Clinical Methods Flashcards
(67 cards)
1
Q
Sodium
A
in mEq/L: 135-147
2
Q
Potassium
A
in mEq/L: 3.5-5.2
3
Q
Chloride
A
in mEq/L: 95-107
4
Q
Bicarbonate
A
22-29
5
Q
Blood Urea Nitrogen (BUN)
A
in mg/dl: 7-20
6
Q
Creatinine (Crt)
A
in mg/dl: 0.5-1.4
7
Q
Glucose
A
in mg/dl: 60-110
8
Q
Total Bilirubin
A
in mg/dl: 0.1-1.2
9
Q
Alkaline Phosphatase
A
in IU/L: 33-153
10
Q
SGOT (AST)
A
<35
11
Q
SGPT (ALT)
A
<35
12
Q
Albumin
A
in g/dl: 3.2-5
13
Q
Calcium
A
in g/dl: 8.8-10.3
14
Q
Phosphate
A
in mg/dl: 2.5-4.5
15
Q
Magnesium
A
in mEq/L: 1.6-2.4
16
Q
WBCs
A
4500-10,000
17
Q
RBCs
A
4.0-5.5 (x10^6)
18
Q
Hgb
A
(g/dl) 12.0-16.5
19
Q
Hct
A
36-50 %
20
Q
MCV
A
80-100
21
Q
Platelet count
A
100,000-450,000
22
Q
Protime (PT)
A
10-14 sec
23
Q
Partial Prothrombin Time (PTT)
A
25-39 sec
24
Q
Systolic Bp
A
Normal:119 or less
Prehypertension: 120-139
Stage 1 htn: 140-159
Stage 2 htn: 160 or greater
25
INR (PTtest/PTnormal)
0.8-1.2
26
Diastolic Bp
Normal: 79 or lower
Prehypertension: 80-89
Stage 1htn: 90-99
Stage 2 htn: 100 or higher
27
Mitral valve
Cardiac apex
28
Tricuspid valve
Lower left sternal border
29
Pulmonic valve
2nd and 3rd interspace near sternum
30
Aortic valve
Heard anywhere from 2nd interspace to apex
31
PR interval
Time from start of atrial depolarization to start of ventricular depolarization 0.12-0.2 seconds
32
ST segment
Time from end of ventricular depolarization to start of ventricular repolarization
33
QT interval
Time from start of ventricular depolarization to end of ventricular repolarization
34
S1
1st heart sound, mitral valves shut
35
S2
2nd heart sound, aortic valve shuts. Split with inspiration
36
S3
Sound of deceleration of blood on ventricular wall
37
S4
Atrial contraction
38
Tidal volume (TV)
About 500 ml, amount of air inspired during relaxed normal breathing
39
Inspiratory Reserve Volume (IRV)
about 3,100 ml, the additional air that can be forcibly inhaled after the inspiration of a normal tidal volume
40
Expiratory Reserve Volume (ERV)
about 1,200 ml, the additional air that can be forcibly exhaled after the inspiration of a normal tidal volume
41
Residual Volume (RV)
about 1,200 ml, the volume of air still remaining in the lungs after the expiratory reserve volume is exhaled
42
Total Lung Capacity (TLC)
about 6,000 ml, maximum amount of air that can fill the lungs (TLC=TV+IRV+ERV+RV)
43
Vital Capacity (VC)
about 4,800 ml, total amount of air that can be expired after fully inhaling (VC=TV +IRV+ERV = approximately 80% of TLC)
44
Inspiratory Capacity (IC)
about 3,600 ml, maximum amount of air that can be inspired (IC=TV+IRV)
45
Functional Residual Capacity (FRC)
about 2,400 ml, amount of air remaining in lungs after a normal expiration (FRC= RV+ERV)
46
Forced Expiratory Volume (FEV1)
volume of gas exhaled in one second by a forced expiration from a full inspiration
47
Forced Vital Capacity (FVC)
vital capacity measured with a forced expiration
48
FEV1/FVC ratio
The percent of forced vital capacity that is exhaled in the first second (should be 80% in a healthy individual)
49
Obstructive Lung Disease
COPD, Asthma. Involves difficulty exhaling due to damage to the lungs or narrowing of airways inside the lungs, air comes out more slowly than normal. At the end of a full exhalation, an abnormally high amount of air may still linger in the lungs. This will reduce FEV1/FVC ratio to <70%.
