Things I Forget Over and Over Again ;)

Question 1

Pre diabetic Range

Answer 1

5.7-6.4

Question 2

When to consider insulin for diabetes

Answer 2

def @ 10, consider @ 9

Question 3

Atrial Septal Defect murmur

Answer 3

systolic ejection murmur at pulmonary area
fixed split S2
plus/minus diastolic rumble at tricuspid valve

Question 4

PDA physiology

Answer 4

connection between pulmonary artery and aorta to shunt blood away from lungs

Question 5

PDA murmur

Answer 5

continuous machinery murmur at left second ICS

wide pulse pressures, bounding peripheral pulses

Question 6

Disseminated Zoster

Answer 6

3 or more dermatomes

Question 7

Indications for Severe C diff Treatment

Answer 7

WBC 15+
Albumin less than 3
Cr 1.5x the prior level

Question 8

Treatment of systolic CHF

Answer 8

loop
ACEI or ARB
BB
Aldosterone if EF<35%

Question 9

Pathophysiology of CHF

Answer 9

decreased CO – > Activate RAS + SNS –> systemic vasoconstriction

Question 10

Systolic HF- main cause

Answer 10

impaired contractility

–ischemic heart disease

Question 11

Diastolic HF- main cause

Answer 11

impaired ventricular filling during diastole

• • HTN
• • aortic stenosis

Question 12

CKD defined as

Answer 12

abnormal markers of kidney damage for 3 months

or GFR less than 60 for more than 3 months

Question 13

Neonatal vs Infantile Acne

Answer 13

first month of life vs age 3-4 months

Question 14

Base Deficit

Answer 14

takes out respiratory component so it represents the metabolic acidosis
normal -2 to 2

Question 15

Albumin in acid base and correction

Answer 15

weak acid
more albumin = more acidic
Add 2.5 to AG for every 1 albumin below 4

Question 16

Strong Ion Difference

Answer 16

Na - Cl
>38 metabolic alkalosis
<38 NAGMA

Question 17

Acid/Base pCO2 determination

Answer 17

> 40 resp acidosis

<40 resp alkalosis

Question 18

Delta Gap Interpretation

Answer 18

more than 2 is metabolic alkalosis

less than 1 is NAGMA or urinary anion loss (DKA, CKD)

Question 19

Change in Metabolic acidosis

Answer 19

change in c02 = 1.2 x bicarb delta

Question 20

Change in Metabolic alkalosis

Answer 20

change in co2 = .7 x bicarb delta

Question 21

Change in Resp Acidosis

Answer 21

acute is .1 x change in co2; chronic is .4 x change in co2

Question 22

Change in Resp Alkalosis

Answer 22

acute is .2 x change in co2; chronic is .4 x change in co2

Question 23

Causes of AGMA

Answer 23

GOLD MARK
Glycols, Oxoproline (Tylenol), L-lactate, D-lactate
Methanol, Aspirin, Renal Failure, Ketoacidosis

Question 24

Causes of NAGMA

Answer 24

HARDUPS
Hyperalimentation, acteozolamide & Addison’s, RTA
Diarrhea, Urteopelvic things, pancreatic fistulas
Saline

Question 25

Metabolic Alkalosis with LOW urine chloride

Answer 25

responsive
Vomiting
NG suction
Over diuresis
post hypercapnia

Question 26

Metabolic Alkalosis with HIGH urine chloride

Answer 26

non-responsive
HTN: Cushing, Conn, RAS, alkali
no HTN: Low Mag, K, Laxatives, Bartler, Gitelman

Question 27

Causes of RTAs

Answer 27

type 1 - decreased secretion of H+
type 2 - decreased reabsorption of Bicarb
type 4 - aldosterone def/resistance

Question 28

Polyuria =

Answer 28

more than 3 L