laboratory values

ABG
Analysis 5D 's to REMEMBER
pH 7.35-7.45
pH 6.0s
Paco , 35-45 mmHg potassium 6.0 ≥

HCO } 22 -26
MEG 1- CO2 60
Paoz 80-100 mmHg 02 60s
Ozsat 95 -100% Platelet 40.000

Blood work

Electrolytes CBC
sodium Nat -91L
135 -145mF
Hemoglobin Hgb F. 12
-16mg / dl
Potassium 3.5 -5.0mF-9L
K+
Hematocrit Hct
M :/ 4-
18mg / dl
Chloride Cl
-

-9L
96 -108mF F. 37 -47%
Glucose Glu 70 -110mg DL m :42 -52%
Calcium ca
"
8.4 -10.2mg dl Red Blood Cells RBC 4.5 -5.5mi /

Magnesium Mg White Blood Cells WBC

1.6 -2.6mg / dl 5,000-10,000
Phosphorus P) 2.5
-4.5mg / OIL Platelets 150,000-400,000
cells / MCL

Gastro
Renal
Total protein 6.2 -8.291dL creatinine Cr 0.6 -1.2mg dl
Albumin 3.4 -5.491dL Blood Urea Nitrogen BUN 7
-20mg dl

Pre 15 dl 6
albumin
-36mg GFR
-

Ammonia 15-45
mcgldl urine
Bilirubin 1mg / dl Specific Gravity 1.005-1.030

3.5 -5.0mmol / Lop cardiac

Lipids ,

Total cholesterol 200mg dl

Troponin 0
-0.4mg / mL
LDL 60mg / DL CK -

MB 3- 5%
HDL 100mg dl Myoglobin Mb 25 -72mg / mL
Triglycerides 150mg dl BNP
loopy / mL

coagulation 11-14 secs

PT
25-35 secs
PTT
APTT 30-40 secs Til -5-2.5×1

INR 0.8-1.2 T :3 -3

Thyroid Pancreatic
TSH 0.5-5 Milli -
IUL / L ALT / 560T 0 -35141L

-14 5-12
ng
1dL AST / SGPT 4- 36141L
70 / DL
-13 -220mg
ELECTROLYTES

if it DOWN DOWN
pH goes , my patient goes
↳ te pit te patient -

except (K ) potassium

Potassium ↑↑K ↑
patient -

except heart rate and urine output

parathyroid gland
calcium Mca ↓ patient OPPOSITE of prefix ca is
-

inversely related
related to phosphorus
directly
secreted in
Magnesium ↑↑Mg ↓ to the
patient OPPOSITE of prefix Mg -

KIDNEY

sodium ↑↑Na ↓ fluid DEHYDRATION

↑ fluid seizure
↳ ↓ Na Fluid OVERLOAD precautions

chloride directly related to Na and K

related to bicarbonate
inversely
ANTIBIOTICS

micin "
"

Aminoglycosides THE GUN NEOmicin.KANamic.in

Sterilize Bowel
Macrolides thromycin
Lincosamides clindamycin
penicillin cillin ,
ancef

Cephalosporins cepha ,
Cefa -

Fluoroquinolones floxacin
Nitro imidazole Metronidazole Flagyl
Tetracycline Doxycycline
Anti-viral
acyclovir
Anti -

fungal amphotericin B

nystatin
STIMULANTS

caffeine
cocaine
PCP LSD Psychedelic Hallucinogens
Metamphetamines
ADHD medications Ritalin , Adderall amphetamine
methylphenidate
dexmethylphenidate
 ANTI -

HYPERTENSIVES
HEART
GOLD STANDARD TREATMENT FAILURE

ACE inhibitors
pri / Bp RAAS watch out for cough
-
-

Cl :
pregnancy
Angiotensin -11 Receptor Sartan
Blockers ARBS

discontinue
slowly
Beta -101 vBP,↓HR
signs of hypoglycemia
-
blockers masks

hypotension bradycardia ,

calcium Channel avoid GRAPEFRUIT

Blockers -
dipine cardiac causes
gingival hyperplasia
contractility Cl : Heart failure
others :
•

