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Critical Care Flashcards

1
Q

Cardioplegia solution

A

High concentration potassium

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2
Q

Location of the SA node

A

Junction of RA and SVC

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3
Q

Most common cause of acquired aortic stenosis

A

Calcific degeneration

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4
Q

Mild hypothermia

A

90-94 shivering and mild mental changes, tachycardic

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5
Q

Moderate hypothermia

A

(84-89) agitated combative, afib hypoT

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6
Q

Severe hypothermia

A

(70-84) flaccid comatose, vfib, death

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7
Q

Profound hypothermia

A

(<70) loss of vitals/cardiac activity

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8
Q

Unstable patient in afib; tx

A

Synchronized cardioversion

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9
Q

Tx systolic heart failure with fluid overload

A

Dobutamine and diuretics

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10
Q

Cardiac arrest hypothermic; next step

A

ABC’s then immediate rewarming

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11
Q

PCWP 6; CO 1.5; SVR 400; venous O2 50%

A

Neurogenic shock

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12
Q

Pre-op workup for patient able to perform 4 METs

A

None

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13
Q

Lethal triad

A

Hypothermia, coagulopathy, metabolic acidosis

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14
Q

CPP define and target for TBI

A

CPP=MAP - ICP; 60-70mmHg

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15
Q

Percent septic shock idiopathic

A

30%

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16
Q

Septic shock resuscitated and started on NE with MAP of 50; next step

A

Vasopressin 0.03units/min

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17
Q

Sodium deficit

A

(Desired sodium - patients sodium) x TBW(60% males and 50% females)

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18
Q

High CVP, PCWP and SVR with low CI; type of shock

A

Cardiogenic

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19
Q

Renal response to hypovolemia

A

Vasoconstriction of efferent arteriole, secretion of ADH, RAAS stimulation

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20
Q

Definitive treatment hyperkalemia

A

Dialysis

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21
Q

Highest risk surgeries for post-op delirium

A

Cardiothoracic followed by ortho

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22
Q

Most common risk factor for post-op afib

A

fluid overload

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23
Q

PCWP 6, CI 1.5, SVR 1800, venous O2 50%; type of shock

A

Hypovolemic or hemorrhagic

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24
Q

POD2 hypoxia with normal vitals, exam, CXR; dx and tx

A

Atelectasis, IS

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25
Q

Gradual change in amplitude with twisting of QRS around isoelectric line; dx and tx

A

Torsades; IV magnesium 2g push followed by 2-3mmol/L infusion

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26
Q

Gastric outlet obstruction acid-base/electrolyte disorder and renal excretion

A

hypochloremic hypokalemic metabolic alkalosis, aciduria with potassium excretion

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27
Q

Precipitates dysrhythmias even at low-normal potassium levels

A

Digoxin (binds to Na/K ATPase at K+ binding site

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27
Q

Precipitates dysrhythmias even at low-normal potassium levels

A

Digoxin (binds to Na/K ATPase at K+ binding site

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28
Q

Post-op SOB, ipsilateral dullness to percussion, decreased breath sounds, contralateral tracheal deviation; dx

A

Pleural effusion/empyema

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29
Q

Orientation of great neck vessels for IJ placement

A

IJ lateral to Common Carotid

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30
Q

Early finding of compartment syndrome

A

Pain with passive stretch

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31
Q

Compartment pressure indicating fasciotomy

A

Delta 20-30mmHg

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32
Q

Hard sign to stop therapeutic hypothermia

A

Hemorrhage

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33
Q

Marker for Hepatorenal syndrome and tx

A

Decreased GFR, transplant

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34
Q

Spine trauma, hypertension, bradycardia and diaphoresis; dx, level of injury

A

Autonomic dysreflexia, T6 or above

35
Q

Unstable, suspected pulm art injury s/p Swan-Ganz placement; next step

A

mediam sternotomy

36
Q

Hypertension, hypokalemia, hypernatremia, metabolic alkalosis); dx and next step

A

Hyperaldosteronism, serum renin/aldosterone

37
Q

Primary v secondary hyperaldosteronism (renin/aldo)

A

Primary - reduced renin, elevated Aldo and ratio
Secondary - elevated renin/aldo and Aldo/renin ~10

38
Q

Hyperglycemia in critical illness due to what

A

Insulin resistance

39
Q

Hx of COPD s/p lobectomy in afib; tx

A

Rate control with CCB

40
Q

Atelectasis effect on FRC and VC

41
Q

NE receptors and effects

A

alpha-1, peripheral vasoconstriction
alpha-2, splanchnic vasoconstriction
beta-1, increased HR and contractility

42
Q

Concerned for CO poisoning; next step

A

Send carboxyhemoglobin and start 100% O2

43
Q

Vfib; next step

A

Administer non-synchronized cardio version of 200J, followed by another 200J with 1mg epinephrine every 3-5min

