Critical care Flashcards
Increased skin pigmentation?
Acute adrenal insufficiency - Primary
What usually causes acute secondary adrenal insufficiency?
stopping long term exogenous steroids
Predominant manifestation of adrenal crisis?
Shock. And other non specific symptoms
Treatment of adrenal crisis?
IV fluids (2-3 liters), dexamethasone bolus (4mg) every 12 hours (hydrocortisone is second choice)
Thyroid storm is usually caused by what?
An acute event, such as trauma, surgery, infection
Presentation of thyroid storm?
Tachycardia/Afib, high fever, agitation, altered mentation
Treatment of thyroid storm?
Propranolol, steroids
S/S of Acute angle closure glaucoma.
Headache, N/V, severe eye pain, decreased vision, halos
treatment of acute glaucoma?
Timolol, pilocarpine, apraclonidine.
Laser peripheral iridotomy
S/S of acute PE
Usually SOB (rapid onset!), pleuritic pain, cough. Maybe sudden death
risk factors for PE?
Virchow’s triad
PE diagnostic studies
CT angiography
ABG - resp alkalosis
EKG - tachy, ST-T wave changes
D dimer
PE treatment
Anticoagulate - LMWH, then LMWH or warfarin to continue for 3 months minimum
IVC filter for pts who can’t tolerate anticoagulation
Causes of ARDS
sepsis syndrome
severe multiple trauma
gastric content aspiration
What is happening in ARDS?
Increase in alveolar capillary permiability, leading to protein rich pulmonary edema
S/S of ARDS
Rapid onset of severe dyspnea, refractory to O2 therapy
ARDS treatment
Treat underlying cause, intubate, ventillator PPV and low PEEP
young woman at rest in the early morning, associated ST elevation, negative cardiac enzymes
Prinzmetals Angina
diagnosis of angina pectoris
ST changes on stress test with ECG
tx of angina pectoris
ASA, O2, Nitro, Morphine
Beta blockers, CCBs, ACEIs
Common causes of upper GI bleed
PUD, esophagitis/gastritis, Mallory-Weiss tear, esophageal varices
Common causes of lower GI bleed
Diverticulosis, angiodysplasia, IBD, hemorrhoids/fissures, neoplasm, AVM
