PATHOGNOMONIC DRUG OF CHOICE

NERVOUS SYSTEM
DISEASE PATHOGNOMONIC SIGNS DRUG OF CHOICE
AND SYMPTOMS

Stroke - Sudden weakness Alteplase

- Speech difficulty (Thrombolytic agent)
- Facial droop
- Vision problems

Meiningitis - Fever Ceftriaxone

- Neck stiffness (Antibiotic)
- Headache
- Photophobia

Bell’s Palsy - Facial weakness Prednisone

- Drooping on one side (Corticosteroid)
- Cannot close eye

Parkinson’s Disease - Tremors Levodopa Carbidopa

- Rigidity (Dopaminergic agent)
- Slowed movements
- Balance issues
Epilepsy - Recurrent seizures Valproic Acid
- Confusion (Anticonvulsant)
- Jerking movements

INTEGUMENTARY SYSTEM
I. SKIN
Hives -itchy skin rash -Antihistamine
-raised skin bumps -Corticosteroids

Chicken Pox -Acyclovir

Characteristic rash -
Macules
-Papules
-Vesicles
-Crusts.
 Shingles -Pain, burning or tingling -Acyclovir
Sensitivity to touch

-A red rash that begins a few

days after the pain

-Fluid-filled blisters that break

open and crust over

-itching

Eczema -Itchiness -Topical corticosteroids

-Dry skin -Topical Antibiotics
-Rash
-Flaky, scaly or crusty skin.

Seborrhoeic dermatitis -inflammed skin -antifungal oral meds

-stubborn dundruff on scalp -topical antifungals
-scaly patches on face -antibacterial

PSORIASIS -appearance of pinpoint -topical corticosteroids

bleeding when scales are -Methotrexate
removed from psoriatic
plaques

II. HAIR
 Alopecia Areata -Patches of hair loss - Corticosteroids
-Nail pitting -Minoxidil
-Phototherapy

Folliculitis -pustules in scalp -topical antibiotics

III. NAILS
Koilonychia (Spoon Nails) -Spoon shaped nails -Iron supplements

Fungal Nail Infection -changes of nail color -oral and topical Anti Fungals
-thickened nail
-sides of the nail are painful

IV. SEBACEOUS GLANDS

Acne -Pimples -Topical Antibiotics

MUSCULAR SYSTEM

DISEASE PATHOGNOMONIC SIGNS DRUG OF CHOICE

AND SYMPTOMS

Myasthenia Gravis Dropped Head Sign- Pyridostigmine bromide

Weakness of neck (Cholinesterase Inhibitor)
extensor muscles, causing
the head to fall forward; Route: Oral
worsens with activity and
improves with rest. Side Effects: Nausea,
Cramps, BradyCardia

Facioscapulohumeral Winged Scapula- Scapula Prednisone

Dystrophy protrudes like wings when (Corticosteroids)
pressing against a wall due
to weakness of shoulder Route:Oral
stabilizing muscles.
Side Effects: Weight gain,
mood swings

Inclusion Body Myositis Triceps and Quadriceps IV Immunoglobulin (IVIG)

Weakness- Selective, (Immunomodulator)
asymmetric muscle
weakness, especially in the Route: Intravenous
 back of the arms and front
of the thighs. Side Effects: Headache,
fever, nausea

Duchenne Muscular Gowers' Sign- Using hands Deflazacort

Dystrophy to push up from sitting due (Corticosteroid)
to pelvic muscle weakness;
classic in early DMD. Route: Oral

Side Effects: Growth delay,

Weight gain

Charcot-Marie-Tooth Foot Drop- Inability to lift Gabapentin

Disease the front of the foot during (Anticonvulsant/
gait due to lower leg Neuropathic Pain Agent)
muscle weakness; causes
high-stepping gait. Route: Oral

Side Effects: Drowsiness,

dizziness
SKELETAL SYSTEM

DISEASE PATHOGNOMONIC SIGN DRUG OF CHOICE

Tuberculosis of Bone - Gibbus deformity Antitubercular medications

(Pott’s Disease) (e.g., Isoniazid, Rifampin,
Pyrazinamide, Ethambutol

Achondroplasia - Shortened long bones with Vosoritide (Voxzogo)

"rhizomelic" shortening

Rickets / Osteomalacia - “Rachitic rosary" and "Bow Vitamin D supplements (e.g.,

legs" Ergocalciferol or
Cholecalciferol)

Marfan Syndrome - “Arachnodactyly" Beta-blockers (e.g.,

Metoprolol, Atenolol),
Angiotensin receptor blockers
(ARBs) (e.g., Losartan)

Gout - Tophi Acute attack: Colchicine,

NSAIDs (e.g., Indomethacin),
or Corticosteroids.
Long-term control: Allopurinol
or Febuxostat

ENDOCRINE SYSTEM
DISEASE PATHOGNOMONIC SIGNS DRUG OF CHOICE
AND SYMPTOMS

Hyperthyroidism - Weight loss Methimazole

- Tremors Antithyroid agent – Inhibits
- Heat intolerance thyroid hormone synthesis
- Palpitations

Diabetes Mellitus Type 1 - Frequent urination Insulin

- Excessive thirst Hormone / Antidiabetic –
- Fatigue Lowers blood glucose
- Weight loss

Cushing’s Syndrome - Central obesity Ketoconazole

- Moon face Antifungal – Imidazole
- Buffalo hump class antifungal agent
 - Skin thinning

Addison’s Disease - Fatigue Hydrocortisone

- Weight loss Corticosteroid – Anti-
- Low blood pressure inflammatory and
- Hyperpigmentation immunosuppressant

Diabetes Insipidus - Excessive thirst Desmopressin

- Frequent urination Antidiuretic hormone
- Dilute urine analog- Synthetic form of
vasopressin

RESPIRATORY SYSTEM

DISEASE PATHOGNOMONIC SIGNS DRUG OF CHOICE

AND SYMPTOMS

- Amoxicillin (or
Pneumonia - Lobar consolidation Ceftriaxone for
on chest X-ray hospitalized patients).

Tuberculosis (TB) - Cavitary lesions in the - Rifampicin + Isoniazid

upper lobes on chest + Pyrazinamide +
X-ray Ethambutol (RIPE)

Chronic Obstructive - Bronchodilators (e.g.,

Pulmonary Disease (COPD) - Barrel-shaped chest Salbutamol) +
(seen in emphysema Systemic
subtype) corticosteroids
- Hyperinflated lungs
on imaging.

Asthma - Inhaled
- Curschmann spirals corticosteroids (e.g.,
in sputum Budesonide) +
- Charcot-Leyden Salbutamol
crystals (from
eosinophils).

- Azithromycin (long-
Bronchiectasis - Tram-track term for anti-
appearance on CT inflammatory &
 antibacterial use)
scan
- Dilated bronchi with
thickened walls.

- Heparin (initial), then

Pulmonary Embolism (PE) - Hampton's hump or Warfarin or DOACs
Westermark sign on (e.g., Apixaban)
chest X-ray.

Cystic Fibrosis - Positive sweat - Ivacaftor (for specific

chloride test (>60 mutations),
mmol/L) Azithromycin
(maintenance),
Pancreatic enzymes

- Morphine
Pneumothorax - Tracheal deviation - Oxygen
away from affected
side

CARDIOVASCULAR SYSTEM

DISEASE PATHOGNOMONIC SIGNS DRUG OF CHOICE

AND SYMPTOMS

Coronary heart disease

● Obstructive Atorvastatin
Angina pectoris-chest pain Aspirin
-Atherosclerosis
brought about by myocardial Warfarin or heparin
ischemia.

