Little Doctor

Emergency steps💯

This creepy, fictional figure is a version of the homunculus—it represents the weighted significance of our sensory receptors.

Learn how this concept plays a role in psychology: http://bit.ly/Homunclus

Serum K+ < 3.5 mmol/L

:-
1) ↓ intake:-
☞ Dietary deficiency
☞ K+ free IV fluids

2) Redistribution into cells :-
☞ Alkalosis
☞ Insulin
☞ Catecholamine
☞ B2 agonist

3) ↑Urinary excretion(Urine K > 20-30 mmol/L)
* Activation of Mineralocorticoid receptors :-
☞ Conn's syndrome
☞ Cushing syndrome
☞ Glucocorticoid excess
☞ Carbenoxelone

* Genetic disorder :-
☞ Liddle's syndrome
☞ Bartter syndrome
☞ Gitelman's syndrome
☞ RTA (type I & II)
☞ Acetazolamide
☞ Diuretics :- loop , thiazides

* Increase GI loss :- ( Urine K < 20-30mmol/L)
☞Upper GI:- Vomiting , NG aspiration
☞ Lower GI :- Diarrhoea , laxative abuse , villous adenoma , Bowel obstruction

:-
(3.0-3.3)
☞ Asymptomatic
reduction < 3.0
☞ Muscular weakness
☞ Tiredness
☞ Ventricular ectopic beats
☞ Arrhythmias
☞ Functional bowel obstruction
☞ Renal tubular damage
☞ polyuria , polydypsia
☞ :- Flattened T-wave , U wave , ST dep

:-
☞ Plasma Electrolytes
☞ Bicarbonate
☞ Urine K
☞ Plasma Ca
☞ Mg level
☞ Plasma renin

If kidney is route then urine K > 30
If GI is route then urine K < 20

:-
☞ Treat the underlying cause
☞ Slow release K-Cl tablets
☞ In acute case → Iv KCl
☞ K bicarbonate
☞ Mg supplements
☞ K sparring diuretics → Amiloride

> 5 mmol/L

:-
☞ Hemolysis during venepuncture
☞ Hemolysis in vitro
☞ Thrombocytosis / Leukocytosis
☞ ↑ K+ intake
☞ Acidosis
☞ Insulin def
☞ severe hyperglycemia
☞ Beta adrenergic blockers
☞ Rhabdomylosis
☞ severe hemolysis
☞ Tumour lysis syndrome
☞ ↓Urine excretion :-
* Acute kidney inj , chronic kid inj
* Reduce mineralocorticoid
* Addison's disease
* Congenial adrenal hyperplasia
* Isolated aldosterone def
* ACEI / ARBs
* Spirolonolactone , Eplerenone
* Heparin , NSAIDs
* Interstitial nephritis
* Diabetic nephropathy
* obstructive uropathy

:-
☞ Nausea , Vomiting
☞ Interstitial colic
☞ Progressive muscle weakness
☞ Flaccid paralysis
☞ Cardiac Arrhythmias
☞ :- Tall peaked T-wave , wide QRS
Prolonged PR interval

:-
☞ Electrolytes level
☞ Creatinine
☞ bicarbonate
☞ Plasma sodium ( in aldosterone def)
☞ ECG

:-
level < 6.5 mmol/L :-
☞ reduce intake of K
> 6.5-7.0
1) Stabilize cell membrane potential:-
☞ IV calcium gluconate (10 ml of 10% sol)

2) Shift K into cells:-
☞ Inhaled B2 adrenoceptor agonist
☞ IV glucose (50 ml of 50% sol )
☞ Insulin (5 IU )
☞ Iv sodium bicarbonate

3) Remove K from body:-
☞ IV furosemide and Normal saline
☞ Ion-exchange resin (Resonium)
☞ dialysis

It is to announce with heavy heart that Prof. Muhammad Javed of ENT department Hayatabad Medical Complex Peshawar, lost his battle against , he is no more with us. He met his Creater today early morning.
May GOD give him highest Rankin in jannat.

The most authentic dhikr (remembrance) at the time of breaking fast.

But it is preferable to diversify one’s supplications, between the aforementioned and those that are of interest to a person concerning his religion and worldly life — without restriction.

-Shaykh Abdul Aziz At-tarefe.

Covid19' sty home sty safe😇

:-
When HCO3- < 24 mmol/L , PCO2 < 5.33 kPa2
Blood H+ > 40 nmol/L , PH < 7.35

:-
1) :-
☞ Ingestion or infusion of inorganic acid (HCl , NH4Cl)
☞ GI Hco3 loss ( diarrhea , small bowel fistula)
☞ Renal tubular acidosis

2) :-

☞ DKA
☞ Starvation Ketoacidosis
☞ Alcoholic Ketoacidosis
☞ Lactic acidosis
☞ kidney disease

☞ Aspirin poisoning
☞ Methanol poisoning
☞ Ethylene glycol poisoning

:-
☞ Nausea , Vomiting
☞ diarrhea
☞ Confusion
☞ loss of consciousness
☞ Arrhythmias
☞ Increase heart rate
☞ Increase Resp rate

:-
☞ Blood gas measurement
☞ Creatinine
☞ Bicarbonate level
☞ Electrolytes :- Potassium level
☞ acid challenge test
☞ Urine PH
☞ ketone (blood & urine)
☞ blood glucose
☞ Plasma lactate


:-
☞ diarrhea :- fluid
☞ lactic acidosis :- restore oxygenation & tissue perfusion
☞ Salicylate pois :- Vigorous gastric lavage with isotonic saline , activated charcoal
☞ Ethanol intox :- Osmotic diuresis , thiamine , fomepizole
☞ Diabetic KA :- Iv fluid , insulin
☞ Alcoholism & starvation KA :- Iv glucose
☞ Type I & II RTA :- Sodium & potassium bicarbonate
☞ type IV RTA :- loop diuretics , thiazides or Fludrocortisone

When PH < 7.00 or H+ > 100 nmol/L

For Renal failure