Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

issues and policy > AACN > Flashcards

AACN Flashcards

1
Q

Anterior/Septal leads LAD

A

V1-4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Inferior leads L circ or RCA

A

II III or AVF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Anterior wall MI complications

A

VSD, LEFT HEART failure, acute MITRAL regurg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Most likely etiology of aortic valve disease over vs under 70

A

over is calcified aortic stenosis

under is congenital bicuspid aortic valve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Rheumatic fever and valves

A

most likely mitral vale

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Mitral valve murmur

A

regurg of blood from Left ventricle to left atria for the entire systolic time(HOLOSYSTOLIC murmur) described as blowing and associated with S3 gallop

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

non mitral causes of holosystolic murmurs

A

VSD, Tricuspid regurg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

SYSTOLIC EJECTION murmur with click

A

aortic stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

HYPERTROPHIC CARDIOMYOPATHY
ECG
MURMUR
SYMPTOM

A

SYNCOPY
ECG: Biphasic P in V1 and V2, deep narrow Q waves in 1, AVL, V5 and V6
MURMUR: non-radiating systolic

usually found in young adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Hypertensive encephalopathy for hypertensive emergency:

A

HE: blurred vision associated with profound HTN

reduce slowly like 20% in the first 1-2 hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

First steps in MI

A

NITRO, MORPHENE, antiplatelet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

A-fib in COPD post coronary revascularization or CABG

A

goal is rate control: Dilt, cardizem
NO AMIODORONE because of risk of pulmonary fibrosis, (worse in old, long term use, and COPD)
NO BB because of bronchospasm- metoprolol is caridioselective but still

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

pericarditis

A

sharp CP worse on INSPIRATION
Diffuse ECG changes
pericardial friction RUB, muffled heart tones, and HYPOtension, maybe low temp

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Costocondritis pain

A

reproducable by appling pressure to chest,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

GERD sx

A

coorelate with eating or lying down

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

PULM edema
card causes
non card causes
Clinical presentation

A

CC: Heart failure,
mitral STENOSIS
non card: infection, aspiration and ARDS

CP: dyspnea
parox nocturnal dyps
wheezing
frothy sputum
cephalization 
effusions
Kerley B
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Pleurisy pleuritis

CP

A

worse on inspiration and no cough

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Tamponade triad

A

muffled heart sounds, jugular venous distension, hypotension

narrowing pulse pressure
radial and brachial pulses may be weak or absent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

HTN refractory to multiple meds think

A

pheocromocytoma: prolonged catecholane excess

or renal artery stenosis
OSA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

pheocromocytoma DX

A

TSH is normal
Pasma free metanephrines

normetanephrine: over 2.5
metanehrine ove 1.4

24 hr urine to look for urine CATECHOLAMINES

TX with ALPHA adrenergic: phentolamine, (regitine) or phenoxbenzamine(dibenzyline)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

valve disorder most associated with aortic aneurysm

A

associated with poorly controlled HTN, Ascending aneurysm can widen the aortic base and lead to regurg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

S4 gallop

A

AS from narrowing of valve outflow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

opening snap

A

mitral valve prolapse or regurg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

antiplatlet pre cath

A

plavix 300 then 75 daily

asa 81-325

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

ADHF causes

A 
change in diet 
(reversible) 
not taking meds 
dysthrymias
anemia
systemic infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

normal CVP

A

0-6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

normal PAP

A

15-25sys /5-15dias )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

PCWP

A

LVEDP

6-12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

ISCHEMIC cardiomyopathy (in addition to ICD

A

antiplatelet and BBto reduce morbid and mortality but dont directly reduce the risk of sudden cardiac death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

HTN urgency reduction schedule

A

10-20 in hr 1

5-15 in next 23

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Constrictive pericarditis and restrictive cardiomypathy dx

A

cardiac MRI
CT or eccho

restrictive cardiomyopathy -
calcium deposits on pericardium
endomyocardial biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

bypass common complications

A

kidney dysfunction
throbocytopenia
systemic inflammatory response among other s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

mechinical circulatory support indications

A

stabilization of cardiogenic shock with mechanical complication

mitral regurgitaiton
ventricular septal defect or free wall rupture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Lovenox and nstemi in the old

A

renally cleared and shuld be dose adusted based on creat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Angina therapies