Unstable angina or acute Aspirin

-Acute Coronary myocardial infarction not
Syndrome (ACS) relieved by rest or medication.

● Non-Obstructive
Coronary Artery
 Disease
Angiographic findings- Aspirin, nitrates and calcium
-Spontaneous Coronary multiple radiolucent lumens, a channel blockers
Artery Dissection radiolucent intimal flap, and
contrast staining of the vessel
wall

Rheumatic heart disease Aschoff nodules are benzathine penicillin G IM

characteristic inflammatory
masses found in the heart
muscle

congenital heart disease

Cyanotic Heart TET spell - deep blue or morphine, propranolol (or
Defects: gray skin, lips, and nails metoprolol)
- Tetralogy of Fallot

cyanosis, a bluish tint to the Prostaglandin E1 (PGE1) IV

Transposition of skin, lips, and nails.
the great blood
vessels/ arteries chest X-ray may show a prostaglandin E (PGE) until
Total Anomalous characteristic "snowman" surgery
Pulmonary Venous or "figure of 8"
Return (TAPVR) appearance

diuretics, digoxin, and ACE

inhibitors

Bounding pulses, a loud Prostaglandin E1 (PGE1)

Truncus arteriosus single second heart sound
(S2), and a hyperdynamic
precordium (an overactive
chest)
Acyanotic Heart Defects Blood pressure differential
- Coarctation of and pulse delay between the Digoxin,captopril,diuretics
Aorta upper and lower extremities
Chest X-ray, the area of the
aorta where the narrowing
occurs can sometimes appear Indomethacin
as a "3" or "reverse 3"
 shape
Beta-blockers, anti-
coagulant

Loud holosystolic murmur-

Ventricular Septal Defect harsh, blowing sound

Machinery murmur heard at

- Patent Ductus left upper sternal border
Arteriosus
Fixed, split S2 heart sound
- Atrial Septal and a systolic murmur
heard over the pulmonary
Defect
valve area are commonly
associated with ASDs.

deep vein thrombosis Throbbing pain in 1 leg Anti Coagulants ( blood

(rarely both legs), usually in thinners)heparin, or
the calf or thigh, when warfarin
walking or standing up

pulmonary embolism Sudden shortness of breath Anti Coagulants ( blood

Chest pain (usually worse thinners)heparin, or
with breathing) warfarin

peripheral arterial intermittent claudication- Antiplatelet

disease pain or cramping in the leg medications( aspirin and
muscles that occurs during clopidogrel)
exercise and is relieved by Statins
rest ACE inhibitors or ARBs-
managing blood pressure

Cerebrovascular disease
- stroke ● F: ace drooping:
One side of the Tissue plasminogen activator
(tPA) for ischemic stroke
face may droop or
feel numb.
Anticonvulsants, Hydantoins
● A: rm weakness: Phenytoin (Dilantin) for
One arm may feel hemorrhagic stroke
 weak or numb,
drifting downward
when raised.
● S: peech difficulty:
Speech may be
slurred or the person
may have trouble
understanding
others.

Thunderclap headache -
sudden, severe onset of
headache Nimodipine- a calcium
Cerebral Aneurysm channel blocker used to
prevent cerebral ischemia
(reduced blood flow)

IMMUNE SYSTEM

DISEASE PATHOGNOMONIC SIGNS DRUG OF CHOICE

AND SYMPTOMS

Lupus Butterfly-shaped rash on Hydroxychloroquine

the face that covers the (Plaquenil)
cheeks and bridge of the
nose or rashes elsewhere
on the body

Psoriasis Auspitz sign describes topical corticosteroids

pinpoint bleeding on the skin triamcinolone (Trianex) or
after dry scales are scraped clobetasol
awayì
HIV( Human Immuno Pathognomonic feature of Antiretroviral medicines
Deficiency)antiretroviral HIV is the progressive
medicines reduction in the CD4+ T cells

Physical- fever, fatigue,

swollen lymph nodes, sore
muscles and joint pain, rash,
oral thrush

DIGESTIVE SYSTEM

DISEASE PATHOGNOMONIC SIGNS DRUG OF CHOICE

AND SYMPTOMS

Gastroesophageal reflux
disease (GERD) -A burning sensation in the Aluminum hydroxide - treats
chest, often called occasional heartburn,
heartburn. Heartburn indigestion, upset stomach, or
usually happens after eating other conditions caused by too
and might be worse at much stomach acid.

-night or while lying down.

-Backwash of food or sour

liquid in the throat.

-Upper belly or chest pain.

-Trouble swallowing, called

dysphagia.

-Sensation of a lump in the

throat.

Gallstones (Cholelithiasis) Upper abdominal pain and Ursodeoxycholic acid (ursodiol)

nausea. - used to dissolve gallstones in
people who do not want
surgery or cannot have surgery
to remove gallstones.

Gastroenteritis Diarrhea, vomiting, and Loperamide is used to control

 abdominal pain. Fever, lack and relieve the symptoms of
of energy, and dehydration acute diarrhea.
may also occur.

Pancreatitis Pain in the upper abdomen, Ibuprofen can be used for pain
nausea, vomiting, fever relief in some cases of
pancreatitis.

Gastrointestinal (GI) Bleeding Abdominal cramping, Dark- Omeprazole, a proton pump

colored poop or regular- inhibitor (PPI), is used to
colored poop with blood in it, manage and prevent upper
Pale appearance, Shortness gastrointestinal bleeding
of breath (dyspnea),
Tiredness Vomit with blood in
it or a substance that looks
like coffee grounds,
Weakness and fatigue.

URINARY SYSTEM

DISEASE PATHOGNOMONIC SIGNS DRUG OF CHOICE

AND SYMPTOMS

- Nitrofurantoin (for
Urinary Tract Infection (UTI) Dysuria (painful urination) uncomplicated UTI)
with positive urine culture - Trimethoprim-
sulfamethoxazole
(TMP-SMX),
Fosfomycin.

Acute Pyelonephritis Costovertebral angle (CVA) - Ciprofloxacin (oral) or

(kidney infection) tenderness Ceftriaxone (IV)

Nephrolithiasis (Kidney - NSAIDs (e.g.,

Stones) - Severe, colicky flank Ibuprofen or
pain radiating to the Ketorolac)
groin - Tamsulosin (alpha-
- Hematuria (blood in blocker)
urine) - Antibioticsl
Glomerulonephritis - Cola-colored (dark) - Corticosteroids, ACE
urine due to inhibitors, and
hematuria Diuretics
- Facial puffiness
(especially in the
morning)

Weak urine stream with - Tamsulosin (alpha-1

Benign Prostatic hesitancy and incomplete blocker)
Hyperplasia (BPH) emptying. - Finasteride

(common in older men)

- Leakage when - Oxybutynin or

Urinary Incontinence coughing/laughing. Tolterodine
- Sudden urge to - Mirabegron
urinate with leakage.

Bilateral enlarged kidneys - Tolvaptan

Polycystic Kidney Disease with multiple cysts on - Control BP with ACE
imaging. inhibitors or ARBs.

Tender, boggy prostate - Ciprofloxacin or

Prostatitis (Acute Bacterial) on digital rectal exam, Levofloxacin
painful ejaculation. - Alternatives: TMP-
SMX
- Severe cases: IV
Ceftriaxone then
switch to oral.

