OB admnister c in 3h of attack lang

meds:
best time for prenatal checkup - first trimester heparin
SQ only
fetal heart heard by APTT = if >80-90 secs, give protamine sulphate
doppler - 8-12 wks N = 20-30 secs
fetoscope - 16 wks coumadine
steth - 20 wks PT = N 9-12 secs
M 18-24 secs
pre eclampsia vit k = >30 secs
screening - ASAP/11 wks sa ibang source INR - international normalized ratio
treatment - 16th wk lowest sa dalawa, N 2-3
vit k = >4.5
CARDIO
MI
epi - for dysrythmia S/Sx - DANCEPAD
CI - grapefruit juice dyspnea
atropine - for brady (pampabilis) anxiety
nausea and vomiting
v tach chest pain (crushing, radiating to left)
meds for vtach: elevated temp (severe pain, up heat)
 amiodarone - can cause bluish discoloration on skin pallor
 lidocaine arrythmias
 procainamide diaphoresis
Dx
v fib - pt may die in 3-5 mins ECG
injury - ST elevation
meds for hypertension ischemia - T inversion
ACE - pril infarction - pathological q
ARBS - sartan Cardiac Enzyme
ALPHA 1 blocker - osin confirm - trop I - 2-3hrs (elevate)
ALPHA 2 blocker - catapress
BETA blocker - olol infective endocarditis
CALCIUM - dipine risk factors
heart disease
vasodilator bleeding gums
s/e dental prox
 headache mech valve replacement
 orthostatic hypotension unsterile IV
c/x
 hypotension stroke
aka: CVA, Brain Attack, cerebral infarction
alpha 1 blocker down o2 in brain
 doxazosin thrombosis - clot
 terazosin embolism - travel
 prazosin hemorrhage - bleeding
types (+patho)
vasoconstrictor - triptan 1. ischemic
obstruction
HMG, COA Reductase Inhibitor atherosclerosis
 action fat deposit
increase HDL bv necrosis
decrease LDL decreased blood supply
decrease triglyceride decreased o2
 taking 2. hemorrhagic
evening bleeding
c or s meal raptured aneurysm
sleeping - cholesterol synthesis hemorrhage
decreased blood supply
anti platelet decreased o2
aspirin - acetylsalysilic acid
aneurism
thrombolitics 1. cerebral
2. TAA - thoracic aortic aneurism b) coughing - hemoptysis
3. AAA - abdominal aortic aneurism WOF: shock
2. thyriod storm
shock stress
types: infection
1. septic trauma
2. hypovolemic hyperthermia - antipiretics
3. anaphylactic agitation, tachycardia - acute anxiety
4. cardiognic propanolol (inderal)
5. spinal/neurogenic (-) inotropic - down contractility
(-) chronotropic - down hr
development of stroke 3. xPTG - down PTH - hypoglycemia
level 1 TIA - transient ischemic attack 4. laryngeal nerve damage
<24 hrs - temporary damage horseness of voice
level 2 Stroke in evolution - 48-72 hrs
level 3 Completed stroke - >72 hrs myxedema coma
*2 and 3 - permanent damage manifestation:
 down LOC
hema  stuporous
hypoxia - brain  obtunded
hypoxemia - blood  lethargic
ischemia - muscles  down arrousability