A

BB< statin, and and ASA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

supplemental 02 below

A

90

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

hyperoxia remote risk

A

vasoconstriction worsoning cardiac ischemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

secondary causes of dyslipidemia

A

hypothyroidism
DM
nephrotic syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

ischemic stroke HOB

A

less than 30 for 24 hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

dialated left ventricle HF

A

heart failure with reduced EF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

HFpEF mngmt

A

B control and diuresis but no therapy yet reduces morbidity and mortality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

cardiogenic shock

A

epi
mirlinone, -primacor
dobutamine-dobutrex
or nitro

no BB beta ag vs beta antag

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

NSTEMI preferred treatment

A

not thrombolytics

PCI is preferred

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

target for ablation of a-fib

A

pulmonary veins are foci over 90% of the time

anticoag for 2-3 months following ablaiton, evaluate at that point

sinus node dysfunction and need for pacer in necessary in 10% of cases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

seat belt sign

A

indicates intra abdominal injury up to 1/3 of pts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

gallstone pancreatitis

A

common cause

CT with contrast most reliable can identify panc and complications to guide treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

SBP dx

A

with para
Broad spectrum ABX
Cefotaximine
can also treat with NA restriction and diuretics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

transudative fluid

A 
protein pleural/serum 
less than 0.5
LDH plerual/serum
less than 0.6
Pleural LDH less than two thrids upper limit of normal serum LDH 140-280

cirrhosis, nephrotic syndrome

CHF

Constrictive pericarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Exudative effusion

A 
protein pleural/serum 
more than 0.5
LDH plerual/serum
more than 0.6
Pleural LDH more than two thrids upper limit of normal serum LDH 140-280
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

murphys sign

A

acute cholecystitis - deep breath while palpating gallbladder which slips down producing pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

giradia incubation

A

7-21

metro for 7 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

C difff incubation

A

12-36 hours
Gram plus
vanc and metro

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

e coli incubaiton

A

3-4 days
gram neg
ammox-

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Staph aureus incubaiton

A

1-8 hours
gram positive
cefazolin, cephalothin and cephalexin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

gastroparesis sx

A

common complication of uncontrolled hypoglycemia
early satiety
post prandial fullness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

chrons def

A

inflammatory bowel disease afffecting ileum and colon,
diarrhea and bloody stool
endoscopy
treat with immunosuppressants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

nutritional support guide

A

25-30x wght in KG
protein
1.2-1.6xkg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

H pylori eradication

A

gram neg
MOC- metro, omep, clarithromycin (biaxin) for 7 days

AOC ammox, omepp, clarithromycin,

or metro and ammox 7-14

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

PUD

A

free ab air absent recet sx is perf

PUD is most common cause of stomach and duodonal perf

bowel perf tx is fluids NPO and broad spectrum abx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

meld score calculation

A

creat
bili
inr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

significant post cabg bleed

A

150mL in 1st 30 minutes
> 250mL in 1st hour (call surgeon and intensivist)
> 150mL in 2nd hour
> 100mL in subsequent hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

restrictive cardiomyopathy

A

least common
amaloidosis or sarcoid

Diffuse myocardial infiltration leads to low voltage QRS complexes.
Atrial fibrillation may occur due to atrial enlargement; ventricular arrhythmias are also common.
Infiltration of the cardiac conducting system (e.g. due to septal granuloma formation in sarcoidosis) may lead to conduction disturbance — e.g. bundle branch blocks and AV block.
Healing granulomas in sarcoidosis may produce “pseudo-infarction” Q waves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

dialated cardiomyopathy most common

A

treat with prils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

cholesterol screen

goals

A

at 20 then q5
over 40 is every 2 or 3 or annualy with HLD

Total:
less than 200
200-239
greater than 240 is hi

HLD
men over 40
woman over 50

LDL

less than 100
greater than 190

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Joint comission HTN class

A 
Blood Pressure SBP	DBP
Classification	mmHg	mmHg
Normal	      <120	  and <80
Pre                120–139	or 80–89
Stage 1
	              140–159	or 90–99
Stage 2
Hypertension	≥160	or  ≥100
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

HTN goal over 60

A

less than 150/90 unless ckd or DM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

HTN urgency vs emergency

A

(ie, systolic BP >220 mm Hg or diastolic BP >120 mm Hg with or without end organ damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

carotid endartorectomy indicaton

A

over 70% stenosis with tia or stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

pseudomonas infections abx

A

zosyn, cefe, imi, mero
plus
cipro or levoflox

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

m catorales

A

Amoxicillin-clavulanate, second- and third-generation oral cephalosporins, and trimethoprim-sulfamethoxazole (TMP-SMZ) are the most recommended agents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

