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EOR - Internal Med > Critical Care > Flashcards

Critical Care Flashcards

1
Q

4 renal causes of acute abdomen

A

stones
RCC
pyelo
glomerulonephritis

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2
Q

pancreatic causes of acute abdomen

A

pancreatitis
pancreatic ca

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3
Q

3 gallbladder causes of acute abdomen

A

cholecystitis
choledocholithiasis
ascending cholangitis

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4
Q

2 hepatic causes of acute abdomen

A

hepatitis
cirrhosis

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5
Q

2 splenic causes of acute abdomen

A

rupture
infarct

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6
Q

3 gastric causes of acute abdomen

A

PUD/perforated ulcer
gastritis
GERD

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7
Q

intestinal causes of acute abdomen

A

obstruction
cancer
volvulus
appendicitis
gastroenteritis
ileus
hernia
mesenteric ischemia
diverticulitis
IBD
IBS
celiac

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8
Q

pelvic causes of acute abdomen

A

ovarian torsion
ectopic
ruptured ovarian cyst
PID
endometriosis
vaginitis
cystitis

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9
Q

tx for primary adrenal insufficiency (addisons)

A
  1. hydrocortisone
  2. fludrocortisone
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10
Q

t/f: fludrocortisone should be used for secondary adrenal insufficiency

A

f!

only for primary

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11
Q

tx for secondary adrenal insufficiency

A

pituitary adenoma resection
iatrogenic: wean steroids

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12
Q

presentation of upper GIB

A

hematemesis/coffee ground emesis
melena: black tarry stool

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13
Q

upper GIB’s originate proximal to the

A

ligament of treitz

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14
Q

6 causes of upper GIB

A

peptic ulcer
esophageal ulcer
mallory weiss tear
esophageal varices
malignancy
erosive esophagitis

