Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

BTK Review 2024 > Critical Care > Flashcards

Critical Care Flashcards

1
Q

What is the formula for oxygen delivery?

A

CO x {(Hgb x SaO2 x 1.34) + (PaO2 x 0.003)}

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

What is the formula for oxygen consumption?

A

CO x (PaO2 - PvO2)

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

What is the formula for the oxygen extraction ratio?

A

O2 consumption/O2 dlivery

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

CVP is a surrogate for what other measurement?

A

RV end diastolic volume

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

Pulmonary wedge pressure is a surrogate for what other measurement?

A

LV end diastolic volume

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

What pressures can we measure to estimate RV and LV end diastolic volume?

A
  • RV = CVP
  • LV = PWP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How are cardiac output and cardiac index calculated?

A
  • output = SV x HR
  • index = CO/BSA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How do SVR, CVP, and CO change for hypovolemic shock?

A
  • SVR: increase
  • CVP: decrease
  • CO: decrease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How do SVR, CVP, and CO change for cardiogenic shock?

A
  • SVR: increase
  • CVP: increase
  • CO: decrease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How do SVR, CVP, and CO change for septic shock?

A
  • SVR: decrease
  • CVP: decrease
  • CO: increase
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How do SVR, CVP, and CO change for neurogenic shock?

A
  • SVR: decrease
  • CVP: decrease
  • CO: decrease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How dose dopamine act as a vasopressor?

A
  • low dose: dopamine receptors in kidneys
  • med dose: B1 activity
  • high dose: a activity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How does dobutamine act as a vasopressor?

A

B1 activity

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

How does milrinone work as a vasopressor?

A

is a PDE-III inhibitor which increases cAMP to reduce after load and increase CO

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

How is the SOFA score best used?

A

to compare patients and allocate resources; higher score means a higher likelihood of mortality

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

What are the criteria for septic shock?

A

lactate >2 and vasopressor requirement despite adequate fluid resuscitation

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

How is procalcitonin best used?

A

to provide guidance about when to stop antibiotics

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

Mannan antigen is a test used for what?

A

to look for invasive candidiasis

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

What is the utility of 1,3 B-d-glucan?

A

an assay used to test for fungal infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the sepsis treatment guidelines?

A
  • send cultures before antibiotics
  • start antibiotics within 1 hour
  • bolus at 30cc/kg within 3 hours
  • start pressure within 6 hours if needed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the empiric treatment for adrenal insufficiency?

A

200mg/day of hydrocortisone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What labs support the diagnosis of adrenal insufficiency?

A
  • hyponatremia
  • hyperkalemia
  • hypoglycemia
  • azotemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the difference between peak and plateau airway pressures on the vent?

A
  • peak reflect large airway pressures
  • plateau reflect alveolar pressures
24
Q

Describe the various modes of ventilator support.

25
What is the best predictor of successful extubation? What is best predictor of failure?
- best predictor of success: RSBI < 100 - best predictor of failure: NIF < 20
26
Describe the Berlin definition of ARDS.
- symptoms within 1 week of insult - characteristic bilateral opacities on CXR - no other explanation for findings - P/F ratio < 300
27
What interventions have been shown to have a mortality benefit in those with ARDS?
prone positioning, neuromuscular blockade
28
What are treatment strategies for those with ARDS?
- low TV ventilation (4-6cc/kg) - target plateau pressure < 30 - permissive hypercapnia (ok to allow for pH > 7.2) - prone positioning, neuromuscular blockade - sedation - vasodilators (inhaled NO)
29
How will an ABG change in someone with a PE?
respiratory alkalosis
30
What is the most common EKG finding associated with PE? What is the classic/pathognomonic change?
- most common: sinus tach - classic: S1Q3T3
31
Describe the believed pathophysiology contributing to hepatorenal syndrome.
portal hypertension leads to splanchnic vasodilation which decreases effective arterial blood volume and subsequently renal perfusion
32
How is hepatorenal syndrome managed?
- octreotide induces splanchnic vasoconstriction - midodrine: induces systemic vasoconstriction - albumin: increased oncotic pressure and intra-vascular volume
33
Which patients on a steroid regimen are NOT at risk for peri-operative adrenal insufficiency?
those on a steroid regimen for < 3 weeks or at < 5mg/day
34
How is peri-operative adrenal insufficiency treated?
- IV hydrocortisone 25-50mg on day of surgery and then transition to normal PTA dose for minor surgeries - IV hydrocortizone 50-75mg q8 for 1-2 days and then transition to normal PTA dose for major surgeries
35
How should oral anti-hyperglycemic medications be managed perioperatively?
- hold SGLT2 inhibitors for 3-4 days pre-operatively - hold all other PO anti-hyperglycemic medications on day of surgery
36
How is respiratory quotient calculated and used?
- it is a measure of CO2 production/O2 consumption - increases with carbohydrate overfeeding which can cause difficulty weaning from the ventilator - 0.7 = fat metabolism - 0.8 = protein metabolism - 1.0 = carbohydrate metabolism
37
How is nitrogen balance calculated and used?
= protein intake/6.25 - (urine urea nitrogen + 4) - negative balance indicates catabolism - positive balance indicates anabolism
38
How man calories are in... - carbohydrates - dextrose - lipids - protein
- carbohydrates: 4kcal/g - dextrose: 3.4kcal/g - lipids: 9kcal/g - protein: 4kcal/g
39
Which fatty acids are less inflammatory and immunogenic?
omega-3 fatty acids
40
What are the essential fatty acids?
lineolic acid alpha-lineolic acid
41
Folate deficiency contributes to what lab changes?
a macrocytic anemia
42
What are the components and role for immunonutrition?
- includes omega-3 fatty acids, glutamine, arginine - associated with lower infectious complication rates
43
What defines intra-abdominal hypertension? What about abdominal compartment syndrome?
- hypertension is sustained pressure of 12 or higher - compartment syndrome is sustained pressure of greater than 20 with new onset multi-organ failure
44
What are the signs of abdominal compartment syndrome?
- abdominal distension - oliguria - increased SVR - increased airway pressures
45
What would cause an apnea test to be indicative of brain death?
PaCO2 > 60 or increase in PaCO2 more than 20 above baseline
46
What is the diagnosis and treatment in a patient that develops hemoptysis after Swan Ganz balloon inflation?
- diagnosis is ruptured pulmonary artery - treatment is embolization
47
What is the treatment for torsades de pointes?
IV magnesium
48
What are the indications for renal replacement therapy?
- acidosis - electrolyte abnormalities - intoxicants - overload (volume) - uremia
49
Which anesthetic induction medication should be avoided in patients at risk for adrenal insufficiency?
etomidate (inhibits steroid synthesis)
50
What is a side effect of etomidate?
it inhibits steroid synthesis and puts patients at risk for adrenal insufficiency
51
What is virchow's triad?
- venous stasis, hypercoagulable state, endothelial injury - factors contributing to thrombosis
52
What is the most common post-operative complication in patients over age 65?
delirium
53
What are the indications for thrombolysis in patients with pulmonary embolism?
hemodynamic instability or with evidence of right heart strain
54
What lab values are consistent with hepatorenal syndrome?
- oliguria - increased Cr and BUN - urine Na < 10 - urine RBC < 50 - urine protein < 500mg/day
55
What happens to K, Mg, and Phos in patients with refeeding syndrome?
they all decrease
56

BTK Review 2024 (19 decks)

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