by Paul Fabian R.

Gumabao Digoxin – digoxin immune fab

(digibind)
Dopamine – phentolamine (Regitine)
PHARMA EPS sx – diphenhydramine (Benadryl)
Flourouracil, methotrexate – leucoverin
ml/hr = μgtts/min Ca
1 ml = 60 μgtts Heparin – protamine sulfate
1 ml = 15 gtts Insulin rxn – IV glucose (D50)
1 gtt = 4 μgtts Iron – deferoxamine
KCl – albuterol inhaler, insulin and
1 teaspoon = 5 ml glucose, NaHCO3, kayexalate
1 tablespoon = 15 ml Lead – dimercaprol, edetate Ca
2 tablespoons = 30 ml disodium, succiner, penicillamine
1 glass = 240 ml = 8 ounces Methanol, ethylene glycol – ethanol,
500 ml = 1 pint dialysis
1000 ml = 1 quart Methemoglobin – methelyne blue
1 kg = 2.2 lbs Narcotics/opiod analgesics –
1 lb = 454 grams naloxone/naltrexone
1 ml = 1 g Salicylates – dialysis, alkalinize urine
1 L = 1 kg TCA – physostigmine, NaHCO3
Thrombolytics (Tpa kinase) –
0.60 mg = gr 1/100 aminocaproic acid
1000 micrograms = gr 1/60 Warfarin, coumadine – phytonadione
1 mg = gr 1/60 (vit k)
6 mg = gr 1/10 Opiates withdrawal - methadone
1 g = 15 grains
gr 1 = 60 mg laxatives
osmotic – duphalac, lactulose
antidotes chemical stimulant – dulcolax
acetaminophen, Tylenol, paracetamol – bulk forming – Metamucil
acetylcysteine emollient – stool softener, colace
anticholinergic, antimuscarinic –
physostigmine
anticholinesterase, organophosphate F&E
(orchids spray) – atropine or pralidoxime
Arsenic, mercury, gold – dimercaprol, Serum osmolality: 285-295 mosm/kg
succimer Na: 135-145 meq/L
BDZ – flumazenil (romazicon) K: 3.5-5 meq/L
B blockers, Ca channel blockers – Cl: 98-107 meq/L
glucagon HCO3: 22-26 meq/L
Carbon monoxide – hyperbaric 02 Ca: 8.5-10.5 mg/dL
(100%) Phosphourus: 2.5-4.5 mg/dL
Copper, arsenic – penicillamine Mg: 1.8-3 mg/dL
Cyanide – amyl nitrate, Na thiosulfate
Cyclophosphamide – mesna IV Gauge
Digitalis – lidocaine, Mg Adult
 o Gray 16 Halothane – red
o Green 18 Isoflurane – violet
o Pink 20 Sevoflurane – yellow
o Blue 22
Pedia Gas tank
o Yellow 24 02 – green
o Violet 25 Nitrous oxide – blue
CO2/compressed air - black
Spinal needles
Test tube cover
Gauge 18 pink
Hct – purple
19 ivory
Coagulation profile (PTT, PT) – blue
20 yellow
Serum chemistry – red/plain
21 green
22 black
Sutures
23 light blue
Absorbable
24 violet
o Polyglycolic
25 orange
26 brown o Polyglyconate
27 gray o Polyglactic
29 red o Polydiaxanone
o Catgut
Urine pH: 4.5-8 (slightly acidic) Non-absorbable
o Polyester
Urine formation o Polypropelene
1. filtration – nonselective, passive o Nylon
2. reabsorption – selective, active o Silk
3. secretion o Stainless steel

Removal of sutures (usually 7 days)

