Kindle Notes & Highlights
Albumin is the major unmeasured anion and contributes almost the whole of the value of the AG.
The ileal conduit secretes bicarbonate into the lumen of the bowel in exchange for chloride. This results in bicarbonate loss from the body and excess chloride re-absorbtion.
The SID = [Na+] + [K+] – [Cl–]; the normal value is 40 mmol/L.
Aim to rule out causes such as airway compromise, hypoventilation, residual neuromuscular
block, atelectasis and preumothorax.
A high A–a gradient signifies an underlying problem with either a ventilation/perfusion (V/Q) mismatch or the presence of a shunt.
methaemoglobinaemia caused by the use of dye to help aid localization of lymph nodes.
It can be congenital (cytochrome b5 reductase deficiency) or acquired. [1] Acquired causes include exposure to drugs including: [1] Nitrates Certain local anaesthetics – e.g. prilocaine, benzocaine Certain antibiotics – e.g. dapsone Analine dyes
The ferrous ion Fe+2 in haem is oxidized to the ferric state Fe+3. Fe+3 ions have poor oxygen affinity. The remaining ferrous ions have increased oxygen affinity causing a left shift of the oxygen disassociation curve and reduced oxygen delivery to tissue.
A normal methaemoglobin fraction is about 1% (range, 0–3%).
You might consider cautious flexible sigmoidoscopy.
Osmotic:
magnesium salts,
bile salts (malab...
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some lax...
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Secretory:
enterotoxins from Vibrio cholerae or E. coli.
Inflammatory:
autoimmune or infective diarrhoea
Dysmotility:
related to drugs,
recovery from ileus or pseudo-...
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1. Factors that disturb endogenous intestinal flora/function:
Antibiotics
Gastric acid suppression
conflicting
Enteral feeding
Chemotherapy, radiotherapy, immunosuppression
Drugs causing gastro-intestinal stasis
2. Environmental exposure to Cdiff spores
3. Patient factors:
Age > 65 years
Inflammatory bowel disease
HIV/AIDS
Chronic kidney disease
Concomitant infection
Clostridium difficile is a Gram-positive, spore-forming bacteria.
exotoxins (A and B).
cause neutrophilic infiltration of and damage to the colonic mucosa.
disrupt the actin cytoskeleton of enterocytes
An inflammatory slough may form over mucosal ulcerations creating the appearance of a pseudomembrane with is pathognomic for Cdiff infection.
