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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
Type C pelvic fractures:
both rotationally and vertically unstable
26
Type B pelvic fractures:
Rotationally unstable but vertically unstable.
27
Aortic dissection:
a tear in the lumen of the aorta that caused blood to flow between the layers of the aortic wall.
28
What is the cause of aortic dissection?
degeneration of the elastin/collagen in the intima causing a breach in the lumen
29
What is the most common place for an aortic dissection?
The ascending aorta (65%)
30
Normal PaO2 values:
10,0-13,3 kPa
31
Normal PaCO2 values:
4,7-6,4 kPa
32
Bicarbonate
22-26 mmol/L
33
Triad of death:
Hypothermia, acidosis, coagulopathy
34
Septic shock is clinicaly characterized by:
- Hypotension following volume treatment AND | - serum lactate > 2 mmol/L
35
Knee mottling
Represents poor circulation in septic shock
36
The cardiac function curve rotates up through:
Increased HR
37
The cardiac function curve rotates down through:
Decreased HR
38
The vascular function curve shifts right through:
Increased blood volume or venoconstriction
39
The vascular function curve shifts left through:
decreased blood volume or venodilation
40
The vascular function curve rotates up through:
Arterial vasodilation (decreased preload)
41
The vascular function curve rotates down through:
Arterial vasoconstriction (increased preload)
42
What happens to the body during sepsis that affects the vascular function curve? + result?
Massive vasodilation --> the curve shifts to the left. The result is a decrease in CO
43
Renal insufficiency is characterized by:
Decreased GFR
44
Prerenal renal insufficiency is caused by:
Hypovolemia/low CO
45
Renal renal insufficiency is caused by:
Acute tubular necrosis/ acute interstitial nephritis
46
Changes in renal insufficiency: - Prerenal cause - Renal cause
- increased RAAS action --> increased sodium reabsorption --> low urine sodium (<20 mmol/L) - decreased sodium reabsorption --> high urine sodium (>50 mmol/L)
47
First degree burn: - Damage to: - Characteristics: - Healing in:
- only damage to the epidermis - painful, red and dry, capillary refill intact - Days
48
Superficial 2nd degree burn: - Damage to - Characteristics - Healing in
- Damage to the dermis with intact skin adnexae - Very painful, red, shiny/moist, blistering, capillary refill intact - Healing <2 weeks
49
Deep 2nd degree burn: - Damage to - Characteristics - Healing in
- 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
3rd degree burn: - Damage to - Characteristics - Healing:
- Full thickness of the skin - Dry, white/black, no blistering, no pain, no capillary refill - Skin grafting required.
51
Extensive burns: - In adults - In children
- In adults: >15% of the body surface area; | - In children: >10%
52
An ulcer is defined as:
a persistent defect in an epithelial or mucosal surface.
53
The virulence of an organism depends on:
its qualities of adherence and invasiveness and its ability to produce toxins.
54
Intermittent claudication:
pain on walking, usually felt in the calf
55
Chronic ischemic rest pain:
Ischemic pain felt during rest. This is usually felt in the skin of the foot
56
An aortic dissection forms a false lumen between the:
Media and adventitia
57
Stanford type A:
any dissection in which the ascending aorta is involved.
58
Stanford type B:
Only the descending aorta is involved.
59
Formula of anion gap:
[Na+]-[Cl-]-[HCO3-]
60
Normal anion gap:
10-14 mmol/L
61
When is the anion gap increased:
whit excessive production of a nonvolatile acid.
62
When is the anion gap normal?
When there is bicarbonate loss
63
What is the change of the vascular function curve in hypovolemic or distributive shock?
A shift to the right because of decreased blood volume in hypovolemic shock and venodilation in distributive shock
64
What happens to the vascular function curve in obstructive shock?
Rotation downwards, because of increased resistance to blood flow
65
What happens to the cardiac function curve in cardiogenic shock?
Rotates downwards because of decreased contractility
66
Fluid challenge:
Infusion of a small bolus of fluid in 5-10 min and see if the patient improves
67
Aortic aneurysm:
A dilation of the aorta of >3 cm
68
Pulmonary hypertension is defined as:
a mean pulmonary artery pressure of >25 mmHg
69
Definition of dyspnea:
a sense of awareness of increased respiratory effort that is unpleasant and that is recognized by the patient as being inappropriate.
70
Respiratory failure:
occurs when pulmonary gas exchange is sufficiently impaired to cause hypoxemia with or without hypercapnia
71
Type 1 respiratory failure is characterized by:
PaO2 is low and PaCO2 is normal or low
72
Type 1 respiratory failure is caused by:
diseases that cause lung tissue damage.
73
Type 2 respiratory failure is characterized by:
PaO2 is low and PaCO2 is high
74
In type 2 respiratory failure, there is:
Insufficient ventilation to remove enough CO2
75
The cardinal feature of ARDS
Non cardiogenic pulmonary edema
76
Formula for A-a gradient:
(20-PaCO2/0.8)-PaO2
77
Normal A-a gradient:
<15 mmHg or 2 kPa
78
An increased A-a gradient indicates:
A defect in diffusion, V/Q mismatch or right-to-left shunt
79
FEV1/FVC ratio:
Represents the proportion of a persoon's vital capacity that they are able to expire in the first second of forced expiration.
80
An FEV1/FVC ratio below 70% indicates:
an obstructive lung disease
81
In hypoventilation, the A-a gradient is:
Normal
82
Hypoventilation: - PaCO2 - A-a gradient - Reaction to 100% O2?
- Increased - Normal - Yes
83
Ventilation perfusion mismatch: - PaCO2 - A-a gradient - reaction to 100% O2?
- Normal (sometimes increased) - increased - yes
84
Shunt: - PaCO2? - A-a gradient - reaction to 100% O2?
- Normal (rarely increased) - Incrreased - No
85
Diffusion impairment: - PaCO2 - A-a gradient - Reaction to 100% O2?
- Normal or decreased - Increased - Yes
86
A barcode sign indicates:
Pneumothorax
87
Inferior leads: + which artery?
II, III, AVF --> RCA
88
Lateral leads:
I, AVL, V5, V6 --> CX
89
Septal leads:
V1, V2 --> LAD
90
Anterior leads:
V3, V4 --> LAD
91
Valvular stenosis leads to:
Pressure overload cardiac hypertrophy, which results in an increase in wall thickness
92
Valvular insufficiency leads to:
Volume overload cardiac hypertrophy, which results in dilation of the ventricle
93
Class 1 shock: - Volume loss - S: - D: - Pulse rate
- 750 ml - Normal - Normal - Normal
94
Class 2 shock: - Volume loss - S - D - Pulse rate
- 800-1500 - Normal - Increased - 100-120
95
Class 3 shock: - Volume loss - S - D - Pulse rate
- 1500-2000 ml - Decreased - - Decreased - - 120 +
96
Class 4 shock: - Volume loss - S - D - Pulse rate
- >2000 ml - Decreased - - - Decreased - - - 120+ and thready

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