structures
Lateral to medial: Nerve, Artery, Vein, Lymphatics
77
Very high drainage from NGT
NGT may be in duodenum and picking up 3L/hr fluid
78
Bowel prep
Colon cathartic (Golytely), oral abx (neomycin, erythromycin), and IV abx before incision
79
Pringle maneuver
Occlusion of the porta hepatis through hepatoduodenal ligament: Hepatic aa, Portal vv, and CBD
-Temporary control of liver blood flow when parenchyma is actively bleeding
80
Hartmann's procedure
1) Proximal colostomy
| 2) Distal stapled-off colon or rectum that is left in peritoneal cavity
81
What reverses the deleterious effects of steroids on wound healing?
Vit A
82
Wound dehiscence
Opening of the fascial closure --> OR for immediate fascial reclosure
83
Dakin solution
Dilute sodium hypochlorite (bleach) used in contaminated wounds
84
Gerota's fascia
Fascia surrounding the kidney
85
Collateral circulations in portal HTN
1) Esophgeal varices
2) Hemorrhoids (inf hemorrhoidal vv to internal iliac vv)
3) Umbilical vv (caput medusa)
4) Retroperitoneal vv (via lumbar tributaries)
86
Retroperitoneal GI tract structures
Most of duodenum, ascending colon, descending colon, pancreas
87
What is the Gubernaculum?
Embryologic structure - adheres the testes to the scrotal sac
88
Rotter's LNs
LNs between the pectoralis minor and major mm
89
Hesselbach's triange
Bordered by:
1) Inguinal ligament
2) Epigastric vessels
3) Lateral border of the rectus sheath
90
Calot's triangle
Bordered by:
1) Cystic duct
2) Common hepatic duct
3) Cystic aa
* * Calot's node is LN in th triangle
91
Gastrinoma triangle
>80% of gastrinomas located within borders of:
1) Junction of the 2nd/3rd protions of the duodenum
2) Cystic duct
3) Pancreatic neck
92
White lines of Toldt
Lateral peritoneal reflections of the ascending and descending colon
93
Submucosa of the GI tract
Strongest layer of small bowel
| *SEROSA not present in esophagus, middle, and distal rectum
94
Vein of Mayo
vv overlies the pylorus
95
Layers of abd wall
1) Skin, fat
2) Scarpa's fascia
3) Ext oblique
4) Int oblique
5) Transversus abdominis
6) Transversalis fascia
7) Preperitoneal fat
8) Peritoneum
96
Jejunum vs ileum
Jejunum - long vasa rectae, large plicae circularis (valvulae conniventes), thicker wall
Ileum - shorter vasa rectae, smaller plicae circulares, thinner wall
97
Lg vs Sm bowel
Lg - has taeniae coli, haustra, and appendices epiploicae (fat appendages)
Sm - smooth
98
Should pt take anti-hypertensive med on day of surgery?
Yes - Esp clonidine because it has a rebound HTN effect
99
Billroth I
Antrectomy with gradtoDUODenostomy (pylorus and gastric antrum is removed and duodenum is attached to the remaining gastric pouch)
100
Billroth II
Antrectomy with gastroJEJUnostomy (greater curvature attached to the jejunum, the duodenum is a limb no longer attached to the stomach)
101
Bassini Herniorrhaphy
Inguinal hernia repair:
| Approximating transversus abdominis aponeurosis and conjoint tendon to Poupart's (inguinal) ligament
102
McVay Herniorrhaphy
Inguinal hernia repair:
Approximating transversus abdominis aponeurosis and conjoint tendon to Cooper's ligament (superior pubic bone periosteum)
103
Lichtenstein Herniorrhaphy
Inguinal hernia repair:
| Tension free - uses mesh (or synthetic graft)
104
Shouldice Herniorrhaphy
Inguinal hernia repair:
Imbrication of the transversalis fascia, transversus abdominis aponeurosis, and conjoint tendone and approximation of the transversus abdominis aponeurosis and the conjoint tendon to the inguinal ligament
105
Plug and Patch Herniorrhaphy
Prosthetic plug pushes hernia sac in and is then covered with prosthetic path to repair hernia
106
AbdominoPerineal Resection (APR)
Removal of rectum and sigmoid colon through abdominal and perineal incisions (pt w/colostomy)
For low rectal cancers <8cm from anal verge
107
Low Anterior Resection (LAR)
Resection of low rectal tumors through anterior abd incision
108
Kocher Maneuver
Dissection of the duodenum from the R sided peritoneal attachment --> allows for mobilization and visualization of the back of the duodenum and pancreas
109
Puestow Procedure
Side-to-side anastomosis of the pancreas and jejunum
110
Stamm gastrostomy
Gastrostomy placed by open surgical incision and tacked to the abdominal wall
111
Highly selective vagotomy
Transection of vagal fibers to the body of the stomach. Fibers to the pylorus remain intact (no need for pyloroplasty or other drainage since pylorus continues to function)
112
Heineke-Mikulicz pyloroplasty
Longitudinal incision through all layers of the pylorus, however, closure in a transverse direction to make pylorus non-functional.
