Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Revision > Critical Care > Flashcards

Critical Care Flashcards

1
Q

Features of TCA overdose

What changes are seen on ECG?

A

Excessive sedation, dry mouth and dry flushed skin
Tachycardia, sweating, dilated pupils (sympathomimetic effect)
Hypotension
ECG - sinus tachycardia, prolongedQRS, QT, PR
Wide QRS, broad complex tachycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Management of TCA overdose

A

ECG monitor
Metabolic acidosis- IV bolus NS 250ml
+ Na bicarbonate 50mmol slowly of 8.4% NaHco3 IV

Aim for pH 7.5-7.55
The bicarbonate will correct the ecg changes and cardiac rhythm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Electrolyte imbalance in refeeding syndrome?

A

Hypophosphatemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is refeeding syndrome?

A

Metabolic disturbances that occur as a result of reinstitution of nutrition in patient who have starved/severely malnourished

Starvation — low glucose, low insulin , high glucagon, increased gluconeogenesis == hypophosphatemia as a result of depletion of phosphate stores due to low glucose

Refeeding -high glucose, high insulin, increased cellular uptake of phosphate
Hypophosphatemia from starvation + phosphate demand from refeeding

== severe hypophosphatemia
- tissue hypoxia, myocardial dysfunction, diaphragm can’t contract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Other electrolyte imbalances in refeeding syndrome

A

Hypophosphatemia
Hypokalemia
Hypomagnesemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How do you avoid refeeding syndrome?

A

Slow feeds

Magnesium K+ and phosphate supplement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What drug is useful in SAH

A

Aspirin/ClopidogreL

Sumatriptan/ Nimodipine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What serious complication can occur with SAH at 4-12 days

How do you manage it

A

Cerebral vasospasm

Diminish this by giving calcium antagonist (Nimodipine) for 5-14 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Most common cause of SAH

A

Aneurysm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Common associated genetic conditions to SAH

A

Ehler-Danlos

Polycystic kidney disease (ADPKD) - HTN + repeated kidney stones = assoc. berry aneurysm = assoc SIADH = HypONa**

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Dx SAH

A

CT w/o contrast
If inconclusive - LP after 12 hrs on onset
= bloody CSF -> Xanthochromic (due to bilirubin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Splenic rupture manifestations

A

Left sided chest pains + abdomen * esp after RTA
Rapid fall in BP
Rise in HR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Findings on imaging splenic rupture

What method is diagnostic?

A

XR - Absent left posts shadow
FAST - free peritoneal fluid
CT** DIAGNOSTIC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

If splenic rupture is confirmed what is the Tx?

A

Urgent surgery

*subsplenic hematoma can be treated conservatively if stab;e and kept under observation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Coiled NGT above hemidiaphragm after RTA is a sign of?

A

Diaphragmatic rupture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the most accurate way of assessing NGT placement

A

XRAY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is triple vessel disease?

A

LAD RCA Circumflex arteries are blocked with atherosclerotic plaques

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Management of ACS in pt with triple vessel disease + anemia

ECG shows ST depression ischemia in several leads

A

Dual anti platelets - aspirin + clopidogrel
+ SC Fondaparinux ( LMWH)
+blood transfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Heart ischemia - what 2 meds should be given

What is the indication for blood transfusion

A

Aspirin oral
SC LMWH - Fondaparinux

Blood transfusion -
Hb < 80 g/l + sx of anaemia
Or
Hb < 70 g/l with or w/o sx of anaemia

20
Q

Death certificate

What is to be written in 1a or 1b

A

1a - clear and specific “disease or condition directly leading to death”

1b - write the condition that has lead to 1a

21
Q

When do you intubate in resp failure?

A

Desaturation despite HF O2 + silent chest

22
Q

Medications that can cause metabolic acidosis

A

Paracetamol
Aspirin
Alcohol
SSRI (e.g citalopram)

23
Q

Respiratory conditions that cause Respiratory acidosis

A

Asthma

COPD

24
Q

What metabolic abnormality can be seen in pulmonary contusion

A

Respiratory acidosis

Fall on chest - contusion/ oedema - hypoxemia + CO2 accumulation

25
Q

What metabolic abnormality is seen in PE and panic attacks

A

Resp alkalosis

*PAO2 is NORMAL in panic attacks and LOW in PE

26
Q

What is the GCS

At what GCS should you intubate?

A

E - 4 = spontaneous, speech, pain, no response
V - 5 = oriented, sentences, words, sound, no responses
M - 6 - obeys, localises pain, flex-pain, ext-pain, no response

13-15 - mild
9-12 - moderate
3-8 - severe

Below 8 - intubate

27
Q

What is acute chest syndrome?

A

a complication of sickle cell disease

New pulmonary infiltration on CXR + >/= 1 of :
Chest pain
Cough 
Sputum
Fever
Hypoxia
Lung infiltrates
28
Q

What is the most common presenting complaint of acute chest syndrome in adults

A

Chest pain when breathing

29
Q

What is the most common presenting complaint of acute chest syndrome in children/infants

A

Fever cough tachypnea hypoxemia or abdominal pain

30
Q

Treatment of acute chest syndrome

A

Adequate analgesia - morphine sulphate
O2
Empiric antibiotics

Blood transfusion depending on clinical investigations

Careful with IV fluid as it may worsen pulmonary oedema

31
Q

HTN + chest pain radiating to back + big pressure difference in rt & lt arm
What do you suspect?
What is your investigation of choice ?

A

Aortic dissection
If stable - CT angio
Unstable - TEE (transoesophageal echo)

32
Q

What are important risk factors of aortic dissection?

What is seen on the CXR?

A

Marfans syndrome
Ehler-Danlos

CXR - wide mediastinum

33
Q

What is a massive blood transfusion?

A

Pt receives >= 10 units of blood or 50% blood volume within 24 hours

34
Q

Important complications of blood transfusion

A

Hypocalcemia
Hypomagnesemia
Hypo/Hyperkalemia
Metabolic alkalosis - citrate is metabolised to bicarbonate — increased pH

Hypomagnesemia/calcemia can result due to citrate toxicity - when citrate is high Ca++ and Mg++ bind to it and thus become reduced

35
Q

How many grams of citrate does 1 unit of blood contain?

A

3g

36
Q

Red flag criteria of sepsis (10)

What happens if any of the red flag criteria are present?

A 
Responds to voice/pain/unresponsive*
Acute confusional state
Systolic BP 40 from normal*
HR >130*
RR >_ 25/min*
Pt  requires oxygen to keep spo2 >_ 92%
non blanching rash , mottled ashen or cyanotic
UO _2mmol/l*
Recent chemo

Start SEPSIS 6 - give 3 take 3

Give - high flow o2, IV fluids (500 ml bolus <15 mins), iv broad spectrum ABx
Take - blood cultures, FBC U&E clotting factors, lactate
Start monitoring UOP hourly

Admit with in patient management

37
Q

What are the signs of AKI in sepsis?

A

Oliguria

High serum urea and creatinine

38
Q

What is septic shock?

A

Sepsis + BP fails to respond to fluid bolus

39
Q

What is one of the most common causes of tension pneumothorax?

A

Mechanical ventilation

Suspect it if patient on MV and suddenly deteriorates and develops low O2 saturation and hypotension

40
Q

Fat embolism vs tension pneumothorax

A

FE - long bone fracture , desaturation, hypotension

TP - decreased air entry on one side of chest
Higher pressure required to achieve tidal volume
These make a dx of TP more likely

41
Q

What is the appropriate fluid for dehydration caused by vomiting and diarrhoea?

A

NS .9% NaCl

42
Q

Hemodynamics of shock

A

Hypovolemic shock = decreased preload
CO and after load increase

Cardiogenic shock - preload & after load increase; CO decreases

Distributive shock - decreased preload and afterload ; CO increases

Preload=PCWP
Afterload = SVR

43
Q

Treatment of aortic dissection

A

Give iv beta blockers = labetalol

44
Q

How do you manage drug induced hyperthermia?

A

Dantrolene

45
Q

MDMA/ ecstasy overdose symptoms

A 
Agitation confusion*, anxiety, ataxia
Tachycardia *, HTN
Tachypnea*
Thirst*
Metabolic acidosis* - increased venous lactic acid
Hyyperthermia*
Spots of colours*
Uncontrolled body movements, muscle rigidity *, trismus.
46
Q

How do you manage and MDMA overdose

A

Supportive care - ABC + treat metabolic acidosis
IV diazepam or lorazepam - for agitation
Dantrolene - hyperthermia if simple measures fail

Revision (31 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions