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CardioResp > (2) ICU Pathology > Flashcards

(2) ICU Pathology Flashcards

1
Q

What is sepsis?

A
  • life threatening caused by the bodies response to infection
  • begins when immune system turns on itself
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2
Q

Systemic Inflammatory Response Syndrome (SIRS) is 2 of the following:

A
  • Temp >38 degrees or <36
  • HR >90bpm
  • WCC >11
  • RR >20 bpm & PaCO2 <4.3
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3
Q

How is sepsis diagnosed?

A

2 SIRS + confirmed/suspected infection

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4
Q

How is severe sepsis diagnosed?

A
  • Sepsis + signs of organ failure
  • Hypotension
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5
Q

How is septic shock diagnosed?

A
  • Sepsis + persistent organ damage
  • Hypotension
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6
Q

What are the 6 stages of septic shock?

A
  1. Inadequate tissue perfusion
  2. Anaerobic metabolism
  3. Lactic acidosis
  4. Metabolic acidosis
  5. Cellular damage
  6. Organ failure
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7
Q

What are the clinical signs or septic shock?

A
  • fever/hypothermia
  • unexplained tachycardia
  • peripheral vasodilation
  • unexplained shock
  • changes mental state
  • SOB & hypotension
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8
Q

What is haemodynamics?

A

the study of blood flow

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9
Q

What is thrombocytopenia?

A

abnormally low platelets observed

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10
Q

What is in the 1 hour bundle for a patient in septic shock?

A
  • measure lactate levels
  • obtain blood cultures
  • administer antibodies
  • administer crystalloid
  • apply vasopressors
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11
Q

What is Acute Respiratory Distress Syndrome?

A
  • aka leaky lung syndrome
  • inflammation & increased permeability of alveolar capillary membrane
  • severe resp distress & hypoxemia
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12
Q

What is the PaO2/FiO2 ratio in someone with ARDS?

A

<25Kpa

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13
Q

What happens during the exudative phase of ARDS?

A
  • weight of alveoli increase
  • become soggy & full liquid
  • 30% chance pneumothorax
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14
Q

What are the 3 phases of ARDS?

A
  1. Exudative
  2. Proliferative
  3. Fibrotic
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15
Q

What happens during the proliferative phase of ARDS?

A
  • compression atelectasis
  • less surface area gas exchange
  • lungs produce granulation tissue
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16
Q

What happens during the fibrotic phase of ARDS?

A
  • end stage, lung develops scarring
  • not enough O2
  • 87% chance pneumothorax
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17
Q

What is the P/F ratio?

A

arterial O2 partial pressure to fractional inspired O2

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18
Q

What are direct causes of ARDS?

A
  • O2 toxicity
  • pneumonia
  • aspiration
  • chest trauma
  • burns
  • smoking
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19
Q

What are indirect causes of ARDS?

A
  • shock
  • sepsis
  • cardiopulmonary bypass
  • drugs
  • multiple transfusions
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20
Q

What are signs of ARDS?

A
  • acute onset
  • increased WOB & tachypnoea
  • tachycardia
  • PaO2/FiO2 <25
  • Peak airway pressure <18mmHg
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21
Q

What is seen on a CXr in ARDS?

A
  • silhouette sign
  • diaphragm & ribs difficult to see
  • not a lot air in lungs
22
Q

What is the medical treatment for ARDS?

A
  • Mechanical ventilation with high PEEP
  • monitor intravascular volume
  • prone positioning
  • Extracorpeal life sport (ELS)
23
Q

What are complications for treatment in ARDS?

A
  • organ failure
  • pulmonary fibrosis
  • ventilator pneumonia
  • pneumothorax
24
Q

What is the function of the kidneys?

A
  • remove waste & drugs
  • BP regulation
  • red blood cell production
  • produce vit D
  • fluid balance
25
Q

How does kidney failure occur?

A

fail response to hypotension, hypoxia, multiple organ failure

26
Q

What does dialysis help with?

A

helps body remove extra fluid and waste from the body

27
Q

What is the normal amount of urine output?

A

1ml/kg/hr

28
Q

What are causes of acute renal failure?

A
  • blood loss
  • severe burns
  • kidney stone
  • multi organ failure
29
Q

What are causes of Chronic renal failure?

A
  • diabetes
  • anything blocks drainage
  • intrinsic renal disease
30
Q

What is erythropoietin?

A

red blood cell production in bone marrow

31
Q

What are signs of renal failure?

A
  • metabolic acidosis
  • tachypnoea & hyperventilation as they look to compensate
  • uraemia
  • hypertension
  • fluid retention
32
Q

What should be present in a kidney function test?

A

urea and creatine

33
Q

What are risks with dialysis?

A
  • infection
  • hypotension
  • hypoxemia
34
Q

What are the functions of the liver?

A
  • production bile & proteins
  • regulating blood levels & clotting
  • clear blood drugs
  • conversion glucose to glycogen
35
Q

What happens as a result of acute failure?

A

Multiple organ failure

36
Q

What are resp burns?

A

thermal damage by inhalation of hot gas

37
Q

What causes resp burns?

A
  • bronchospasm
  • pulm oedema
  • ulceration
  • lung tissue burns
  • infection
38
Q

What are implications of resp burns for a physio?

A
  • secretion clearance
  • humidification
  • maintain LV
  • postural drainage contraindicated if oedema near head
39
Q

What are signs of a head injury?

A
  • reduced GCS
  • pupils unreactive light
  • change pupil size, muscle tone & vitals
  • vomiting
40
Q

What increases intracranial pressure?

A
  • high paCO2
  • low PaO2
  • hypertension
  • tachycardia
  • fluid overload
  • head down
41
Q

What is the management for a head injury?

A
  • ventilation
  • protect airways
  • monitor vitals
  • head elevation and neck alignment
42
Q

What are the two reasons of a heart and lung transplant?

A
  • improve survival from disease
  • improve QOL
43
Q

What is the physio tx post transplant?

A
  • secretion
  • ROM
  • weaning from FiO2
  • mobility
  • transfers
  • ADLs
44
Q

How does multiorgan failure occur?

A
  • direct insult or SIRS
  • hypoperfusion and reperfusion
45
Q

What is the physio role in MOF?

A
  • supportive
  • limb care
  • myopathies
46
Q

What is the medical management of MOF?

A
  • treat sepsis focus
  • restore homeostasis and pH
  • nutrition & fluid
47
Q

What is mechanical ventilation?

A

technique in which gas moved towards and from lungs through external device connected directly to patient

48
Q

What are indications for mechanical ventilations (6)?

A
  • inadequate gas exchange
  • trend failing ventilation
  • resp failure
  • supplemental O2 not adequate
  • decreased neuromuscular function
  • disorder alveoli/airways
49
Q

How is the mechanical ventilation delivered?

A
  • endotracheal tube
  • tracheostomy
50
Q

What are the 3 different ventilator modes?

A
  • controlled mechanical ventilation
  • synchronised intermittent mandatory ventilation (SIMV)
  • pressure support (PS)
51
Q

How does PS work?

A
  • patient triggers each breath
  • maintains pre selected pressure
52
Q

How does SIMV work?

A
  • support patients breath to set pressure
  • if patient does not breathe, ventilator triggers breath

CardioResp (9 decks)

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