Adams, CP, Shock Flashcards
Familial risk factors pertaining to MI (age):
father
Familial risk factors pertaining to MI (age):
father
duration of sx to qualify as angina:
unstable angina vs stable:
increased duration, frequency, or intensity
new associated sx
occurs with less activity or at rest
ST elevation amount for MI:
at least 0.1 mV in all leads except V2 and 3 (0.2 mV)
difficulty in dx new MI with new LBBB?
LBBB have ST elevation normally
EKG in posterior MI?
ST depressions
High sensitivity Trop can still be normal in_______?
unstable angina
first tx of STEMI:
tPA
If pt can’t take ASA in MI give?
clopidogrel
Medical management of MI in first 24 hours:
ACE inhibitors
Beta blockers
Definition of shock?
Hypoperfusion of vital organs
**especially the brain
lab marker elevated due to anaerobic metabolism in shock?
Lactic acid
duration of sx to qualify as angina:
unstable angina vs stable:
increased duration, frequency, or intensity
new associated sx
occurs with less activity or at rest
ST elevation amount for MI:
at least 0.1 mV in all leads except V2 and 3 (0.2 mV)
difficulty in dx new MI with new LBBB?
LBBB have ST elevation normally
EKG in posterior MI?
ST depressions
High sensitivity Trop can still be normal in_______?
unstable angina
first tx of STEMI:
tPA
If pt can’t take ASA in MI give?
clopidogrel
Medical management of MI in first 24 hours:
ACE inhibitors
Beta blockers
Definition of shock?
Hypoperfusion of vital organs
**especially the brain
lab marker elevated due to anaerobic metabolism in shock?
Lactic acid
Loss of cellular integrity in shock leads to findings of (5)?
Hyperkalemia
Hyponatremia
Metabolic acidosis
Hyperglycemia
Lactic acidosis
What is SIRS?
systemic inflammatory response syndrome
-requires two of:
temp 38
pulse > 90
RR > 20
PaCO2 12,000 or at least 10% bands
***sepsis like disorder in absence of infx
Whats is MODS?
multi-organ dysfunction syndrome
Classic findings in shock?
hypotension (but not always)
cool clammy skin (if warm and flushed, more likely infx cause)
altered mental status
urine output
two easiest ways to monitor pt in shock
level of alertness
urine output
capillary wedge measures?
LV pressure
treatment for shock?
FLUIDS!!!
vasopressors (NE, epi, dopamine, dobutamine)