50
Restrictive Lung Disease
Pulmonary Fibrosis, Sarcoidosis- results from a condition causing stiffness in the lungs themselves (or area surrounding lungs). Therefore the FEV1/FVC ratio will remain normal or may be elevated to >80%.
51
Normal ABG ranges
```
pH: 7.35-7.45
pCO2: 35-45
pO2: 80-100
HCO3: 22-26
O2 sat: 95-100%
```
52
Flexible Bronchoscopy Contraindications
Severe Bronchospasm and Bleeding
53
VQ scan
Uses Scintigraphy and medical isotopes to evaluate circulation of air and blood within a patients lungs to determine the ventilation/perfusion ratio
54
Sinus Arrythmia
Normal, except slightly irregular. Reflects variation with inspiration and expiration
55
Sinus Arrest
Sinus node stops firing, could lead to asystole. Fortunately other myocardial cells spring in to action and take over pacing (escape beats)
56
Pacemakers
SA node: 60-100 BPM
Atrial foci: 60-75 BPM
Junctional foci (AV node): 40-60 BPM
Ventricular foci (His bundle, bundle branches and purkinje system): 20-40 BPM
57
Junctional Escape Rhythm
one of the most common escape mechanisms, depolarization originates near AV node and usual pattern of atrial depolarization does not occur, so NO P WAVES
58
Paroxysmal Supraventricular Tachycardia
Regular QRS. P aves are retrograde if visible. Rate 150-250 BPM. Initiated by premature supraventricular beat and persisted by reentrant. Carotid massage slows or terminates.
59
Atrial Flutter
Regular, saw toothed. 2:1, 3:1, 4:1 block. Atrial rate: 250-350 BPM. Ventricular rate is fraction of atrial rate. Carotid massage: increases block
60
Atrial Fibrillation
Irregularly irregular, without discernable p waves. Undulating baseline. Atrial rate 350-500 BPM. Ventricular rate is variable. Carotid massage may slow ventricular rate.
61
Multifocal Atrial tachycardia
Irregular with rate of 100-200 BPM. At least 3 different p-wave morphologies from different atrial foci. Wandering pacemake when rate < 100BPM. Carotid massage has no effect.
62
Paroxysmal Atrial Tachycardia
Regular, rate 100-200 BPM. Characteristic warm up period in the automatic form. Carotid massage has no effect or mild slowing.
63
Premature Ventricular Contractions
PVC's, most common of ventricular arrythmias. QRS complex is wide and bizarre b/c ventricular depolarization does not follow normal conduction
64
Ventricular Tachycardia
Run of 3 or more consecutive PVCs. Rate: 100-200 BPM and may be slightly irregular. Sustained VT is an emergency preceding cardiac arrest. Can be uniform or polymorphic (torsades de pointes)
65
Ventricular Fibrillation
Preterminal event, seen almost solely in dying hearts. Most frequently encountered arrythmia in adults who experience sudden death. Course or fine, no true QRS complexes. No cardiac output (CPR/defibrillation immediately)
66
Accelerated Idioventricular Rhythm
Benign rhythm seen during acute MI. Regular rhythm occuring at 50-100 BPM. Represents a ventricular escape focus that has accelerated sufficiently to drive the heart. Rarely sustained, does not progress to VF and rarely requires treatment.
67
Torsades De Pointes
Form of VT usually seen in pts with prolonged QT intervals. Prolonged QT:congenital or result from electrolyte disturbance