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15
Q

odynophagia
GERD
dysphagia

A

esophageal ulcer

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16
Q

emesis, retching, or coughing -> hematemesis

A

mallory-weiss tear

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17
Q

odynophagia, dysphagia
retrosternal chest pain

A

erosive esophagitis

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18
Q

indications for blood transfusion

A

high risk pt: hgb < 9
low risk pt: hgb < 7

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19
Q

empiric tx for uppper GIB

A

IV PPI

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20
Q

hallmark presentation of lower GIB

A

hematochezia/BRBPR

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21
Q

6 causes of lower GIB

A

hemorrhoids
anal fissure
proctitis
polyps
colorectal ca
diverticulitis

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22
Q

painless bleeding w. wiping

A

hemorrhoids

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23
Q

severe rectal pain w. defecation

A

anal fissure

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24
Q

painless rectal bleeding
no red flag signs

A

polyps

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25
increased IOP -> optic n damage decreased flow of aqueous humor thru trabecula -> increased pressure in anterior chamber
acute glaucoma
26
2 types of glaucoma
**open angle - mc** angle closure - emergency
27
acute glaucoma triad
injected conjunctiva steamy cornea fixed, dilated pupil
28
sx of acute angle closure glaucoma
**painful vision loss** tearing n/v diaphoresis
29
tx for acute angle closure glaucoma (4)
emergent ophto referral IV acetazolamide topical timolol iridotomy
30
moa for acetazolamide
carbonic anhydrase inhibitor
31
med contraindicated in acute angle closure glaucoma
mydriatics
32
2 sx of open angle glaucoma
**loss of peripheral vision** increased cup to disc ratio
33
management of angle closure glaucoma
ophto referral **1st line: latanoprost** timolol acetazolamide laser vs surgery
34
moa for latonoprost
prostaglandin analog
35
respiratory failure characterized by fluid collecting in the lungs and depriving organs of O2
ARDS
36
5 rf for ARDS
critically ill **sepsis - mcc** trauma aspiration near-drowning
37
hallmark presentation of ARDS (4)
-rapid onset of profound dyspnea 12-24 hr after precipitating event -tachypnea -pink frothy sputum -crackles
38
CXR findings of ARDS
air bronchograms bilat fluffy infiltrate
39
75% of episodes of cardiac arrest are caused by (2)
v tach v fib
40
5 h's of cardiac arrest
hypoxia hypovolemia hyperkalemia/hypokalemia H+ (acidosis) hypothermia
41
causes of cardiac arrest (5 t's)
tamponade tension ptx toxins thromboembolism thrombosis
42
patient's who are able to be resuscitated after cardiac arrest may have improved outcomes w. what treatment (2)
targeted temperature management implantable defibrillator
43
what medication is contraindicated in stable, chronic diastolic HF
diuretics decrease preload -> may further impair filling
44
how does morphine function in diastolic heart failure
reduces preload
45
how do nitrates work in diastolic heart failure
reduce preload O2
46
poor prognostic factors w. CHF
CKD DM lower LVEF severe sx old age
47
build up of fluid btw the pericardial sac and the heart that constricts the heart
cardiac tamponade
48
2 types of tamponade
-acute onset: trauma, MI, aortic dissection, pericardial effusion -slow onset: cancer, chronic inflammation, uremic pericarditis, hypothyroidism, connective tissue dz
49
beck's triad for cardiac tamponade
muffled heart sounds JVD hypotn
50
what is this showing
electrical alternans -> cardiac tamponade
51
hallmark PE finding of cardiac tamponade
pulsus paradoxus: 10 mmHg drop in SBP on inspiration narrow pulse pressure
52
what is this showing
water bottle heart -> cardiac tamponade
53
tx for cardiac tamponade
pericardiocentesis
54
2 brainstem reflexes
pupillary light eye movements
55
pathology behind pupillary light reflex defects
-anisocoria (asymmetric pupils): uncal herniation -pinpoint pupils: narcotics, ICH -bilat fixed, dilated pupils: severe anoxia -unilateral fixed, dilated pupil: CN3 compression
56
what is the oculocephalic test
when head is turned to one side, eyes should move conjugately to the opposite direction if brainstem is intact
57
sure way to know brainstem is intact
pt can breathe on their own
58
how does DKA cause hypokalemia
insulin deficiency -> hyperglycemia -> dehydration -> ketonemia -> anion gap metabolic acidosis -> potassium deficit
59
hallmark labs of DKA
BG > 250 pH < 7.3 bicarb < 18
60
healthy pt w. fasting hypoglycemia
insulinoma mc: adenoma of islet of langerhans
61
-sx of hypoglycemia usually occur at what BG level -impaired brain fxn usually occrus at what BG leve
sx: <60 impaired brain fxn: <50
62
5 meds that cause hypoglycemia
FQ quinine ACEI salicylates bb
63
what is factitious hypoglycemia
self induced
64
mcc of postprandial hypoglycemia
gastric surgery
65
lifestyle management of postprandial hypoglycemia
small meals increase complex carbs/fiber reduce simple carbs
66
pharm for post prandial hypoglycemia
octreotide 30 min prior to meals
67
classifications of hypertensive crisis
urgency: >180/120 w.o organ damage emergency: >180/120 w. organ damage malignant: DBP > 140
68
malignant htn is associated w. (3)
papilledema encephalopathy nephropathy
69
tx for htn urgency vs emergency vs malignant
urgency: clonidine emergency: sodium nitroprusside malignant: hydralazine
70
in MI, troponin appears at: peaks at: lasts:
appears: 2-4 hr peaks: 12-24 hr lasts: 7-10 days
71
in MI, CK/CK-MB appears: peaks: lasts:
appears at: 4-6 hr peaks at: 12-24 hr lasts for: 48-72 hr
72
in MI, myoglobin appears: peaks: lasts:
appears: 1-4 hr peaks: 12 hr lasts: 24 hr
73
management of MI
bb NTG asa + clopidogrel heparin ACEI statins PCI
74
management of MI
bb NTG asa + clopidogrel heparin ACEI statins PCI
75
timeline for 2 types of reperfusion in STEMI
1. PCI w.in 90 min 2. thrombolytics w.in 3 hr if PCI not available
76
causes of pleural effusion (lots!)
aortic dissection heart failure hypoalbuminemia lymphatic obstruction malignancy radiation renal failure trauma AI dz acute pericarditis myxedema drugs iatrogenic idiopathic
77
ekg findings of pericardial effusion
low voltage QRS electrical alternans
78
3 PE findings of PTX
decreased tactile fremitus hyperresonance to percussion diminished breath sounds
79
3 causes of secondary PTX
asthma CF ILD
80
management of PTX based on size
<15% diameter of hemithorax: resolve spontaneously >15% diameter of hemithorax: chest tube serial CXR q 24 hr
81
management of tension PTX
large bore needle decompression
82
pharm management of PE
acute: heparin post acute: Xa inhibitors, DOACs
83
duration of anticoagulation with PE
reversible rf: 3 mos unprovoked: 6 mos 2 episodes unprovoked: indefinite
84
s/sx of shock
weakness hypotn tachycardia tachypnea sweating anxiety increased thirst anuria/oliguria AMS lactic acidosis
85
initial management of shock
fluid bolus (500-1,000 L NS vs LR) pressors if hypotn persists depite fluids
86
4 types of shock
cardiogenic hypovolemic neurogenic septic
87
2 types of hypovolemic shock
hemorrhagic nonhemorrhagic
88
5 causes of non hemorrhagic hypovolemic shock
vomiting diarrhea dehydrtation burns third spacing
89
4 causes of neurogenic shock
SCI head injury spinal anesthesia vascular tone
90
sz lasting > _ may result in permanent brain damage
60 min
91
thyroid storm is caused by (2)
graves dz toxic multinodular goiter
92
5 precipitating factors for thyroid storm
infxn trauma embolism DKA preeclampsia
93
6 s/sx of thyroid storm
heat intolerance palpitations wt loss tachycardia anxiety jaundice
94
why does jaundice occur w. thyroid storm
increased peripheral consumption of O2 -> hepatic tissue hypoxia
95
management of thyroid storm
bb PTU vs methimazole iodine hydrocortisone bile acid sequestrants (cholestyramine)
96
moa for PTU
inhibits conversion of thyroxine to triiodothyronine

EOR - Internal Med (13 decks)

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