TB drugs

A

isoniazid, rifampin, pyrazinamide, ethambutol, if fully succiptable to INH and RIF then ethambutol can be dropped

2 monthos fo ISO, RIF, Pyrazin
then two of ISO, RIF

HIV for 9 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

postitive tb test

A

over 5 for HIV
over 10 for high risk,
over 15 for all other

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Hospital aquired pnu

A

Hospital-acquired pneumonia (HAP) or nosocomial pneumonia refers to any pneumonia contracted by a patient in a hospital at least 48–72 hours after being admitted. It is thus distinguished from community-acquired pneumonia. It is usually caused by a bacterial infection, rather than a virus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

low risk HCAP tx

A

> mild: augmentin or benzylpenicillin + gentamicin

-> moderate/severe: ceftriaxone or cefotaxime or tazocin or timentin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

HCAP high risk of MDR treatmet

A

cover MDR organisms
stop antibiotics for VAP at 6-8 days (evidence that longer courses lead to colonisation with MROs)
treat Pseudomonas aeruginosa, Acinetobacter species or Stenotrophomonas maltophilia for 15 days
-> tazocin or timentin or cefepime
-> if suspected MRSA add in vancomycin (pre-existing longterm lines, prior MRSA, in hospital > 7day or recent admission <3 months)
-> add gentamicin if critically ill (ventilated) to cover MDR organisms (use ciprofloxacin if age >65y, GFR <50 or recently on gentamicin)
-> add teichoplanin if VRE colonized

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

predicted post op pft for volume reduction

A

Predicted post-operative PFTs = Preop Value (5 – number of lobes resected)/5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

aspergillus s and s

A 
Fever and chills.
A cough that brings up blood (hemoptysis)
Shortness of breath.
Chest or joint pain.
Headaches or eye symptoms.
Skin lesions.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

strep pnu treatment

A

macrolide (MYCINS)or tetra if healthy

floroquinolone (floxacin) + or betalactam (combos pip/tazo) plus macrolide if not

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

p aregunosa treatment

A 
pip/tazo (betalactam) 
or
mero- carbepenam
or
cefepime (cephalo sporin)

plus

AMG(gent)/azithro (macrolide

add

vanc or linezolid for MRSA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

fever-sob-pleural effusion with blunting of costovetebrial angle

A

empayema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

scleroderam

A

anti-centromere antibodies (80%)

mmunosuppression (methotrexate)
steroids
care with vasoconstrictors
risk of ileus, malabsorption, nutritional deficiencies, GORD, stress ulceration
optimise right ventricular function
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

COPD

A

quit smoking
no steroids for mild stable disease
LABA for moderate disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

COPD EKG

A

ECG: right heart strain, RV hyperthrophy, P pulmonale, RAD, RBBB, ST depression or inversion in V1-V3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

COPD staging

A

In patients with FEV1/FVC < 0.70:

GOLD 1—mild: FEV1≥ 80% predicted

GOLD 2—moderate: 50% ≤ FEV1 < 80% predicted

GOLD 3—severe: 30% ≤ FEV1 < 50% predicted

GOLD 4—very severe: FEV1 < 30% predicted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

laba for-sal

A

LABAs include: Salmeterol (Serevent Diskus) Formoterol (Perforomist) Arformoterol (Brovana)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

saba

A

albuterol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

lama

A

tio

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

ICS for eos over 300

A 
beclomethasone dipropionate (Qvar Redihaler)
budesonide (Pulmicort Flexhaler)
ciclesonide (Alvesco)
flunisolide (Aerospan)
fluticasone propionate (Flovent)
mometasone (Asmanex)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

normal creat clearence

A

Normal creatinine clearance is 88–128 mL/min for healthy women

and 97–137 mL/min for healthy men.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

gfr

A 
over 90 is good 
60-90
30-59
15-30
under 15
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

indications for hd pneumonic

A 
Acidosis
electrolyte
intox
overload
uremea
92
Q

acute SOB and normal chest films

A

PE
gold standard is CT with contrast
vent perfusion substitue for CKD players

93
Q

acute copd excerab

A

NON invasive positive pressure bipap 10/5
azithromycin
methylpred

94
Q

taccy and tubed outside other causes

A

pneumothorax high plt

95
Q

ARDS

A 
lung protective vent
peep
sedation
prone
paralytic
96
Q

pseudomonas

A

levoflox, ciproflox or mero

97
Q

R heart cath

A

R side pressures and pulm art pressure

98
Q

cardiac mri

A

congenital disease, structural disorders of the heart

99
Q

L heart cath

A

CAD

100
Q

needle decompress

A

2nd intercostal mid clavicular

101
Q

cor pulmonale

A

R heatr failure from underlying lung disease

hypoxemea LT vasoconstriction and pulm htn LT afterload on RV LT peripheral edema and big liver/spleen