Methyl dopa
-

Hydra / azine -
vasodilator ; rafter load

ANTI -
DEPRESSANTS

SNRI Duloxetine
Anticholinergic
Blurred vision
GSR Fluoxetine
-

Prozac
constipation
selective serotonin sertraline 2010ft Drowsiness
Inhibitor Cetera Euphoria
Reuptake Citalopram Insomnia
Escitalopram Lexapro suicidal Precaution
Paroxetine serotonin syndrome G

TCA
Anticholinergic
Tricyclic Antidepressant triptyline
-

Blurred vision
constipation
Amitriptyline Drowsiness
Euphoria
Imipramine

MAOI lsocarboxacid Mar plan Anticholinergic 2- 4wks

Blurred vision to take
Monoamine Phenetidine Nardi / constipation effect
Oxidase Inhibitor Tranylcypromine Parnate Drowsiness
Avoid Tyramine
Selegiline Causes
Hypertensive Crisis

ANTI -

ANXIETY

Benzodiazepines short Midazolam ersed Avoid Alcohol

acting
minor
tranquilizer Diazepam / Valium ) Don't stop abruptly
Long acting clonazepam Klonopin Highly addictive
LOW and SLOW Alprazolam Xanax
Flumazenil
Lorazepam Ativan antidote

Barbiturates
Buspirone does not sedate
MOOD STABILIZER

Lithium Peeing Metallic taste Do not

give c- NSAIDs

0.6 -1.2 Pooping severe diarrhea Increase FLUIDS

Paresthesia Tremors Monitor ↑ ↓ SODIUM

/TERM 1 BIPOLAR

ANTI -

PSYCHOTICS

TYPICAL old
major tranquilizer
Chlorpromazine Thorazine Anticholinergic
phenothiazine Zine Blurred vision
Trifluoperazinestelazine
-

constipation
Piperazine Drowsiness
THE GUN
"

Extrapyramidal
"
Vistaril
Hydroxy zine symptoms
Foto sensitivity
Agranulocytosis
Haloperidol Haldol Anticholinergic
schizo ,
Tourets PREGNANT Blurred vision

if benefits
constipation
outweighs risks
Drowsiness
NMS -

elderly .
Extrapyramidal
neuroleptic
↑↑↑ temp symptoms
malignant
syndrome + EPS Foto sensitivity
Agranulocytosis
Prolong QT interval
- Tardive Dyskinesia
ATYPICAL new
major tranquilizer weight gain
Agranulocytosis
clozapine _

zapine Clozaril I WBC

Olanzapine Neuroleptic Malignant

Syndrome
Geodon FATAL QT interval
Ziprasidone prolong
-

-
causes sudden
cardiac arrest
DIURETICS

Loop Diuretics Bumetanide Monitor K potassium ; ↓ Calcium

Torsemide MOST EFFECTIVE
Furosemide

K Triamterene monitor K
sparring potassium
-

combined with
Amiloride
commonly a

LOOP THIAZIDE diuretics

spironolactone
Thiazide chlorothiazide causes calcium Retention
Chlorthalidone
lndapamide
Hydro chlorothiazide
 NSULI Onset Peak Duration

with
Rapid acting-

Aspart Novo rapid 15 mins 30-90 3- 5hr5

given
meals
mins
Lispro Humalog
short-acting Regular
30-60
mins
2- 4hr5 6- 8hr5 CLEAR
IV Drip

