Adams, CP, Shock

Question 1

Familial risk factors pertaining to MI (age):

Answer 1

father

Question 2

Familial risk factors pertaining to MI (age):

Answer 2

father

Question 3

duration of sx to qualify as angina:

Question 4

unstable angina vs stable:

Answer 4

increased duration, frequency, or intensity

new associated sx

occurs with less activity or at rest

Question 5

ST elevation amount for MI:

Answer 5

at least 0.1 mV in all leads except V2 and 3 (0.2 mV)

Question 6

difficulty in dx new MI with new LBBB?

Answer 6

LBBB have ST elevation normally

Question 7

EKG in posterior MI?

Answer 7

ST depressions

Question 8

High sensitivity Trop can still be normal in_______?

Answer 8

unstable angina

Question 9

first tx of STEMI:

Answer 9

tPA

Question 10

If pt can’t take ASA in MI give?

Answer 10

clopidogrel

Question 11

Medical management of MI in first 24 hours:

Answer 11

ACE inhibitors

Beta blockers

Question 12

Definition of shock?

Answer 12

Hypoperfusion of vital organs

**especially the brain

Question 13

lab marker elevated due to anaerobic metabolism in shock?

Answer 13

Lactic acid

Question 14

duration of sx to qualify as angina:

Question 15

unstable angina vs stable:

Answer 15

increased duration, frequency, or intensity

new associated sx

occurs with less activity or at rest

Question 16

ST elevation amount for MI:

Answer 16

at least 0.1 mV in all leads except V2 and 3 (0.2 mV)

Question 17

difficulty in dx new MI with new LBBB?

Answer 17

LBBB have ST elevation normally

Question 18

EKG in posterior MI?

Answer 18

ST depressions

Question 19

High sensitivity Trop can still be normal in_______?

Answer 19

unstable angina

Question 20

first tx of STEMI:

Answer 20

tPA

Question 21

If pt can’t take ASA in MI give?

Answer 21

clopidogrel

Question 22

Medical management of MI in first 24 hours:

Answer 22

ACE inhibitors

Beta blockers

Question 23

Definition of shock?

Answer 23

Hypoperfusion of vital organs

**especially the brain

Question 24

lab marker elevated due to anaerobic metabolism in shock?

Answer 24

Lactic acid

Question 25

Loss of cellular integrity in shock leads to findings of (5)?

Answer 25

Hyperkalemia

Hyponatremia

Metabolic acidosis

Hyperglycemia

Lactic acidosis

Question 26

What is SIRS?

Answer 26

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

Question 27

Whats is MODS?

Answer 27

multi-organ dysfunction syndrome

Question 28

Classic findings in shock?

Answer 28

hypotension (but not always)

cool clammy skin (if warm and flushed, more likely infx cause)

altered mental status

urine output

Question 29

two easiest ways to monitor pt in shock

Answer 29

level of alertness

urine output

Question 30

capillary wedge measures?

Answer 30

LV pressure

Question 31

treatment for shock?

Answer 31

FLUIDS!!!

vasopressors (NE, epi, dopamine, dobutamine)