102
Q

OBese hypo syndrom e

A

BMI over thirty, awake PC)2 over 45.

103
Q

idiopathic pulmonary firbosis sound

A

fine crackles at bases

104
Q

lung nodule treatment

A

surgical excision
one lobe only -no pneumonectomy
LYmph positive- may need chemo/rads

105
Q

ppe for tb

A

airborn

AFB to determine active TB

106
Q

alpha 1 antityrpsan defficiency

A

COPD should get tested

107
Q

angio edema

laryngeal swelling

A

benedryl and H2 blocker

epi -stridor etc

108
Q

sulfonureal -glyburide

DiaBeta, Glynase, or Micronase (glyburide or glibenclamide)
Amaryl (glimepiride)
Diabinese (chlorpropamide)
Glucotrol (glipizide)
Tolinase (tolazamide)
Tolbutamide.
A

stims insulin scretion not for older adults -dehydration and AKI, not for gfr less than 60

109
Q

DKA treatment

A

first correct fluid deficit
in most adults 1-3L in the first hour

serum electrolytes before initiation of insulin to make sure K is above 3.3

insulin

110
Q

insulin prior to surgery

hyperglycemic

A

yes basal yes correctional no prandial (NPO)

111
Q

SIADH cold intolerance

A

retention of free water
LOW serum NA
LOW osmolality below 280
and HIGH urine osmo over 100 and urine NA over 40

causes stroke, CNS disorder, trauma, infection, malignancies some meds

112
Q

siadh treatment

A

serum na over 120 1000ml restrict

over 110 under 120
500ml

under 110 hypertonic and lasix

113
Q

hypothroid

A

High TSH
low t4
hashimotos

pituatiry or hypothalmus dysfuction

cold intolerance, britle nails, puffy eyes, hair loss

low NA and sugar

synthroid

114
Q

hypothyroid crysis

A

myxedema
tube
iv synthroid
slow rewarm’

115
Q

hyper thyroid

A 
20-40 years
graves
smooth moist warm skin
lid lag
HEAT intolerance

TSH low
T3 and 4 up

radioactive iodie uptake

high is graves
low is subacute

treat with 
propanool for tremor
pctu
tapazole
lugols
116
Q

thyroid crisisi

A 
extension of hyper
ptc uor tapazole 
with 
propanolol
lugols
sodium iodine
hydrocort
AVOID ASA
117
Q

tacchy agitated tremor

A

thyroid storm, propanalol

118
Q

adrenal insufficieny

A

early morning corticol less than 5 with increased ACTH (2 fold above normal limit ) is Primary

119
Q

dex supression test

A

cushings - dex 1 time and then check in the morning

120
Q

cushings

A

moon face and buffalo

121
Q

urine metanephrines

A 
pheocromocytoma 
normal TSH
CT adrenals 
alpha block for HTN- phentolamine - regitine 
of phenoxybenzamine- dibenzyline
122
Q

steroid for plama cortisol assy (does not interfere)

A

dexamethasone- can be given before ACTH test, switch to hydro or pred after test

123
Q

Normal MCH

A

32-36

124
Q

HCT

A

45% to 52% for men and 37% to 48% for women.

125
Q

Normal MCV

A

80-96

126
Q

coombs test

A

think hemolytic anemia

127
Q

cancer and pE

A

lovonox

128
Q

absolute contraindication to TPA

A

Significant head trauma or prior stroke in the previous 3 months.

Symptoms suggest subarachnoid hemorrhage.

Arterial puncture at a noncompressible site in previous 7 days.

History of previous intracranial hemorrhage.
Intracranial neoplasm,
AVM, or an aneurysm.

Recent intracranial or intraspinal surgery.