113
Whipple Procedure
Pancreaticoduodenectomy"
- Removal of the head of the pancreas and duodenum
- Cholecystectomy
- Choledochojejunostomy
- Truncal Vagotomy
- Pancreaticojejunostomy (Anastomosis of distal pancreas remnant to the jejunum)
- Gastrojejunostomy (Anastomosis of the stomach to jejunum)
114
L Vagus nn
Positioned anteriorly - the esophagus rotates during development
115
Foregut
Midgut
Hindgut
Foregut - mouth to ampulla of Vater
Midgut - ampulla of vater to distal 1/3 of transverse colon
Hindgut - distal 1/3 of transverse colon to anus
116
Cantle's line
Line drawn from the IVC to just the L of the GB fossa --> Separates the R and L lobes of the liver
117
Anterior Spinal Syndrome (Beck's syndrome)
MC form of spinal cord infarction from blood flow interruption in the aa of Adamkiewicz (a branch of the aorta). Ant 2/3 and medulla oblongata effected, causing loss of motor below the level and loss of pain/temp sensation
118
Layers of the artery
Outside to inside:
1) Adventitia
2) Media
3) Intima
119
Body fluid composition
Total fluids = 60% Total Body Weight (TBW)
- -Intracellular = 40% TBW (66% of body fluid)
- -Extracellular = 20% TBW (Interstitial and intravascular - 33% of body fluid)
-Blood is 7% TBW (0.07 x body weight = volume in L)
120
Paradoxical alkalotic aciduria
Seen in severe hypokalemic, hypovolemic, hypocholermic metabolic alkalosis with paradoxic metabolic alkalosis of serum and acidic urine. H lost in urine in exchange for Na in attempt to restore volume, H exchanged preferentially instead of K because K is low.
121
Maintenance fluid
100/50/20 for 24 hours or 4/2/1 for hrly rate
Adult - D5 1/2 NS + 20 mEq KCl
Peds - Ds 1/4 NS +20 mEq KCl
122
Why is dextrose added to maintenance fluid (D5 IVF?)
Inhibits mm breakdown
123
Min urine output for adult
30 mL/hr or 0.5 cc/kg/hr
124
1 oz = ? mL
30 mL
125
Bolus fluids
Isotonic fluids (NS or LR) 1L given over 1 hour
126
Possible consequence of hyperglycemia in hypovolemic patient?
Osmotic diuresis
127
Portion of 1L NS remaining in intravascular space after laparotomy?
in 5 hours, ~200 cc (20%)
Post lap: give LR or DSLR for 24-36 hours then maintenance fluids
128
When is a pt's fluid mobalized after lap?
POD3 - mobalization of fluid back into IV space
129
What IVF is used to replace duodenal or pancreatic fluid loss?
LR (bicarb loss)
130
Normal range for Potassium (K)?
3.5-5 mEq
131
Surgical causes of hyperkalemia?
- Iatrogenic overdose
- Blood transfusion
- Renal Failure
- Diuretics
- Acidosis
- Tissue destruction (injury/hemolysis)
132
Signs & symptoms of hyperkalemia?
- Decreased DTRs or areflexia
- Weakness
- Parenthesia or paralysis
- Resp failure
133
EKG findings of hyperkalemia?
- Peaked T waves
- Depressed ST segment
- Prolonged PR
- Wide QRS
- Bradycardia
- V-fib
134
What is a critical Potassium (K) level (critical hyperkalemia)?
K>6.5
135
Treatment for critical hyperkalemia?
