20 cards Flashcards
Mechanism behind lithium causing diabetes insipidus
Lithium enters principal cells of collecting ducts –> decrease adenyl cylase activity –> decrease CAMP –> decrease aquaporin & insertion
Mechanism behind lithium causing hypernatremia
XS free water loss –> plasms sodium concentration
Usually thirst and water intake compensate but if not, then increase sodium
Common meds causing hypernatremia
Lithium
mannitol
loop diuretics
Which blood gas abnormailty does PE cause
resp alkalosis
Features of CCB toxicity
Profound bradycardia, hypotension
Features of oxycodone overdose
resp depression
pinpoint pupils
decreased consciousness
Features of temazepam overdose
CNS depression
Indicators of airway compromise requiring early intubation in burns pts:
Voice changes, facial burns, singed hair, smoke exposure in an enclosed space
Expected Na+ levels in shock
Hypernatremia
Expected k+ levels in shock
Hyperkalemia due to renal dysfunction, acidosis
Expected Cr levels in shock
Markedly increased - AKI due to hypoperfusion
Types of transfusion reactions
Immune mediated, acute (<24 hrs): acute hemolytic transfusion reaction, mild allergic transfusion reaction, tranfusion related lung injury, febrile non hemolytic transfusion reaction
Immune mediated, non acute (>24 hours): delayed hemolytic transfusion reaction, transfusion associated graft vs host disease
Non immune mediated, acute: transfusion associated circulatory overload, transfusion transmitted bacterial sepsis
Management of AF in hemodynamically stable patients
IV metoprolol
Management of AF in hemdynamically unstable patient
IV amiodarone
Expected HR in acute MI involving the inferior wall
Bradycardia
What ppx should be given to patients with TBI
Seizure ppx- leviteracetam or phenytoin for 7 days
Management of VT
IV magnesium sulphate
ECG leads and territories
Septal - v1, v2 - prox LAD
Anterior - v3, v4 - distal LAD
Lateral - V5, V6, avL, 1 - Left circumflex, distal LAD, L cx or RCA
Inferior - 2, 3, avF, avR - 90% RCA, 10% L circumflex
Define pulmonary HTN
Mean pulmonary artery pressure > 20 mmhg at rest
Classifications of pulmonary HTN
1- Pulmonary arterial HTN
2- Secondary to L sided heart disease
3- secondary to pulmonary disease or hypoxia
4- secondary to chronic thromboemolism
5- unclear, multifactorial
Treatment of pulmonary HTN acc to group/ classifcaition
1- epoprostenol for vasodilation and bosentan to inhibit pulmonary vasocontriction
2- frusemide
3- inhalers, o2, PDE5 inhibitors
4- lifelong warfarin, surg management, balloon pulmonary angioplasty
