TheLiberation93

Hepatitis B Serology Interpretation HBsAg HBcAb HBsAb - BIDMC Infectious Diseases Fellowship @BIDMC_IDFellows #HepatitisB #HBV #HepB #Serology #Interpretation #hepatology #diagnosis

Acid Base Disorders - Blood Gas Interpretation Steps for Blood Gas Interpretation: 1. Acidemia or Alkalemia? 2. Respiratory or Metabolic? 3. Compensated? Acute or chronic? 4. Anion gap? Delta-delta? 5. Differentials? ABG And BMP Normal Values • pH: 7.35-7.45 • PaCO2: 35-45 mmHg • PaO2: 80-100 mmHg • HCO3 (on BMP): 22-26 mmol/L Step 1 - Acidemia or Alkalemia: • pH <7.35 = Acidemia • pH >7.45 = Alkalemia Step 2 - Respiratory or Metabolic: pH pCO2 ↓ ↓ Metabolic Acidosis ↑ ↑ Metabolic alkalosis ↓ ↑ Resp Acidosis ↑ ↓ Resp Alkalosis Step 3 - Compensation, Acute vs Chronic: • Metabolic compensation • Respiratory compensation Step 4 - Anion gap, Delta-delta: Anion Gap (AG) = {Na - (Cl + HCO3)} Normal = 12 +/- 2 Corrected Anion Gap = AG + 2.5(4-albumin) Delta: Delta = (AG-12) / (24-HCO3) Delta: Delta Interpretation For Metabolic Acidosis <0.4 Pure Normal AG metabolic acidosis 0.4-0.8 Normal + High AG metabolic acidosis 0.8-2.0 Pure High AG metabolic acidosis >2.0 Metabolic acidosis with superimposed Metabolic alkalosis/Resp acidosis Step 5 - Differential Diagnosis: Causes of High Anion Gap Metabolic acidosis: G Glycols - ethylene glycol “antifreeze” and propylene glycol (present in IV benzodiazepines) O Oxoprolin (associated with acetaminophen dosing) L L-lactate (common form of lactate) D D-lactate (short bowel syndrome, intestinal bacterial overgrowth, propylene glycol) M Methanol A Aspirin (salicylates) R Renal failure (uremia) K Ketoacidosis (starvation, diabetic) Causes of Normal Anion Gap Metabolic acidosis: - Diarrhea - Renal tubular acidosis/Chronic renal failure - Adrenal insufficiency - Rapid saline infusion - Acetazolamide Causes of Metabolic Alkalosis: - Vomiting, NG suction - Volume depletion (diuresis) - Mineralocorticoid excess Causes of Respiratory alkalosis: - Hyperventilation (Anxiety, pain, fever, hypoxia) - “Classically” noted with pulmonary embolism (with associated hypoxia) - Salicylates Causes of Respiratory acidosis: - CNS depression (sedation, narcotics, CVA) - Neuromuscular weakness (GBS, Myasthenia gravis) - Obstructive or restrictive lung disease (COPD, OSA, Asthma, Obesity hypoventilation) - Airway obstruction (foreign body, aspiration) M. Daniyal Hashmi, MD @MDaniyalHashmi1 #AcidBase #disorders #Interpretation #Diagnosis #Summary #Nephrology #ABG #bloodgas #Acid #Base #Gas #VBG #differential

Thyroid Function Test Interpretation Table TSH, Free T4, Free T3 and Associated Condition #Diagnosis #Endocrinology #Hyperthyroid #Hypothyroid #Function #Tests #TFTs #Comparison #Table #TSH #FreeT3 #FreeT4 #Labs #Interpretation

A better approach to Torsades de Pointes - Algorithm and Magnesium Infusion Protocol #TorsadesdePointes #Algorithm #Magnesium #Infusion #Protocol #TorsadesDePointes #Management

Phosphate Binders - Pros and Cons Calcium carbonate (TumsTM) - Most inexpensive, antacid properties useful for reflux and peptic ulcer disease Calcium Acetate (PhosLo) - Relatively inexpensive, less GI calcium absorption compared to Ca carbonate Aluminum hydroxide (Amphogel) - Most effective, potent binder, inexpensive Sevelamer-HCI (RenageI) - Calcium and metal-free binder; may have ancillary benefits such as lipid lowering, uric acid lowering, anti-inflammatory effect. Sevelamer Carbonate (Renvela) - Calcium and metal-free binder; may have ancillary benefits (see above), no metabolic acidosis. - Improved GI tolerance. Lanthanum Carbonate (Fosrenol) - No calcium load. Low pill burden. Magnesium based (MagneBind) - Minimal calcium load. - Anti-constipating. Trivalent iron containing binders (sucroferric oxyhydroxide Velphoro, ferric citrate Auryxia) - No calcium load. Low pill burden - May supply additional Fe, decrease ESA Dr. Edgar V. Lerma @edgarvlermamd - Nephrology Secrets https://amzn.to/34t5DgJ #Phosphate #Binders #Table #Comparison #Pharmacology #Nephrology

Calcium Channel Blockers - Dihydropyridines vs Non-Dihydropyridines Dihydropyridines (amlodipine, felodipine, nifedipine, nicardipine) • SVR: Decrease • Inotropy: No effect • Chronotropy: No effect • Dromotropy: No effect Non-Dihydropyridines (diltiazem, verapamil) • SVR: Decrease • Inotropy: Decrease • Chronotropy: Slows • Dromotropy: Slows - Dr. Eric Strong @DrEricStrong - Strong Medicine https://www.youtube.com/c/EricsMedicalLectures/ #CCBs #Calcium #Channel #Blockers #Dihydropyridines #NonDihydropyridines #pharmacology #comparison #table #cardiology

Calcium Homeostasis Serum Calcium - PTH - Vitamin D Regulation #Calcium #Homeostasis #Pathophysiology #Autoregulation #VitaminD #PTH #Endocrinology

Antiarrhythmic Medications - Vaughan Williams Classification - Summary Table Class I agents - Sodium Channel Blockers⠀ Class II agents - Anti-sympathetic agents. Most agents in this class are beta blockers.⠀ Class III agents - Potassium Channel Blockers Class IV agents - Calcium Channels Blockers ⠀ Class V agents - Other - Dr. Eric Strong @DrEricStrong - Strong Medicine https://www.youtube.com/c/EricsMedicalLectures/ #Antiarrhythmic #Medications #Classification #Summary #Table #pharmacology #VaughanWilliams

Drugs affecting the cardiac action potential. The sharp rise in voltage ("0") corresponds to the influx of sodium ions, whereas the two decays ("1" and "3", respectively) correspond to the sodium-channel inactivation and the repolarizing eflux of potassium ions. The characteristic plateau ("2") results from the opening of voltage-sensitive calcium channels. #Pathophys #Pharmacology #Cardiology #Antiarrhythmics #Classes #Effect #ActionPotentials

Potassium Repletion - Oral vs IV Oral KCl - 40mEq at a time, q2-4 hrs - Side Effect: GI upset IV KCl - 10 mEq/hr via peripheral vein - 20 mEq/hr via central line - Side Effect: Burning pain proximal to IV site Dr. Eric Strong https://twitter.com/DrEricStrong #Potassium #Repletion #Hypokalemia #Oral #Intern #Management