Intermediate NPH lsophane 1- 2hr5 4- 6hr5 12 -

14hr5
CLOUDY
( suspension

1- 2hr5 24hr5
Long Acting Glargine Lantus 12
safetogive
-
-

at bedtime

TROUGH and PEAKS

T P

30 mins
sublingual 5 -10min
15 -30min
IV before
IM next dose 30-60 mins

SQ insulin
PO 1 A

TOXICITY
Therapeutic Toxic
Lithium 0.5-1.6 2

Digoxin Lanoxin 1-2 2

Theophylline Aminophylline 10-20 -20

Phenytoin Dilantin 10-20 20

Bilirubin NEWBORN 12-20 20

ANTIDOTES
Acetaminophen Protamine Sulfate
Acetyl cysteine ,
Mucomyst Heparin
Anticholinesterase Iron Deferoxamine
Atropine.pro/idoxime
Anticholinergic Malignant Hyperthermia Dantrolene
physostigmine Leucovorinca
Benzodiazipines Glucagon Epinephrine
,
Methotrexate
Ca Channel Blocker Ca Chloride Narcotics Morphine Narcan
Glucagon
,

Coumadin Potassium Insulin Bicarb

Phytonadionqvitk ,

Digoxin Digibind Kayexelate

Dopamine Regitinephentolamine Tricyclic Antidepressants Physostigmine .

Heroin Narcan Naloxone Bicarb

Magnesium Sulfate Calcium Gluconate Benzodiazepines Flumaxenil

Urokinase Amicar Lorazepam
Acid Succimer
Aminocaproic Lead Heavy metals
61 Meds
Sucra /fate Cara fate
-
-
coats stomach lining to 1 acid production ;SE : constipation 61 protectant
Metoclopramide Region -
↑
gastric motility and emptying
PROTON PUMP INHIBITOR

Omeprazole Pri / 0sec increase pH

Mg absorption
H2 RECEPTOR BLOCKERS ANTAGONISTS
Ranitidine -
blocks secretion of HCL acid

cimetidine Tagamet acid production

Famotidine

Respiratory
RESCUE MEDS
Albuterol -

asthma COPD ; relaxes smooth muscle in airway ; ↑ BP ,↑HR

,

salbutamol -
beta -2 agonist
lpratropium -

anticholinergic ; opens up airway

LONG TERM

Guaitenesin -

expectorant
Monte / ukast -
leukotriene modifiers ; given prior exercise activities

Theophylline -
does not work
right away

stimulants
caffeine
cocaine
PSP LSD

Methampethamines
ADHD medications Ritalin Adderall ,

Hyperthyroidism Medication
be 18 yrs & below
Propyl thiouracil PTU most common ; can
given to

Methimazole Tapazole
Radioactive Iodine RAI -
Cl :
Pregnancy &
Breastfeeding
F- TT medications ANTI -

CONVULSANT

Naloxone Carbamazepine
Divalproex sodium
Atropine Valproic Acid
,

vasopressin -

except in Pedia Lamotrigine

Take with
Epinephrine food
Avoid Grapefruit
Lidocaine
SE : vision changes
INOTROPES ↑ hearts
contractility
Dopamine
IV FLUIDS

HYPOTONIC ISOTONIC HYPERTONIC

0.45 : NaCl 0.9° NaCl
.
NS b-
•

Nac D5NS TPN

•

0.330.2 NaCl Lactated 3. Nac D5LR Albumin

Ringers •

172.5W 135W 5. Nac • DIOW

GLASGOW COMA SCALE

EYES VOICE MOTOR

1 Absent Absent Absent

2 Eyes to painful Incoherent Decerebrate

stimulus speech extending
3 Opens eyes Inappropriate Decorticate
to voice words flexing )
4 spontaneously confused withdraws from
open eyes painful stimulus
5 Oriented Localises to

painful stimulus
6
Obeys command
APGAR

INDICATOR
0 I 2
APPEARANCE skin color Blue ; Pale Acrocyanosis Pink
PULSE ABSENT BELOW 1006pm over 1006pm
GRIMACE reflex irritability Floppy Minimal response
prompt response
ACTIVITY muscle tone ABSENT Flexed arms
legs Active
RESPIRATION ABSENT Slow and
Irregular vigorous cry

