NYHA Functional Classification of Heart Failure

Molecular Markers in the Diagnosis of

Acute Myocardial Infarction
Test

Time to
Detection

Peak

Duration

Sampling Schedule

Troponin T
Sn: 100%
Sp: 84%

3-12 hours 24 hours

5-14 days

Once at least 12 hours

after chest pain

Troponin I
Sn: 92%
Sp: 92%

3-12 hours 24 hours

5-10 days

Once at least 12 hours

after chest pain

CK-MB

3-12 hours 24 hours

2-3 days

Every 12 hours x 3; start

at 6 hours after chest
pain

7th Joint National Committee Classification for Hypertension

Category

Systolic
(mmHg)

Diastolic
(mmHg)

Recommendations

Normal

<120

<80

Recheck in 2 years

Prehypertension

120-139

80-89

Advise healthy lifestyle and

recheck in 1 year

Hypertension
Stage I

140-159

90-99

Confirm hypertension in 2
months

Hypertension
Stage II

160

100

Evaluate or refer to source

of care within 1 month

Human Albumin Transfusion

>Please transfuse __unit/s of 25% human albumin, ___cc,
with incorporation of Furosemide ____.
>Obtain baseline vital signs and CP status prior to BT
> Transfusion running time: 4 hours
>Maintain mainline to KVO
>Monitor VS and CP status while on transfusion
>Watch out for any untoward signs and symptoms
>Refer accordingly

No limitation of physical activity

Physical activity does not cause fatigue, palpitation or shortness of
breath

Slight limitation of physical activity

Comfortable at rest but physical activity results in fatigue,
palpitations or shortness of breath

3A

Limitation of physical activity

Comfortable at rest but ordinary activity causes fatigue, palpitations,
or shortness of breath

3B

Significant limitation of physical activity

Comfortable at rest but minimal activity causes fatigue, palpitations,
or shortness of breath

Unable to carry on any physical activity without discomfort

Symptoms of heart failure at rest

Killip Classification of AMI with Expected

Hospital Mortality Rate
I

No signs of pulmonary or venous congestion

0-5%

II

Moderate heart failure or presence of bibasal crackles,

S3 gallop, tachypnea or signs of right heart failure
including venous (JVP) and hepatic congestion

10-20%

III

Severe heart failure, rales >50% of the lung fields or

pulmonary edema

35-45%

IV

Shock with SBP <90mmHg and evidence of peripheral

vasoconstriction, peripheral cyanosis, mental confusion
and oliguria

85-95%

Simplified Diagnostic Approach in Acute Hepatitis

HbsAg

IgM
Anti-HAV

IgM
Anti-HBc

Anti-HcV

Diagnostic Interpretation

Acute Hepatitis B

Chronic Hepatitis B

Acute Hepatitis A superimposed on

Chronic Hepatitis B

Acute Hepatitis A and B

Acute Hepatitis A

Acute Hepatitis A and B (HbsAg below

detection threshold

Acute Hepatitis B (HbsAg below

detection threshold

Test for Acute Hepatitis C (Anti-HCV)

Blood Transfusion Order

>Please transfuse __units of ____ of patient's blood type

after proper crossmatching
>Obtain baseline vital signs and CP status prior to BT
>Initially run BT at a rate of 5-10 gtts/min for 30 min then
gradually increase to 20-25 gtts/min if without BT reaction
>Maintain mainline to KVO
>Watch out for any untoward signs and symptoms
>Refer accordingly

recommended)
-2

Bicarbonate deficit

Most likely infarction

(0.4) x [desired (HCO3) measured (HCO3)]

Note: give only half of the computed deficit

Sodium deficit (mEq) 0.6 x (wt in kg) x [desired Na actual Na]

45 highly suggestive of thyroid storm

25-44 suggestive of impending storm
<25 unlikely to represent a thyroid storm

Potassium deficit
Corrected serum
calcium (mg/dl)

Measured Ca in mg/dl + 0.8 x (4-albumin in

g/dl)

Estimated Creatinine Clearance

= (140-age) x weight in Kg
72 (males) x serum Cr (mg/dl)
85 (females) x serum Cr (mg/dl)

ABG Calculation
I. (713 x FiO2) PaCO2
0.8
II. PO2
I
III. Desired FiO2 by age + PaCO2
II
0.8
_____________________________
713
Siriraj Stroke Score
Variables

Clinical
Features

Consciousness

Alert
Drowsy, stupor

Score
0
2.5

Semicoma,
coma

No

Yes

Headache within 2
No
hours onset of stroke
Yes

Vomiting

Diastolic BP

Actual DBP x
0.1

Atheroma Markers
(DM, angina,
intermittent
claudication)

None

One or more

Constant

90mmH
g x 0.1
= 9 pts

-12

TOTAL
Interpretation:
+2
-1, 0 and +1

Most likely hemorrhage

Equivocal (CT scan

FiO2:
Room air: 0.21
Nasal prong: LPMx4+20 / 100
Face mask: LPM 1 x 10 / 100
Debreather bag: LPM x 10 / 100
Intubated: 80%* = 0.8
Desired FiO2
In patients <60yo, nonCOPD, nonsmoker: 80
In patients <60yo or >60 with COPD or
pulmonary problems: 60
In patients >60: 80 yrs in excess of 60