- IV Ca (Cardioprotective - stabilizes cardiac membranes) - monitor EKG
- Sodium Bicarbonate IV (Alkalosis drives K intracellularly)
- Glucose + insulin
- Albuterol
- Kayexalate (Na polystyrene sulfonate) and furosemide (dec K uptake via GI and GU tracks)
- Dialysis
CB DIAL K - Calcium, Bicarb, Dialysis, Insulin/dextrose, Albuterol, Lasix, Kayexalate
136
Treatment for hyperkalemia (non-critical)?
- Furosemide
| - Kayexalate (Na polystyrene sulfonate)
137
Pseudohyperkalemia
Hyperkalemia from falsely elevated K in sample from hemolysis
138
What acid-base change lowers serum K?
Alkalosis
139
What are the surgical causes of hypokalemia?
- Diuretics
- Antibiotics
- Steroids
- Alkalosis
- Diarrhea
- Intestinal fistulae
- NG aspitation
- Vomiting
- Insulin
- Insufficient supplementation
- Amphotericin B
140
Signs & symptoms of hypokalemia?
- Tetany
- Ileus
- Weakness
- N/V
- Parasthesias
141
EKG findings of hypokalemia?
- Flattening T waves
- U waves (appears after T wave)
- ST segment depression
- PACs and PVcs
- A-fib
142
Rapid treatment for hypokalemia?
IV KCl (max amount given 10 mEq/hr via peripheral IV and 20 mEq/hr via central line)
143
Maximum amounts of KCl that can be given for hypokalemia?
10 mEq/hr - peripheral IV
| 20 mEq/hr - Central line
144
What electrolyte condition exacerbates digitalis toxicity?
Hypokalemia
145
What other electrolyte deficiency can cause hypokalemia?
Hypo-Magnasemia
| --Low Mg inhibits K reabsorption from the renal tubules
146
What electrolyte needs replacement before replacing K?
Magnesium
147
Normal range for Sodium (Na)?
135-145 mEq/L
148
Surgical causes of hypernatremia?
- Inadequate hydration
- Diabetes Insipidus
- Diuresis
- Diarrhea/Vomiting
- Diaphoresis
- Tachypnea
- Iatrogenic (TPN)
149
Signs & symptoms of hypernatremia?
- Seizures
- Confusion
- Stupor
- Pulm or peripheral edema
- Tremors
- Resp paralysis
150
Treatment of hypernatremia?
Slowly (<12 mEq/L change per day)
- D5W
- 1/4 NS
- 1/2 NS
151
Complication of correcting hypernatremia too quickly
Seizures -likely from cerebral edema
152
Surgical causes of hyponatremia
Hypovolemic:
- -Excess diuretics
- -Hypoaldosteronism
- -Vomiting/NG suctioning
- -Burns
- -Pancreatitis
- -Diaphoresis
Euvolemic
- -SIADH
- -CNS abnormalities
- -Drugs
Hypervolemic
- -Renal failure
- -CHF
- -Liver failure (cirrhosis)
- -Iatrogenic fluid overload (dilutional)
153
Signs & symptoms of hyponatremia?
- Seizures/coma
- N/V
- Ileus
- Lethargy
- Confusion
- Weakness
154
Treatment for hyponatremia?
Slowly (<12 mEq/L change per day)
Hypovolemic
--IV NS, correct underlying cause
Euvolemic
- -Fluid restriction
- -SIADH - furosemide and NS acutely
Hypervolemic
--Dilutional - Fluid restriction and diuretics
155
Complication of correcting hyponatremia too quickly?
Central pontine myelinolysis
- -Confusion
- -Spastic quadriplegia
- -Horizontal gaze paralysis
156
Signs of central pontine myelinolysis?
