Tuesday, October 21, 2014

BODY MASS INDEX --BMI

BMI = 22.96 kg/m2   (Normal)
  • Normal BMI range: 18.5kg/m2 - 25 kg/m2
  • Normal BMI weight range for the height: 128.9lbs - 174.2 lbs
  • Ponderal Index: 12.91 kg/m3

The Body Mass Index (BMI) Calculator takes age into consideration when calculating the BMI value and weight status of that individual. Below is a referenced weight range and calculation formula.

Reference

It should be noted that BMI measures your body weight based on your height and weight. Your BMI does not actually "measure" your percentage of body fat, but it helps to estimate a healthy body weight based on a person’s height. A person’s BMI "number" can serve as an indicator that a person is underweight, normal weight, overweight, or obese. Note that body types, the distribution of muscle and bone mass varies among individuals. Therefore BMI should not be the only or final indicatior for diagnosing the weight stsatus of an individual.


Body Mass Index Formula

The formulas to calculate BMI based on two of the most commonly used unit systems:

    BMI = weight(kg)/height2(m2)         (Metric Units)
    BMI = 703·weight(lb)/height2(in2)         (U.S. Units)

BMI Table for Adults

This is the World Health Organization's (WHO) recommended body weight based on BMI values for adults. It is used for both men and women, age 18 or older.

CategoryBMI range - kg/m2
Severe Thinness< 16
Moderate Thinness16 - 17
Mild Thinness17 - 18.5
Normal18.5 - 25
Overweight25 - 30
Obese Class I30 - 35
Obese Class II35 - 40
Obese Class III> 40

BMI Table for Children and Teens, Age 2-20

The Centers for Disease Control and Prevention (CDC) recommends BMI categorization for children and teens between age 2 and 20.

CategoryPercentile Range
Underweight<5%
Healthy weight5% - 85%
At risk of overweight85% - 95%
Overweight>95%

CDC GROWTH CHARTS

The Centers for Disease Control and Prevention (CDC) Age percentiles growth charts.

CDC CHARTS

Ponderal Index

Similar to BMI, the Ponderal Index (PI) is a measure of leanness of a person. It was also called Rohrer's index. Comparatively, the Ponderal Index is more even for different stature. Therefore, it was commonly used in pediatrics.

    PI = weight(kg)/height3(m3)         (Metric Units)

Friday, October 10, 2014

Normal Lab Values and Vital signs -- USMLE

USMLE Step 2 CS

Vital signs

Vital signs include your heart beat, breathing rate, temperature, and blood pressure. A healthcare provider will measure, or monitor your vital signs to determine your level of physical functioning. Note that the normal vital signs varies with age, sex, weight, exercise tolerance, and your overall health.
These are the normal vital sign ranges for a resting, average healthy adult
  • Blood pressure: 90/60 mm/Hg to 120/80 mm/Hg
  • Breathing: 12 - 18 breaths per minute
  • Pulse: 60 - 100 beats per minute
  • Temperature: 97.8 - 99.1 degrees Fahrenheit / average 98.6 degrees Fahrenheit

 

