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Nausea Nausea is the unpleasant sensation of about to vomit.  This can occur alone or with vomiting.  Many differentials are associated with nausea depending on patient's symptoms.   Always check patients electrolytes if they have been having severe vomiting...

Check if patient has Bowel Obstruction before giving anything PO Stool Softeners - Colace 100-250mg po qd or bid  Osmotic Laxatives   MiraLAX 17gm daily Lactulose 30ml q4hr until bowel movement Milk of Magnesia 30ml to 60ml qd Suppository - Dulcolax 10mg...

Anemia can be caused by many things but first we should get some basic labs such as CBC that will show MCV, and Reticulocyte count.  This table from UTD summarizes on the different causes of anemia depending on the MCV. Increased reticulocyte count (increa...

Sickled cells occlude arterioles and cause tissue infarction, resulting in recurrent painful episodes, and a variety of serious organ system complications that can lead to life-long disabilities and even death. Causes: Precipitated by infection, fever, dehydr...

Packed red blood cells (PRBC): - Consent: Always consent the patient or family member for transfusion of blood products on admission, unless emergent. - Dose effect: 1 unit PRBC (volume = 350 cc) should raise Hgb by about 1 g/dl - Leukocyte filtered/reduced...

For all reactions (except mild allergic/uricaria): STOP transfusion, send remaining blood product and fresh blood sample to blood bank) Acute Hemolysis (caused by ABO incompatibility) - Signs: fever/chills, hypotension, flushing, dyspnea, flank pain. Fever o...

General Principles Initiate empiric therapy based on severity of illness, likely pathogen, likelihood of drug resistance, host factors (allergy, poor renal function, immunocompromised) Initiate antibiotic therapy as soon as possible tailor antibiotic therap...

Objective The primary objectives of the medical evaluation of the first seizure are to establish whether the event was a seizure, and if so, whether it resulted from a correctable systemic process or whether the patient is at risk for developing further unpro...

Causes CNS insults, Systemic Infections, Metabolic Disturbances, Toxin Exposure, Medications, Chronic Systemic Diseases, Psychiatric conditions Definition Change in consciousness, appearance, behavior, mood, affect, motor activity or cognitive function Bes...

Common causes Streptococcus pneumoniae (pneumococcus) and respiratory viruses are the most frequently detected pathogens in patients with CAP Typical bacteria S. pneumoniae (most common bacterial cause) Haemophilus influenzae Moraxella catarrhalis Staphy...

Initial pharmacologic therapy Beta adrenergic agonists Dose and administration – Albuterol 2.5 mg (diluted to a total of 3 mL with sterile normal saline) by nebulizer or one to two inhalations (most commonly two, occasionally four; 90 mcg per inhalation) by ...

●Venturi masks permit a precise upper limit for the FiO2, preferable for patients at risk of hypercapnia. Venturi masks can deliver an FiO2 of 24, 28, 31, 35, 40, or 60%. ●Nasal cannula can provide flow rates up to 6 L per minute with an associated FiO2 of ap...

Pathophysiology: Scattered, nonhomogeneous alveolar damage that leads to oxygenation (V/Q mismatch) problems Diagnosis: Onset: within one week of a known clinical insult, or new or worsening respiratory symptoms Imaging: bilateral infiltrates on CXR not fu...

Intermittent (Step 1) — Symptoms — <2 days a week, <2x nighttime awakenings/month, SABA use <2 days/weekPreferred: SABA prn Mild persistent (Step 2) —Symptoms — >2 days a week, 3-4x nighttime awakenings/month, SABA use >2 days/week Preferred: Low dose ICS Alt...

What is AKI? According to The Kidney Disease: Improving Global Outcomes (KDIGO), which it the most current and preferred definition, it is: an increase in serum creatinine of ≥0.3 mg/dL within 48 hours OR an increase in serum creatinine of ≥50% within 7 days...

Definition GFR <60 for 3 months or more AND/OR presence of kidney damage (albuminuria, sediment or anatomic abnormalities or a hx of kidney transplantation). Stages of CKD: Etiology:  Most common is DM. Others are HTN/RAS, glomerular, interstitial , dr...

Acute Indications: Volume overload refractory to diuresis Severe hyperkalemia (K >6.5 mEq/L) or rapidly rising K+ levels Severe metabolic acidosis ( and pH <7.1) Uremia (pericarditis, uremia, unexplained mental status decline) Toxic overdose of a dialyzab...

Management: Ensure airway, adequate respiratory drive, and management of secretions/emesis Thiamine, consider folate/MVI, D5NS (for volume and glycogen/NAD+ depletion - will not enhance elimination ) Check FSBG. Hypoglycemia is caused by impaired gluconeoge...

Check Acetaminophen levels and urine toxicology for co-ingestions Call poison control NGT, lavage with 2 L NS Activated charcoal: Give a single dose of activated charcoal at 1 g/kg p.o. via NG tube within 4 hours of ingestion N–Acetylcysteine: Passive give...

Check salicylate level and check urine toxicology for co-ingestions. Try to determine whether salicylate was regular or enteric-coated (Affects pharmacokinetics). Call poison control NGT, lavage with 2L NS Intubate for respiratory depression if indicated A...