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7 Factors that Shift the Oxygen-Hb Dissociation Curve to the Left

MetHb
COHb
Fetal Hb
Decreased temp
Decreased 2,3-DPG
Decreased elevation
Decreased [H+]

4 Factors that Shift the Oxygen-Hb Dissociation Curve to the Right

Increased temp
Increased 2,3-DPG
Increased elevation
Increased [H+]

Amount of Desaturated Hb to Manifest Cyanosis

>40-50 g/L of desaturated Hb

Differential of Clubbing of Nails (9)

Idiopathic
Hereditary
Cyanotic heart disease
COPD
CF
Infective endocarditis
Cirrhosis
Crohn's
Regional enteritis

Differential Diagnosis of Cyanosis (9)

PERIPHERAL
-Shock
-Cold exposure
-Arterial obstruction (thrombosis, embolism, vasospasm)
CENTRAL
-Decreased FIO2 (high altitude)
-Hypoventilation (opioid overdose)
-VQ mismatch (PE, ARDS)
-R to L shunt (atelectasis)
-Diffusion impairment (pulmonary fibrosis)
-Abnormal Hb (MetHb, COHb)

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