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First Aid for the USMLE Step 1 (2023) | Medicine (MD/DO) School Study Aid

Liver Enzyme Tests: AST and ALT

AST/ALT Ratio

AST: 8-20 U/L

ALT: 8-20 U/L

1 min

Bilirubin Lab Value

0.2-1.2 mg/dL

Increased Bilirubin Causes Jaundice

54 secs

Hyperbilirubinemia

Increased Unconjugated Bilirubin

Jaundice

Kernicterus

Early Feedings

Heme Oxygenase Inhibitors

Phototherapy

Protect Eyes

Monitor for Dehydration

Monitor Bilirubin Levels

3 mins

Calcium (Ca2+) Lab Value

8.5 to 10.5 mg/dL

26 secs

Hypocalcemia

Muscle Spasms

< 8.5 mg/dL Ca2+

Decreased Bone Density

Tetany

Chvostek's Sign

Trousseau's Sign

Increased DTR

ECG Changes

QT Prolongation

Oral and IV Replacement of Ca2+

Seizure Precautions

2 mins

Hypercalcemia

> 10.5 mg/dL Ca²⁺

Pathologic Fractures

Lethargy

Hypercoagulation

Constipation

ECG Changes

QT Shortening

No Calcium Intake

Chelating Drugs

Calcitonin

Bisphosphonates

Loop Diuretics instead of Thiazide Diuretics

Increased Risk for Renal Calculi

Increase Fluids

3 mins

Calcium Correction for Hypoalbuminemia

0.8 * (Normal Albumin - Patient Albumin) + Calcium

Multiply * 0.8

Subtract (Normal Albumin - Patient Albumin)

Add Calcium

1 min

Cholesterol Lab Values

LDL (Low Density Cholesterol)

< 100 mg/dL

HDL (High Density Cholesterol)

> 40 mg/dL Males

> 50 mg/dL Females

Total Cholesterol

< 200 mg/dL

1 min

Creatinine Lab Values

Measures Renal Function

0.6 - 1.3 mg/dL

1 min

Normal Electrolyte Lab Values

Potassium (K⁺)

3.5 to 5.0 mEq/L

Calcium (Ca²⁺)

8.5 to 10.5 mg/dL

Phosphate (PO₄^3–)

2.5 to 4.5 mg/dL

Magnesium (Mg²⁺)

1.5 to 2.5 mEq/L

Sodium (Na⁺)

135 to 145 mEq/L

Chloride (Cl^–)

95 to 105 mEq/L

2 mins

Sodium (Na+) Lab Value

135-145 mEq/L

24 secs

Hypernatremia

> 145 mEq/L Na+

Change in LOC

Extreme Thirst

Orthostatic Hypotension

Dry Flushed Skin

Muscle Twitching

Seizures

Treat and Prevent Dehydration

Hypotonic Solutions (0.225% or 0.45% NaCl)

Sodium Restriction

Diuretics

2 mins

Hyponatremia

< 135 mEq Na+

Nausea and Vomiting

Decreased LOC

Confusion / Lethargy

Seizures

Assess Airway

Reduce Diuretic Dosage

Mannitol (Osmitrol)

Fluid Restriction

Hypertonic Solution (3% or 5% NaCl)

2 mins

Chloride (Cl-) Lab Value

95-105 mEq/L

28 secs

Potassium (K+) Lab Value

3.5 to 5.0 mEq/L

20 secs

Hyperkalemia

> 5.0 mEq/L K+

Abdominal Cramps

Muscle Weakness

Diarrhea

Arrhythmia

Tall, Peaked T Waves

IV Calcium

Infusion of Glucose and Insulin

Loop or Thiazide Diuretics

Kayexalate

Dialysis

Prevention Education

2 mins

Hypokalemia

< 3.5 mEq/L

Muscle Weakness

Arrhythmia

U Wave

Ileus

Hyporeflexia

IV K+ Infusion at 5-10 mEq/hr

Give Orally with Food

Monitor Respiratory Status

3 mins

Magnesium (Mg2+) Lab Value

1.5 to 2.5 mEq/L

28 secs

Hypermagnesemia

Flushing

Lethargy

Muscle Weakness

Decreased Deep Tendon Reflexes (DTRs)

Decreased Respirations

Bradycardia

Hypotension

Dialysis

IV Calcium Gluconate

Diuretics

Avoid Antacids and Laxatives containing Mg²⁺

2 mins

Hypomagnesemia

Confusion

Increased Deep Tendon Reflexes (DTRs)

Neuromuscular Irritability

Seizures

Muscle Cramps

Tremors

Insomnia

Tachycardia

Magnesium Sulfate

Foods High in Magnesium

1 min

pH - Blood and Urine Lab Value

Blood

7.35 - 7.45

Urine

4.0 - 8.0

1 min

Blood Glucose Lab Value

70-100 mg/dL

25 secs

Anterior Pituitary

Hypothalamic Control

FLAT PeG Mnemonic

Follicle-Stimulating Hormone (FSH)

Lutenizing Hormone (LH)

Adrenocorticotropic Hormone (ACTH)

Thyroid-Stimulating Hormone (TSH)

Prolactin (PRL)

Growth Hormone (GH)

2 mins

Phosphate (PO43-) Lab Value

2.5 to 4.5 mg/dL

29 secs

Total Protein Lab Values

6.4 - 8.3 g/dL

1 min

Albumin Lab Value

3.5 - 5.5 g/dL

49 secs

BUN (Blood Urea Nitrogen) Lab Values

10-20 mg/dL

40 secs

CSF Lab Values: Normal

Pressure: < 20 cm H2O

Color/Appearance: Clear or Colorless

Proteins: < 40 mg/dL

Lactate Dehydrogenase: 10% of Serum Level

Cells: 0-5 Small Lymphocytes

Glucose: 40-70 mg/dL

2 mins

Red Blood Cell Count (RBC) Lab Values

Women: 3.5-5.5 million cells/ MuL

Men: 4.3-5.9 million cells/ MuL

1 min

Hematocrit (Hct) Lab Values

Women: 36% - 46%

Men: 41% - 53%

1 min

Hemoglobin (Hgb) Lab Values

Men: 13 - 17 g/dL

Women: 12 - 16 g/dL

47 secs

WBC Differential Lab Value

White Blood Cells (WBC)

5-10 (5,000-10,000)

Neutrophils (50%-70%)

Bands (2%-5%)

Segs (50%-70%)

Lymphocytes (20%-40%)

Monocytes (4%-8%)

Eosinophils (2%-4%)

Basophils (0.5%-1.5%)

2 mins

PT/PTT Lab Values

Prothrombin Time (PT)

10-14 seconds

Activated Partial Thromboplastin Time (PTT or aPTT)

25-35 seconds

1 min

Platelet Lab Value

150,000-400,000 Micro L

40 secs

Bleeding Time Lab Values

2-7 Minutes

41 secs

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