REPRODUCTIVE SYSTEM

DISEASE PATHOGNOMONIC SIGNS DRUG OF CHOICE

AND SYMPTOMS
 HORMONAL THERAPIES
-infertility and Ibuprofen and
-chronic pelvis pain naproxen

CISPLATIN
-abnormal vaginal bleeding
(especially after intercourse
or menopause),
-abnormal vaginal discharge
(which may be watery,
bloody, or foul-smelling)
-a new lump or thickening in doxorubicin and
the breast or underarm, cyclophosphamide
changes in breast size or
shape, skin changes like
dimpling or redness, nipple
changes such as inversion or
discharge, and breast pain

-menstrual irregularities CLOMIPHENE CITRATE

-polycystic ovaries
-infertility
 hormonal contraceptives
-pelvic pain, menstrual (birth control pills) and
irregularities, and abdominal acetaminophen and
bloating morphine for severe cases.

-difficulty starting or stopping

urination, a weak urine DOCETAXEL
stream, or the need to urinate
more frequently, especially at
night. Blood in the urine or
semen and pain or burning
during urination
 BEP (bleomycin,
-Painless lump or swelling etoposide, and cisplatin)
Heaviness in the scrotum and EP (etoposide and
cisplatin).

CHN LAWS

● Republic Act 7305: Magna Carta of Public Health Workers

The law was approved on March 26,1992. According to section 2 of this Act, this aims
to:

Ø Promote and improve the social and economic well-being of the health
workers, their living and working conditions and terms of employment.

Ø To develop their skills and capabilities in order that they will be more
responsive and better equipped to deliver health projects and
programs;

Ø To encourage those with proper qualifications and excellent abilities to

join and remain in government service.

● Presidential decree 856: Sanitation Code of the Philippines

This code aims to improve the way of the Filipinos through leading public health
services towards protecting and promoting health of the people.
 ● Republic Act 8749: The Philippine Clean Air Act

This act states that government shall develop holistic national program that shall be
implemented through proper delegation and effective coordination of function and
activities.

Ø Government shall encourage cooperation and self- regulation

among citizens and industries through the application of
incentives, market-based instruments.

● Republic Act 6675: Generics Act of 1988

Ø This act aims to promote require and ensure the production of an

adequate supply, distribution, use and acceptance of drugs and
medicines identified by their generic names.

Ø Philippine government passed the Generics Act of 1998 to

ensure that all Filipinos have access to affordable and effective
medications.

● Republic Act 7875: National Health Insurance Act of 1995

An act establishing the Philippine Health Insurance Corporation for the purpose of
establishing a national health insurance program for all Filipinos.

· Republic Act No. 10121: Philippine Disaster Risk Reduction and

Management Act of 2010

This Act strengthens the Philippine Disaster Risk Reduction Management Framework
Institutionalizes the National and Risk Reduction and Management Plan, it also
appropriates funds for the plans and for other purposes.

· Republic Act (RA) 10821: Children Emergency Relief and Protection Act of
2011

It sets a standard of accountability to children in terms of protection and provision of

their needs before, during. and after a disaster. Child protection in disasters and
emergencies refers to the prevention and response to abuse, neglect, exploitation, and
violence against children in times of emergency caused by natural or manmade
disasters. conflicts, or other crises.
 · Presidential Decree No. 603: Child and Youth Welfare Code

This PD legally defines unique categories of youths. along with younger offenders,
and directs the Ministry of Social services and Improvement (MSSD) to assist
comprehensively in the development of the youth.

It mandates in coordinating the enforcement and implementation in all laws,

formulate, monitor and evaluate policies, programs and measures for the children.

· Republic Act No. 9211: Tobacco Regulation Act of 2003

An omnibus law that regulates smoking in public places, tobacco advertising, promotion.
and sponsorship, as well as sales limits, among other things.

· Republic Act No. 1136: An Act Reorganizing the Division of Tuberculosis in

the Department of Health

This Act reorganizes the Division of Tuberculosis in the Department of Health (DOH)
through including an administrative section with a statistical, motor and electrical
maintenance. library, and buildings and grounds maintenance units: a section of clinics
and therapy: a section of prevention and Immunization with a BCG Immunization and
children's clinic. and health education and social service units: a section of X-ray
operation and maintenance; and a section of TB laboratory and research.

· Republic Act 8423: Traditional and Alternative Medicine Act (TAMA) of

1997

Q1This Act aims to preserve and promote people’s right to health, especially children’s
rights to survival and complete and healthy development as normal humans.

· Republic Act No. 7719: National Blood Services of 1994

This act encourages voluntary blood donation in order to ensure the sufficient supply of
banks in check. The goal of this act is to raise public awareness about the importance of
blood donation as a humanitarian act. This act mission includes blood safety, blood
adequacy, rational blood use, and efficiency of blood services.

· Republic Act No. 11332 Mandatory Reporting of Notifiable Diseases and

Health Events of Public Health Concern Act.
It is established that the State’s policy is to safeguard and promote people’s right to
health and to create health consciousness in them. It will work to protect people from
public health threats by conducting efficient and effective disease surveillance of
Notifiable Diseases.

Senior Citizens Laws

Ø This program focuses on promoting the health and wellness of senior citizens and
alleviating the conditions of older persons who are encountering degenerative
disease.

· Republic Act No. 9165: Comprehensive Dangerous Drugs Act of 2002

This is an act which prohibits and regulates the manufacture, trade, usage and
maintenance of illegal drugs in one's territory.

· Republic Act No. 9502 Universally Accessible Cheaper and Quality

Medicines of 2008

An act that intends to achieve better health outcomes for the Filipino people by
assuring that quality medicines are Accessible and affordable to as many Filipinos
especially the poor.

· Republic Act No. 7610: Special Protection of Children Against Abuse,

Exploitation and

Discrimination Act.

This act aims to combat child abuse, exploitation and prejudice by providing greater
counter measures and unique protections.

· Republic Act 9262: Anti-Violence Against Woman and their Children Act of
2004

This act protects women and children against violence. It also covers the issuance of
protection orders as well as the procedures for doing so.

· Republic Act 7600: The Rooming -In and Breast-feeding Act of 1992

This act declares that the State adopts rooming in as a national policy to encourage,
protect and support the practice of breastfeeding. It shall create an environment where
basic physical, emotional and psychological needs of mothers and infants are fulfilled
through the practice for it has been proved that breastmilk is the best food since it
contains essential nutrients completely suitable for the infant’s needs.
 · Republic Act 10354: The responsible Parenthood and Reproductive Health
Act of 2012

A groundbreaking law that ensures universal and free access to virtually all modern and
contraceptives at public health centers for all citizens, including the poor, at public
health centers.

· Republic Act No. 10152: Mandatory Infants and Children Health

Immunization Act of 2011

It is stated that the States policy is to take a proactive role in the preventive health care
of newborns and children, in accordance with Article II, section 15 of the constitution. To
this goal, the State must implement a comprehensive, mandatory, and long-term
immunization program for all newborns and children against vaccine preventable
diseases.

· Republic Act 8423: Traditional and Alternative Medicine Act (TAMA) of 1997

This act aims to preserve and promote people's right to health, especially Children
rights to survival and complete and healthy development as normal human.

Types of IV Fluids

IV (intravenous) fluids are specially designed liquid solutions that treat dehydration,
restore electrolyte balance, and help your body recover in challenging situations like
illness, surgery, or intense physical activity.

I.ISOTONIC

Isotonic IV solutions that have the same concentration of solutes as blood plasma.