CANCER 'S CLASSIC WARNING SIGNS

Change in bowel & bladder habits

A sore that does not heal

Unusual bleeding or
discharge
Thickening lump or in abreast
elsewhere

Indigestion or difficulty swallowing

Obvious
change in wart or mole a

Nagging cough or hoarseness

 Pregnancy medications

TOCOLYTICS stops labor

threatening prematurity
Terbutaline -
do not use with a beta blocker antagonist
sulfate mixed into DLR IV
Mg
-

lndomethac.in
Nifedipine ( Ca channel blocker that acts as tocolytic
OXYTOCIC stimulates &
strengthens labor
-

pitocin

Methergine
Misoprostol

FETAL LUNG MATURITY

Betamethasone -

given to MOM via 1M

Beractant survanta -

given to BABY via intra tracheal

Antihypertensive ( in
Pregnancy )
✓ La beta 101
✓
Methyl dopa ✗ ACE inhibitors
✓ ✗ ARBS
Nifedipine
✓
Hydra / azine
×
category
Warfarin coumadin )
Finasteride ( Propecia ,
Pro spar )
PROBABLE SIGNS
Chadwick 's sign bluish or purplish discoloration of
-
vulva or cervix
Goodell 's sign softening of the cervix
-

's sign
Hegar -

softening of the lower segment of the uterus

Chloasma -

hyper pigmentation of the face

skin
Linea Nigra -

darkening of the midline abdominal

false labor ) irregular painless contractions

'
Braxton -

hicks -

Ballotement rebound of the fetus following a

tight tap on the uterus
-

LABOR and DELIVERY

Fetal Heart rate

changes
Variable Cord compression
Early deceleration Head compression
Acceleration Okay
Late deceleration placental insufficiency
Post-partum assessment Abdominal Pain in
Pregnancy
Breast Labor
Uterus Abruptio placenta
Bowel Rupture ectopic uterine
Bladder Abortion spontaneous
Lochia Cholestasis
Episiotomy Rectus sheath hematoma
Homan 's sign hgb.net Ovarian tumor
Emotional status affect Fibroids
Torsion of the uterus

Preeclampsia Postpartum
Hemolysis
Elevated
Liver
enzyme
LOW

Platelet count

%.. ÷÷÷÷ ;÷; ;

PHASE DILATION CONTRACTION DURA
-

NST

LATENT 0 -4cm 5- 30 mins 15 -30sec Mild

ACTIVE 5- 7cm 3- b- mins 30 -60sec Moderate

PROGRESSIVE 8- 10cm 2- 3. mins 60 -90sec

strong

every 2 minutes
 Congenital heart diseases
Patent Ductus Arteriosus PDA

ductus arteriosus remains open even after birth

Tetralogy of fallot arie D Pictures 1- A Ranch

VD ventricular septal defect -
hole between 2 ventricles
stenosis
PS pulmonic narrowing &
stiffening of pulmonary valve
0A aorta
overriding opening of aorta sitting on top of R / L ventricles
-

RH
right ventricular hypertrophy overworking due to stenosis

Coa rotation of the aorta

constriction of the aorta

descending
-

Transposition of the
great arteries TGA

switch of the aorta and pulmonary artery

-

-
creates 2
parallel tracks :
aorta
coming off of the RV
is
-

the LV
pulmonary artery is coming off of
•

Hypoplastic left Heart syndrome HLHS

4 components :

-
Mitral stenosis or atresia
- aortic stenosis or atresia
.
aortic Coa rotation

'

hypoplastic left ventricle

R to shunt = TROUBLE

TROUBLE DEFECTS

Truncus arteriosus -

single blood vessel comes out of the R/ L ventricles instead of 2

,

Tricuspid atresia tricuspid valve did not develop

-

Total anomalous pulmonary venous return TAP R

blood does not return from the lungs to the left atrium
Oxygen-rich
 psychosocial development
Erikson 's
Piaget 's
Infants Trust V5 Mistrust sensorimotor Noconceptof time
( O -