iron deficiency anemia cretinism

low iron in rbc - o2 deficiency -down t3 and t4 - down brain development
may lead to: -mental retardation (old term)
baby -intelectual disability
neural tube defect
low birth wt GCS
pre term N - 12-15
mommy 7-10 - prep ICU transfer
cardiac probs 4-6 - prep intubation
pretem labor 3 - deep coma - severe neuro impairement
death
DOC hypocalcemia - CATS
ferrous sulphate chvostek’s - hallmark
12 wks arrythmia
30-50mg (90 if deficit) trosseau tetany - hallmark
morning (empty stomach) seizure attack
route:
oral - staining, use straw vit d
IM - skin and muscle staining, use z track produced - kidney
activated - skin
endocrine storaged - liver
hyperthyroidism
meds - BACKS cushing
Beta blocker incresed stenoids - stress hormones
Anti thyroids meds
prophylthiouracil mytotane
methinazole metypapone
*down immunity both ketoconazole
Corticosteriods
K+ iodide Transfrontal Craniotomy Hypophysectomy
SSKI - saturated solution of k+ iodide (Lugols) mgt.
-days before thyroidectomy RTCT - tumor
-decrease vascularity of glands exercise - blood stasis
-oral (bitter) warm room - vasodilation
mix c juice/choco/candy
empty stomach before meds intra op
enema
thyriodectomy types
1. bleeding 1. return flow - parasite, up down 3-4x, change
a) assess nape 2. crminative - utot
3. cleansing - dx -down Na, decrease OFI, 1500mL at most
 low - 12 in above buttocks -diuretics
 hign - 16 in above buttocks -paracentesis, WOF hypovolemia (shock)
pxn  spider angioma
left lateral sims  esophagial varices
(-) if may cardiac prob -ice chips, sorbetes, ice cream
vagus nerve, down HR -sengstaken blakemore tube (3 lumens)
--1st, inflate esophagus - esophagial bloon
nephro --2nd , baloon, seals of GIT, gastric baloon
kidney --3rd , lavage, gavage
function: BE BRAVE  hemorrhoids/anal varicosities
blood volume - cardiomegaly - chf
excretion of waste products inflammatory bowel disease
bun - 10-20 1. ulcertive colitis
crea - 0.6-0.2 a) 10-20 diarrhea per day
bp regulation - trigger: hypotension - RENIN b) left colon
acid base balance - h+ ion, release or retain c) (+) blood in stool (fresh)
vit d synthesis - ca+ absorption - bone pain 2. chron’s disease
electrolyte and fluid balance a) 5-10 darrhea per day
hyper k, hyperphosphotemia, edema b) (-) blood
mgt c) (+) mucus
diuretics d) (+) pus
dialysis common in eauropeans (jewish)
meds: autoimmunity
antihypertensive hypersensitivity reaction
epogen mgt
sodium bicarb prevent dehydration
vit d DOC: Azulfedine
insulin, d50w, kyexalate -chemotherapeutic
-immunosupressive
renal failure -also used in rheumatoid arthritis
pre renal - down blood supply (before[taas] kidney)
intra renal - direct damage (kidney) grey turner’s sign - bluish discoloration of flank
post renal - obstruction (after[baba] kidney) cullen’s sign - bluish discoloration of umbilicus

chronic renal failure cholelitiasis - outpouching

stage cholecistitis - inflammation
1. minimal - 90-125
2. mild - 60-89 hirshprung - increase abd size, ribbon-like stool
3. .
a) mild-mod - 45-59 pyloric stenosis - projectile vomiting, olive shaped mass
b) mod-sev - 30-49
4. severe - 15-29 intussuception - invagination, telescoping, jelly-like stool,
5. ESRD (end stage) - <15 sausage shaped mass

hemodialysis pain meds:

s/sx BADBAD percocet - narcotics + acetaminophen
bone pain percodan - narcotics + aspirin
anemia
dysequilibrium hepatitis
bp down pre icteric phase
arrythmia flu like symptoms
dyspnea hepatomegaly
diarrhea
GI body weakness
cholecystitis joint pain
hallmark - murphy’s, boa’s sign icteric phase
sclera - icteric sclera
hepatitis skin - jaundice
fibrosis - degeneration stool - clay colored, pale looking
portal hypertension urine - tea colored
manifestations of portal htn post icteric phase
 ascitis recovery
hepa verapamil
a - fecal-oral *c beta blocker propanolol sila both
b - blood borne
c - sexual diuretics
d - derived from hep b serum k+ = 3.5-5 (normal)
e - fecal-oral ecg - t waves
*a and b - meron vax volume overload

