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Fa: Sim 3 > Blue Charts Ex 1 > Flashcards

Blue Charts Ex 1 Flashcards

1
Q

peds respiratory characteristics (14)

A
  1. incr RR
  2. incr O2 consumptions
  3. decr lung compliance
  4. incr chest wall compliance
  5. decr FRC
  6. lg head/tongue
  7. narrow nasal passages
  8. anterior/cephalad larynx
  9. longer epiglottis
  10. short trachea/neck
  11. prominent adenoids/tonsils
  12. weaker intercostal/diaphragm
  13. incr resistance to airflow
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2
Q

peds CV characteristics (6)

A
  1. HR-dependent CO
  2. incr HR
  3. decr BP
  4. non-compliant LV
  5. residual fetal circ
  6. difficult cannulation
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3
Q

normal ALT

A

5-35 IU/L

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4
Q

ALT shows

A

hepatocellular injury
gluconeogenesis
primary liver function

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5
Q

normal AST

A

10-40 IU/L

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6
Q

AST shows

A

hepatocellular injury
gluconeogenesis
can be produced outside liver

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7
Q

normal LDH

A

122-222 IU/L

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8
Q

LDH shows

A

hepatocellular injury
follows ALT/AST trend

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9
Q

normal albumin

A

3.5-5.5 g/dL

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10
Q

albumin shows

A

hepatic protein synthesis
oncotic pressure

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11
Q

normal PT

A

12-14s

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12
Q

PT shows

A

hepatic protein synthesis
shortage of procoagulants

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13
Q

normal ALP

A

10-30 IU/L

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14
Q

ALP shows

A

cholestatic disorder
hepatic injury
malignancy

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15
Q

normal bilibrubin

A

0.2-1.1 mg/dL

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16
Q

bilirubin shows

A

hepatic excretory function
jaundice level

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17
Q

ESLD complication: CNS

A

hepatic encephalopathy

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18
Q

hepatic encephalopathy

A

confusion
personality
sleep disorder
coma

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19
Q

ESLD complication: CV (4)

A

hyperdynamic state
cardiomyopathy
altered blood flow
portal HTN

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20
Q

hyperdynamic state (4)

A

decr SVR
high CO
low-normal BP
mild elevated HR

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21
Q

cardiomyopathy

A

CHF

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22
Q

altered BF

A

incr splanchnic flow
incr MvO2 sats

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23
Q

portal HTN

A

ascites
varices

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24
Q

ESLD complication: pulmonary

A

hypoxemia
portopulmonary syndrome

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25
Q

hypoxemia (3)

A

impaired HPV
incr atelectasis
heptatopulmonary syndrome

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26
Q

hepatopulmonary syndrome

A

intrapulmonary vascular dilation and shunting

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27
Q

portopulmonary syndrome

A

pulm HTN
portal HTN

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28
Q

ESLD complication: renal

A

hepatorenal syndrome
edema/ascites

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29
Q

hepatorenal syndrome

A

prerenal failure
severe cirrhosis

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30
Q

edema/ascites

A

portal HTN
Na+/H2O retention
electrolyte abnormalities

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31
Q

ESLD complication: hematologic system

A

coagulopathy
hypercoagulable
thrombocytopenia

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32
Q

coagulopathy and hypercoagulability

A

variable presentation due to protein synth abnormalities

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33
Q

thrombocytopenia

A

plt sequestration due to portal HTN causing splenomegaly

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34
Q

ESLD complication: endocrine

A

abnormal glucose use

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35
Q

abnormal glucose use

A

insulin resistane
loss of glycogen

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36
Q

ESLD complication: GI

A

esophageal varices

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37
Q

esophageal varices

A

manifestation of portal HTN
caution OG/TEE

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38
Q

vasoconstrictor systems

A

sympathoadrenal system
RAAS
aldosterone
ADH

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39
Q

vasoconstrictor system SE

A

decr RBF
decr GFR
decr urine flow
decr Na+ excretion

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40
Q

vasodilatory systems

A

prostaglandins
kinins
ANP

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41
Q

vasodilator system SE

A

incr RBF
incr GFR
incr urine flow
incr Na+ excretion

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42
Q

distilled water issues

A

hypotonic
hemolysis
volume overload
hyponatremia

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43
Q

glycine 1.2/1.5% issues

A

transient blindness

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44
Q

mannitol 5% issues

A

pulmonary edema

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45
Q

glucose 2.5% issues

A

severe hyperglycemia

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46
Q

chest bleeding diagnosis

A

radiography
thoracostomy tube output
CT scan

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47
Q

chest bleed treatment

A

observation
surgery

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48
Q

abdomen bleed diagnosis

A

exam
FAST scan
CT
peritoneal lavage

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49
Q

abdomen treatment

A

surgical ligation
angiography
observation

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50
Q

retroperitoneum bleed diagnosis

A

CT
angiography

51
Q

retroperitoneum treatment

A

angiography

52
Q

long bone bleed diagnosis

A

exam
radiography

53
Q

long bone bleed treatment

A

fracture fixation
surgical ligation

54
Q

external bleed diagnosis

A

exam

55
Q

external bleed treatment

A

digital pressure
surgical ligation

56
Q

class 1 hemorrhage

A

< 15% loss of volume
no change HR/BP
no resuscitation required

57
Q

class 2 hemorrhage

A

15-30% loss of volume
HR incr
DBP incr
narrow PP
give IV fluids

58
Q

class 3 hemorrhage

A

30-40% loss of volume
HR incr
BP decr
metabolic acidosis
start transfusion

59
Q

class 4 hemorrhage

A

> 40% loss of volume
profound hypotension
TIC
start massive transfusion protocol

60
Q

early resuscitation goals (10)

