Blue Charts Ex 1 Flashcards
1
Q
peds respiratory characteristics (14)
A
- incr RR
- incr O2 consumptions
- decr lung compliance
- incr chest wall compliance
- decr FRC
- lg head/tongue
- narrow nasal passages
- anterior/cephalad larynx
- longer epiglottis
- short trachea/neck
- prominent adenoids/tonsils
- weaker intercostal/diaphragm
- incr resistance to airflow
2
Q
peds CV characteristics (6)
A
- HR-dependent CO
- incr HR
- decr BP
- non-compliant LV
- residual fetal circ
- difficult cannulation
3
Q
normal ALT
A
5-35 IU/L
4
Q
ALT shows
A
hepatocellular injury
gluconeogenesis
primary liver function
5
Q
normal AST
A
10-40 IU/L
6
Q
AST shows
A
hepatocellular injury
gluconeogenesis
can be produced outside liver
7
Q
normal LDH
A
122-222 IU/L
8
Q
LDH shows
A
hepatocellular injury
follows ALT/AST trend
9
Q
normal albumin
A
3.5-5.5 g/dL
10
Q
albumin shows
A
hepatic protein synthesis
oncotic pressure
11
Q
normal PT
A
12-14s
12
Q
PT shows
A
hepatic protein synthesis
shortage of procoagulants
13
Q
normal ALP
A
10-30 IU/L
14
Q
ALP shows
A
cholestatic disorder
hepatic injury
malignancy
15
Q
normal bilibrubin
A
0.2-1.1 mg/dL
16
Q
bilirubin shows
A
hepatic excretory function
jaundice level
17
Q
ESLD complication: CNS
A
hepatic encephalopathy
18
Q
hepatic encephalopathy
A
confusion
personality
sleep disorder
coma
19
Q
ESLD complication: CV (4)
A
hyperdynamic state
cardiomyopathy
altered blood flow
portal HTN
20
Q
hyperdynamic state (4)
A
decr SVR
high CO
low-normal BP
mild elevated HR
21
Q
cardiomyopathy
A
CHF
22
Q
altered BF
A
incr splanchnic flow
incr MvO2 sats
23
Q
portal HTN
A
ascites
varices
24
Q
ESLD complication: pulmonary
A
hypoxemia
portopulmonary syndrome
25
hypoxemia (3)
impaired HPV
incr atelectasis
heptatopulmonary syndrome
26
hepatopulmonary syndrome
intrapulmonary vascular dilation and shunting
27
portopulmonary syndrome
pulm HTN
portal HTN
28
ESLD complication: renal
hepatorenal syndrome
edema/ascites
29
hepatorenal syndrome
prerenal failure
severe cirrhosis
30
edema/ascites
portal HTN
Na+/H2O retention
electrolyte abnormalities
31
ESLD complication: hematologic system
coagulopathy
hypercoagulable
thrombocytopenia
32
coagulopathy and hypercoagulability
variable presentation due to protein synth abnormalities
33
thrombocytopenia
plt sequestration due to portal HTN causing splenomegaly
34
ESLD complication: endocrine
abnormal glucose use
35
abnormal glucose use
insulin resistane
loss of glycogen
36
ESLD complication: GI
esophageal varices
37
esophageal varices
manifestation of portal HTN
caution OG/TEE
38
vasoconstrictor systems
sympathoadrenal system
RAAS
aldosterone
ADH
39
vasoconstrictor system SE
decr RBF
decr GFR
decr urine flow
decr Na+ excretion
40
vasodilatory systems
prostaglandins
kinins
ANP
41
vasodilator system SE
incr RBF
incr GFR
incr urine flow
incr Na+ excretion
42
distilled water issues
hypotonic
hemolysis
volume overload
hyponatremia
43
glycine 1.2/1.5% issues
transient blindness
44
mannitol 5% issues
pulmonary edema
45
glucose 2.5% issues
severe hyperglycemia
46
chest bleeding diagnosis
radiography
thoracostomy tube output
CT scan
47
chest bleed treatment
observation
surgery
48
abdomen bleed diagnosis
exam
FAST scan
CT
peritoneal lavage