Caution: observe for signs of fluid overload for patient with hypertension and heart
failure because isotonic fluids expand the intravascular space.

TYES OF IVF USES

Normal Saline (0.9% An isotonic solution
NaCl) perfect for rehydration and
treating issues like
hemorrhage, vomiting, or
diabetic ketoacidosis.

● Blood transfusions
● Sodium
replacement
● General hydration

Lactated Ringer’s 5%
Dextrose in Water It is the most
(D5LRS) physiologically adaptable
fluid because its electrolyte
content is most closely
related to the composition
of the body’s blood serum
and plasma.

Ringer’s solution
Contains electrolytes
similar to your body's
plasma, making it ideal for
burn victims, surgery
recovery, or significant fluid
loss.

● Burn recovery
● Lower GI fluid loss
● Replacing blood and
pH buffers
 Dextrose 5% in Water Crystalloid isotonic IV fluid
(D5W) with a serum osmolality of
252 mOsm/L. It is
administered to supply
water and to correct an
increase in serum
osmolality. It should also
be avoided to be used in
clients at risk for increased
intracranial pressure as it
can cause cerebral edema.

II.HYPOTONIC

Hypotonic solutions have lesser concentration of solutes than plasma.

Caution: Hypotonic solutions may exacerbate existing hypovolemia and hypotension

causing cardiovascular collapse. Avoid use in patients with liver disease, trauma, or
burns. Do not administer along with blood products. Most hypotonic solutions can cause
hemolysis of red blood cells especially during rapid infusion of the solution

0.45% Sodium Chloride a hypotonic IV solution

(0.45% NaCl) used for replacing water in
patients who have
hypovolemia with
hypernatremia.
 0.33% Sodium Chloride used to allow kidneys to
Solution (0.33% NaCl) retain the needed amounts
of water and is typically
administered with dextrose
to increase tonicity. It
should be used in caution
for patients with heart
failure and renal
insufficiency.

0.225% Sodium Chloride used as a maintenance

(0.225% NaCl) fluid for pediatric patients
as it is the most hypotonic
IV fluid available at 77
mOsm/L. Used together
with dextrose.

2.5% Dextrose in Water used to treat dehydration

(D2.5W) and creased the levels of
sodium and potassium. It
should not be administered
with blood products as it
can cause hemolysis of red
blood cells.

● D2.5W becomes
hypotonic once
the dextrose is
metabolized
III.HYPERTONIC

Hypertonic solutions have greater concentration of solutes than PLASMA. Hypertonic

sodium chloride solutions are used in the acute treatment of sodium deficiency (severe
hyponatremia) and should be used only in critical situations to treat hyponatremia. They
need to be infused at a very low rate to avoid the risk of overload and pulmonary
edema. If administered in large quantities and rapidly, they may cause an extracellular
volume excess and precipitate circulatory overload and dehydration. Therefore, they
should be administered cautiously and usually only when the serum osmolality has
decreased to critically low levels.

Colloids

Colloids contain large molecules that do not pass through semipermeable membranes.
Colloids are IV fluids that contain solutes of high molecular weight, technically, they are
hypertonic solutions, which when infused, exert an osmotic pull of fluids from interstitial
and extracellular spaces. They are useful for expanding the intravascular volume and
raising blood pressure.

Albumin: % albumin and 25%

albumin. 5%
Albumin is used to
increase the
circulating volume
and restore protein
levels in conditions
such as burns,
pancreatitis, and
plasma loss
through trauma.
25% Albumin is
used together with
sodium and water
restriction to
reduce excessive
edema.
Dextrans polysaccharides that
act as colloids.
They are available
in two types: low-
molecular-weight
dextrans (LMWD)
and high-
molecular-weight
dextrans (HMWD).
LMWD is used to
improve the
microcirculation in
patients with poor
peripheral
circulation. HMWD
used for patients
with hypovolemia
and hypotension.

Etherified Starch derived from starch

and are used to
increase
intravascular fluid
but can interfere
with normal
coagulation.
Examples include
EloHAES,
HyperHAES, and
Voluven.
 Gelatins have lower molecular
weight than
dextrans and
therefore remain in
the circulation for a
shorter period of
time.

Plasma Protein Fraction is a solution that is also

prepared from
plasma, and like
albumin, is heated
before infusion. It
is recommended to
infuse slowly to
increase circulating
volume.

Fetal Circulation

Blood transports between fetus and placenta through the umbilical cord containing two
umbilical arteries and one umbilical vein. The umbilical arteries carry deoxygenated fetal
blood toward the placenta for replenishment, and the umbilical vein carries newly
oxygenated and nutrient-rich blood back to the fetus. When delivering oxygenated blood
throughout the developing fetus, there are unique physiologic needs, supported by specific
structures unique to the fetus which facilitate these needs.

The first important structure is a vessel termed the ductus venosus. When the umbilical vein
enters the fetal umbilicus, it branches into two veins: the larger ductus venosus, and a
smaller portal sinus. The ductus venosus is a vein which largely bypasses the liver and
drains most oxygenated blood directly into the inferior vena cava. However, the liver tissue
itself still needs an oxygenated blood supply; to provide this, a portion of blood from the
umbilical vein enters the smaller second branch, the portal sinus, which carries oxygenated
blood to the liver tissue. These branches of the portal sinus and the ductus venosus allow
delivery of some oxygenated blood to be distributed throughout the liver while most
oxygenated blood is shunted around the liver to continue on through the ductus venosus
and into the inferior vena cava.

Shunt Functional closure Anatomical closure Remnant

Ductus arteriosus 10-96 hours after 2-3 weeks after birth Ligament arteriosum
birth

Foramen ovale Within several one year after birth Fossa ovalis
minutes after birth

Ductus venosus within several 3-7 days after birth Ligamentum

minutes after birth venosum

Blood enters the right atrium. This is the chamber on the upper right side of the heart. When
the blood enters the right atrium, most of it flows through the foramen ovale into the left
atrium.

Blood then passes into the left ventricle. This is the lower chamber of the heart. Blood then
passes to the aorta. This is the large artery coming from the heart.

From the aorta, blood is sent to the heart muscle itself and to the brain and arms. After
circulating there, the blood returns to the right atrium of the heart through the superior vena
cava. Very little of this less oxygenated blood mixes with the oxygenated blood. Instead of
going back through the foramen ovale, it goes into the right ventricle.

This less oxygenated blood is pumped from the right ventricle into the pulmonary artery. A
small amount of the blood continues on to the lungs. Most of this blood is shunted through
the ductus arteriosus to the descending aorta. This blood then enters the umbilical arteries
and flows into the placenta. In the placenta, carbon dioxide and waste products are
released into the mother's circulatory system. Oxygen and nutrients from the mother's blood
are released into the fetus' blood.

Fetal Circulation

1. Oxygenated, nutrient-rich blood from the placenta is carried to the fetus by the umbilical
vein.
2. most of the blood enters Ductus venosus, shunt that bypass the liver

3. Blood enter through the inferior vena cava.

4. Then to the right atrium of the heart.

5. Most of it flows to the Foramen Ovale

6. then goes to the left atrium

7. Blood then passes to the left ventricle

8. Blood then passes to the aorta

9. Blood is sent to the heart muscle, brain and arms

10. enters superior vena cava

11. Then blood returns to the right atrium

12. Instead it goes to the foramen ovale, it goes to the right ventricle

13. the blood is pumped to the pulmonary artery. small amount of blood continuous to the
lungs

14. Most of the blood is shunted through the ductus arteriosus

15. Then to the descending aorta

16. The blood enters the umbilical arteries and flows into the placenta

17. In the placenta, Carbon dioxide and waste product are released into the mother's
circulatory system.
Developmental Milestones
Developmental milestones are markers of a child’s development from infancy into
childhood. They help in identifying whether an infant is developing normally or if they
have delayed development in various areas as they're aging. The following are
milestones: gross motor, fine motor, language, and social/cognitive.

