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Year 3 > Catch up 3.2.1 > Flashcards

Catch up 3.2.1 Flashcards

1
Q

What is cardiogenic shock?

A

the heart cannot pump enough blood through the body

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2
Q

What is obstructive shock?

A

There is a physical obstruction in the flow of blood

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3
Q

What is distributive shock?

A

There is an abnormal peripheral circulation that results in inadequate supply of oxygen to the tissues

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4
Q

What happens in the nonprogressive/compensated stage of shock?

A

normal circulatory mechanisms cause compensatory circulatory recovery.

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5
Q

What happens in the progressive stage of shock?

A

Without therapy, the shock becomes increasingly worse until death occurs.

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6
Q

Signs and symptoms of septic shock?

A
  • warm skin
  • pulsating pulse
  • hypotension
  • elevated body temperature
  • nausea and vomiting
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7
Q

Prerenal kidney failure is caused by:

A

Low blood pressure to the kidneys

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8
Q

When will kidney cells become hypoxic?

A

When blood flow decreases by 75-80%

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9
Q

What is the underlying mechanism of respiratory acidosis?

A

reduced CO2 elimination

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10
Q

respiratory alkalosis

A

increased CO2 elimination

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11
Q

metabolic acidosis:

A

decreased bicarbonate

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12
Q

metabolic alkalosis

A

increased bicarbonate

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13
Q

Type I respiratory failure

  • PaO2?
  • PaCO2?
  • Cause?
A

PaO2 = low
PaCO2 = normal or low
caused by damage to the lung tissue

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14
Q

Type II respiratory failure:

A

PaO2 = low
PaCO2 = high
Caused by insufficient alveolar ventilation

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15
Q

Definition septic shock:

A

sepsis + hypotension despite adequate IV fluids

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16
Q

Neuropraxia

A

Damage to a peripheral nerve, nerve continuity is preserved

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17
Q

Axonotmesis:

A

The axon and its myelin sheath are damaged, but the endoneurium, epineurium and perineurium are still intact

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18
Q

Neurotmesis

A

The nerve is completely functionally disconnected.

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19
Q

When does SIRS occur with burns?

A

When > 30% of the body surface is affected

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20
Q

Gas gangrene is caused by:

A

clostridium perfringens

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21
Q

When is a spinal fracture unstable?

A

when damage to the middle column is combined with damage to the anterior or posterior column.

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22
Q

Type A1 pelvic fracture

A

fractures of the pelvis not involving the ring

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23
Q

Type A2 pelvic fracture:

A

Stable, minimally displaced fracture of the pelvic ring

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24
Q

B1 pelvic fracture:

A

Open book, the pelvic ring fails anteriorly and posteriorly

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25
Q

Type C pelvic fractures:

A

both rotationally and vertically unstable

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26
Q

Type B pelvic fractures:

A

Rotationally unstable but vertically unstable.

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27
Q

Aortic dissection:

A

a tear in the lumen of the aorta that caused blood to flow between the layers of the aortic wall.

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28
Q

What is the cause of aortic dissection?

A

degeneration of the elastin/collagen in the intima causing a breach in the lumen

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29
Q

What is the most common place for an aortic dissection?

A

The ascending aorta (65%)

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30
Q

Normal PaO2 values:

A

10,0-13,3 kPa

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31
Q

Normal PaCO2 values:

A

4,7-6,4 kPa

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32
Q

Bicarbonate

A

22-26 mmol/L

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33
Q

Triad of death:

A

Hypothermia, acidosis, coagulopathy

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34
Q

Septic shock is clinicaly characterized by:

A
  • Hypotension following volume treatment AND

- serum lactate > 2 mmol/L

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35
Q

Knee mottling

A

Represents poor circulation in septic shock

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36
Q

The cardiac function curve rotates up through:

A

Increased HR

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37
Q

The cardiac function curve rotates down through:

A

Decreased HR

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38
Q

The vascular function curve shifts right through:

A

Increased blood volume or venoconstriction

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39
Q

The vascular function curve shifts left through:

A

decreased blood volume or venodilation

40
Q

The vascular function curve rotates up through:

A

Arterial vasodilation (decreased preload)

41
Q

The vascular function curve rotates down through:

A

Arterial vasoconstriction (increased preload)

42
Q

What happens to the body during sepsis that affects the vascular function curve? + result?

A

Massive vasodilation –> the curve shifts to the left. The result is a decrease in CO

43
Q

Renal insufficiency is characterized by:

A

Decreased GFR

44
Q

Prerenal renal insufficiency is caused by:

A

Hypovolemia/low CO

45
Q

Renal renal insufficiency is caused by:

A

Acute tubular necrosis/ acute interstitial nephritis

46
Q

Changes in renal insufficiency:

  • Prerenal cause
  • Renal cause
A
  • increased RAAS action –> increased sodium reabsorption –> low urine sodium (<20 mmol/L)
  • decreased sodium reabsorption –> high urine sodium (>50 mmol/L)
47
Q

First degree burn:

  • Damage to:
  • Characteristics:
  • Healing in:
A
  • only damage to the epidermis
  • painful, red and dry, capillary refill intact
  • Days
48
Q

Superficial 2nd degree burn:

  • Damage to
  • Characteristics
  • Healing in
A
  • Damage to the dermis with intact skin adnexae
  • Very painful, red, shiny/moist, blistering, capillary refill intact
  • Healing <2 weeks
49
Q

Deep 2nd degree burn:

  • Damage to
  • Characteristics
  • Healing in
A
  • Damage to the dermis with involvement of skin adnexae
  • No/diminished pain, patchy white/red, some blistering, capillary refill impaired
  • Healing >4 weeks, epithelization will come from the healthy tissue around the wound, not the wound bed
50
Q

3rd degree burn:

  • Damage to
  • Characteristics
  • Healing:
A
  • Full thickness of the skin
  • Dry, white/black, no blistering, no pain, no capillary refill
  • Skin grafting required.
51
Q

Extensive burns:

  • In adults
  • In children
A
  • In adults: >15% of the body surface area;

- In children: >10%

52
Q

An ulcer is defined as:

A

a persistent defect in an epithelial or mucosal surface.

