Equations
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Pharmacokinetics and pharmacology
Plasma concentration
- Concentration = Dose/Volume of distribution
- Loading dose = volume of distribution x desired concentration
- Infusion rate = desired concentration x clearance
Rate of elimination and half life
- Rate of elimination = Css x clearance
- Half life = 0.693 x Volume of distribution/Clearance
- Half life = 0.693/Ke
- τ =1/Ke
- τ =Vd/Cl
- Ke = Clearance/Vd
Css = steady state concentration
Ke = elimination rate constant
Explanation here
Clearance
- Clearance = Ke x Volume of distribution
- Clearance = Urine concentration x urinary flow/plasma concentration
- Clearance = Dose/AUC
Caudal block dose
- Lumbosacral block - 0.5 ml/kg
- Thoracolumbar block - 1 ml/kg
- Midthoracic block - 1.25 ml/kg
This is for 0.25% bupivacaine.
Steroid equivalence
The following are all equivalent doses
- Methylprednisolone - 4mg
- Prednisolone - 5mg
- Hydrocortisone - 20mg
- Cortisone - 25 mg
Physics
Ohm's law
- Volts = Current x Resistance
Power, charge and energy
- Charge = Voltage x capacitance
- Power = Current x Voltage
- Power = Energy/Time
- Volts = Energy/Charge
- Energy = Charge x voltage/2
- Energy = (Capacitance x voltage^2) /2
- Energy = Mass x specific heat capacity x temperature
Resistance
For a series circuit
- Total resistance = R1 + R2 + ... + Rn
For a parallel circuit
- 1/Total resistance = 1/R1 + 1/R2 + ... + 1/Rn
Force, energy and pressure
- Energy = Force x distance
- Energy = pressure x volume
- Force = mass x acceleration
- Kinetic energy = 0.5 x mass x velocity^2
- Potential energy = mass x gravitational acceleration x height
Hagen Pouiselle
- Q = πΔPr4/8ɳl
Q = Flow, ΔP - change in pressure, ɳ - viscosity, l - length of tube
Turbulent flow
Re = pvD/ɳ
p - density, D - diameter of tube, ɳ - viscosity
Turbulent flow is more affected by density
Laminar flow is more affected by viscosity
Doppler equation
- Fd= 2FtVCos θ / C
Ft -transmitted Doppler frequency, V i- speed of blood flow, Cos θ - Cosine of the blood flow to beam angle, C - speed of sound in tissue
Pressure equivalence
The following are all the same:
- 101 kPa
- 1 atm
- 760 mmHg
- 1033 cmH2O
- 101 325 N/M^2
- 101 325 Dynes/cm^2
- 14.4 PSI
Gas laws
Universal gas law
- PV = nRT
Boyle's law
- V1P1 = V2P2 at a given temperature
Charles' law
- V is proportional to T for a given pressure
Gay-Lussac's law
- P is proportional to T for any given volume
Dalton's law
- Total pressure = sum of all the partial pressures
Fick's law of diffusion
- Volume of gas is proportional to (Area/Thickness) x diffusion constant x pressure gradient
- Diffusion constant is proportional to gas solubility/√molecular weight
More here
Cardiovascular physiology
Cardiac output and blood pressure
- Cardiac output = Stroke volume x Heart rate
- Blood pressure = Cardiac output x Systemic vascular resistance
- Mean arterial pressure = diastolic + (systolic - diastolic)/3
- Systemic vascular resistnace = (MAP - CVP/CO) x 80
- Pulmonary vascular resistance = (MPAP-PAWP/CO) x 80
Oxygen transport
- Oxygen content = cardiac output x (Hb x SaO2 x 1.34) + (0.02 x PaO2)
- Saturations = HbO2 x 100%/Hb + HbO2
Laplace law
- The pressure inside a sphere is proportional to the surface tension in the wall
- The pressure inside a sphere is inversely proportional to the radius of the sphere