AGE GROSS FINE MOTOR LANGUAGE SOCIAL/

MOTOR COGNITIVE

1 MONTH Head -Grasp Reflex - Responds to Fine safety with

Lag(poor o-3 mo. touch and caregiver
head control) voices
- Babinski
Reflex 0-12 - Sensory
mo. motor and
communication
- Rooting 0-4
mo.
- Tonic neck
Reflex 0-4 mo.

2-3 Kicks Legs Grasp Reflex - Response to - Smiles and coos

MONTHS Diminished sounds when seeing a
familiar face
- 2 legs kick - Able to make
at 2 mo. sound with
mouth
- Raises
head when
prone
• Less
head
lag
4-5 NO more Grabs object - Mimics sound - Soothed by
MONTHS head lag voluntarily heard caregivers voice
( Report if (Grabs rattle) - Able to - Copies
head lag is change cry expressions
found after 4 tone for
months) Diminished - Cries when doesn’t
different needs
Moro reflex get their way
(startle reflex)
5 months and other
rolls from reflexes
front to the
back

6-9 Birth weight 6 months -Babbling -Identifies faces &

MONTHS DOUBLES at words strangers
-Holds a big
6 months bottle “MAMA DADA” -Separation anxiety
-Rolls from begins at 6 months
-Responds to
back to front
7 months name
-can sit up
-transfers NOT Babbling
unsupported
objections from 9 Months?
-can pull self 1 hand to the MUST
up other REPORT IT

10-12 10 months: 10 months: -Able to make Vocalization &

MONTHS a variety of speech
• Prone 1. Pincer
sound
to grasp (Talking toys &
sitting -Mimics Books) purpose for
“pick up
positi gestures play
small
on finger -Understands
foods” simple word:
2. Grasp a Yes or No
rattle or
doll by
the arm
 3.
Transfe
r
objects
from
hand to
hand

12 -Birth 1. Fully -3-5 words -Shy: stranger

MONTHS/ 1 WEIGHT developed 2 danger
-nonverbal
YR TRIPLES fingers pincer gestures -Can follow short
grasp
-Sits down (waiving, head simple directions
from standing nodding)
-Crawls up 2. Tries to
stairs build2 block
st
tower
-Walks 1 unsuccessfully
step while
holding
hands 3. Attempts to
turn book
pages

-12 months use

fingers
-1&2 fully
developed
pincer grasp
18 1. Walk -Turn 2 pages -10+ words -Angry baby: temper
MONTHS up/down in a book at a and ownership
- Follows
stairs while time ”mine”.
commands
holding a (uncoordinated “don’t touch
hand ) that”
2. Throws a - Holds cup
ball and spoon
-Uses gestures
3. Jump in -Build tower of to show what
place with four blocks they want
both feet -Scribble with
crayons

No finger
dexterity
• No
scissor
s
• No color
pencils
2 YEARS 1. Walks 2. Builds a 3. Says own Imitates adults
OLD without help tower of 7 name behavior
-Run and kick blocks -300+ words
ball -Draws vertical -2-3 words
lines
-Walks sentences
up/down -Books: able to -Identifies
stairs turn 1 page at pictures with
independentl a time names
y once step -Open doors by
at a time turning door
knobs
-2 years, 2
legs for
walking
-2 names
(first and last)
-2-3 words
sentences
Toilet Trained
by Two

3 YEARS Tricycle & -Draws circles 3-4 words Associative play 3-5
OLD Jumps sentences yrs.
- Spoon feed
forward self - Asks “why” a “Unorganized play
- Learning lot without a goals or
- Undresses
balance rules”
self - Follows more
- Walks complex
- Holds
upstairs with instruction
crayons with
alternating fingers instead
feet of fist
-Yes- scissors
4 YEARS -Skips, hops - Draw 4 sided - Able to tell - Imaginary play:
OLD on 1 foot shapes like a stories dress up and tea
square or party
- Catches a - Can
rectangle
ball 50% of memorize - Plays with other
the time - Can pour alphabet and children rather than
drinks and numbers alone
- Climbs and
make foods
jumps

5 YEARS - Buttons - Your child’s - Tells a story - Counts to 10

OLD some buttons hands are she heard or - Names some
getting better made up with
- Hops on numbers between 1
at doing small, at least two
one foot and 5 when you
careful tasks. events point to them
-They can draw - Answers
and color more - Pays attention for 5
simple
neatly. to 10 minutes during
questions
-They can fold activities.
about a book
paper properly. - Writes some letters
or story
-They can hold in her name
a pencil the -Uses or
recognizes - Names some
right way.
simple rhymes letters when you
(bat-cat, ball- point to them
tall)
 Psychosocial Developmental Stages

Erik Erikson’s Stages of Psychosocial Development

Erik Erikson was an ego psychologist who developed one of the most popular and
influential theories of development. While his theory was impacted by psychoanalyst
Sigmund Freud's work, Erikson's theory centered on psychosocial development rather
than psychosexual development.

● Stage 1: Trust vs. Mistrust (Infancy from birth to 18 months)

The first stage of Erikson's theory of psychosocial development occurs between

birth and 1 year of age and is the most fundamental stage in life. Because an
infant is utterly dependent, developing trust is based on the dependability and
quality of the child's caregivers.

At this point in development, the child is utterly dependent upon adult caregivers
for everything they need to survive including food, love, warmth, safety, and
nurturing. If a caregiver fails to provide adequate care and love, the child will
come to feel that they cannot trust or depend upon the adults in their life.

● Stage 2: Autonomy vs. Shame and Doubt (Toddler years from 18 months to
three years)

The second stage of Erikson's theory of psychosocial development takes place

during early childhood and is focused on children developing a greater sense of
personal control.

● Stage 3: Initiative vs. Guilt (Preschool years from three to five)

The third stage of psychosocial development takes place during the preschool
years. At this point in psychosocial development, children begin to assert their
power and control over the world through directing play and other social
interactions.

Children who are successful at this stage feel capable and able to lead others.
Those who fail to acquire these skills are left with a sense of guilt, self-doubt, and
lack of initiative.

● Stage 4: Industry vs. Inferiority (Middle school years from six to 11)
 The fourth psychosocial stage takes place during the early school years from
approximately ages 5 to 11. Through social interactions, children begin to
develop a sense of pride in their accomplishments and abilities.

Children need to cope with new social and academic demands. Success leads to
a sense of competence, while failure results in feelings of inferiority.

● Stage 5: Identity vs. Confusion (Teen years from 12 to 18)

The fifth psychosocial stage takes place during the often-turbulent teenage
years. This stage plays an essential role in developing a sense of personal
identity which will continue to influence behavior and development for the rest of
a person's life. Teens need to develop a sense of self and personal identity.
Success leads to an ability to stay true to yourself, while failure leads to role
confusion and a weak sense of self.

● Stage 6: Intimacy vs. Isolation (Young adult years from 18 to 40)

Young adults need to form intimate, loving relationships with other people.
Success leads to strong relationships, while failure results in loneliness and
isolation. This stage covers the period of early adulthood when people are
exploring personal relationships

Erikson believed it was vital that people develop close, committed relationships
with other people. Those who are successful at this step will form relationships
that are enduring and secure.

