Open Letter

Dear Everyone,

I created this site to help those who had intense desire of passing any examinations. I know that I may never be able to provide everything but I will try the best I could to help . Frustrations come and go but as long as you continue pursuing your dreams there is no way you will not succeed. The review books , review centers and your strong desire to pass examinations with flying colors may not always have great result. I will be here to simply share my knowledge to the fullest of my ability so you can stand again after a fall or simply take pride after a great examination result. Try extra effort in reading, searching and enhancing your knowledge. I want to make a strong connection to each one of you . Good luck and think positively in all your battles.

Very truly yours,
The Author







Ideal Body Weight (IBW)
Infant
1-6 months
IBW = BW + ( Age in months x 600) = grams
2nd 6 months
IBW = BW + (Age in months x 500) = grams
2nd 6 months (Unknown BW)
IBW = Age in months/2 + 3 = kg
Unknown BW ( Constant = 3000 g)
IBW = 3000 + (Age in months x 600) = g
Children
IBW = (Age in years x 2) + 8 = kg
Adult
Height in cm. - 100 then less 10% = kg

Category of Nutritional Status (NS)
NS = Actual Body Weight/Ideal Body Weightx 100 = %
60 % Below IBW = 3rd degree or Severely underweight
61-75 = 2nd degree or Moderately underweight
76-90 = 1st degree or Mild underweight
91-110 = Normal
111-120 = Overweight
121 above = Obese

Estimate on Total Energy Requirement (kcal/day)

Infants 1-6 months
TER = kIBW x 110

Infants 2nd 6 mos.
TER = kIBW x 120

Children
TER = 1000 + (Age in years x 100)

Adult
TER = kIBW x P.A.


Distribution Gram Calorie

CHO - 50% - 80% an average of 60% 1 gm CHO = 4 calories
CHON - 10% - 15% maximum of 15% 1 gm CHON = 4 calories
Fats - 20% - 35% an average of 25% 1 gm Fats = 9 calories

CHO = TER x 0.60/4 = g/day
CHON = TER x 0.15/4 = g/day
Fats = TER x 0.25/9 = g/day

Physical Activity

Sitting patient = 30
Light : Student, housewife with maid = 35
Moderate : Housewife without maid = 40
Heavy : Manual laborer = 45

Food Exchange List

Food Group No. of exchange/ CHO /CHON/ Fats/ Calories

Vegetables 1 /3 /1 /-/ 16
Fruits 1/ 10/ -/ - /40
Milk
WM (Whole milk) 1 /12/ 8/ 10 /170
FM (Filled Milk) 1 /12/ 8/ - /80
Rice 1 /23 /2/ -/ 100
Meat
LF (Low Fat) 1 /- /8 /1 /41
MF (Medium Fat) 1 /- /8/ 6/ 86
HF (High Fat) 1/ -/ 8 /10/ 122
Fats 1/ -/ - /5 /45
Sugar 1 /5/ -/ - /20

Restrict avocado (high in fats), noodles, tinapa, cold cuts to hypertensive persons
Restrict sugar to diabetics

Normal Values:
K=3.5-5 mEq/L
Na=135 - 145 mEq/L
Ca=4.5-5.8 mEq/L or 8.6-10 mg/dL
Mg=1.5-2.5 mEq/L
Phosporous = 3.5-5.5 mEq/L
Cl= 98-108 mEq/L
HPO4= 1.7 - 2.6 mEq/L
HCO3= 22-26 mEq/L
PO2= 80-100 mmHg
Sat= 95-98
PCO2= 35-45 mmHg
pH= 7.35-7.45
RBC= 4.5 to 5.5M / cu.m.
WBC= 5,000 to 10,000/ cu.m.
Platelets = 150,00 to 450,000/ cu.m.
Hematocrit: Male= 42 to 50 %; Female= 40-48 %
FBS= 109 mg %
Hemoglobin= 12 to 17 g/dL
Leukocytes:
Neutrophils= 60 to 70 %
Eosinophils= 1 to 4 %
Basophils= 0 to 0.50 %
Lymphocytes= 20 to 30 %
Monocytes= 2 to 6 %
Bleeding time= 1 to 9 mins.
ESR : Males= 15 to 20 mm/hr; Females 20 to 30 mm/hr
PT- Coumadine= 11 to 16 secs.
PTT- Heparin= 60 to 70 secs.
APTT- Heparin= 30 to 45 secs.
BUN= 10 to 20 mg/dL
Cholesterol= 150 to 200 mg/dL
Triglycerides= 140 to 200 mg/dL
AST (SGOT)= 10 to 40 u/ml
CK-MB : Males= 50-325 mU/ml; Females= 50-250 mU/ml
LDH= 100-225 mU/ml
HBD= 140-350 mU/ml
ALT (SGPT)= 10-40 u/ml
GGT ; Males= 45 u/L ; Females= 30 u/L
Lipase= 0.20 to 1.50 u/ml
Amylase= 60 to 160 somogyi u/dL
FBS, FBG= 70 to 110 mg/dL
2nd Degree PPBS= 100 g of CHO
OGTT = 150 to 300 g of glucose P.O.
HBAic= 4.4 to 6.4%
T3= 75 to 200 ng/dL
T4= 4.5 to 11.5 mcg/dL
BMR= +20 to -20%
VMA tst= 0.70 to 6.8 mg/24 hour
Epinephrine= 100pg/ml (590 pmol/L)
Norepinephrine= 100 to 550 pg/ml (590 to 3240 pmol/L)
IOP= 11-21 mmHg
BUA=2.5 to 8 mg/dL
CVP: SVC= 0 to 12 cmH2O
RA = 5-12 cmH2O
PAP= 4-12 mmHg
PCWP= 4-12 mmHg
GIT: CEA= 11 g/L (non-smokers)
= 0-5 microgram/L
Hepato B and Pancreatic S:
Cholesterol= 140-200 mg/dL
Phospholipids= 150-250 mg/dL
CHON= 6-8 g/dL
Albumin= 3.5-5 g/dL
Globulin= 1.5-3 g/dL
Blood ammonia= 40-80 ug/dL
Bilirubin= 0.10-1 mg/dL
Conjugated Bilirubin /direct= 0.10-0.20 mg/dL
Creatinine= 0.70-1.40 mg/dL
Uric acid= 2.5 - 8 mg/dL
Alkaline phosphatase= 30-150 mU/ml
Aldolase= 22-59mU/ml @ 37 degrees Celsius
BP = 120/80
RR = 20
PR = 80
T = 37 C



Nutrition Pyramid:

- @ the top of triangle: eat a little fats,oil sugar and salt
- eat some fish,poultry, dry beans, nuts, egg, lean meat, low fat , dairy
- eat more vegetable, green salad, fruit, juice
- eat most rice, root crops, corn, noodles, bread, cereals
- @ the bottom of triangle: drink a lot of water, clear broth

Hypoglycemia- dizziness, diaphoresis, weakness, blurring of vision; occurs during peak action of insulin; give orange juice
Insulin Peaks @

Short-acting/ Regular- 2 to 3 hours
Intermediate/ Lente- 6 to 8 hours
Long-acting/ Ultralente- 16 to 18 hours

Conversion:
Metric/Apothecary/Household
1 ml/15-16 minims (m)/15 drops (gtt)
4-5 ml/1 fluidram/1 teaspoon (tsp)
15 ml/4 fluidram/1 tablespoon (tbsp)
30 ml/ 1 fluid ounce/ 2 tbsp
240 ml/8 fluid ounce/ 1 cup
480 ml (approx. 500 ml)/1 pint (pt)/ 1 pint
960 ml (approx. 1 liter)/ 1 quart (qt)/ 1quart
100 u= 1 m = 15 minims
60 mg= 1 grain
BP= 120/80
PR= 80
RR= 20
T= 37 C
Signs of Danger (Bleeding during pregnancy)
1. Any vaginal bleeding
2. Headache, dizziness, blurred vision
3. Puffiness of face and hands
4. Pale or anemic

Malaria prophylaxis- Chloroquine 150 mg base/tab; 2 tabs/wk
Iron Folate - 60 mg tab; 2 tabs daily for 125 days

True Pelvis:
1. Inlet - entrance to true pelvis
Transverse diameter = 13.5 cm
Anteroposterior diameter = 11 cm.
R & L Oblique diameter = 12.75 cm.
2. Cavity - space between I & outlet
3. Outlet - inferior portion of pelvis; here AP dia. > transverse dia.

Pregnancy:
1. Presumptive- changes felt by mother; breast changes; urinary changes; fatigue; amenorrhea; morning sickness; enlarged uterus; lassitude; quickening
2. Probable- feelings of mother and observed by examiner; Hegar's sign (uterine softening); Chadwick's sign : Goodell's sign; Ballotement; Braxton Hicks (painless); uterine enlargement; positive pregnancy kit; outlining of fetal body; shouffle ; contraction @ 28 weeks
3. Positive- Diagnostic
Elisa- 7 to 8 weeks from LMP
RIA- Radio Immunoassay
Ultrasound
With fetal heartbeat and movement

Spinnbarkheit- mucus stretched 10-13 cm.
Thelarche - budding of breasts
Adrenarche - axillary and pubic hair
Nidation- implantation
Decidua - endothelium called after implantation
Zygote- 12 days to 14 days
Embryo- 15 days to 8th weeks
Fetus- 8th weeks to birth
Abortion- viability within 20th week
Preterm- within 37th week
Term- 38th - 42nd week; 280 days; 10 lunar months; 40 weeks; 9 calendar months
Naegel's EDC= January to March Add 9 months and 7 days to LMP;
April onward subtract 3 months add 7 days and 1 year to LMP
Mcdonald's gestational weeks= fundic height in cm x 8/7
McDonald's gestational month= fundic height x 2/7
Bartolomeow month's of pregnancy= 1 finger above umbilicus add 1 month; @ umbilicus it is 5 months; 1 finger below umbilicus subtract 1 month
Nulligravy- never had pregnancy
Nulliparous- have pregnancy but never reach viability
Gravidity - pregnancy
Parity- pregnancy that reach viability
GTPAL- gravidity; parity; term; preterm; abortion; No. of living