URT and Salivary Disorders Flashcards Preview

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Flashcards in URT and Salivary Disorders Deck (12):
1

Henderson-Hasselbach

pH = 6.1 + log (HCO3-)/ 0.03 PCO2

2

Elevated Anion Gap >11

MethanolUremia*Diabetic Ketoacidosis*Propylene glycolIzoniazid, IronLactic Acidosis*Ethanol (ketoacidosis)*Salicylates (Aspirin)

3

Non-Gap

GI Loses: Diarrhea, Laxative abuse, Villous Adenomas, small bowel fistulas, iIleo conduitsRenal: RTA’s, Carbonic Anhydrase inhibitorsExcessive Steroids, HypoaldosteroneExcessive CL: TPN hyperalimentation, Massive rescusitation with NaCL

4

Winter's Formula

Predicted PaCo2 = (1.5 x HCO3) + 8 +/- 2

5

5 Physiologic Causes of Hypoxemia

1) Low Inspired PiO22) Hypoventilation3) Diffusion limitations4) Shunt5) V/Q imbalanceFirst 2 the A-a gradient will be normal as the lungs are normal.Last 3: Abnormalities in the respiratory system so the A-a gradient will be increased.

6

A-a Gradient Equation

PAO2 = (760-47) x FiO2 – PaCO2/0.847 = water pressureFiO2 = 0.21PAO2 = 151 – PaCO2/0.8Nl PAO2 = 150 – 40/0.8 = 100

7

PAO2 normal valuePaO2 normal valueNormal A-a

PAO2 = 100 mmHgPaO2 = 95 mmHgNormal A-a = 5-10 mmHg

8

Light's Criteria

Pleural protein/ serum protein > 0.5Pleural LDH/ Serum LDH > 0.6Absolute Pleural LDH > 2/3 upper limit of normal plasma LDH ( 200)**2/3 of the criteria involve LDH, so the LDH ones involve the value ~2/3

9

Pleural Effusion StudiesLDH/ProteinCytologyMesothelial CellsLow Glucose/Low pH

LDH/proteins - transudative/exudativecytology - malignancy, but low PPD (neg test doesn't r/o cancer)Mesothelial cells - excludes TB if

10

Pleural effusion Cell CountLymphocytesNeutrophilsEosinophils

Lymphocytes - cancer, chronic infections (TB)Neutrophils - parapneumonic (bacterial pneumonia)Eosinophils - air/blood in pleural space

11

Pleural Effusion Special studiesAcid-Fast Smear (AFB)Adenosine DeaminaseHematocritAmylase

AFB - TBAdenosine Deaminase - TBHematocrit - Hemothorax f >50% serum hematocrit (due to trauma)Amylase - Booerhave's Esophagus (ruptured) or pancreatitis

12

Causes of Mediastinal Mass (T's)

ThymomaT-cell LymphomaThyroidTeratoma