LAB TESTS & VALUES

LAB TEST & VALUES

BP 120/80 mmHg ; HTN if 140/90 ; Postural HoTN if SBP drops >20mmHg or standing SBP <100mmhg
HR 60-90 bpm ; 40-60 bpm if AV nodal rhythm (as in SA heart block)
RR 12-20 ; Hyperpnea = increase both rate and depth ; Tachypnea =increase rate only
Pediatric Vitals Low BP (110/60) with high HR (120±50) and RR (30-60)

SaO₂ 95-99% ; Rx if O₂ <88%>O₂ 80-110 mmHg ; decrease c/ COPD ; increase c/ hyperventilation
PaCO₂ 35-45 mmHg ; increase c/ COPD ; decrease c/ pregnancy, PE, anxiety (hyperventilation)
pH 7.35-7.45 ; increase c/ hyperventilation, vomiting ; decrease c/ DM, COPD, RF (K⁺)
K⁺ 3.5 - 4.5 ; increase K⁺ = mm flaccidity, decrease HR, tall peaky T
Na⁺ 135-145 ^; increase Na⁺ = HTN, tachycardia
Ca²⁺ ; increase Ca²⁺ = increase heart activity, decrease mm tone ; decrease Ca²⁺ = mm spasm, cramp, tetanus

PT/PTT 15/40 sec ; PT Tx CI'd if >2.5 x normal value or >30sec ; PT extrinsic ; PTT intrinsic
INR 09-1.1 ; <2.0>2.0 = check with attending pr to Tx ; >3.0 = risk of hemarthrosis c/ activities ; 2.0-3.0 may be normal for pt. c/ anti-coagulant
Bleeding Time 2-10 min

WBC (Leukocytes) 5,000-10,000 ; decrease c/ aplastic anemia or B₁₂ (FA) deficiency (infection related anemia) ; ~5000 light activity only ; <5000 style="color: rgb(0, 102, 0);">RBC (Erythrocytes) 4-6 million ; increase significantly c/ polycythemia
Hct (% RBC in bld) 37-52% ; >25% light activities only ; <25% style="color: rgb(0, 102, 0);">Hgb 12-18 g/dL ; <8> = expect decrease Ex tolerance and Ex may be C/I ; if tachycardia + fatigue = light activities only
Platelet 150K - 450K ; decrease c/ chemotherapy or anemia ; 30-50K MOD activities only ; 20-30K light activities only ; <20k style="font-weight: bold; color: rgb(153, 0, 0);">

LIPID PANEL:
Cholesterol <200>240 high risk
HDL 35-60 ; <35>60 negative risk
LDL <100-160>6.0 high risk ; <0.5-3.0 style="color: rgb(0, 102, 0);">Triglycerides <165>≤200-126 ; fasting glc should be 100-125 ; >250 hyper ; fasting >200 = DM ; <60 style="color: rgb(0, 102, 0);">BMI 18.5-24.9 ; 25-30 over weight ; >30 obesity ; >40 morbid obesity

CARDIAC FUNCTION VALUES
MET 3.5mLO₂/kg-min ; VO_{2 max} / 3.5 = MET
RPP = HR x SBP ; increase myocardial oxygen demand with increase HR or increase BP ; thus keeping Ex intensity low or Rx such as calcium-Ch blocker to protect from further injury by keeping th heart workload low
SV = 70mL ; 120-50
CO = ~6mL/min ; CO = SV x HR (0.7 x 60-90)
EF = 60-70% ; EF = SV/LV EDV ; should be at least 0.55 to have sufficient output ; increase LV EDV + decrease SV = indicates CHF ; EF <20 severe heart failure
MAP = 70-110 mmHg ; (SBP+2DBP)/3 ; if <60 may cause ischemia

Ex RX
Intensity is the primary mode to improve cardiovascular endurance and strength training
duration is the primary mode to improve pulmonary aerobic endurance traning

Str Trng : decrease resting BP decrease Rxn time increase mm endurance
CV Endurance Trng : to have aerobic effect allow rhythmic contraction of mm ; ≥ 70% HR_MAX ; 13-16/20 RPE (somewhat hard – hard) ; talk test
Pulm Aerobic Trng : cardiac hypertrophy c/ normal respiratory func. ; increase Hgb = increase O₂ delievery ; increase CO (SV) ; decrease HR_REST decrease BP_REST

PFT
COPD Decrease FVC, FEV1, FEV1/FVC ; Increase RV to <70% style="color: rgb(0, 102, 0);">RLD Decrease FVC, FEV1 ; Normal or increase FEV1/FVC; decrease all capacities

Brunnstrom Motor Recovery Stages

Brunnstrom stages describe sequential motor recovery of post-CVA pt's specially those with hemiplegia:

Stage 1: initial flaccidity - no voluntary movement
Stage 2: emergence of spasticity, hyper-reflexia, synergies (mass patterns of movement)
Stage 3: voluntary movements possible, but only in synergies, spasticity strong
Stage 4: voluntary control in isolated joint movements emerging, corresponding decline of spasticity and synergies
Stage 5: increasing voluntary control out-of-synergy; coordination deficits present
Stage 6: control and coordination near normal

PCA Syndrome

Weber's syndrome
= oculomotor palsy (CN III) + contralateral hemiplegia

Claude's syndrome
= oculomotor palsy (CN III) + contralateral ataxia

학교를 다닐땐 그렇게 공부하기가 싫었다. 어른들은 줄 곳 한살이라도 젊을 때 하나라도 더 배우라고 하셨는데, 요즘은 그 말이 진심이셨구나라고 느끼며 하루하루를 보낸다.
요즘은 외우는 것도 힘들어 졌음은 물론 배운것도 쉽게 잊곤 하니 말이다...

한살이라도 더 젊을 때 하나라도 더 배우기...