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Hypernatremia:
Free water deficit = weight × TBW% × ((S.Na/140) - 1)
Young men: 0.6
Elderly men & young women: 0.5
Elderly women: 0.45
Free water deficit + insensible loss is calculated and Infused over 48 hrs.
Correction rate should not exceed 1mmol/hr and 10mmol/24 hrs to avoid cerebral edema.
Change in Serum Sodium = ([Na] Infused - [Na] serum) / (TBW + 1)
5% dextrose in water (D5W): 0 mmol/L
0.2% sodium chloride in 5% dextrose in water (D5 2NS): 34 mmol/L
0.45% sodium chloride in water (0.45NS): 77 mmol/L
Ringer's lactate solution: 130 mmol/L
0.9% sodium chloride in water (0.9NS): 154 mmol/L
Dr. Mazin M.Alhassan
R2 Pulmonology registrar
Neurological history:
1. Higher functions (language, vision, recognizing objects in space (visuospatial recognition), awareness and memory)
2. Cranial nerves (from I to XII)
I. Olfactory nerve: anosmia/hypermedia
II. Optic nerve: loss of vision or tunneled vision
III, IV, VI. oculomotor, troclear and abducent: diplopia/nystagmus
V. Trigeminal nerve: facial pain
VII. Facial nerve: drooling of saliva, mouse deviation, inability to close the eye (UMNL: spare upper face)
VIII. Vestibulochoclear nerve: diffness, tinnitus and vertigo
XI. Glossopharyngeal nerve: aspiration, nasal tone and nasal regurgitation
X. Vagus nerve: dizziness
XI. Accessory nerve: neck pain and spasm
XII. Hypoglossal nerve: dysarthria and gysphagia
3. Sensory (posterior column and spinothalamic tract)
4. Motor
5. Symptoms of IPC (headache, blurring of vision and progectile vomiting)
6. Symptoms of meningism (neck spasm, photophobia)
7. Sphincteric control (incontinence or retention)
Collected by Dr. Mazin MohamedAlhassan
R2 Registrar of pulmonology
Pneumonia :
CURB65 :
C :confusion
U : urea >50mg
R : RR>/=30
Bp Systolic <90
Diastolyic <60
Age >65
0_1 👉👉
Pneumonia :
تركززز إنت بتتعامل مع CAP or Hospital - acquired
ودا من الhistory
Hospital acquired defined as >48h after hospital admission
أو يقول ليك قبل up to 90 days كاااانadmitted .
تعرف المسبب والعلاج.