ER NSG Face: 3-5 days
Ext: 7 days
Triage (3 Tier) Joints: 7-10 days
Red – emergent/most urgent, life Back: 2 wks
threatening, TRAUMA, shock, hypoxia
Yellow – urgent/2nd urgent, injuries with Length of cutting from end
systemic effects but not yet life Silk vessel ties: 1-2 mm
threatening, HTN Abd fascia closure: 5 mm
Green – delayed/non-urgent, localized Skin suture: 5-10 mm
injuries without immediate systemic Drain suture: 5-10 mm
implications
Black – death
NEUROSENSORY
PERIOP IOP: 12 – 21
Anesthesia machine GCS

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Motor response
6 – obeys commands Beck’s triad (Cardiac tamponade)
5 – localizes pain 1. hypotension
4 – withdraws 2. jugular vein distention
3 – flexion 3. muffled heart sounds
2 - extension
1 – none
verbal response INTEG
5 – oriented
4 – confused pressure ulcer stages
3 – inappropriate words I - deep pink, red, or mottled skin
2 – incomprehensible words II – superficial skin breakdown
1 – none III – subcutaneous damage or necrosis
eye opening IV – damage to muscle or bone
4 – spontaneous
3 – to voice
2 – to pain OB
1 – none
Duration of pregnancy: 266-280
LOC days/38-42 wks
Alert and conscious – responds
immediately to people and surroundings HCG: 400,000-500,000 IU/24 hrs
Lethargic – sleeps but can be easily (peaks at 60-70th day of pregnancy)
roused by touch
Stuporous – maintain consciousness only Urinary frequency – increased frequency
with constant stimulation during 1st and 3rd tri
Comatose – cannot be roused from sleep
Stages of fetal dev’t
CPP/MAP = [systolic + (diastolic x 2)]/3 1. Ovum – ovulation to fertilization
2. Zygote – fertilization to
implantation
OXY 3. Embryo – 2 wks to 2 mos,
organogenesis (3 germ layers)
Bronchial – loud, high-pitched, heard 4. Fetal – 2 mos to birth
over trachea, E>I
Vesicular – soft, low-pitched, heard over Haase rule – length of fetus in cm
lung periphery, I>E AOG 1st 5 mos – square the age in mos
Bronchovesicular – soft, medium- AOG 6-10 mos – multiply the age by 5
pitched, heard over major bronchi, I=E
Johnson’s rule – wt of fetus in grams
Fundic ht in cm - 12 (engaged) x 155
CARDIO Fundic ht in cm - 11 (if not engaged) x
155
JVP: 3 – 8 cm (>8 venous congestion)
LMP (unknown)
CVP: 4 – 10 cm H2O/3 – 7 mm Hg Bartholomew’s rule = fundic ht in cm

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LMP (unknown)
McDonald’s rule
Fundic ht in cm x 2/7 = age in mos
Fundic ht in cm x 8/7 = age in wks
Quickening
Primi (20 wks/5th mo) add 4 mos and 20
days
Multi (16 wks/4th mo) add 5 mos and 4
days
If maternal serum AFP : neural tube
defect
AFP : down syndrome
Fetal mov’ts: 10x in 3 hrs or 3x in 1 hr
Fetal distress
o <10 fetal mov’t in 12 hrs
o lack of mov’t for 8 hrs
o sudden  in violent mov’ts
especially if followed by  mov’t
Insulin requirement
1st tri: decreased because placenta is not
yet fully developed
2nd tri: increased
3rd tri: increased because placenta is
well developed
normal wt gain: 25-35 lbs
1st tri – 3 lbs (1 lb/mo)
2nd tri – 12 lbs (1 lb/wk)
3rd tri – 12 lbs (1 lb/wk)
automatic wt loss after delivery: 10-12
lbs
pregnant 300 cal
breastfeeds 500 cal
8th mo – 2x a mo
9th mo – every week
Ultrasound
1st and 2nd tri = drink
3rd tri = ask to void because abdomen is
already big
amniocentesis
o done between 15-18 wks/2nd tri
o 20 cc
o results available after 2-3 wks
chorionic villus sampling
o suggested between 10-12 wks of
pregnancy/1st tri
o results available after 1 wk
nonstress test
reactive (-) = normal,  FHR of 15bpm
lasting for about 15 secs
nonreactive (+) = abnormal, fetal
compromise
contraction stress test
o a.k.a. oxytocin challenge test
o done only if nonstress test is
nonreactive
sex during pregnancy contraindicated if:
bleeding unless 2 wks have passed
abd’l pain
PROM
Incompetent cervix (dilates easily)
A month before EDC
Lightening/engagement
Primi = 2 wks before labor
Multi = on the day/during labor