● Stage 7: Generativity vs. Stagnation (Middle age from 40 to 65)

Adults need to create or nurture things that will outlast them, often by having
children or creating a positive change that benefits other people. Success leads
to feelings of usefulness and accomplishment, while failure results in shallow
involvement in the world.

During adulthood, we continue to build our lives, focusing on our career and
family. Those who are successful during this phase will feel that they are
contributing to the world by being active in their home and community. Those
who fail to attain this skill will feel unproductive and uninvolved in the world

● Stage 8: Integrity vs. Despair (Older adulthood from 65 to death)

The final psychosocial stage occurs during old age and is focused on reflecting
on life. At this point in development, people look back on the events of their lives
and determine if they are happy with the life that they lived or if they regret the
things they did or didn't do,

Erikson's theory differed from many others because it addressed development

throughout the entire lifespan, including old age. Older adults need to look back
 on life and feel a sense of fulfillment. Success at this stage leads to feelings of
wisdom, while failure results in regret, bitterness, and despair.

At this stage, people reflect back on the events of their lives and take stock.
Those who look back on a life they feel was well-lived will feel satisfied and ready
to face the end of their lives with a sense of peace. Those who look back and
only feel regret will instead feel fearful that their lives will end without
accomplishing the things they feel they should have.

MEDICAL TERMS AND ABBREVIATION

A.

A.A.R.O.M Active assistive range of motion

AAC Augmentative and alternative

communication

A.B.G. Arteria blood gas

a.c Before meals

A/c Assist control

ADA Diet American Diabetes Association Diet

A.D.L. Activities of daily living

A.fib Atrial fibrillation

AKA Above-knee amputation or above-

the-knee amputation

ALS Amyotrophic lateral sclerosis

AMA Against medical advice

A&O Alert and oriented

A/P Anterior-posterior

A.R.O.M. Active range of motion

ASAP As soon as possible

ASD Autism spectrum disorder

ASL American Sign Language

B.

BID Twice a day

BKA Below-knee amputation

B.L bilateral

B.L.BS Bilateral breath sounds

BMR Basal metabolism rate

BP Blood pressure

BR Bed rest

Bs Bowel sound

BS Breath Sounds

B/S Bed side

Bx biopsy

C.

c̅ with

C Celsius. Centigrade

C1, c2 etc First cervical vertebrae, second

cervical Vertebrae, etc

CA Cardiac arrest
CA, ca Cancer. carcinoma

CABG Coronary artery bypass graft

CAD Coronary artery disease

Cal calorie

Cath catheter

CBC Complete blood count

CC Cubic centimeter

CHF Congestive heart failure, chronic

heart failure

CCU Coronary care unit

CHI Closed head injury

Cm centimeter

CMT Continuing medication and treatment

CN Cranial Nerve

CNA Certified nursing assistant

CNS Central nervous system

C/O Complains of

COTA Certified occupational therapy

assistant

Cont Continue(d)

COPD Chronic obstructive pulmonary

disease

CP Cerebral Palsy

CPAP Continuous positive airway pressure

CPR Cardiopulmonary resuscitation

CRF Chronic renal failure

CRNP Certified registered nurse practitioner

CSF Cerebrospinal fluid

CT Computerize tomography

CV Cardiovascular

CVA Cerebral vascular accident

CXR Chest x-ray

D.

D day

D/C Discontinue

DC Discharge

DM Diabetes mellitus

DNK Do not know

DNKA Did not keep appointment

DNR Do not resuscitate

DNT Did not test

DOA Dead on arrival

DOB Date of birth

DOE Dyspnea on exertion

D/T Due to

DX Diagnosis

E.

ECC, EKG electrocardiogram

ED Emergency department
EEG electroencephalogram

EENT Eyes, ears, nose. throat

EMG Electromyogram

ENT Ears, nose, throat

ER Emergency room

ETOH Ethanol

EXAM Examination

EXT External, exterior

F.

F fahrenheit

FH Family history

FIB Fibrillation

FL,FLD Fluid

FOB Foot of bed

F/U Follow-up

FWB Full weight bearing

FX Fracture

G.

GB Gall bladder

GCS Glasgow coma scale

GE Gastroenterology

GERD Gastroesophageal reflux disease

G/E Gastroenteritis

GEN General
GEST Gestation

G.I. gastrointestinal

GNA Geriatric nursing assistant

gluc Glucose

GP General practitioner, general

paralysis

GSW Gunshot wound

GTT Glucose tolerance test

Gt. Tr Gait training

GYN Gynecology

H.

H hour

h/a Headache

HAV Hepatitis A virus

Hb. Hemoglobin

HB Heart block

HBP] High blood pressure

h.d At bedtime

HEENT Head, eyes, ears, nose, throat

HEP Home exercise program

H2O Water

h/o History of

HOB Head of bed

H&P History and physical

HR Heart rate

HTN Hypertension

HVD Hypertensive vascular disease

Hx History

Hz Hertz (cycle/second)

I.

ICCU Intensive coronary care unit

ICP Intracranial pressure

ICU Intensive care unit

Imp Impression

Incr. Increase(ing)

Inf Infusion, inferior

Inspire Inspiration, inspiratory

Int. Internal

I&o Intake and output

IPPB Intermittent positive pressure

breathing

Irreg. Irregular

IV Intravenous

J.

J, jt joint

K.

K Potassium, kidney
L.

L Left, liver, liter, lower, light, lumbar

L2, L3 Second lumbar vertebrae, third

lumbar vertebrae

Lab Laboratory

Lac Laceration

Lat Lateral

LBW Low birth weight

L.E. Lower extremities

liq Liquid

L.O.C. Loss of consciousness, level of

consciousness, laxative of choice

LOS Length of stay

LP Lumbar puncture

LPN Licensed practical nurse

LUE Left upper extremity

Lx larynx

L&W Living and well

M.

M, M Married, male, mother, murmur,

meter, mass, molar

Max Maximum, maxillary

MBC Maximum breathing capacity

MBSS Modified barium swallow study

MCA Middle cerebral artery

MD Muscular dystrophy

Mdnt. Midnight

Med. Medicine

Mets. Metastasis

MG Myasthenia gravis

ML Myocardial infarction

Mins Minute

MICU Medical intensive care unit

Mod Moderate

MRI Magnetic resonance imaging

MRSA methicillin-resistant Staphylococcus

aureus

MSS massage

MVA Motor vehicle accident

n. nerve

Na sodium

NaCl sodium chloride

NAD no abnormality detected

NAD no apparent distress

neg. negative

neur. neurology

NG nasogastric
 NIC neonatal intensive care

NICU neonatal intensive care unit

NKA no known allergies

no. number

NOS not otherwise specified

NPO nothing by mouth

NSA no specific abnormality

NST nonstress test

N&V nausea and vomiting

NVD nausea, vomiting, diarrhea

N&W normal and well

NWB non–weight bearing

NYD not yet diagnosed

o none, without

O oral

O2 oxygen

O2 cap. oxygen capacity

O2 sat. oxygen saturation

OA osteoarthritis

OB, OBG obstetrics

OB/GYN obstetrics and gynecology

 Obs observation

OBS organic brain syndrome

ODD oppositional defiant

disorder

O/E on examination

OH occupational history

OHD organic heart disease

oint. ointment

O.M. otitis media

O.M.E. otitis media with effusion

OOB, oob out of bed

Op. operation

ot. ear

Oto otolaryngology

OTC over-the-counter
(pharmaceuticals)

