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Internal Medicine | Medical (MD/DO) School Study Aid


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Calculations & Formulae
8 Picmonics to Learn | 14 mins

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Winter's Formula
Evaluates Respiratory Compensation
Used in Metabolic Acidosis
Equation
(HCO3 x 1.5 ) + 8 plus-minus 2 = PCO2
Steps
Bicarbonate (HCO3) x 1.5
+ 8
± 2
= Expected Value for PCO2
1 min
TIMI Score (Thrombolysis In Myocardial Infarction)
Use
Mortality Predictor
Unstable Angina or NSTEMI
2 Week Risk of Death and Ischemic Events
AMERICA (Each is +1)
Age Greater or Equal to 65
Markers Elevated
EKG ST Changes (Greater or Equal to 0.5mm)
Risk Factors for CAD (Coronary Artery Disease)
Ischemia (2 Anginal Events in 24 Hours)
Coronary Artery Disease (CAD)
Aspirin Use in the Last 7 Days
3 mins
CHA2DS2-VASc for Stroke Risk in Atrial Fibrillation
CHF (+1)
Hypertension (+1)
Age 75 + (+2)
Diabetes (+1)
Stroke or TIA or Thromboembolism History (+2)
Vascular Disease (+1)
Age 65-75 Years (+1)
Sex Female (+1)
Interpretation
0 = No Anticoagulation
1 = Consider Anticoagulation
2 = Anticoagulation
3 mins
Calcium Correction for Hypoalbuminemia
0.8 * (Normal Albumin - Patient Albumin) + Calcium
Steps
Multiply * 0.8
Subtract (Normal Albumin - Patient Albumin)
Add Calcium
1 min
Corrected Na+ for Hyperglycemia
Equation
[(Glucose-100) * 0.016 ] + Na+
Steps
Glucose-100
Multiply * 0.016
Add Na+
1 min
Physiologic Dead Space (VD)
Tidal Volume (VT)
Partial pressure of arterial CO2 (PaCO2)
Partial pressure of CO2 in expired air (PECO2)
VD = TV x (PaCO2-PECO2) / PaCO2
2 mins
A-a Gradient
Partial pressure of alveolar oxygen (PAO2)
Partial Pressure of Arterial O2 (PaO2)
Normal 10 to 15 mmHg
Hypoxemia with an Abnormal A-a Gradient
Diffusion problem
Shunting (Low V/Q)
Dead space (high V/Q)
1 min
Alveolar Gas Equation
Equation
Partial Pressure of Alveolar Oxygen (PAO2)
Partial Pressure of Oxygen in the Inspired Air (PIO2)
PIO2 Normally Approximated = 150 mmHg
Arterial Partial Pressure of CO2 (PaCO2)
Respiratory Quotient (R)
R Normally Approximated = 0.8
PAO2 = PIO2 - (PaCO2/R)
1 min

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