44
Q

Intra-abdominal hypertension; tx

A

Decompress with NG, Foley and Rectal tubes

45
Q

Effects of compartment syndrome (card/pulm/renal)

A

Decreased preload/CO, increased peak airway pressures, renal dysfunction

46
Q

Inferior wall infarct; next step

A

Saline bolus to increase preload and hypotension

47
Q

Post-op resp failure, hypoxia, tachycardia, tachypnea, respiratory alkalosis; dx

48
Q

Lung-protective ventilation in ARDS

A

4-6mL/kg TV and plateau pressure <30cmH20
Also prone >12hrs and P:F<100 has survival benefit

49
Q

Rate of sodium correction for children with acute severe hypernatremia

A

no more than 0.5 mEq/L/hour or 10-12 mEq/L/day

50
Q

Hydronephrosis from ureteral obstruction refractory to conservative management; tx

A

Perc nephrostomy

51
Q

Causes of anion-gap metabolic acidosis

A

Methanol
Uremia
Diabetic ketoacidosis
Propylene glycol
Isoniazid
Lactic acidosis
Ethylene glycol
Salicylates

52
Q

Hyponatremia <120; tx and rate

A

Hypertonic saline (3%), 0.5 mEq/h

53
Q

Normal anion gap acidosis causes

A

Loss of bicarb (diarrhea, ileostomy, EC fistula, type II/proximal RTA)
Decreased renal acid excretion (type I/distal RTA)

54
Q

Early sign of hypocalcemia

A

circumoral or fingertip paresthesias

55
Q

Lung cancer, bx with absent nucleoli, hyponatremia; dx

A

SIADH secondary to small-cell lung cancer

56
Q

Lung cancer, hypercalcemia; dx

A

Squamous cell carcinoma of the lung (PTH-related peptide)

57
Q

Components of LR

A

Na 130
K 4
Cl 109
Ca 2.7
Lactate 28

57
Q

Components of LR

A

Na 130
K 4
Cl 109
Ca 2.7
Lactate 28

58
Q

High ileostomy output; acid-base disorder

A

Normal anion gap metabolic acidosis

59
Q

Complication from severe hyponatremia <115

60
Q

Risk of rapid correction of hyponatremia

A

Central pontine myelinolysis or osmotic demyelination syndrome

60
Q

Risk of rapid correction of hyponatremia

A

Central pontine myelinolysis or osmotic demyelination syndrome

61
Q

FENa

A

FENa =[(Urine Na/Serum Na) / (Urine Creatinine/Serum Creatinine)] x 100)

62
Q

FENa < 1; dx and tx

A

Prerenal AKI, IV fluid resuscitation

63
Q

FENa > 2; dx and tx

A

Intrinsic AKI, adress underlying renal pathology

64
Q

FENa > 4; dx and tx

A

Postrenal AKI, relieve obstruction

65
Q

Vit D effects on Calcium

A

Vit D increases absorption of Ca in small intestine

66
Q

Free-water deficit

A

FWD = weight x 0.5women or 0.6men x [(Na-140)/140]

67
Q

Euvolemic, hyponatremia, asymptomatic; tx

A

Free water restriction

68
Q

pH 7.25, PaO2 88, PaCO2 60, HCO3- 26; acid base disorder

A

Respiratory acidosis

69
Q

Hyponatremia in the setting of DKA; dx

A

Pseudohyponatremia

70
Q

Maintenance fluid newborn and why

A

1/4NS with D5, decreased GFR with poor ability to concentrate urine

71
Q

Gastric fluid loss

72
Q

Biliary and Pancreatic fluid loss

A

500 and 1500mL

73
Q

Small bowel fluid loss

74
Q

Adrenal response to hyperkalemia

A

Aldosterone production by zone glomerulosa

75
Q

Best measurement of intravascular volume

76
Q

Hypomagnesemia effects on Ca, PTH, Cacitriol

A

Hypocalcemia, hypoparathyroidism, decreased calcitriol synthesis

77
Q

Gastric outlet obstruction; acid base disorder

A

Hypochloremic, hypokalemic, metabolic alkalosis with paradoxical aciduria

78
Q

First-line tx for hyperkalemia with ECG changes

A

Calcium gluconate

79
Q

Post-op fever and respiratory alkalosis; dx

80
Q

Femoral canal lateral to medial

A

NAVEL: Femoral nerve, artery, vein, lymphatics

81
Q

CVP 4, PCWP 10, SVR 2100, CI 1.5

A

Hypovolemic shock

82
Q

Hx of RA s/p extensive surgery with hyponatremia, hyperkalemia; dx and tx

A

Adrenal insufficiency, IV hydrocortisone

83
Q

SOFA components

A

P:F, GCS, MAP, Vaopressors, Cr and UOP, Bili, Plt

84
Q

SBT readiness criteria

A

Lack of profound hypoxemia or pH derangement, hemodynamic stability, ability to initiate breathe

ABSITE (34 decks)

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