129
Q

ANC

A

WBC x total neutrophils (segs% bands%)x10

normal is over 1000

An ANC (Absolute Neutrophil Count) measures the percentage of neutrophils (shown in this listing as Polys) in your white blood count. multiply your white blood count (WBC) x total neutrophils (segmented neutrophils% + segmented bands%) x 10 = ANC. A normal ANC is over 1,000.

130
Q

transfuse hgb

A

between 7 and 8

131
Q

most common risks in transfusion of blood

A

allergic reactions, volume overlaod, infection

132
Q

bactericidal

A

beta-lactam antibiotics (penicillin derivatives (penams), cephalosporins (cephems), monobactams, and carbapenems) and vancomycin.

133
Q

principles of abx

A

degree of imunocompromise, prior infection history, local resistance, bactericidal preffered

134
Q

CLL

A

lymphadenopathy, increased WBC, LYMPHOCYTES over 5K
splenomegaly

dx with peripheral smear

135
Q

serum protien electrophoreisis

A

confirms multiple myeloma with gama spike

136
Q

serum hapto

A

low in hemolytic anemia

below 50 or .5

137
Q

clinical evaluation for staging

A

symptom directed with particular attention paid to non pulmonary symptoms that suggest mets

138
Q

breast cancer genitic testing

A

DCIS and ca before 50
tow or more occurances of breast, ovarian, rostate, or panc on same side of family, maternal or paternal
male breast or triple neg breast.

139
Q

multiple myeloma

crab

A

bone marrow plasma cells over 10%

c: calcium of 11 or higher
Renal- creat over 2
Anemia: hgm less than 10
Bone lesions one or more on imaging

140
Q

hodkins

A

Hodgkin lymphoma is marked by the presence of Reed-Sternberg cells, which a physician can identify using a microscope. In non-Hodgkin lymphoma, these cells are not present.

141
Q

MICRO less than 80, hypo less than 32 with low iron and ferritin

A

iron deff

142
Q

micro less than 80

macro less than 32 with normal iron

A

thallasemia
no iron
splenectomy if severe

143
Q

MCV 80-100

MCHC 32-36

A

chronic disease 2nd most common

144
Q

macro MCV over 100

Normo MCHC over 32

A

with neuro is b12

without neuro is folic (pernicious)

145
Q

ALL

A

pancytopenia and circulaton of blasts

146
Q

CML has

A

philadelphia

147
Q

lymphoma stage

A

1 single node or group
2 more than one node but only one side of diaphgram
3 spleen involved, both sides of diaphgrm
4 liver or bone marrow

148
Q

ITP

A

steroids to pump up platelets

ivig for hi people

149
Q

DIC

A

fibrin degraded products

150
Q

hepatorenal syndrome

A

profound oliguria and na retention with liver dysfunction

oncentrated urine with low Na+ (<10mol/L)
few granular casts (doesn’t improve with fluid replacement)
no proteinuria
normal kidneys on U/S

151
Q

pancreatitis

A

Symptoms consistent with pancreatitis (e.g. epigastric pain)
Elevation of serum amylase or lipase (to 3 times normal level)
Radiological features consistent with pancreatitis (e.g. CT or MRI)

152
Q

refeeding syndrome

A

hypo phos
hypo k
hypo mag

153
Q

resiliancy

A

ability to bounce back

154
Q

complexity

A

two or more systems - body, family,

155
Q

sability

A

ability to maintain equalibrium

156
Q

vulnerabilty

A

suceptibility to actual or poential stresssors that may adversely affect outcomes

157
Q

resource availability

A

what resources are around

158
Q

participation in decision making

A

wht degree pt and family participate in decisions

159
Q

clinical judgement

A

critical thinking, grasping of clinical situation, appling skills from guidelines, integrating ebp

160
Q

clinical inqury

A

questioning, evaluating practice, creating change through research and learning

161
Q

systems thinking

A

managing environmental, and system resources for pt fam and staff

162
Q

caring practices

A

respond to the uniqueness of pt and family to promot comfort, limit suffering, respond to the patient as a unique individual

163
Q

collaboraton

A

work with othes in a way that promots contribution from all

164
Q

advocacy and moral agency

A

representing the needs of a patient or family or community and resolving ethical or clinical concerns

165
Q

facilitator of learning

A

promote knowledge aquisition

166
Q

nurse

A

physiological changes, presence or abcence of complications, attainment of care objectives

167
Q

pt

A

functional change, behavioral change, trust, ratings, satisfactions, comfort, quality of life