should take 300 mg Fe/day Primi = effacementdilatation

400 IU folic acid Multi = dilatationeffacement
1200 mg Ca/day
Fetal station
checkup -4 “floating”
1st 7 mos – every mo -3

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-2
-1
0 engaged PEDIA
+1
+2 Abnormal color of neonate
+3 Gray – septicemia d/t intrauterine
+4 “on the perineum” infection
primi: goes down 1 cm/hr Green – meconium stained d/t fetal
multi: goes down 2 cm/hr distress
Blue – congenital cyanotic cardiac dse
fetal expulsion Yellow – pathologic jaundice d/t blood
1. descent incompatibility (ABO/Rh)
2. flexion
3. internal rotation pediatric computation
4. extension Fried’s rule (0-12 or 0-24)
5. external rotation Infant’s dose = age in mos. x adult dose
6. expulsion 150
young’s rule (1 yr – 12 yrs)
signs of placental separation child’s dose = age in yrs___ x adult dose
o culkin’s – globular age in yrs + 12
o fundus rises up in the clark’s rule (0-12yrs)
abdomen child’s dose = wt in lbs x adult dose
o sudden gush of blood 150
o lengthening of cord BSA rule
Child’s dose = child’s BSA m2 x adult dose
ambulate after delivery 1.73 m2
NSD after 3-4 hrs
CS after 24 hrs Milk expiration
6 mos (freezer)
Lochia 6 days (ref)
Rubra 1st 3 days (few small clots)
Serosa 4-9 days (no clot) developmental milestones/gross motor
Alba 10-14 days (no clot) skills
Scant <2cm stain on perineal pad neonate – head lag, no head control,
Light <10cm don’t place in prone (may lead to SIDS)
Moderate <15cm 2 mos – begins to have head control, lifts
Heavy 1 saturated pad in 1 hr head on prone
Excessive 1 saturated pad in 15 mins 4 mos – full head control, lifts head and
chest on prone
Return of menstrual flow 6 mos – sits with support
If not breastfeeding 2 mos 8 mos – sits alone
If breasfeeds 3 or 4 mos 10 mos – stands with support
12 mos – stands alone, walks with
support
14 mos – walks alone

fine motor development (proximo-distal)

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neonate – strong grasp reflex autosomal recessive (25% w/dse – 25%
3 mos – grasp reflex gone, hands held w/o dse – 50% carrier)
open, “hand regard” (plays with hands)  Cystic fibrosis
6 mos – palmar grasp, holds feeding  Albinism
bottle with two hands  PKU
9 mos – pincer grasp (thumb and finger  Sickle cell Anemia
to hold objects)  Tay sach’s dse
12 mos – puts things in and out of
containers, throws/put objects Sex-linked (occurs more frequently in
males)
2 mos – social smile  Hemophilia
3 mos – follows a moving object past the  Color blindness
midline  Baldness
6 mos – focus securely w/o eye crossing  Duchennes’s muscular dystrophy
8 mos – has peaked fear of strangers
9 mos – creeps; “dada”, “mama” Rooting reflex - disappears at 6 wks
10 mos – “byebye”, “no”, object Tonic neck/boxer/fencing reflex – 3 mos
permanence, peek-a-boo, patty-cake Palmar grasp reflex – 3 mos
11 mos – cruises Step/walk in place reflex – 3 mos
12 mos – says two words besides dada Babinski reflex – 3 mos
and mama Extrusion reflex – 4 mos
2 ½ yrs – 1st dental visit (2x a yr) Moro/startle reflex – 5 mos
7 yrs – “eraser year” (never quite content Sucking reflex – 6 mos
w/ what they have done, they set too Plantar grasp reflex – 9 mos
high a standard for themselves and then
have difficulty performing at that level) Ectoderm
8 yrs – best friends develop CNS, PNS
9 yrs – gang age Skin, hair, and nails
10 yrs – collecting age Sebaceous glands
Sense organs
introduction of solid foods Mucous membranes of anus, mouth, and
6 mos - iron fortified infant cereal mixed nose
w/ breast milk, orange juice, or formula Tooth enamel
7 mos – vegs Mammary glands
8 mos – fruit Mesoderm
9 mos – meat Supporting structures of body
10 mos – egg yolk (connective tissue, bones, cartilage,
muscle, ligaments, and tendons)
autosomal dominant (50% - 50%) Dentin of teeth
 huntington’s chorea Kidneys and ureters
 osteogenesis imperfecta Reproductive system
 marfan syndrome Heart
 myotonic muscular dystrophy Circulatory system
 night blindness Blood cells
 neuro fibromatosis Lymph vessels