NORMAL LABORATORY VALUES


Normal Lab Values and Vital signs -- USMLE
REFERENCE RANGESI REFERENCE INTERVALS
BLOOD, PLASMA, SERUM
Alanine aminotransferase (ALT) 8-20 U/L8-20 U/L
Amylase, serum25-125 U/L25-125 U/L
Aspartate aminotransferase (AST) 8-20 U/L8-20 U/L
Bilirubin, serum (adult) Total // Direct0.1-1.0 mg/dL // 0.0-0.3 mg/dL 2-17 µ mol/L // 0-5 µ mol/L
Calcium, serum (Total)8.4-10.2 mg/dL2.1-2.8 mmol/L
Cholesterol, serum< 200 mg/dL< 5.2 mmol/L
Cortisol, serum 0800 h: 5-23 µ g/dL // 1600 h: 3-15 µ g/dL 138-635 nmol/L // 82-413 nmol/L
2000 h: ≤ 50% of 0800 h Fraction of 0800 h: ≤ 0.50
Creatine kinase, serum (at 30 ° C) ambulatory Male: 25-90 U/L25-90 U/L
Female: 10-70 U/L10-70 U/L
Creatinine, serum0.6-1.2 mg/dL 53-106 µ mol/L
Electrolytes, serum
Sodium135-145 mEq/L136-145 mmol/L
Chloride95-105 mEq/L95-105 mmol/L
Potassium3.5-5.0 mEq/L3.5-5.0 mmol/L
Bicarbonate22-28 mEq/L22-28 mmol/L
Magnesium1.5-2.0 mEq/L1.5-2.0 mmol/L
Estriol (E3) total, serum (in pregnancy)
24-28 wks // 32-36 wks30-170 ng/mL // 60-280 ng/mL104-590 // 208-970 nmol/L
28-32 wks // 36-40 wks40-220 ng/mL // 80-350 ng/mL140-760 // 280-1210 nmol/L
Ferritin, serumMale: 15-200 ng/mL 15-200 µ g/L
Female: 12-150 ng/mL 12-150 µ g/L
Follicle-stimulating hormone, serum/plasmaMale: 4-25 mIU/mL4-25 U/L
Female: -- premenopause 4-30 mIU/mL4-30 U/L
-- midcycle peak 10-90 mIU/mL10-90 U/L
--postmenopause 40-250 mIU/mL40-250 U/L
Gases, arterial blood (room air)
pH7.35-7.45 [H + ] 36-44 nmol/L
PCO 233-45 mm Hg4.4-5.9 kPa
PO 275-105 mm Hg10.0-14.0 kPa
Glucose, serumFasting: 70-110 mg/dL3.8-6.1 mmol / L
2-h postprandial: < 120 mg/dL< 6.6 mmol/L
Growth hormone - arginine stimulationFasting: < 5 ng/mL < 5 µ g/L
provocative stimuli: 7 ng/mL > 7 µ g/L
Immunoglobulins, serum
IgA76-390 mg/dL0.76-3.90 g/L
IgE0-380 IU/mL0-380 kIU/mL
IgG650-1500 mg/dL6.5-15 g/L
IgM40-345 mg/dL0.4-3.45 g/L
Iron 50-170 µ g/dL 9-30 µ mol/L
Lactate dehydrogenase, serum45-90 U/L45-90 U/L
Luteinizing hormone, serum/plasmaMale: 6-23 mIU/mL6-23 U/L
Female: --follicular phase 5-30 mIU/mL5-30 U/L
--midcycle 75-150 mIU/mL75-150 U/L
--postmenopause 30-200 mIU/mL30-200 U/L
Osmolality, serum275-295 mOsmol/kg275-295 mOsmol/kg
Parathyroid hormone, serum, N-terminal230-630 pg/mL230-630 ng/L
Phosphatase (alkaline), serum 20-70 U/L20-70 U/L
Phosphorus (inorganic), serum3.0-4.5 mg/dL1.0-1.5 mmol/L
Prolactin, serum (hPRL)< 20 ng/mL < 20 µ g/L
Proteins, serum
Total (recumbent)6.0-7.8 g/dL60-78 g/L
Albumin3.5-5.5 g/dL35-55 g/L
Globulins2.3-3.5 g/dL23-35 g/L
Thyroid-stimulating hormone, serum or plasma 0.5-5.0 µ U/mL 0.5-5.0 mU/L
Thyroidal iodine ( 123 I) uptake 8-30% of administered dose/24 h0.08-0.30/24 h
Thyroxine (T 4 ), serum 5-12 µ g/dL 64-155 nmol/L
Triglycerides, serum35-160 mg/dL0.4-1.81 mmol/L
Triiodothyronine (T 3 ), serum (RIA) 115-190 ng/dL1.8-2.9 nmol/L
Triiodothyronine (T 3 ) resin uptake 25-35%0.25-0.35
Urea nitrogen, serum (BUN)7-18 mg/dL1.2-3.0 mmol urea/L
Uric acid, serum3.0-8.2 mg/dL0.18-0.48 mmol/L
CEREBROSPINAL FLUID
Cell count 0-5 cells/mm 3 0-5 x 10 6 /L
Chloride118-132 mEq/L118-132 mmol/L
Gamma globulin3-12% total proteins0.03-0.12
Glucose40-70 mg/dL2.2-3.9 mmol/L
Pressure 70-180 mm H 2 O 70-180 mm H 2 O
Proteins, total< 40 mg/dL< 0.40 g/L
HEMATOLOGIC
Bleeding time2-7 minutes2-7 minutes
Erythrocyte count Male: 4.3-5.9 million/mm 3 4.3-5.9 x 10 12 /L
Female: 3.5-5.5 million/mm 3 3.5-5.5 x 10 12 /L
Erythrocyte sedimentation rate (Westergren)Male: 0-15 mm/h0-15 mm/h
Female: 0-20 mm/h0-20 mm/h
HematocritMale: 41-53%0.41-0.53
Female: 36-46%0.36-0.46
Hemoglobin A 1C≤ 6% ≤ 0.06%
Hemoglobin, bloodMale: 13.5-17.5 g/dL2.09-2.71 mmol/L
Female: 12.0-16.0 g/dL1.86-2.48 mmol/L
Hemoglobin, plasma1-4 mg/dL 0.16-0.62 µ mol/L
Leukocyte count and differential
Leukocyte count 4500-11,000/mm 3 4.5-11.0 x 10 9 /L
Segmented neutrophils54-62%0.54-0.62
Band forms3-5%0.03-0.05
Eosinophils1-3%0.01-0.03
Basophils0-0.75%0-0.0075
Lymphocytes25-33%0.25-0.33
Monocytes3-7%0.03-0.07
Mean corpuscular hemoglobin25.4-34.6 pg/cell0.39-0.54 fmol/cell
Mean corpuscular hemoglobin concentration31-36% Hb/cell4.81-5.58 mmol Hb/L
Mean corpuscular volume .80-100 µ m 380-100 fl
Partial thromboplastin time (activated)25-40 seconds25-40 seconds
Platelet count 150,000-400,000/mm 3 150-400 x 10 9 /L
Prothrombin time11-15 seconds11-15 seconds
Reticulocyte count0.5-1.5% of red cells0.005-0.015
Thrombin time< 2 seconds deviation from control< 2 seconds deviation from control
Volume
PlasmaMale: 25-43 mL/kg0.025-0.043 L/kg
Female: 28-45 mL/kg0.028-0.045 L/kg
Red cellMale: 20-36 mL/kg0.020-0.036 L/kg
Female: 19-31 mL/kg0.019-0.031 L/kg
SWEAT
Chloride0-35 mmol/L0-35 mmol/L
URINE
Calcium100-300 mg/24 h2.5-7.5 mmol/24 h
ChlorideVaries with intakeVaries with intake
Creatinine clearanceMale: 97-137 mL/min
Female: 88-128 mL/min
Estriol, total (in pregnancy)
30 wks6-18 mg/24 h 21-62 µ mol/24 h
35 wks9-28 mg/24 h 31-97 µ mol/24 h
40 wks13-42 mg/24 h 45-146 µ mol/24 h
17-HydroxycorticosteroidsMale: 3.0-10.0 mg/24 h 8.2-27.6 µ mol/24 h
Female: 2.0-8.0 mg/24 h 5.5-22.0 µ mol/24 h
17-Ketosteroids, totalMale: 8-20 mg/24 h 28-70 µ mol/24 h
Female: 6-15 mg/24 h 21-52 µ mol/24 h
Osmolality50-1400 mOsmol/kg
Oxalate 8-40 µ g/mL 90-445 µ mol/L
PotassiumVaries with dietVaries with diet
Proteins, total< 150 mg/24 h< 0.15 g/24 h
SodiumVaries with dietVaries with diet
Uric acidVaries with dietVaries with diet

