Ch 11 And 22

Question 1

When is cyanosis evident?

Answer 1

Desaturated Hg in circulating capillary blood is elevated to 5 g/dL

Question 2

Where to see central cyanosis?

Answer 2

Perforation skin, oral mucosa, conjuctivae

Question 3

Where to see peripheral cyanosis?

Affects what?

Answer 3

Extremities and nail beds

Capillary beds

Question 4

DDx of peripheral cyanosis?

Answer 4

Low CO states - shock, LV failure, hypoVol
Environmental
Arterial occlusion - thrombosis, embolism, vasospasm, PVD

Question 5

DDx of central cyanosis?

Answer 5

Dec art ox saturation
-high altitude
-impaired pulm fx —> V/Q mismatch vs respiratory compromise
Anatomic shunts

Question 6

First point in evaluation algorithm of peripheral cyanosis?

Answer 6

ABCs, Check O2 sat, GIVE O2

If improves w/O2 then consider low CO states

If it doesn’t then consider vascular occlusion and warm them

Question 7

Evaluation algorithm for central cyanosis?

Answer 7

ABCs, Check O2 sat and ABG, GIVE O2

If O2 improves get a CXR

If it does not get a CXR, CO, CN and MetHgb levels

Question 8

How to treat methemoglobinemia?

Answer 8

Methylene blue 1-2 mg/kg over 5 minutes

Question 9

Do CO and CN cause cyanosis?

Answer 9

NO!!!

Question 10

What marks RELATIVE polycythemia?

Answer 10

Inc RBC mass d/t dehydration

Question 11

What can cause an acquired methemoglobinemia?

Answer 11

Benzocaine, lidocaine, prilocaine

Question 12

Sudden onset of dyspnea, what must you consider?

Slow building dyspnea think what?

Answer 12

PTX and PE

COPD, CHF, PNA, Malignancy

Question 13

What are some non pulm-cardiac ddx for dyspnea?

Answer 13

DKA, Toxic ingestion, renal failure, epiglottitis, CO or CN poisoning, acute chest syndrome (Sickle cell), CVA, Neuromuscular (GBS, MS, tick)

Question 14

What symptoms in addition to dyspnea will make you want to intubate?

Answer 14

Decreased mental status
Inability to speak in more than 1 word sentences
Body position