1 cause preventable morbidity/mortality US
Smoking (eg- atherosclerosis, cancer, COPD)
2cause preventable morbidity/mortality US
Alcohol
Alcohol M&M
- > 50% accidental & intentional deaths involve alcohol
- Cancer
- Cirrhosis
- Fatal in withdrawal
1 Cause preventable MR
Alcohol
Alcoholic hepatitis liver enzymes
Aspartate aminotrasferase: alanine aminotransferase
(AST):(ALT) >= 2:1
Vitamin needs in:
- Pregnant women
- Alcoholics
- Pernicious anemia
1. Pregnant women - folate
(prevents neural tube defects)
2. Alcoholics - thiamine
(prevent Wernicke-korsakoff)
3. Pernicious anemia - Vit B12
(prevent permanent neurologic deficits)Most common anemia & cause
Iron deficiency anemia
- menstruation in reproductive-aged women
- cancer in men or menopausal women
Complications of atherosclerosis
MI, CHF, CVA, gangrene
Atherosclerosis is involved in 1/2 deaths in US
Risk factors of atherosclerosis
age, sex, fam hx, cigarette smoking, HTN, DM, high LDL, low HDL
DM complications
- atherosclerosis + it’s complications
- retinopathy (a leading cause of blindness)
- nephropathy (a leading cause of ESRD)
- PVD (a leading cause of limb amputation)
- peripheral neuropathy (sensory & autonomic)
- infection
Severe HTN sx
- hypertensive emergency
- headache
- dizziness
- blurry vision
- papilledema
- cerebral edema
- altered mental status
- seizures
- intracerebral hemorrhage (classically in basal ganglia)
- renal fail/azotemia
- angina
- MI
- CHF
What mild diseases may be treated with lifestyle modifications?
HTN, hyperlipidemia, DM, GERD, insomnia, obesity, sleep apnea
ABG analysis
- pH - alkalosis or acidosis
- CO2 & Bicarb - cause if same direction as pH
- compensation if opposite
exogenous hyponatremia
oxytocin, surgery, narcotics, inappropriate IV fluids, antiepileptic meds, diuretics
EKG changes
- hypERkalemia
- hypOkalemia
- hypERcalcemia
- hypOcalcemia
- hypERkalemia - peaked T waves
- hypOkalemia - lost/flat T waves + u waves
- hypERcalcemia - short QT
- hypOcalcemia - long QT
Shock - steps of treatment
- O2
- IV line
- Monitors
- Fluid bolus
- 1L NS or Lactated ringers if no signs of CHF
Virchow triad
of DVT
- Endothelial damage - surgery, trauma
- Venous stasis - immobilization, surgery, severe CHF
- Hypercoagulable - malignancy, OCPs, preg, lupus
CHF treatment
Diuretics, ACEI, & Beta Blockers
Screen for atherosclerosis
