Internal Medicine Scholars Note

Copy paste from everywhere, not an official guidelines. Personal use only.2011Internal Medicine Scholars NoteAny critics, suggestion, improvement please email at iin@dr.comsekolastika indriaty sundari sasongko(ed)

Table of ContentsEQUATIONS123ENDOCRINOLOGY456 CARDIOVASCULAR123GASTROENTEROHEPATOLOGY456 NEPHROLOGY HYPERTENSION123RHEUMATOLOGY456 RESPIROLOGY1Type chapter title (level 2)2Type chapter title (level 3)3HEMATOLOGY ONCOLOGY4Type chapter title (level 2)5Type chapter title (level 3)6 TROPIC INFECTION1Type chapter title (level 2)2Type chapter title (level 3)3ALLERGY IMMUNOLOGY4Type chapter title (level 2)5Type chapter title (level 3)6 GERIATRY1Type chapter title (level 2)2Type chapter title (level 3)3Type chapter title (level 1)4Type chapter title (level 2)5Type chapter title (level 3)6

EQUATIONS Perhitungan BB menurut LLA LLA = ------- x (TB - 100) 26,7 LLA = ------ x (TB 100) 25,9

KOREKSI ALBUMIN(4 - Alb) x BB x 0,8 25

KOREKSI Na(140 Na) x BB x 0,6 256

KOREKSI K[0,3 x (4,5 K) x BB] + (BB x 1 mEq) = .mEq1flacon = 25cc = 25 mEqMasukkan via syringe pump.Kecepatan maximum via perifer : 5cc/jam (syringe pump) Via sentral : 10 cc/jam (CVP)) BODY WATER DEFICIT (L) in Hypernatremia0,6 x weight x (Na serum 140) 140

MDRDGFR= 186 x Scr-1.154 x age-0.203 x 0.742 if female x 1.210 if African American

PROTEIN NEED ASSESSMENTUsual0,8g/kg/dRenal failure22 mm)4 = Extraocular muscle involvement (diplopia)5 = Corneal involvement6 = Sight loss SIGNS AND SYMPTOMS OF THYROTOXICOSIS(DESCENDING ORDER OF FREQUENCY)SymptomsHyperactivity,irritability,dysphoriaHeat intolerance and sweatingPalpitationsFatigue and weaknessWeight loss with increased apetiteDiarrheaPolyuriaOligomenorrhea, loss of libidoSignsTachycaria;AF in the elderlyTremorGoiterWarm,moist skinMuscle weakness,proximal myopathiesLid retraction or lagGynecomastia

INSULIN THERAPY INDIKASI INSULIN Kurus Tidak sadar Komplikasi akut : koma hiperglikemik, HONK, asidosis laktat Komplikasi kronis DM tipe 1 Tidak berhasil dengan kombinasi INDIKASI INSULIN IV DRIPSIMA dan syokEdema anasarkaStrokePersalinanFrakturTerapi glukokortikoidInfeksi sistemikPerioperatif termasuk op jantungSyok kardiogenikKetoasidosis diabetik/HONKTransplantasi organInsulin rapid 0,1 U/kgBB atau 5-10 U insulin IVTergantung gula darah : 150 mg/dL : +70/100< 150 mg/dL : langsung drip, tidak usah bolus INSULIN IV DRIPSMasukkan 50 U insulin rapid dalam syringe pump.Dosis sesuai protokol diatas, monitor per jam> 300 mg/dL: 6 U/jam 200-300 mg/dL: 2-4 U/jam< 200 mg/dL: 1,5 U/jamGDS/jam dalam 6-8 jam pertama, selanjutnya tiap 2 jam.GDS 50-75 mg/dL dalam 1-2 jam naikkan dosis insulin 2x.SASARAN TARGERT GULA DARAHICU/ICCU: 80-110 mg/dLNon critical care : preprandial