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Ranson criteria
Screening for pancreatitis
On admission:
->55yo
-WBC>16
-glucose >200
-AST>250
-LDH>350
48hrs after admission:
-HCT drop >10%
-BUN incr >5
-Ca<8
,-arterial pO2<60
-base deficit >4 (24-HCO3)
-fluid needs >6L
Mortality risk: 28% if 3 points
40% if 6 points
100% if 7 points
immunoglubulins
IgM- Recent infection, 1st line B-cells
IgG- Indicates prolonged infection. 2nd immune response (only
immunoglobulin that crosses the placenta).
IgE- hypersensitivity response (allergic reaction)
IgA- support immune function of mucus membranes.
,Addison's disease
Adrenal glands do not produce enough cortisol or aldosterone. Sx=
bronze pigmentation of skin, changes in distribution of body hair, GI
disturbances, weakness, hypoglycemia, hypotension, weight loss. Tx=
glucocorticoids
SIADH Tx
Fluid restriction, IV hypertonic saline, furosemide (Lasix)
diabetes insipidus (DI)
Inadequate antidiuretic hormone (ADH), or there is a resistance of the
kidney to ADH. Often 2/2 head trauma/tumor. Tx= desmopressin
Hashimoto's disease
Autoimmune disease in which the body's own antibodies attack and
destroy the cells of the thyroid gland. Tx= Levothyroxine
Microcytic anemias
iron deficiency, anemia of chronic disease, thalassemia, sideroblastic
anemia
, Macrocytic anemias
Folate or vitamin B12 deficiency
Distributive shock
Systemic vasodilation
-Septic
-Neurogenic (damage to the spinal cord),
-Anaphylactic
Tx= IVF, vasopressors
Hypovolemic shock
2/2 severe blood/fluid loss.
Tx= IVF, PRBS/blood product
Cardiogenic shock
Inadequate function of the heart, or pump failure. Tx= IVF 1st, then
vasopressors/inotropes. If pressors fail, intra-aortic balloon pump