O.T. occupational therapy, old

tuberculin

OR operating room

PA physician’s assistant

p&a percussion and

auscultation

PACU post anesthesia care unit

 PAF paroxysmal atrial fibrillation

palp. palpate, palpated, palpable

Path pathology

PA view posterior–anterior view on

X-ray

p/c, p.c. after meals

PD Parkinson’s disease

pdr. powder

PDN private duty nurse

PE physical exam, pulmonary

embolism, pressure
equalizer (tubes)

Ped. pediatrics

PEEP positive end-expiratory

pressure

PEG percutaneous endoscopic

gastrostomy

PET positron emission

tomography

PH past history

pharm pharmacy

PHYS. physical, physiology

PI present illness, pulmonary

insufficiency

PICU pulmonary intensive care

unit

PID pelvic inflammatory disease

plts. platelets
 P.M. afternoon, postmortem

PMH past medical history

PMR physical medicine and

rehabilitation

PN poorly nourished, practical

nurse

P&N psychiatry and neurology

PNA pneumo, pneumonia

PNI peripheral nerve injury

PNX pneuomothorax

p.o. by mouth

p.o.d. postoperative day

pos. positive

post. posterior

POSTOP. postoperative

pot. or potass. potassium

PR proctology

pre-op preoperative

prep. prepare for

p.r.m. according to circumstances

p.r.n., PRN as often as necessary, as

needed

prod.
productive

Prog. prognosis

PROM passive range of motion

 pron. pronator, pronation

prosth. prosthesis

PSH past surgical history

Psych. psychiatry

pt., Pt. patient

PT, P.T. physical therapy

PTA prior to admission

PTA pulse posterior tibial artery pulse

PUD peptic ulcer disease

PVD peripheral vascular disease

PVT previous trouble

PWB% partial weight bearing with

percent

Px, PX physical examination

q every

q.h every hour

q.i.d. four times a day

qt. quart

quad. quadriplegic

R
 R, r right

R. rub, rectal temperature

RA rheumatoid arthritis, right

atrium

rad. radial

r.a.m. rapid alternating

movements

R.A.S. right arm sitting

RAtx radiation therapy

rbc/RBC red blood cell, red blood

count

RCA right coronary artery

RCU respiratory care unit

RD respiratory distress

RDS respiratory distress

syndrome

RE reconditioning exercise

reg. regular

rehab. rehabilitation

resp. respiratory, respirations

RF rheumatic fever

RLAS Rancho Los Amigos Scale

R to L&A react to light and

accommodation

RLE right lower extremity

RN registered nurse
 RND radical neck dissection

RO, R/O rule out

S.

S without

S Sensation, sensitive, serum

Sa Saline

s.c Subcutaneous(ly)

Scc Squamous cell carcinoma

SCCA Squamous cell carcinoma, squamous cell

carcinoma

SCD Sudden cardiac death

CSI Spinal cord injury

Schiz Schizophrenia

SCU Specia care unit

Sec Second

Sens Sensory, sensation

Sep. Separated

SGA Small for gestational age

s.gl. Without correction

SH Social history

SI Stroke index

Sib Sibling

SICU Surgical intensive care unit

Skel Skeletal
Sl. Slightly

SLP Speech0language pathologist

Sm Small

SNF Skilled nursing facility

SOAP Subjective, objective. Assessment, plan

SOB Shortness of breath

S/P, s/p Status post (previous condition)

Sp. Cd. Spinal cord

Spec Specimen

Sp. Fl. Spinal fluid

Sp&H Speech and hearing

Spin. Spine, spinal

Spont Spontaneous

S/S Sign and symptoms

ST Speech therapy

STAT Immediately

STD Sexually transmitted disease

SUBCUT Subcutaneous

Subling Sublingual

Sup. Superior

Supin. Supination

Surg. Surgical

Sx Symptoms

sys System

Syst Systolic
Sz Seizure

T.

T&A Tonsils and adenoids, tonsillectomy and

adenoidectomy

TAB Tablet

TAH Total abdominal hysterectomy

TB Tuberculosis

TBI Traumatic brain injury

Temp Temperature

Therap Therapy, therapeutic

THR Total hip replacement

TIA Transient ischemic attack

TKR Total knee replacement

TNM Tumor, nodes, and metastases

TO Telephone order

TPN Total parenteral nutrition

TPR Temperature, pule, respiration

Tr Trace

Trach Tracheostomy

Tsp. Teaspoon

Tx. Treatment

U.

U/A urinslysis

UCD, UCHD Usual childhood diseases

UG Upward gaze

Unilat Unilateral

u/o Under observation

Ur Urine

URD Upper respiratory disease

URI Upper respiratory infection

Urol. Urology

u/s. Us Ultrasound

UTI Urinary tract infection

V.

VA Visual acuity

Vag Viginal, vagina

VC, vit.cap Vital capacity

VD Venereal disease

Vent ventilator

Vert Vertical

VF Visual field, ventricular fibrillation

VFSS Videofluroscopic swallowing study

Via By way of

Vit. Vitamin

VN Visiting nurse

VO Verbal order

VS, V.S. Vital sign

W.
w. wk week

W/C, WH,CH Wheelchair

WBT Weight bearing tolerance

WFL Within functional limits

w/n Within

WNL Within normal limits

WP Whirlpool

Wt. Weight

w/u Workup

X.

X Times

y.o. Years old

Yrs years

Cephalocaudal-Based Laboratory Assessment Guide

1. Head (Neurological & Endocrine)

Lab Test Normal Values Significance

Serum Na⁺: 135–145 mEq/LK⁺: Electrolyte imbalances can

Electrolytes (Na⁺, 3.5–5.0 mEq/LCa²⁺: 8.5– cause seizures, altered LOC
K⁺, Ca²⁺, Mg²⁺) 10.5 mg/dLMg²⁺: 1.5–2.5
mEq/L

Thyroid Function TSH: 0.4–4.0 µIU/mL Screens for

Tests (T3, T4, hyper/hypothyroidism
 TSH) (Graves', Myxedema)

2. Eyes (Indirectly through other labs)

Lab Test Significance

Blood Glucose (FBS, ↑ may cause blurred vision (diabetic

HbA1c) retinopathy risk)

Vitamin A levels Deficiency may affect vision (night blindness)

3. Ears, Nose, Mouth, and Throat

Lab Test Normal Significance
Values

WBC Count 5,000– ↑ in otitis media, sinusitis,

10,000/µL pharyngitis

Culture and Sensitivity – Identifies causative organism

(throat/ear swab) (e.g., strep throat)

4. Neck and Thorax (Cardiopulmonary System)

Lab Test Normal Values Significance

Chest X-ray (CXR) – Assesses pneumonia, TB, CHF

ABG (Arterial pH: 7.35–7.45PaCO₂: Assesses acid-base status,

Blood Gas) 35–45HCO₃⁻: 22–26 respiratory/metabolic issues

Troponin I < 0.04 ng/mL ↑ = myocardial infarction

BNP (B-type < 100 pg/mL ↑ = heart failure

 Natriuretic
Peptide)