gastrectomy hypo k+
 roux EnY (gastric bypass) diet: k rich
 billroth 1 - gastroduodenostomy A - appricot, apple
 billroth 2 - gastrojejunostomy B - banana (2nd highest k+)
complications C - cantalope, camatis, calamansi
1. shock - hypovolemic D - dates, dalandan
2. marginal ulcer P - potato, papaya (highest k+)
3. pernicious anemia (-) diuretics
kalium durule - supplement
dumping syndrome KCl - (-) IV
15-30 mins
s/sx hyper k+
diarrhea kayexalate - excrete k+ in stool
hypoglycemia furosemide
mgt d5050 + insulin
(-) ambulation emergency dialysis
(-) fluid c meals, fluids = 1-2 hrs after meal
(-) upright pxn after eating loop diuretics - OSMOTIC
(+) supine oliguric pt
(-) high fiber, simple sugar, dairy stop water reabsorption (kidney)
increase CHON and fats mannitol
osmitrol
pharma tissue dehydration
HTN INO monitoring, Increase VO
N = 120/<80 circulatory overload (-) chf
elevated = 121-129/<80 *works by removing water from cells to bloodstream
stage 1 = 130-139/81-89
stage 2 = >140/>90 GABA - inhibitory neurotransmitter
crisis = >180/>120  benzo antidote
flumazenil (romazicon)
RAAS taper
low blood volume (stimulus)  non benzo
kidney - renin - juxta glumerular aparatus busperone (buspar)
liver - renin to angiotensin 1 elderly (-) cns depression s/e
lungs - angiotensin 1 to 2 10 days - long acting
angiotensin converting enzyme - ARBS -
vasoconstriction - up BP seizure
adrenal cortex - aldosterone anti - diazepam
renla tubules - Na reabsorption 1. dilantin (phenytoin)
retention - vasoconstrict, up cardiac output, up bp gingival hyperplasia
ACE inhibitor 10-20 days
(+) heart failure fluh iv line before and after
lower heart workload 2. barbituates
lower blood volume phenobarbital - cns depression
captopril - diet: low K+ toxicity: activated charcoal
hyper k+ - peaked t waves 3. vlaproic acid - hepatotoxic
hypo k+ - u wave 4. carbamazepine (tegretol)
trigeminal neuralgia
ARBS - before meal 5. suximide (ethosuximide)
petit mal seizure
Ca channel blocker absence seizure
down co = down bp
vasodilation half life - time required for 1/2 of drug (concentration) to be
atrial fibrilation eliminated
diltiazem
communicable diseases *1 day both
tuberculosis clofacinin 50mg
aerobic dapsole 100mg
causative agent *2-28 days both
mycobacterium tuberculosis normal s/e
5-8 wks - intubation period blackish/brownish skin discoloration
mgt dry skin
2-4 wks - consistent treatment, di na contageous
primary complex - tb among children, (-)contageous influenza
dx causative agent
hemoptysis - only CI to sputum exam viral
1. DSSM common: A, B, C
2. mantoux test common cause of death
screening pneumonia, conolidation of secretion
purified protein derivative vax q 1 year
ID - balik 48-72hrs
10mm induration pneumonia
(+) exposure - BCG vax causative agent
meds Community accuired - strep
RIPES hosp - staph
categories ICU - pseudomonas
1 - (+) sputum, HIV, EPTB, 6mos aspiration pneumonia
2 - relapse, failure in tx, return after 8 mos stasis/hypostatic pneumonia
3 - negative SE - 4 mos s/sx
4 - chronis, still (+) SE 8 mos high fever
*stop if (+) jaundice ruty sputum
increased tactile frenitus
leprosy PNEUMONIA
causative agent pleuritic chst pain
mycobacterium leprae nausea and vomiting
transmission elevated temp
skin to skin, respiratory use of accessory muscle
1 wk of tx, already not communicable mucus (rusty)
mgt orthopnea
RA 4073 - home treatment nasal congestion
affected organs increased hr
eyes, muscles, nerves, skin, respi anorexia
early signs - CLUMP mgt
change in skin color - red to white check lung consolidation
lose of sensation confirm: x-ray
ulcer that does not heal 1. bronchoscopy
muscle weakness/paralysis 2. egophony
painful and thickened nerve steth - diaphragm
late signs - MISC “E” - I sound
madarosis - loss of eyebrows 3. whisper pectoriloquy
inability to close eyelids 1, 2, 3 - not clear - normal
sinking of nosebridge dx
clawing of fingers and toes culture and sensitivity
dx
slit skin smear meds
category NSAIDs
1. pancibacillary antibiotics
intermediate, not infectious antipiretics
6-9 mos o2
rifampicin expectorants
dapsole albuterol
*1 day both
dapsole 100mg 2-28 days dyptheria
2. multibacillary causative agent
infectious pseudomonas
24-30 mos manifestation
rifapicin 600mg bull’s neck - cervical lymph node inflammation
dapsole 100mg dysphagia
aphonia - hoarseness of voice
dx
nose and throat swabbing
mgt
isolate pt
24hrs after antibiotics
(-) isolation: 2 negatives
prevention
DPT vax
4 wks interval
3 doses, 6 wks
given berove 6 mos old
IM, vastus lateralis
booster
1 year after ast dose
4 or 5 y/o

pertussis
aka wooping cough
transmission
droplet
manifestation
explosive outburst of 5-10 coughs
high pitched end (woof)
mgt
abd binder - prevent hernia
cough:
aggravated by drinking, eating, crying
sa bata, use dropper to prevent cough
NPO - prevent aspiration
DOC
erythromycin