From quick correction of hyponatremia
- -Confusion
- -Spastic quadriplegia
- -Horizontal gaze paralysis
157
Pseudohyponatremia
Dilutional from fluid overload from hyperglycemia, hyperlipidemia, or hyperproteinemia
158
Causes of hypercalcemia
- Ca supplementation IV
- Hyperparathyroidism (Primary and Tertiary), hyperthyroidism
- Immobility/Iatrogenic (thiazide diuretics)
- Mets/Milk alkali syndrome
- Paget's disease (bone breakdown)
- Addison's/Acromegaly
- Neoplasm (colon, lung, breast, prostate, MM)
- Zollinger-Ellison syndrome (MEN I)
- Excessive Vit D or A
- Sarcoid
159
Signs and symptoms of hypercalcemia
Stones, bones, abdominal groans, psychiatric overtones
- Polydipsia
- Polyuria
- Constipation
160
ECG findings of hypercalcemia
Short QT interval
| Prolonged PR interval
161
Acute treatment of hypercalcemic crisis
- Vol expansion w/NS
- Diuresis with furosemide (not thazide)
- Streoids
- Calcitonin
- Bisphosphonates (pamidronate)
- Mithramycin
- Dialysis (last resort)
162
Ca levels as relating to hypoalbuminemia
measured albumin x 0.8 + measured CA level = Corrected Ca level
163
Surgical causes of hypocalcemia
- Short bowel syndrome
- Intestinal bypass
- Vit D deficiency
- Sepsis
- Acute pancreatitis
- Osteoblastic met
- Aminoglycosides
- Diuretics
- Renal faliure
- HypoMg
- Rhabdomyolysis
164
Signs & symptoms of hypocalcemia
- Chvostek's -facial mm spasm with tappinc of facial nn
- Trousseau's - carpal spasm after occluding blood flow in forearm or tapping on wrist
- Perioral parasthesia (early)
- Increased DTRs (late)
- Confusion
- Abdominal cramps
- Laryngospasms/stridor
- Seizures
- Tatany
- Psych abnormalities (paranoia, depression, hallucinations)
165
ECG findings of hypocalcemia
-Prolonged QT and ST interval
166
Treatments for hypocalcemia
-Acute - Calcium gluconayte IV
| Chronic - Calcium PO + Vit D
167
Complication of infused Ca if IV infiltrates - for tx of hypocalcemia
Tissue necrosis
| --(Never administer peripherally and Ca GLUCONATE is less toxic than Ca CHLORIDE)
168
Best measure of Ca levels
Ionized Ca
169
Normal range of Magnesium (Mg)
1.5-2.5 mEq/L
170
Surgical causes of hypermagnesemia
- TPN
- Renal failure
- IV over supplementation
171
Signs & symptoms of hypermagnesemia
- Res failure
- CNS depression
- Dec DTRs
172
Treatment of hypermagnesemia
- Ca gluconate IV
- Insulin + glucose
- Dialysis
- Furosemide
173
Surgical causes of hypomagnesemia
- TPN
- Hypocalcemia
- Gastric suctioning
- Aminoglycosides
- Renal failure
- Diarrhea/Vomiting
174
Signs & smptoms of hypomagnesemia
- Inc DTRs
- Tetany
- Asterixis
- Tremor
- Chvostek's sign
- Ventricular ectopy
- Vertigo
- Tachycardia/dysrhythmias
175
Treatment of hypomagnesemia
Acute - MgSO4 IV
| Chronic - Mg oxide PO (AE - diarrhea)
176
Surgical causes of hyperglycemia
- DM (poor control)
- Infection
- Stress
- TPN
- Drugs
- Error (lab or drawing over IV site)
- Somatostatinoma
- Glucagonoma
177
Weiss protocol
Sliding Scale Insulin
178
Goal glucose level in ICU
80-110 mg/dL
179
Surgical causes of hypoglycemia
- Excess insulin
- Dec caloric intake
- Insulinoma
- Drugs
- Liver failure
- Adrenal insufficiency
- Gastrojejunostomy
180
Signs & symptoms of hypoglycemia
- Sympathetic response - diaphoresis, tachycardia, palpitation
- Confusion
- Coma/Neuro deficits
- HA
- Diplopia
- Seizures
181
Normal range of Phosphorous (P)
2.5-4.5 mg/dL
182
Signs & symptoms of hypophosphatemia
- Cardiomyopathy
- Rhabdomyolysis
- Hemolysis
- Poor pressor response
- Neurologic dysfunction (ataxia)
- Weakness
183
Complication of severe hypophosphatemia
Respiratory failure
184
Causes of hypophosphatemia
GI losses, inadequate supplementation, medications, sepsis, ETOH abuse, renal loss
185
Critical value of hypophasphatemia
<1 mg/dL
186
Tx of hypophosphatemia
Sodium phosphate supplement or potassium phosphate IV