18m05 0 -

Zyrs
coordinates senses c- motor response

Toddlers
Autonomy vs shame & Doubt Preoperational Toilet
training
Fantasy Oriented
18m05 3.
yrs Tyrs
2-
-

symbolic thinker
Preschool lniativevs Guilt
3- b- yrs

School Age Operational

Industry Vs
5- 13
Inferiority Concrete
7- llyrs
Rigid
yrs
concepts are attached to specific situations
Rule Oriented
Adolescents
Identity V5 Confusion Formal Operational can
manage
13-21 yrs 121 -

yrs
Theoretical Factual 0Wh Care
, , conceptual thinking
Young adults
Intimacy V5
21-39 yrs
Isolation

Middle adults Generativityvs

40-65
stagnation yrs

Old adults Integrity vs Despair

65 1-
yrs

TOYS

musical mobile ; soft

0 Gmos large toys
-

6- 9m05 cover , uncover toys ; hard large toys

, object permanence

✓ build
9- 12m05
speaking / talking toys sort
,

make construct
stack ,

purposeful activity c- objects ,

motor skills
1- 3yrs gross
push -

pull toys
parallel play
symbolic play
Preschool finger dexterity toys fine motor skills
balance NO concept of time
cooperative play
pretend play highly imaginative
school Age creative
collective

competitive winner & loser

Adolescence peer
group association
 and
growth development
6- 8 wks social smile 12m05 FIRST words
FIRST steps
1- 2m05 POSTERIOR fontanelle closes follow simple directions
weight TRIPLED
2m05 hold head up
1- 2 Head =
chest circumference
yrs
4m05 brings objects to mouth

2yrs jumping
Gmos Palmar
grasp link words
together
rolling over
vocabulary : 300 words

weight DOUBLED
18 24m05
-

Control sphincter
7m05
crawling
pull self up on
things 3. yrs rides a
tricycle
6- 8m05 sitting without
support b- yrs rides bicycle
a

transfers object from hand -

to hand
-
vocabulary : 2,100 words
complete sentences
9m05 PINCER
grasp
6-7
object permanence yrs begin to lose
baby teeth

stranger anxiety 9- loyrs brain reaches full adult size

9- 10m05 creeping
llyrs THELARCHE
9- 18m05 ANTERIOR fontanelle closes MENARCHE -

2yrs after Telarche

without
10 12m05
standing support 9-13yrs
puberty inmate
begins
-

-
voice deepens
Hmos can understand NO -

testicles enlarge

Freud's psychosocial development

0 l Interested in in their mouth
oral
stage putting things
-

2- 3 Anat
stage Toilet
training occurs

3- 6 Phallic Boys attracted to their mothers /vice versa )

stage
are

6- Puberty Latency stage spent most time

peers & same
c- sex

Interest in welfare of other

Puberty Genital
Stage
 CONCEPT OF DEATH

0-2 understand concept of death

Do not

Aware of separation & loss

3- 5 Do not understand per Mance of death

" "
see death as
"
temporary reversible
"
or

6- 9 Understand death is permanent but not its universality

Death is seen applicable
only to older adults "

May feel their negative magical thinking to cause death

"

10-12 Understand the permanence finality

, ,

inevitability and causality of death

"

of death
"
Teen / Adolescents Understand the
abstracity
Thinks
of themselves as immortal egocentrism
see death as something to happen to others
 triad
symptoms
CUSHING 's Triad
^
ICP

↓ HR
RR Stokes
Cheyne -

systolic BP widened Pulse Pressure

CHARCOT 'S Triad Ms

Scanning Speech
Intention Tremor

Nystagmus
BECK 's Triad Cardiac Tamponade
Big juicy veins JVD
Extreme low BP BP narrowed pulse pressure
can't hear heart sounds Muffled heart sounds

VIRCHOW 'S Triad DVT

stasis venous circulation

Hypercoagu lability
Endothelial
Damage vessel
injury
other

Bacterial Meningitis Horner 's syndrome

Fever Ptosis
Neck Stiffness Miosis
Altered mental status An hidrosis

Phenytoin Toxicity Pheochromocytoma

Ataxia Hyperglycemia
Nystagmus Hypertension
Blurred Vision Headache

Measles Rubeola ) 3C 's + Fever

conjunctivitis
coryza
cough
Nephrotic syndrome
proteinuria
Hypoalbuminemia
Edema
DIABETES INSIPIDUS ↓ Gland ↑ SIADH
Pituitary
Fluid volume deficit Antidiuretic Hormone water retention -

euvolemic
Hypotension ↓ urine output ,

shock weight gain

↑ Sodium urine
,
output ↓ Sodium seizures
↓ Spector osmolality
,
^spGr , osmolality
NO peripheral edema