168
Q

system

A

recidivism, cost/resource utilization

169
Q

delerium

A 
t toxic situations
h ypoxemia
i nfection imobillazation
n on pharma, environmental stim 
k potassium or electrolytes
170
Q

high icp treatment

A

corticosteroids, mannitol and hypertonic salene

171
Q

sbp goal after TPA

A

less than 180

172
Q

GB

A

destruction of myelin sheath

173
Q

viral LP

A

OP: normal

WBC: normal or mild elevatoin

Prot: normal or mild elevate

GLU: normal

174
Q

SAH LP

A

elevated RBC and WBC with ration of 1RbC to 700 wbc

175
Q

herpes LP

A

up wbc up rbc, up protein, normal or slightly down pressure

176
Q

strep pneumoneae meningitis

A

cephalosporin and vanc

177
Q

central cord injury

A

affects upper , lower is ok

178
Q

brown sequard motor and nerv

A

same side motor, opposite side pain/propriaception

179
Q

anterior cord

A

loss of all motor, pain and sensation below the level of injury

180
Q

ICH on coum

A

always reverse first

hematoma may expand for 72 hours

181
Q

pupil change think

A

elevated ICP

182
Q

SAH managment

A

non con CT

LP

183
Q

risk for early post traumatic seizure

A

over 65
amnesia
subdural hematoma
phenytoin for 7 days

184
Q

cerebral edema from tumor

A

dexamethasone

185
Q

pre tpa

A

less than 185/110

186
Q

ICP monitoring in tbi

A

gcs 3-8

abnormal ct

187
Q

parkinsons

A

bradykinesia, tremor, rigidity, and postural instability also referred to as parkinsonism. Tremor is the most apparent and well-known symptom.

tret with levadopa

188
Q

TBI treatment goals

A

avoid hypoension, adn hypovolemia

treat hyperthermia

avoid abumin

189
Q

tbi who gets a evd

A

moderate -> severe head injury who can’t be serially neurologically assessed
severe head injury (GCS < 8) + abnormal CT scan
severe head injury (GCS < 8) + normal CT if 2 of the following are present:
Age > 40 yrs
BP < 90mmHg
Abnormal motor posturing

190
Q

bacterial prostatitis abx

A

bactrim or levoquin with sulfa allergy

191
Q

ileal conduit surgery

A

bicarb is peed out in ileal urine so pt gets metabolic acidosis

192
Q

AKI determination

A

bun to creat ration
urine NA - over 20 is kidney
under 10 is extrarenal

193
Q

turp e imbalance

A

dilutional hyponatremia

194
Q

bun to creat over 20 vs under 20

A

bun to creat over 20 is pre real

intrarenal is bun to creat of less than 20

195
Q

pid

A

gon and clamid
gon dx: culture or gram neg

clymidia : culture is most definitive but Enzymime imunoassay EIA is preferred low cost and quick

treat ceftriaxone IM for gon
and azithromycin 1g po for clymidia

196
Q

pid

A

sexual active female
pelvic or lower back pain
cervical or axonal tenderness

197
Q

SJS/ten

A

painful red purple rash, peeling skin and mucosal lesisons

lamictal and anticonvulsants
sulfa abx
nasaids

198
Q

nec fasch abx

A

carbapenem (mero) 0r beta lactam Combos- ammox/clauv

plus clinda

or a mrsa agent: vanc, linezolid, or dapto

199
Q

indications for surgical debridment

A

Removal of the source of sepsis, mainly necrotic tissue

Removal of local infection to decrease bacterial burden, to reduce the probability of resistance from antibiotic treatment, and to obtain accurate cultures

Collection of deep cultures taken after debridement from the tissue left behind to evaluate persistent infection and requirements for systemic antibiotic treatment

Stimulation of the wound bed to support healing and to prepare for a skin graft or flap

200
Q

diabetic foot ulcers

A

debridment, treatment of infection, pressure ofloading, meticulos wound care

201
Q

abx for cellulitis

A

In mild cases of cellulitis treated on an outpatient basis, dicloxacillin, amoxicillin, and cephalexin are all reasonable choices. Clindamycin or a macrolide (clarithromycin or azithromycin) are reasonable alternatives in patients who are allergic to penicillin.

