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PULMONARY BOARDS > Critical Care > Flashcards

Critical Care Flashcards

1
Q

What medications can worsen a myasthenia crisis?

A

macrolides, fluoroquinolone, aminoglycosides, magnesium, beta-blocker

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2
Q

What is the total IVIG dosage for myasthenia gravis treatment?

A

2g/kg in evenly divided doses over 2-5 days

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3
Q

What are the MRI findings in Guillain-Barré Syndrome (GBS)?

A

thickening around intrathecal spinal nerve roots and cauda equina or ocular and cranial nerve enhancement in MF variant

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4
Q

What volume indicates a high chance of self-induced lung injury (SILI)?

A

> 15ml/kg

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5
Q

What are the symptoms of serotonin syndrome?

A

myoclonus, GI symptoms (diarrhea, nausea), hyperreflexia

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6
Q

What are the key features of Neuroleptic Malignant Syndrome (NMS)?

A

CPK elevation, rigidity like Parkinson’s

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7
Q

What triggers malignant hyperthermia?

A

succinylcholine and halothane; genetic

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8
Q

What factors increase hypercapnia?

A
  • Increased dead space while maintaining Ve
  • Decreased VT while maintaining Ve
  • Sedative medications in normal individuals
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9
Q

What determines paCO2?

A
  • Oxygen consumption
  • Respiratory Quotient (R)
  • Fat 0.7; Protein 0.8; CHO (carbs) 1.0
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10
Q

What causes increased CO2 production?

A
  • Increased metabolic rate (sepsis, thyrotoxicosis, fever, activity)
  • Carbohydrate metabolism
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11
Q

What decreases alveolar ventilation?

A
  • Decreased VT
  • Increased VD/VT (dead space) with stable minute ventilation
  • Rapid shallow breathing
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12
Q

What is the formula for paCO2?

A

PaCO2 = k x VCO2/VA

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13
Q

What are the effects of hypercapnia?

A
  • Increased cerebral blood flow and increased ICP
  • Decreased myocardial contractility
  • Decreased diaphragmatic function
  • Shift in O2Hb dissociation curve to the right
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14
Q

What is the central respiratory center?

A

medulla (respiratory pacer cells) influenced by pH, PaCO2, PaO2

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15
Q

What can decrease respiratory drive?

A
  • Hypothyroidism
  • Congenital issues
  • Metabolic alkalosis
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16
Q

What is Ondine’s Curse?

A

impaired autonomic control of ventilation, intact when awake only

17
Q

What are the respiratory patterns associated with strokes?

A
  • Cluster or Biot respiration - irregular
  • Cheyne-Stokes: HF, high altitude, can occur in neurologic disease
18
Q

What is the impact of injury above C3 on respiration?

A

leads to ventilatory failure

19
Q

What is Myasthenia gravis characterized by?

A

decremental response to repetitive stimulation

20
Q

What are the treatments for Myasthenia gravis?

A
  • Plasmapheresis
  • IVIG
  • Acetylcholinesterase inhibitors
  • Immunoadsorption
  • Azathioprine
  • Thymectomy between puberty and 60 years
21
Q

What characterizes respiratory muscle weakness?

A
  • VC decreases in supine position
  • RV decreases
  • TLC decreases
  • MIP decreases
  • Hypercapnia when strength <40% pred
22
Q

What is Obesity Hypoventilation Syndrome (OHS)?

A

BMI >30, PaCO2 >45 while awake

23
Q

What is the SpO2/Fio2 ratio for ARDS according to Berlin criteria?

A

SpO2: Fio2 <315

24
Q

What are the causes of hypoxemic respiratory failure in ARDS?

A
  • Failure of hypoxic vasoconstriction - shunting
  • Disruption of surfactant
  • Volutrauma
  • Atelectrauma
  • Biotrauma
25
Q

What is the ideal body weight calculation for men?

A

50kg + 1.9 kg for every inch above 5 ft

26
Q

What is the PROSEVA trial about?

A

Prone positioning >16h/d lowers mortality, better vent-free days

27
Q

What are the risks associated with dopamine in shock management?

A

increased risk of harm compared to norepinephrine

28
Q

What is the recommended management for extubation failure risk factors?

A
  1. Poor cough
  2. Heavy secretions
  3. Inability to perform all 4 tasks
29
Q

What is the CAM-ICU used for?

A

confusion assessment method for the ICU

30
Q

What is the definition of status epilepticus?

A

> 5 minutes continuous clinical or EEG seizure activity or recurrent seizures without recovery

31
Q

What medications are used for status epilepticus?

A
  • Benzodiazepines (Ativan IV, Midazolam IM, Rectal Diazepam)
  • Follow with Fosphenytoin, Valproate, Levetiracetam
32
Q

What is the depth of chest compressions during CPR?

A

> 5 cm (over 2 in)

33
Q

What is the recommended rate of chest compressions during CPR?

A

100-120 per minute

34
Q

What does the NEWS score indicate?

A

a high risk patient if 7 or more

35
Q

What is the principle of fluid responsiveness assessment using passive leg raise?

A

increase in VTI or SBP; or reduction in PPV

36
Q

What are common risk factors for delirium in critical care?

A
  • Hypertension
  • Alcoholism
  • Dementia
  • Admission severity of illness
  • Benzodiazepines
37
Q

What is the recommended approach for sedation in critical care?

A

Analgesia first, opioid to start

38
Q

What is the significance of the A2F Bundle?

A

decreases likelihood of hospital death in 7 days; reduces delirium & coma; reduces physical restraint use

PULMONARY BOARDS (9 decks)

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