USMLE Step 2 CS
Who actually elect the President of the United States, the Vice President, Senators, Governors, and the Congress? Find out the Answer Here and cross check your facts! !
 
 

Majority Wins

 

The Road to the White House and Becoming the POTUS

 
POTUS … President of the United States

Who are the true Electors? Find out Here!!

Tuesday, October 7, 2014

Family History

Family History

Family History by Dr. Esumei

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USMLE Step 2 CS EKG SIMPLIFIED USMLE Step 2 CS
Who actually elect the President of the United States, the Vice President, Senators, Governors, and the Congress? Find out the Answer Here and cross check your facts! !
 
 

Majority Wins

 

The Road to the White House and Becoming the POTUS

 
POTUS … President of the United States

Who are the true Electors? Find out Here!!
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Sunday, October 5, 2014

USMLE Step 2 CS Patient Note Practice

USMLE Step 2 CS Patient Note Entry Form


   Lines:/ Characters:/


   Lines:/ Characters:/

Diagnosis #1

History Finding(s)
Physical Exam Finding(s)

Diagnosis #2

History Finding(s)
Physical Exam Finding(s)

Diagnosis #3

History Finding(s)
Physical Exam Finding(s)

Diagnostic Study/Studies




Vital Signs

Temperature: 98.2°F (36.8°C)

Blood Pressure: 130/86 mm Hg

Heart Rate: 78/min

Respirations: 18/min

Instructions

  1. Obtain a history pertinent to this patient's problem.
  2. Perform a relevant physical examination (Do not perform a breast, pelvic/genital, corneal reflex, or rectal examination).
  3. Discuss your impressions and any initial plans with the patient.
  4. After leaving the room, complete your patient notes on the given form or computer.

Opening Scenario

Paul Ackers, a 56 years old male comes to the office complaining of fatigue.

USMLE Step 2 CS
Who actually elect the President of the United States, the Vice President, Senators, Governors, and the Congress? Find out the Answer Here and cross check your facts! !
 
 

Majority Wins

 

The Road to the White House and Becoming the POTUS

 
POTUS … President of the United States

Who are the true Electors? Find out Here!!