202
Q

compartment syndrome

A

loss of sensation between first and second tows, weakness with dorsiflexion
associated with fractures

203
Q

rhabdo triad

A

myalgia, gen weak, dark pee

204
Q

cip

A

hyporeflexia, flaccid quadriparesis, SLOWED nerve conduction

205
Q

mynsthenia g nerve conduction

A

is normal

206
Q

fall prevention 9

A

1fix eyes-cataracts

2fix feet adn foot wear

3vitamin d
supplimentation

4rate and rythm abnormalities

5indiviually taylored exercise program

6minimize meds

7education and info

8 modify home environment

9: postural hypotension

207
Q

tubing mg patinet

A

no rock, veck, or cist- unpredictable response, no sux- resistant- use etom

208
Q

dominent vs non

A

People with left-sided strokes may have trouble with skilled movements, depression and speech. In contrast, the right side of the brain has a more big-picture, large-scale processing style. It pulls information together, seems better at handling new information, and is probably more responsible for negative feelings

209
Q

spastic gait

A 
dragging feet 
Brain abscess.
Brain or head trauma.
Brain tumor.
Stroke.
Cerebral palsy.
Cervical spondylosis with myelopathy (a problem with the vertebrae in the neck)
Liver failure.
Multiple sclerosis (MS)
210
Q

types of gait

A

Propulsive gait – a stooped, stiff posture with the head and neck bent forward
Scissors gait – legs flexed slightly at the hips and knees like crouching, with the knees and thighs hitting or crossing in a scissors-like movement
Spastic gait – a stiff, foot-dragging walk caused by a long muscle contraction on one side
Steppage gait – foot drop where the foot hangs with the toes pointing down, causing the toes to scrape the ground while walking, requiring someone to lift the leg higher than normal when walking
Waddling gait – a duck-like walk that may appear in childhood or later in life
Ataxic, or broad-based, gait – feet wide apart with irregular, jerky, and weaving or slapping when trying to walk
Magnetic gait – shuffling with feet feeling as if they stick to the ground

211
Q

alzheimers

A

requires a gradual onset of memory impairment plus one or more of the following: aphasia (language disturbance); apraxia (impairment of motor activities despite intact motor function); agnosia (failure to recognize objects despite intact sensory function); and executive functioning disturbance (planning, organizing, sequencing, abstracting). The deficits cause a significant impairment that represents a considerable decline from previous level of function.

212
Q

uncrosmatched blood is

A

O neg

213
Q

treatment of serotonin sindrome

A

cryohepadine

214
Q

amphotericin B

A

central line, premedicate with tylenol and benedri: chills nausea, emissi and rigors in 70%

215
Q

uncomplicated pnu

A

levoflox

216
Q

sofa score

A 
PF ratio
hypotension and pressor req
bili level
platelet count
creat 
gcs
217
Q

BB OD

A

atropine and ivf, if that fails insulin with glucagon

218
Q

ethylene glycol

A

fomepizole

219
Q

benzo

A

flumazenil

220
Q

insecticide poision

A

atropine

221
Q

failure to thrive

A

The Institute of Medicine as weight loss of more than 5%, decreased appetite, poor nutrition, and physical inactivity, often associated with dehydration, depression, immune dysfunction, and low cholesterol.

222
Q

FUO

A

Background. The syndrome of fever of unknown origin (FUO) was defined in 1961 by Petersdorf and Beeson as the following: (1) a temperature greater than 38.3°C (101°F) on several occasions, (2) more than 3 weeks’ duration of illness, and (3) failure to reach a diagnosis despite one week of inpatient investigation

223
Q

FUO eitology and sub classees

A

classic, nosocomial, immune deficient, and human immunodeficiency virus–related. The four subgroups of the differential diagnosis of FUO are infections, malignancies, autoimmune conditions, and miscellaneous.

224
Q

sepsis

A

Sepsis should be defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. For clinical operationalization, organ dysfunction can be represented by an increase in the Sequential [Sepsis-related] Organ Failure Assessment (SOFA) score of 2 points or more, which is associated with an in-hospital mortality greater than 10%.

225
Q

septic shock

A

Septic shock should be defined as a subset of sepsis in which particularly profound circulatory, cellular, and metabolic abnormalities are associated with a greater risk of mortality than with sepsis alone. Patients with septic shock can be clinically identified by a vasopressor requirement to maintain a mean arterial pressure of 65 mm Hg or greater and serum lactate level greater than 2 mmol/L (>18 mg/dL) in the absence of hypovolemia. This combination is associated with hospital mortality rates greater than 40%. I

issues and policy (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions