Critical Care Flashcards
Acute adrenal insufficiency tx
IVF, hydrocortisone
T1DM, BG=500
Kussmaul resp
DKA
Psuedohyponatremia
For every 100 ↑ BG, Na ↓ 1.6
Why do you need to worry about K in acidotic pt?
Acidotic pt w/ normal or low K, VERY depleted (in acidosis K is driven extracellularly)
DKA tx
IVF (5 L), electrolytes, CORRECT ACIDOSIS w/ insulin
T2DM, BG=700
++polyuria, ++dehydration
HHS
HHS tx
IVF (7 L), insulin slowly
If you correct hyperglycemia too quickly, risk of what?
Cerebral edema
↑ intraocular pressure
Halos, unilateral red eye w/ vomiting
Acute glaucoma
Acute glaucoma tx
Timolol drops, mannitol (osmotic diuresis), acetazolamide
Virchow’s triad
Hypercoagulable state, endothelial injury, stasis
Pulmonary embolism tx
Heparin 1st → enoxaparin or warfarin for minimum 3 months
Mediastinal shift (tracheal deviation) Absent breath sounds on one side
Tension PTX
Tension PTX tx
Needle decompression + chest tube
HTN urgency BP
S >220 or D >125
HTN emergency BP
D >130
HTN emergency tx
IV meds (nitroprusside or nicardipine), gradual reduction Must reduce in 1 hr to avoid end organ damage
HTN urgency tx
Oral meds (labetalol, clonidine, captopril)
Sign of ↑ intracranial pressure in HTN emergency
Papilledema
Causes of variceal and non-variceal UGIB
Variceal = cirrhosis Non-variceal = PUD, cancer
BUN is ↑↑↑ and creatinine is ↑
UGIB
Tx for variceal and non-variceal UGIB
Variceal: octreotide
Non-variceal: PPI
Causes of steady, well-localized abd pain
Ischemia, perforation, inflam, bleed
Cause of colicky, poorly-localized abd pain
Obstruction
Free air under diaphragm
GI tract perf and peritonitis
RLQ pain, fever, vomiting
Appendicitis
Epigastric pain, radiates to back, amylase, lipase
Acute pancreatitis
When does acute pancreatitis need surgery?
If infxn or necrosis
Best test to evaluate gallbladder and biliary tree?
Best test to evaluate gallbladder function?
US is best to evaluate gallbladder and biliary tree
HIDA is best to evaluate gallbladder function
Dilated loops of bowel, air fluid levels
SBO
Pain out of proportion
GI bleed
Mesenteric ischemia
Beck’s Triad
Sign of?
JVD, hypoTN, muffled heart sounds
Pericardial effusion/tamponade
Pericardial effusion/tamponade tx
EMERGENT, IVF, pericardiocentesis
Status epilepticus lasts how long?
> 5 min
Risk of status epilepticus
Brain damage
Risk of correcting hypernatremia too fast
Cerebral Edema
Risk of correcting hyponatremia too fast
Central pontine myelinitis