This lecture is based on National guidelines(Sri Lanka) and guidelines by NHS UK. all the materials used to prepare the lecture are trusted and high in quality. also the books referred are internationally recognized. both hyper and hypokalemia management included in the lecture. lecture is free and you can even download. i kept no copy rights. i appreciate your support, comments and suggestions. also i would be grateful if you can make these lectures popular. wishing your success.
PiCCO tidak hanya memberikan informasi tentang curah jantung (CO) tapi bisa memberi pengukuran untuk menilai preload, kontraktilitas, afterload, dan air paru ekstravaskular (ELWI)
Acupuntura vem como uma ferramenta para auxiliar o técnico na redução de sequelas de doenças degenerativas ou acidentais, onde o paciente torna-se incapaz...
This lecture is based on National guidelines(Sri Lanka) and guidelines by NHS UK. all the materials used to prepare the lecture are trusted and high in quality. also the books referred are internationally recognized. both hyper and hypokalemia management included in the lecture. lecture is free and you can even download. i kept no copy rights. i appreciate your support, comments and suggestions. also i would be grateful if you can make these lectures popular. wishing your success.
PiCCO tidak hanya memberikan informasi tentang curah jantung (CO) tapi bisa memberi pengukuran untuk menilai preload, kontraktilitas, afterload, dan air paru ekstravaskular (ELWI)
Acupuntura vem como uma ferramenta para auxiliar o técnico na redução de sequelas de doenças degenerativas ou acidentais, onde o paciente torna-se incapaz...
Apresentação da Vetpunctura acerca da Acupunctura em animais de companhia.
O objectivo é a compreensão do tratamento de acupunctura efectuada nos animais de companhia.
Iremos falar:
-o que é a acupunctura
- como funciona
- a história e actualidade da acupunctura em Portugal
- as indicações
- a duração do tratamento
- técnicas de acupunctura que poderão ser utilizadas
- quais os animais que podem ser tratados
E finalmente, iremos mostrar um filme de tratamentos pela vetpunctura onde demonstra que a acupunctura pode ser um momento relaxante.
Diabetes mellitus (DM) is a common, chronic, metabolic syndrome characterized by hyperglycemia as a cardinal biochemical feature. The major forms of diabetes are classified according to those caused by deficiency of insulin secretion due to pancreatic β-cell damage (type 1 DM, or T1DM) and those that are a consequence of insulin resistance occurring at the level of skeletal muscle, liver, and adipose tissue, with various degrees of β-cell impairment (type 2 DM, or T2DM). T1DM is the most common endocrine-metabolic disorder of childhood and adolescence, with important consequences for physical and emotional development. Individuals with T1DM confront serious lifestyle alterations that include an absolute daily requirement for exogenous insulin, the need to monitor their own glucose level, and the need to pay attention to dietary intake. Morbidity and mortality stem from acute metabolic derangements and from long-term complications (usually in adulthood) that affect small and large vessels resulting in retinopathy, nephropathy, neuropathy, ischemic heart disease, and arterial obstruction with gangrene of the extremities. The acute clinical manifestations are due to hypoinsulinemic hyperglycemic ketoacidosis. Autoimmune mechanisms are factors in the genesis of T1DM; the long-term complications are related to metabolic disturbances (hyperglycemia).
Type 1 Diabetes Mellitus
Formerly called insulin-dependent diabetes mellitus (IDDM) or juvenile diabetes, T1DM is characterized by low or absent levels of endogenously produced insulin and dependence on exogenous insulin to prevent development of ketoacidosis, an acute life-threatening complication of T1DM. The natural history includes 4 distinct stages: (1) preclinical β-cell autoimmunity with progressive defect of insulin secretion, (2) onset of clinical diabetes, (3) transient remission “honeymoon period,” and (4) established diabetes associated with acute and chronic complications and decreased life expectancy. The onset occurs predominantly in childhood, with median age of 7-15 yr, but it may present at any age. The incidence of T1DM has steadily increased in many parts of the world, including Europe and the USA. T1DM is characterized by autoimmune destruction of pancreatic islet β cells. Both genetic susceptibility and environmental factors contribute to the pathogenesis. Susceptibility to T1DM is genetically controlled by alleles of the major histocompatibility complex (MHC) class II genes expressing human leukocyte antigens (HLAs). It is also associated with autoantibodies to islet cell cytoplasm (ICA), insulin (IAA), antibodies to glutamic acid decarboxylase (GADA or GAD65), and ICA512 (IA2). T1DM is associated with other autoimmune diseases such as thyroiditis, celiac disease, multiple sclerosis, and Addison disease. There is some suggestion that high dietary intake of omega-3 polyunsaturated fatty acids and vitamin D supplementation in early childhood decreases the incidence of autoi
This slide was first presented during the Malaysian 1st Emergency Medicine Annual Scientific Meeting, in conjunction with the Academy of Medicine Malaysia, Academy of Medicine Singapore and the Academy of Medicine Hong Kong Tripartite Meeting in Aug 2016.
