Acute & Critical Care Medicine

Question 1

Colloid types:

Answer 1

Albumin 5%, 25%

Question 2

Crystalloid types:

Answer 2

LRs
Dextrose 5% (D5W)
Normal Saline (0.9% NaCl)

Question 3

Hyponatremia: Na <135 treatment

Answer 3

Diuresis and fluid restriction

Question 4

SIADH/ hypervolemic hyponatremia treatment:

Answer 4

Conivaptan or tolvaptan (samsca)- (arginine vaso. antagonists)

Question 5

How to correctly correct hyponatremia:

Answer 5

Not too quickly, less than 12 mEq/L over 24 hours - can cause osmotic demylination syndrome (ODS) if corrected too fast or central pontine myelinosis = paralysis, seizures, death

Question 6

Hyperkalemia:

Answer 6

Mg is necessary for K uptake - replace Mg first

Question 7

Hypomagnesemia:

Answer 7

can cause seizures, arrhythmias

replacement w/ IV Mg sulfate recommended or Mg oxide (oral)

Question 8

Vasopressors:

Answer 8

dopamine 
epinephrine (adrenaline, EpiPen)
NE (levophed) 
phenylephrine 
vasopressin (vasostrict)

Question 9

epinephrine (adrenaline) MOA:

Answer 9

alpha-1, beta-1, beta-2 AGONIST

Question 10

NE (levophed) MOA:

Answer 10

alpha-1&raquo_space; beta-1 AGONIST

Question 11

Phenylephrine MOA:

Answer 11

alpha-1 AGONIST

Question 12

vasopressin (vasostrict) MOA:

Answer 12

vasopressor AGONIST

Question 13

Extravasation:

Answer 13

vessicants can cause severe tissue damage/ necrosis (leakage during admin)

Question 14

VASODILATORS:

Answer 14

nitroprusside (nitropress, nipride) –> D5W preferred

Nitroglycerin - NTG

Question 15

INOTROPES

Answer 15

dobutamine (beta-1 agonist)

milrinone (PDE-3 inhibitor)