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 Entoderm REPRO
Lining of pericardial, pleura, and
peritoneal cavities bld loss in mens: 30-80 cc
Lining of GIT, respiratory tract, tonsils, length of urethra: 1 ½ in (F), 8 in (M)
parathyroid, thyroid, thymus glands
Bladder and urethra
ONCO
Acyanotic heart defects (L to R
shunting) ACS 7 warning signals
1. aortic stenosis Change in bowel/bladder habits
2. Pulmonary artery stenosis A sore that does not heal
3. ASD Unusual bleeding
4. VSD Thickening or lump in breast
5. PDA – “machine like heart Indigestion
murmur” Obvious change in warts
6. coarctation of the aorta Nagging cough and hoarseness

cyanotic heart defects (R to L shunting)

1. tetralogy of fallot PROF AD
a. Pulmonary artery stenosis
b. Right ventricle hypertrophy PD 651 – birth registration following
c. Overriding aorta delivery within 30 days
d. VSD PD 856 – code of sanitation
2. transposition of the great PD 965 – family planning and
vessels/arteries responsible parenthood instructions prior
3. hypoplastic left heart syndrome to issuance of marriage license
4. truncus arteriosis PD 996 – compulsory immunization for
children below 8 y/o against
immunizable dses
<3rd percentile failure to thrive
<10th percentile SGA EO 51 – milk code
10th-90th percentile AGA
>90th percentile LGA RA 2382 – phil. Medical act
RA 3573 – reporting CDs
<2500g low birth wt RA 4073 – tx of leprosy in a gov’t skin
<1500g very low birth wt clinic, RHU or by a duly licensed
<1000g extremely very low birth wt physician
RA 4226 – hosp. Licensure by DOH
at 6 mos double their birthwt RA 6675 – generics act
at 1 yr triples RA 6713 – code of conduct and ethical
standards for public officials and
posterior fontanel – closes at 2 mos. employees
Anterior fontanel/bregma – closes at 12- RA 7160 – local autonomy code
18 mos. RA 7305 – magna carta for public health
workers

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RA 7600 – rooming-in and breastfeeding
act (CS: within 3-4h; NSD: within 30
mins)
RA 8344 – hosps./doctors to treat E
cases referred for tx
RA 8749 – clean air act
RA 9288 – newborn screening

PSYCH

Id – manic, antisocial, narcissistic

Ego – schizophrenia
Superego – OC, anorexic

ENDO

onset peak duration

"E" immediate acting 10 mins 1 hr 4 hrs
situations humalog (Lispro)      
hosp. short acting 30 mins 3 hrs 7 hrs
setting humulin R      
  novolin R      
  regular      
  semilente      
home intermediate acting 2 hrs 8 hrs 15 hrs
setting NPH      
  lente      
  humulin N      
  long acting 8 hrs 18 hrs 30 hrs
  ultralente