- Wall stress is the wall tension divided by 2 times the wall thickness
- P = 2 x Surface Tension /radius
Shock index
- SI = HR/SBP
>0.9 is suggestive of circulatory failure
Respiratory physiology
Dead space
- Physiological dead space = anatomical + alveolar
Explanations here
Resistance and compliance
- Total airway resistance = airway resistance + tissue resistance
- Compliance = Δ volume/ Δ pressure
- 1/total compliance = 1/lung compliance + 1/thoracic wall compliance
Venturi
- Delivered FiO2 = (O2 flow rate + (0.21 x air flow rate))/Total flow rate
The air flow rate can be calculated from the entrainment ratio
Bohr Equation
- VD/VT = PaCO2 - PeCO2/PaCO2
Explanation here
Shunt Equation
- QS/QT = CCO2 - CaO2/ CCO2 – CvO2
Explanation here
Alveolar gas equation
- PAO2 = FiO2 x (PATM – PH20) – PACO2/RQ
Explanation here
Metabolic physiology
Henderson-Hasselbalch equation and acid/base
- pH = pKₐ + log([A⁻]/[HA])
- pH = -log10 [H+]
For an acid:
- pH = pKa + log[A-/HA]
For a base:
- pH = pKa + log[B/BA+]
More acid base stuff here
Metabolic equivalent of task
- 1 MET = 3.5 ml O2/kg/min
Explanation here
Anion Gap
- [Na+ + K+] - [Cl- + HCO3-]
Explanation here
Serum osmolality
- (2x[Na+]) + [Glu] + [Urea]
- Osmolality = per kg, osmolarity = per litre
- Normally 275 - 290 mOsmol/kg
- Normal urine osmolality = 500 - 850 mOsm/kg
Fluids and stuff here
Corrected sodium
- Corrected Na =Measured Na +2.4 x Glucose/100
Neurophysiology
Cerebral perfusion pressure
- CPP = MAP - (ICP + CVP)
Explanation here
Intracranial pressure
- ICP∝Brain Volume+CSF Volume+Blood Volume
where:
- Compensation: If one increases, the others must decrease to maintain normal ICP.
- Decompensation: Once compensation fails, ICP rises steeply.
CSF production
- CSF Production ≈ 0.3−0.4 mL/min ≈ 500 mL/day
Cerebral blood flow
- CBF=CPP/CVR
where CVR = Cerebrovascular Resistance
- Normal CBF = 50 mL/100g/min
- CBF is autoregulated between a MAP of 50–150 mmHg
Cerebral oxygen consumption
- CMRO₂=CBF×(CaO₂−CjvO₂)
where:
- CaO2 = arterial oxygen content
- CjvO2 = jugular venous oxygen content
Nernst equation
- Ex = RT/zF x ln([X]extracellular/[X]intracellular)
where:
- Ex = equilibrium potential for an ion
- R = universal gas constant
- T = temperature in Kelvin
- z = charge of the ion
- F = Faraday’s constant
Paediatrics
WETFLAG
- Weight = (age+4) x 2
- Energy = 4 J/kg
- Tube = (age/4) + 4
- Fluids = 10ml/kg
- Lorazepam = 0.1mg/kg
- Adrenaline = 0.1ml/kg of 1:10 000 (1mg in 10ml)
- Glucose = 2mls/kg 10% dextrose
Atropine = 20mcg/kg
Fluid resuscitation
- Maintenance=4 mL/kg/hr (first 10 kg)+2 mL/kg/hr (next 10 kg)+1 mL/kg/hr (>20 kg)
Statistics
Sensitivity and Specificity
Sensitivity = Likelihood of detecting a true case of the disease
- true positive/(true positive + false negative)
Specificity = Likelihood of testing negative if you don't have the disease
- true negative/(true negative + false positive)
Positive predictive value = Likelihood you actually have it if test positive
- true positive/(true positive + false positive)
Negative predictive value = Likelihood that a negative test means you don't have the disease
- true negative/(true negative + false negative)
Odds and relative risk
When presented with a 2 x 2 table
Odds ratio = (a/b)/(c/d)
Relative risk = (a/(a + b))/(c/(c + d))
Absolute risk reduction = (c/(c + d)) - (c/(c + b))
Number needed to treat = 1/ARR
Let us know what we've missed and we'll add it in!