A
  1. SBP 80-100 mmHg
  2. Hct 25-50%
  3. normal PT
  4. normal PTT
  5. Plt > 50,000
  6. normal Ca2+
  7. core temp > 35C
  8. functioning pulse ox
  9. decr lactate
  10. good analgesia/anesthesia
61
Q

late resuscitation goals

A
  1. SBP > 100 mmHg
  2. Hct above individual goal
  3. normal coag
  4. normal electrolytes
  5. normal body temp
  6. normal urine output
  7. max CO
  8. reverse acidosis
  9. normalize lactate level
62
Q

fluid infusion system benefits (8)

A
  1. 1500 mL/min
  2. compatible w/most products (not PLTS)
  3. reservoir allows mixing
  4. warms fluids
  5. simultaneous pumps
  6. fail-safe air detection
  7. accurate volumes/pressures
  8. portable
63
Q

products compatible with rapid infusion systems (5)

A

crystalloids
colloids
PRBCs
washed salvaged blood
FFP

64
Q

PRBCs effect

A

incr Hg 1 g/dL
incr Hct 3%

65
Q

FFP effect

A

incr Clotting Factors 2-3%

66
Q

PLTs effect

A

incr 5k-10k/uL

67
Q

cyro effect

A

incr fibrinogen 5-7 mg/dL

68
Q

normal PT

A

11.5-14.5s

69
Q

PT pathway

A

extrinsic

70
Q

normal PTT

A

(25-35s)
24.5-35.2s

71
Q

PTT pathway

A

intrinsic

72
Q

normal thrombin time

A

(22-31s)
22.1-31.2 s

73
Q

thrombin time

A

time to clot once exogenous thrombin added

74
Q

normal fibrinogen

A

175-433 mg/dL

75
Q

firbinogen

A

pure count

76
Q

normal ACT

A

70-180 s

77
Q

ACT

A

test tube reagent clotting

78
Q

normal PLTs

A

150k-450k

79
Q

PLTS

A

pure count

80
Q

normal P2Y12

A

180-376 PRU

81
Q

P2Y12

A

plavix inhibition test

82
Q

Mild TBI GCS

A

13-15

83
Q

Mild TBI symptoms

A

minimal deterioration
post concussive effects

84
Q

Mod TBI GCS

A

9-12

85
Q

Mod TBI symptoms

A

long term morbidity

86
Q

Sev TBI GCS

A

3-8

87
Q

Sev TBI symptoms

A

significant risk of mortality

88
Q

echinacea

A

immunosuppresion

89
Q

ginko biloba

A

inhibits plt activating factor

90
Q

garlic

A

inhibits plt aggregation
incr fibrinolysis

91
Q

ginseng

A

lowers blood glu
incr PT/PTT
inhibits plt aggregation

92
Q

saw palmetto

A

COX inhibitor

93
Q

ephedra

A

indirect sympathomimetic effect

94
Q

valerian

A

sedation

95
Q

kava

A

sedation
anxiolysis

96
Q

st johns wort

A

inhibits NT reuptake

97
Q

premature neonate BV

A

95 mL/kg

98
Q

fullterm neonate BV

A

85 mL/kg

99
Q

infant BV

A

80 mL/kg

100
Q

men BV

A

75 mL/kg

101
Q

women BV

A

65 mL/kg

102
Q

ABL =

A

ABL = EBV * [(hct i - hct f)/ hct i]

103
Q

resuscitation goals

A
  1. SBP 80-100 mmHg
  2. Temp > 35C
  3. Hb > 7 g/dL
  4. pH > 7.2
  5. BE > -6
  6. Lactate < 4 mmol/L
  7. Ca2+ > 1.1mmol/L
  8. PLTs > 50k
  9. PT/PTT < 1.5x normal
  10. INR < 1.5
  11. Fibrinogen > 1.0g/L
104
Q

R value normal

A

5-10 mins

105
Q

R value problem

A

incr time

106
Q

treat R value

A

FFP

107
Q

K value normal

A

1-3 mins

108
Q

K value problem

A

incr time

109
Q

treat K value

A

cryo

110
Q

alpha angle normal

A

53-72 degrees

111
Q

alpha angle problem

A

decr angle

112
Q

treat alpha angle

A

cryo

113
Q

Max amplitued normal

A

50-70 mm

114
Q

MA problem

A

decr MA

115
Q

MA treatment

A

Plt
or
DDAVP

116
Q

LY30 normal

A

0-8%

117
Q

LY30 issue

A

higher value

118
Q

treat LY30

A

TXA

119
Q

threshold for bleeding: plts

A

< 50,000

120
Q

low plts treatment

A

1-2 units of plts

121
Q

threshold for bleeding: fibrinogen

A

< 1.5-2 g/L

122
Q

low fibrinogen treatment

A

5-10 units cry

2 gm fibrinogen

123
Q

threshold for bleeding: PT/PTT

A

1.5x nL

124
Q

prolonged PT/PTT treatment

A

15-30 mL/kg FFP

Fa: Sim 3 (10 decks)

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