5. Abdomen (GI & Hepatobiliary)

Lab Test Normal Values Significance

Liver Function Tests (AST, AST: 10–40ALT: 7–56 ↑ in hepatitis,

ALT, ALP, Bilirubin) cirrhosis

Amylase/Lipase Amylase: 23–85 ↑ in pancreatitis

U/LLipase: 0–160 U/L

Albumin 3.5–5.0 g/dL ↓ = liver disease

or malnutrition

Stool Occult Blood Test Negative Detects GI bleeding

6. Genitourinary
Lab Test Normal Values Significance

Urinalysis Color: yellow, pH: 4.5–8, UTI, diabetes, kidney

protein: negative function

BUN and BUN: 10–20Creatinine: ♀ 0.5– ↑ = renal dysfunction

Creatinine 1.1, ♂ 0.6–1.2

Pregnancy Test Negative/Positive Confirms pregnancy

(hCG) (relevant to OB topics)

7. Musculoskeletal
Lab Test Normal Values Significance

Calcium 8.5–10.5 mg/dL Needed for bone strength; ↓

 in osteoporosis

Uric Acid ♀ 2.4–6.0 mg/dL♂ 3.4– ↑ in gout

7.0 mg/dL

Rheumatoid Factor Negative +RF = Rheumatoid arthritis

(RF)

8. Neurological (Lower CNS & Motor Function)

Lab Test Significance

Lumbar Puncture (CSF Analysis) Confirms meningitis, encephalitis

Creatine Kinase (CK) ↑ in muscle breakdown (e.g.,

rhabdomyolysis)

REFERENCES:

Pathognomonic Drug of Choice

American Heart Association/American Stroke Association. (2019). Guidelines for the early
management of patients with acute ischemic stroke.
https://www.ahajournals.org/doi/10.1161/STR.0000000000000158cdc.gov+15ahajournals.org+1
5ahajournals.org+15
Centers for Disease Control and Prevention. (2024). Clinical guidance for meningococcal
disease. https://www.cdc.gov/meningococcal/hcp/clinical-guidance/index.html cdc.gov
Mayo Clinic. (2023). Bell’s palsy: Diagnosis and treatment. https://www.mayoclinic.org/diseases-
conditions/bells-palsy/diagnosis-treatment pmc.ncbi.nlm.nih.gov+4mayoclinic.org+4p no
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National Institute for Health and Care Excellence. (2017). Parkinson’s disease in adults (NG71).
https://www.nice.org.uk/guidance/ng71 heart.org+15nice.org.uk+15aan.com+15
Epilepsy Foundation. (2023). Valproic acid – seizure medication. https://www.
epilepsy.com/tools-resources/seizure-medication-list/valproic-acid

Integumentary
Hives: Causes, Symptoms, Diagnosis, Treatment & Prevention
Chickenpox - Symptoms and causes - Mayo Clinic
Shingles - Symptoms & causes - Mayo Clinic
Eczema: What It Is, Symptoms, Causes, Types & Treatment
seborrhoeic dermatitis scalp - Search
Psoriasis: What It Is, Symptoms, Causes, Types & Treatment
Alopecia Areata: Symptoms, Causes, Treatment & Regrowth
Folliculitis
Koilonychia (Spoon Nails): What It Is, Causes & Treatment
Fungal Nail Infections: Symptoms Causes, Treatment, and Prevention
Toenail Fungus Treatment: What Works? - GoodRx
Acne: Types, Causes, Treatment & Prevention

Myasthenia Gravis – Pyridostigmine

https://www.ncbi.nlm.nih.gov/books/NBK559331/

Facioscapulohumeral Dystrophy – Prednisone

https://www.ncbi.nlm.nih.gov/books/NBK144574/

Inclusion Body Myositis – IVIG

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7768665/

Duchenne Muscular Dystrophy – Deflazacort

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6973289/

Charcot-Marie-Tooth Disease – Gabapentin

https://www.ninds.nih.gov/health-information/disorders/charcot-marie-tooth-disease

https://my.clevelandclinic.org/health/diseases/21674-congenital-heart-disease
https://emedicine.medscape.com/article/1962779-overview
https://www.mayoclinic.org/diseases-conditions/peripheral-artery-disease/
symptoms-causes/syc-20350557
https://www.nhlbi.nih.gov/health/peripheral-artery-disease/
treatment#:~:text=Medicines,prevent%20blood%20vessels%20from%20narrowing
https://www.mayoclinic.org/diseases-conditions/arteriosclerosis-atherosclerosis/
diagnosis-treatment/drc-20350575
https://my.clevelandclinic.org/health/diseases/16800-brain-aneurysm
- Brunner and Suddarth’s- Textbook of Medical-Surgical Nursing- 15th
edition

⁦ ttps://www.lupus.org/resources/medications-used-to-treat-lupus⁩
h
⁦https://www.medicalnewstoday.com/articles/auspitz-sign-psoriasis⁩
https://www.ncbi.nlm.nih.gov/books/NBK539787/#:~:text=The%20pathognomonic
%20feature%20of%20HIV,and%20antibody%2Dmediated%20immune%20mechanisms⁩

Harrison’s Principles of Internal Medicine, 20th Edition

Current Medical Diagnosis and Treatment (2024), Lange
Kumar and Clark’s Clinical Medicine, 10th Edition
https://www.cdc.gov/antibiotic-use/community/for-hcp/outpatient-hcp/index.html
https://www.auanet.org/guidelines
Global Kidney Health Atlas by ISN (International Society of Nephrology…

Kumar & Clark's Clinical Medicine (10th Edition)

Harrison’s Principles of Internal Medicine (20th Edition)
Current Medical Diagnosis and Treatment (2024) – Lange
Global Initiative for Asthma (GINA) 2024 Guidelines
https://ginasthma.org
Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2024 Guidelines
https://goldcopd.org
World Health Organization (WHO) – Tuberculosis Treatment Guidelines 2023
https://www.who.int/publications/i/item/9789240054348
Nelson Textbook of Pediatrics (21st Edition)
National Institute for Health and Care Excellence (NICE) Clinical Guidelines

https://www.britannica.com/science/reproductive-system-disease

CHN LAWS

https://www.slideshare.net/KenzoAlainDedace/chnpublichealthlawspptx

TYPES OF IV FLUID

https://nurseslabs.com/iv-fluids/#h-types-of-iv-fluids

https://www.azivmedics.com/iv-fluids
FETAL CIRCULATION
https://www.stanfordchildrens.org/en/topic/default?id=fetal-circulation-90-P01790

https://www.stanfordchildrens.org/en/topic/default?id=fetal-circulation-90-P01790

https://www.heart.org/en/health-topics/congenital-heart-defects/symptoms--
diagnosis-of-congenital-heart-defects/fetal-circulation

https://drtrinadh.wordpress.com/2018/08/22/fetal-circulation/

DEVELOPMENTAL MILESTONE

https://www.cdc.gov/ncbddd/actearly/milestones/index.html
https://www.ncbi.nlm.nih.gov/books/NBK557518/
https://www.youtube.com/watch?
v=VVmMK4ZcPxY&pp=ygUhZGV2ZWxvcG1lbnRhbCBtaWxlc3RvbmVzIG1uZW1vbmlj
https://naitreetgrandir.com/en/step/5-8-years/development/5-6-years/child-fine-motor-
skill-development-5-6-years/
PSYCHOSOCIAL DEVELOPMENT STAGES

https://www.verywellmind.com/erik-eriksons-stages-of-psychosocial-
development-2795740

MEDICAL TERMS AND ABBREVIATIONS

A-Z List of Common Medical Abbreviations, Acronyms & Definitions

LABORATORY

https://medlineplus.gov/lab-tests

https://www.mayocliniclabs.com/test-catalog