↓ ↑
HYPOTHYROIDISM Thyroid Gland
-138-14
HYPERTHYROIDISM
Grave 's disease
Myxedema
Hair loss scalp face
,
Exophthalmos
Goiter
weight gain
cool extremities weight loss appetite,

Poor
memory Thyroidectomy
Levothyroxine / Lifetime Thyroid Storm

HYPO PARATHYROID ↓
Parathyroid Gland ↑ HYPER PARATHYROID
Calcium Parathyroid Hormone 1 calcium
↑ ↓ phosphorus levels
phosphorus
seizures muscle weakness

kidney stones constipation

calcium replacement depression & confusion
phosphorus binders Partial Parathyroid éctomy

ADDISON 'S ↓ Adrenal cortex ↑ CUSHING 'S

( Adrenal crisis ) steroids -

aldosterone Cushman )

weight loss moon face

hypoglycemia truncalobesitylwt gain ) .

hypotension thin extremities

↓water& sodium hyperglycemia
↑ Potassium & Pigmentation immuno suppressed
Replace steroids & fluids Adrenalectomy

HYPOGLYCEMIA ↓ Pancreas HYPERGLYCEMIA

" " " ' in
136<70 BG 180

hunger Polyuria
cold .
clammy Polyphagia
irritability .
tremors Polydipsia
give b- grams of carbs ↑ thirst
Blurred vision
push D50W1V(unconscious
numbness
IMG /
ucagon tingling &
Insulin Metformin Exercise ,
,
 LEFT SIDE HF RIGHT SIDE HF

Lungs Body
Pulmonary Congestion Dependent edema
Dyspnea Orthopnea ,
Jugular vein distention
cough Hepatomegaly
Blood
tinged sputum weight gain
tachycardia ascites ,
anorexia
cyanosis

ALCOHOL WITHDRAWAL DELIRIUM TREMENS

EVERY alcoholic
through
goes it
Only a
minority gets DT

NOT life threatening

-
DT can be fatal
NOT
danger to self others Dangerous to self others

Regular diet NPO / clear liquids

semi private room
-

Private room , near the station

Upadlib NO restraints
,
Restricted Bed rest
MUST Restrain

GASTRIC ULCER DUODENAL ULCER

1- 2hr5 after meal meal
pain 2- 4hr5 after
aggravated by eating food -
relieves pain
weight loss
weight gain
hematemesis -

vomiting Melena

PERIPHERAL VENOUS DISEASE PVD PERIPHERAL ARTERY DISEASE PVD

narrow VEIN narrow ARTERY

Blood pools in theleg warm

oxygen problem
cool legs
Volumptuous pulses absence of pulse & hair shiny
NO sharp pain sharp calf pain
Yellow and brown ankles toes and feet pale
black eschar
Irregular shape sores round red
,
sores

ELEVATE HANG
legs legs

ACUTE MYELOGENOUS LEUKEMIA

ACUTE LYMPHOCITIC LEUKEMIA

common in 2- 5- years poor outcomes

too
More common -

Treatable many myeloid cells

TOO
many lymiphoid cells
NON -
HODGKIN 'S LYMPHOMA

HODGKIN 'S LYMPHOMA multiple lymph nodes involved

localized
single group of nodes
,
extra nodal involvement
Reed most type
Stenberg cells
-
common
 hallmark sight and symptoms
excessive
drooling -