Suatu karya besar dari ahli bedah digestif , Profesor Graham L. Hill. Buku ini berisi pedoman-pedoman untuk memahami dukungan nutrisi dan metabolik pada pasien bedah dan rawat krtisi.
Handbook of parenteral fluid & nutrition therapy current literature reviewDr Iyan Darmawan
This handbook covers the four types of parenteral fluid therapy, namely resuscitation fluid therapy, repair fluid therapy, maintenance fluid therapy and parenteral nutrition therapy. Although we have tried to discuss many aspects of parenteral fluid therapy which have been compiled by medical advisors of the Leader in Infusion Therapy with many years of experience in the related scientific activities and medical writing, this handbook is still far from completeness and perfection and we look forward to receiving your feedback and criticism.
The rationale of intradialytic amino acid supplementationDr Iyan Darmawan
Balanced Amino Acids. EAA/NEAA ratio 2.6 is required to prevent hyperammonemia
Replaces amino acid loss during dialysis
High BCAA to improve the amino acid profile
IDPN containing protein,CHO dan Lipid should not routinely used...but the administration of Balanced AA alone is justified
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
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These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
9. Case 1
• A 12 year old patient with DHF. Nausea and
vomiting (+)
• PE : restless;T 100/80 T 37.5 oC HR 120 x/min,
RR 28 /min; cold extremities. Torniquet test(+).
Height 120 cm Weight 50 kg
• Lab: Hct 48%; Platelet 70.000
How is the fluid regimen for this patient?
Answer: Grade 3 DHF requiring 5-10 ml/kg ideal BW /hour and monitor
12. A 15 kg postop patient with Na+ 97 mEq/L,. PE:
Stuporous and convulsion.
How much is Na+ deficit in this patient, if we need to correct it
until 125 mEq/L?
How will you correct hyponatremia ini this? ; what is the
administration rate of 3% NaCl?
Case 2
13. A 15 kg postop patient with Na+ 97 mEq/L,. PE:
Stuporous and convulsion.
How much is Na+ deficit in this patient, if we need to correct it
until 125 mEq/L?
How will you correct hyponatremia ini this? ; what is the
administration rate of 3% NaCl?
Case 2
60% BB x (125-97) = 252 mEq
Infusate Na+– Serum Na+
Total body water + 1
(513-97) : (9+1) = 41.6mE/L
We will raise 1 mmol/L hourly for
5 hours
The amount of 3% NaCl 3% required= 5 : 41.6 = 0.120 L = 120 ml or 24 ml/hour
Observe clinical condition and check serum Na+ after 5 hours.. Reduce rate if there is
improvement, eg 0.5 mmol/L/hour until Na+ 115.
Adrogue, HJ; and Madias, NE. Primary Care: Hyponatremia. New England Journal of Medicine 2000; 342(21):1581-1589
Adrogue, HJ; and Madias, NE. Primary Care: Hypernatremia. New England Journal of Medicine 2000; 342(20):1493-1499.
14. Case 3
A 9 year old 20 kg patient with dehydration and shock (acute GE),
has been resuscitated with Acetated Ringer’s ( Asering) for 5 hours
along with separate line of 8.4% Meylon diluted in D5. Patient was
then unconscious with seizures.
BP 110/75; HR 90/min ; RR 16/min; T 37oC
Na+ 175 mmol/L; K+ 2.1 mmol/L
You wish to correct the hypernatremia and hypokalemia simultaneously with infusion sol
containing 30 mmol/L Na+ (KAEN 4A) plus 20 mmol KCl.
You set a target of Na+ decrease to 165 mmol/L over 10 hours. What is the rate of infusion
you will set up?
Adrogue, HJ; and Madias, NE. Primary Care: Hyponatremia. New England Journal of Medicine 2000; 342(21):1581-1589
Adrogue, HJ; and Madias, NE. Primary Care: Hypernatremia. New England Journal of Medicine 2000; 342(20):1493-1499.
15. A 9 year old 20 kg patient with dehydration and
shock (acute GE), has been resuscitated with
Acetated Ringer’s ( Asering) for 5 hours along with
separate line of 8.4% Meylon diluted in D5. Patient
was then unconscious with seizures.
BP 110/75; HR 90/min ; RR 16/min; T 37oC
Na+ 175 mmol/L; K+ 2.1 mmol/L
You wish to correct the hypernatremia and hypokalemia
simultaneously with infusion sol
containing 30 mmol/L Na+ (KAEN 4A) plus 20 mmol KCl.
You set a target of Na+ decrease to 165
mmol/L over 10 hours. What is the rate of
infusion you will set up?
(Infusate Na+ + K+ ) – serum Na+
Total body water + 1
= (30 + 20) – 175
(60% x 20) + 1
= -125
13
= - 9.6 mmol/L
This means 1 L infusion will decrease the
serum Na+ serum by 9.6 mmol/L
Reuired amount of infusion = 5: 9.61 =
0.520 L = 520 ml
over 10 hr give 520 ml, at the rate of 52
ml/hr.
Correction rate can be repeated for
subsequent 10-14 hours
16. A 62 year old patient was admitted because of malaise and fatigue after
nausea and vomiting for 5 days. Lack of eating and drinking due to anorexia.
History of hypertension and taking medication: Tenormin 50 mg, Aspirin 75
mg HCT 25 mg, Lisinopril 40 mg per day
PE : Alert, pale, moderate dehydration, BP 170/105.
Cor: extrasystole +, lung NA, hepatomegaly –
Lab:
Chest X-ray : LVH.
ECG : u wave & flattened T
Case 4
145
2.6 NA
25
1.0
70
135-145
3.5-5
98-106
23-28
8-20
0.7-1.3
70-105 (fasting)
98
How will you correct the hypokalemia in this patient
17. Hypokalemia( > 2.5 - <3.5 mEq/L )
Heart /cardiovascular disease?
No Yes
Give K+ according to
maintenance requirement
40 mmol
Correction K+ 40 mmol +
Maintenance 40 mmol
18. Hypokalemia ( > 2.5-3.4 mEq/L )
Without cardiovascular disease
* In case of fluid restrition : admix 10 mmol KCL into
1 bag of KAEN 3B, to get final conc of 20 mmol/500 ml.
40 mmol K+ per day
With cardiovascular disease (digitalis, diuretics)
80 mmol K+ per day
20. How about life-threatening Hypokalemia?
Serum K+ < 2 mmol/L
– Alkalosis
– Arrhythmia
– Respiratory paralysis
– rhabdomyolisis
21. Hypokalemia( < 2 mEq/L )
OTSU
NS
20 20 20
KCl 40 ml
+
20
over 1 hour
via central
vein
22. A 62 year old patient was admitted because of malaise and fatigue after
nausea and vomiting for 5 days. Lack of eating and drinking due to anorexia.
History of hypertension and taking medication: Tenormin 50 mg, Aspirin 75
mg HCT 25 mg, Lisinopril 40 mg per day
PE : Alert, pale, moderate dehydration, BP 170/105.
Cor: extrasystole +, lung NA, hepatomegaly –
Lab:
Chest X-ray : LVH.
ECG : u wave & flattened T
Case 4
145
2.6 NA
25
1.0
70
135-145
3.5-5
98-106
23-28
8-20
0.7-1.3
70-105 (fasting)
98
How will you correct the hypokalemia in this patient
30. COPD Height 170 cm Weight 45 kg
• What is the the total calories and protein
requirement?
Ideal BW = ( Hight – 100) x 90% = 63 kg
Adjusted body weight = (Actual BW – Ideal BW)
2
+ Ideal BW
45 - 63
2
+ 63 = 54 kg
25 kcal/kg BW and 1 g protein/kg BW
Case 8
31. Sepsis Height 160 cm Weight 80 kg
• What is the the total calories and protein
requirement?
Ideal BW= ( TB – 100) x 90% = 54 kg
Adjusted body weight = (Actual BW – Ideal BW)
2
+ Ideal BW
80 - 54
2
+ 54 = 67 kg
25 kcal/kg BW and 1.5 g protein/kg BW
Case 9
32. 60% 20% 20%
TOTAL CALORIES
(25 kcal/kg/day)
GLUCOSE LIPID PROTEIN
Average Patient
33. 60% 20% 20%
TOTAL CALORIES
(1500 kcal)
GLUCOSE LIPID PROTEIN
900 kcal
30 g
300 kcal 300 kcal
225 g 75 g
Average Patient
34. 40% 20%
TOTAL CALORIES
(1500 kcal)
GLUCOSE LIPID PROTEIN
600 kcal
60 g
600 kcal 300 kcal
150 g 75 g
40%
COPD Patient