53
Q

The virulence of an organism depends on:

A

its qualities of adherence and invasiveness and its ability to produce toxins.

54
Q

Intermittent claudication:

A

pain on walking, usually felt in the calf

55
Q

Chronic ischemic rest pain:

A

Ischemic pain felt during rest. This is usually felt in the skin of the foot

56
Q

An aortic dissection forms a false lumen between the:

A

Media and adventitia

57
Q

Stanford type A:

A

any dissection in which the ascending aorta is involved.

58
Q

Stanford type B:

A

Only the descending aorta is involved.

59
Q

Formula of anion gap:

A

[Na+]-[Cl-]-[HCO3-]

60
Q

Normal anion gap:

A

10-14 mmol/L

61
Q

When is the anion gap increased:

A

whit excessive production of a nonvolatile acid.

62
Q

When is the anion gap normal?

A

When there is bicarbonate loss

63
Q

What is the change of the vascular function curve in hypovolemic or distributive shock?

A

A shift to the right because of decreased blood volume in hypovolemic shock and venodilation in distributive shock

64
Q

What happens to the vascular function curve in obstructive shock?

A

Rotation downwards, because of increased resistance to blood flow

65
Q

What happens to the cardiac function curve in cardiogenic shock?

A

Rotates downwards because of decreased contractility

66
Q

Fluid challenge:

A

Infusion of a small bolus of fluid in 5-10 min and see if the patient improves

67
Q

Aortic aneurysm:

A

A dilation of the aorta of >3 cm

68
Q

Pulmonary hypertension is defined as:

A

a mean pulmonary artery pressure of >25 mmHg

69
Q

Definition of dyspnea:

A

a sense of awareness of increased respiratory effort that is unpleasant and that is recognized by the patient as being inappropriate.

70
Q

Respiratory failure:

A

occurs when pulmonary gas exchange is sufficiently impaired to cause hypoxemia with or without hypercapnia

71
Q

Type 1 respiratory failure is characterized by:

A

PaO2 is low and PaCO2 is normal or low

72
Q

Type 1 respiratory failure is caused by:

A

diseases that cause lung tissue damage.

73
Q

Type 2 respiratory failure is characterized by:

A

PaO2 is low and PaCO2 is high

74
Q

In type 2 respiratory failure, there is:

A

Insufficient ventilation to remove enough CO2

75
Q

The cardinal feature of ARDS

A

Non cardiogenic pulmonary edema

76
Q

Formula for A-a gradient:

A

(20-PaCO2/0.8)-PaO2

77
Q

Normal A-a gradient:

A

<15 mmHg or 2 kPa

78
Q

An increased A-a gradient indicates:

A

A defect in diffusion, V/Q mismatch or right-to-left shunt

79
Q

FEV1/FVC ratio:

A

Represents the proportion of a persoon’s vital capacity that they are able to expire in the first second of forced expiration.

80
Q

An FEV1/FVC ratio below 70% indicates:

A

an obstructive lung disease

81
Q

In hypoventilation, the A-a gradient is:

A

Normal

82
Q

Hypoventilation:

  • PaCO2
  • A-a gradient
  • Reaction to 100% O2?
A
  • Increased
  • Normal
  • Yes
83
Q

Ventilation perfusion mismatch:

  • PaCO2
  • A-a gradient
  • reaction to 100% O2?
A
  • Normal (sometimes increased)
  • increased
  • yes
84
Q

Shunt:

  • PaCO2?
  • A-a gradient
  • reaction to 100% O2?
A
  • Normal (rarely increased)
  • Incrreased
  • No
85
Q

Diffusion impairment:

  • PaCO2
  • A-a gradient
  • Reaction to 100% O2?
A
  • Normal or decreased
  • Increased
  • Yes
86
Q

A barcode sign indicates:

A

Pneumothorax

87
Q

Inferior leads: + which artery?

A

II, III, AVF –> RCA

88
Q

Lateral leads:

A

I, AVL, V5, V6 –> CX

89
Q

Septal leads:

A

V1, V2 –> LAD

90
Q

Anterior leads:

A

V3, V4 –> LAD

91
Q

Valvular stenosis leads to:

A

Pressure overload cardiac hypertrophy, which results in an increase in wall thickness

92
Q

Valvular insufficiency leads to:

A

Volume overload cardiac hypertrophy, which results in dilation of the ventricle

93
Q

Class 1 shock:

  • Volume loss
  • S:
  • D:
  • Pulse rate
A
  • 750 ml
  • Normal
  • Normal
  • Normal
94
Q

Class 2 shock:

  • Volume loss
  • S
  • D
  • Pulse rate
A
  • 800-1500
  • Normal
  • Increased
  • 100-120
95
Q

Class 3 shock:

  • Volume loss
  • S
  • D
  • Pulse rate
A
  • 1500-2000 ml
  • Decreased -
  • Decreased -
  • 120 +
96
Q

Class 4 shock:

  • Volume loss
  • S
  • D
  • Pulse rate
A
  • > 2000 ml
  • Decreased - -
  • Decreased - -
  • 120+ and thready

Year 3 (4 decks)

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