Epiglotittis
red man
syndrome -

vancomycin rapid
-

infusion
colored
Cola urine -

Rhabdomyolisis
yellow / green vision -

Digoxin toxicity
scarlet fever and Kawasaki disease
strawberry tongue -

acetone breath -
Diabetic ketoacidosis
COPD and GERD
frothy sputum
-

} intussusception
red currant
,
jelly stool
palpable sausage shaped mass

bull 's
eye pattern rash -

Lyme 's disease

simian crease transverse palmar crease ) -

down syndrome
wilm 's tumor in the kidneys in children
}
cancer
DO NOT MASSAGE PALPATE
abdomen ) abdominal aortic
pulsating mass aneurysm
abdominal bruit

diagnostic signs
APPENDICITIS

Blumberg 's sign rebound tenderness -

pain upon removal of pressure

Rousing 's sign -
abdominal pain upon palpation of left side of abdomen
RLQ
RLQ abdominal pain with extension hip while
psoas sign applying counter
-

resistance to
right hip or

Obturator sign -

pain elicited by internally and externally rotating flexed R

hip
HYPOCALCEMIA
Chvostek 's sign -

spasm of facial muscle when tapping over the cheek

Trosseau 's wrist and hands when
sign -

spasm on
compressed by a BP cuff
DVT
Homan 's sign
-

pain in calf when

pointing the toes upward
PANCREATITIS
Cullen 's discoloration of abdomen and peri umbilical
the
sign area
-

bluish discoloration of the flank

Grey Turner 's
sign -

HYDROCEPHALUS
McEwan 's resonant sound upon percussion skull at the
sign hyper of the
-

junction of the frontal temporal & ,

parietal bones
" "
can auscultate a cracked pot
-

BASILAR SKULL FRACTURE

Halo sign lightly stained blood spot in the center
CSF leak
;
-
a
ring around a

MENINGITIS

Kernig 's sign pain upon extension of leg

- while hips are flexed
B rudzinski 's
sign involuntary flexion of
- the knees & hips upon flexion of neck

CARPAL TUNNEL SYNDROME

Tiriel 's tingling sensation tapped

sign -
when nerve is
Phalen 's -

wrist flexion test

 cranial nerves

1 Olfactory some smell

11
Optic says vision
111 Oculomotor money pupil constriction eye mechanical movement
N Trochlear medial
Matters eyes muscular movement down /
V
Trigeminal But facial sensation chewing
V1 Abducens My eye movement lateral
V11 Facial Brother facial muscular movement lateral
V11
Auditory vestibule cochlear say hearing balance

IX taste
Glossopharyngeal Big
✗ Vagus Brain swallowing sense BP ↓ HR
sensory
✗1 Spinal Accessory Matters Shoulder Shrug Motor
movement
✗ 11
Hypoglossal Most tongue Both

Atrial Fibrillation
arrhythmias
-

absence of Pwaves and fibrillation

before the QRS complexes
ventricular Fibrillation
- loss of QRS complexes
SHOCK !
Ventricular Tachycardia
1970 border
wallpaper
-

SHOCK !
if pulse less
A
systole
Epinephrine then Atropine

Atrial Flutter
-

Sawtooth appearance

supra ventricular Tachycardia

Myocardial Infarction
STEMI -

ST elevated M1
 ekg changes electrolyte unbalance
HYPOCALCEMIA CALCIUM HYPERCALCEMIA
interval
Lengthened QT shortened QT interval

QRSdurat
shortened
Lengthened QRS duration

a
severe
Bradycardia

-^h-•~ -n
HYPOKALEMIA POTASSIUM HYPERKALEMIA

widening T -

waves lower
amplitude ) Tall ,
peaked 1- waves
ST
segment depression Prolonged PR interval
I P -
wave amplitude ,
duration
widening QRS complex
P -
wave duration
PR interval
u -
waves
-

torn
I • I
→ -

HYPOMAGNESEMIA MAGNESIUM HYPERMAGNESEMIA

Lengthened QT Flattened P wave

a.)
-

Broad and Flattened -1

Prolonged PR interval

Torsadede Pointers widened QRS complex

-
wave

~ Lon •

÷w
•

MMMMM
can also be seen in macrolide use

PR interval depolarization
atrial 0.12 0.20 seconds
QRS interval ventricular depolarization 0.04 0.12 seconds