Ch 5, 6, 41, 69, shock, dysthymia, PV injury

Question 1

What is the relationship bw compliance (C), stroke volume (SV) and pulse pressure (PP)?

Answer 1

C = SV/PP

Question 2

What conditions can cause a prolongation of the rapid upstroke phase of the capnography curve?

Answer 2

Bronchospasm, COPD, asthma, kinked ET tube

Question 3

If pts in shock require > 4L of fluid, what should you add?

Answer 3

Albumin 5-10 mL/kg Bolus

Question 4

Pts w/signs of hemorrhagic shock and suspected CNS trauma or GCS < 9 should be treated how?

Answer 4

Immediate PRBC

Question 5

What is the MC blunt trauma cause of popliteal artery injury?

Answer 5

Posterior knee dislocation

Question 6

Cascade of what will appear after reperfusion injury?

Answer 6

Oxygen free radicals
Lipid peroxidation
Influx of intracellular calcium

Question 7

What major artery runs with median nerve?

Answer 7

Brachial a

Question 8

What major artery runs w/tibial nerve?

Answer 8

Popliteal artery

Question 9

ABI less than what indicates pathology?

What is the next step to do?

Answer 9

Less than 90%

CTA

Question 10

Reperfusion injury occurs d/t what compounds?

Answer 10

Oxygen free radicals, lipid peroxidation, influx of intracellular Ca

Question 11

How many hours of complete warm ischemia is generally considered the point at which irreversible nerve and muscle damage begin to occur?

Answer 11

6 hours

Question 12

AV node has intrinsic impulse rate of what?

His and Purkinje?

Answer 12

45-60

30-45

Question 13

What term refers to early ventricular depolarization via accessory pathway?

Answer 13

Pre-excitation

Question 14

What do class I agents work on?

Results in what?

Answer 14

Fast Na channels

Membrane stabilization

Question 15

Class II agents act how?

What are they

Answer 15

Depress SA node automaticity, slow AV node conduction

BBers

Question 16

Class III agents work how?

Are what?

Answer 16

Prolong repolarization and refractory period duration pred via K+ channels

sotalol, amiodarone

Question 17

Class 4 agents act how?

Are what?

Answer 17

Slow conduction through the AV node

CC blockers

Question 18

What is the only purely peripherally acting CCB?

What can attenuate vasodilatory effects?

Avoid Class 4 drugs in what patients?

Answer 18

Nifedipine

1g IV calcium sulfate

2nd and 3rd degree heart block

Question 19

How to dose IV Diltiazem bolus?

Then what infusion rate?

Orally?

Answer 19

.25 - .35 mg/kg over 2 minutes

5-15 mg/hr

Orally 60-90 mg

Question 20

Pediatric dose of Adenosine?

Total is what?

Answer 20

.05 mg/kg then double

.25 mg/kg

Question 21

Sinus bradycardia treated 1st line with what med and dose?

Answer 21

Atropine 0.5 mg IV bolus repeated 3-5 min

Up to total dose of 3mg

Question 22

What is AVNRT?

Result of what?

Answer 22

Aka PSVT or SVT
Regular, narrow complex w/rate > 130 or > 160

Reentry circuit w/in the AV node

Question 23

Where does VTach originate?

What is nonsustained VTach?

Answer 23

Within or below bundle of His

< 30s resolves spontaneously

Question 24

How to treat stable VTach?

2nd line?

Answer 24

Amiodarone 3-5 mg/kgIV over 20 minutes —> usual dose is 250-350mg

Procainamide 30-50 mg/min IV up to 18 mg/kg max

Question 25

What are the 2 congenital prolonged QT syndromes?

Answer 25

Jervell and Lange-Nielsen (deaf, AR)

Romano-Ward (normal, AD)

Question 26

What is the primary electrochemical difference bw pacemaker and nonpacemaker cells?

Answer 26

Slow phase 4 spontaneous depolarization via slow Na+ influx in pacemaker cells