49
abdomen treatment
surgical ligation
angiography
observation
50
retroperitoneum bleed diagnosis
CT
angiography
51
retroperitoneum treatment
angiography
52
long bone bleed diagnosis
exam
radiography
53
long bone bleed treatment
fracture fixation
surgical ligation
54
external bleed diagnosis
exam
55
external bleed treatment
digital pressure
surgical ligation
56
class 1 hemorrhage
< 15% loss of volume
no change HR/BP
no resuscitation required
57
class 2 hemorrhage
15-30% loss of volume
HR incr
DBP incr
narrow PP
give IV fluids
58
class 3 hemorrhage
30-40% loss of volume
HR incr
BP decr
metabolic acidosis
start transfusion
59
class 4 hemorrhage
> 40% loss of volume
profound hypotension
TIC
start massive transfusion protocol
60
early resuscitation goals (10)
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
late resuscitation goals
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
fluid infusion system benefits (8)
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
products compatible with rapid infusion systems (5)
crystalloids
colloids
PRBCs
washed salvaged blood
FFP
64
PRBCs effect
incr Hg 1 g/dL
incr Hct 3%
65
FFP effect
incr Clotting Factors 2-3%
66
PLTs effect
incr 5k-10k/uL
67
cyro effect
incr fibrinogen 5-7 mg/dL
68
normal PT
11.5-14.5s
69
PT pathway
extrinsic
70
normal PTT
(25-35s)
24.5-35.2s
71
PTT pathway
intrinsic
72
normal thrombin time
(22-31s)
22.1-31.2 s
73
thrombin time
time to clot once exogenous thrombin added
74
normal fibrinogen
175-433 mg/dL
75
firbinogen
pure count
76
normal ACT
70-180 s
77
ACT
test tube reagent clotting
78
normal PLTs
150k-450k
79
PLTS
pure count
80
normal P2Y12
180-376 PRU
81
P2Y12
plavix inhibition test
82
Mild TBI GCS
13-15
83
Mild TBI symptoms
minimal deterioration
post concussive effects
84
Mod TBI GCS
9-12
85
Mod TBI symptoms
long term morbidity
86
Sev TBI GCS
3-8
87
Sev TBI symptoms
significant risk of mortality
88
echinacea
immunosuppresion
89
ginko biloba
inhibits plt activating factor
90
garlic
inhibits plt aggregation
incr fibrinolysis
91
ginseng
lowers blood glu
incr PT/PTT
inhibits plt aggregation
92
saw palmetto
COX inhibitor
93
ephedra
indirect sympathomimetic effect
94
valerian
sedation
95
kava
sedation
anxiolysis
96
st johns wort
inhibits NT reuptake
97
premature neonate BV
95 mL/kg
98
fullterm neonate BV
85 mL/kg
99
infant BV
80 mL/kg
100
men BV
75 mL/kg
101
women BV
65 mL/kg
102
ABL =
ABL = EBV * [(hct i - hct f)/ hct i]
103
resuscitation goals
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
R value normal
5-10 mins
105
R value problem
incr time
106
treat R value
FFP
107
K value normal
1-3 mins
108
K value problem
incr time
109
treat K value
cryo
110
alpha angle normal
53-72 degrees
111
alpha angle problem
decr angle
112
treat alpha angle
cryo
113
Max amplitued normal
50-70 mm
114
MA problem
decr MA
115
MA treatment
Plt
or
DDAVP
116
LY30 normal
0-8%
117
LY30 issue
higher value
118
treat LY30
TXA
119
threshold for bleeding: plts
< 50,000
120
low plts treatment
1-2 units of plts
121
threshold for bleeding: fibrinogen
< 1.5-2 g/L
122
low fibrinogen treatment
5-10 units cry
2 gm fibrinogen
123
threshold for bleeding: PT/PTT
1.5x nL
124
prolonged PT/PTT treatment
15-30 mL/kg FFP
