CRITICAL CARE

Question 1

4 types of shock

Answer 1

hypovolemic
Vasogenic
Neurogenic
Cardiogenic

Question 2

Normal left atrial pressure

Answer 2

8-10 mmHg

Question 3

what can cause a false reading of left atrial pressure

Answer 3

mitral valve insufficiency

Question 4

effect of PEEP

Answer 4

decrease preload

Increase arterial oxygen content right increase in functional residual capacity via recruitment of alveoli

Question 5

Factors that affect oxygen delivery

Answer 5

Cardiac output
Hemoglobin concentration
Oxygen saturation

Question 6

Where is taken from to determine venous oxygen saturation

Answer 6

pulmonary artery ( D. OXYGENATED BLOOD GOING TO LUNG)

SURROGATE MARKER VENA CAVA

Question 7

Markers of pulmonary embolism

Answer 7

Tachycardic
 tachypnea
 hypotensive
INCREASED pulmonary artery pressure
Increased central venous pressure
DECREASE PaO2 and pCO2
 ventilation perfusion mismatch
Right heart failure
Ralph
Fourth heart sound

Question 8

Treatment per patient with cardiogenic shock and low cardiac output with increased SVR

Answer 8

DOBUTAMINE to support inotropic effect

Question 9

Characteristics of ARDS

Answer 9

#1Pulmonary artery wedge pressure less than 18  mmHg
#2 no clinical evidence of right heart failure subsequent to left heart failure
#3 diffuse bilateral pulmonary infiltrates
#4 PaO2 to FiO2 ratio less than 200

Question 10

First and second most common nosocomial infections with ventilator patient’s

Answer 10

#1
#2 ventilator associated pneumonia

Question 11

Common organisms for ventilator associated pneumonia

Answer 11

#1 polymicrobial
#2 gram-negative rods

Question 12

Diagnostic criteria for ventilator associated pneumonia

Answer 12

#1 fever
#2 pertinent sputum in conjunction with radiographic evidence
#3 blood cultures
 LOOKED this up and Cameron

Question 13

best indicator adequate resuscitation in hypovolemic shock

Answer 13

urine output

Question 14

parameters consistent with septic shock

Answer 14

this is high output cardiac failure
#1 SVR decrease
#2 systemic blood pressure decrease
#3 Central venous pressure decreased
#4 wedge pressure unaffected
#5 SpO2 increase (tissue not extracting oxygen well)

Question 15

free water deficit calculated quick and dirty

Answer 15

for every 3 of sodium above 140 equals 1 L of water

Question 16

EKG changes seen with HYPOKALEMIA

Answer 16

#1 U waves
#2  FLATTENED T waves
#3 ST segment changes
#4 arrhythmia

Question 17

next step in treatment for hypercalcemic crisis after fluids, calcitonin in breast cancer patient with calcium of 20

Answer 17

bisphosphonate onset immediately
(pamidronate - inhibit osteoclastic)
Use for patients with bony metastasis
Mithramycin takes 24 hours to work

Question 18

What is maximum correction rate for hyponatremic

Answer 18

1 mEq per hour until sodium reaches 130 or neurologic symptoms improve

Question 19

Normal serum phosphorus

Answer 19

2.5-5.0

Question 20

Effects of hypophosphatemia

Answer 20

Cardiac dysfunction
Muscle weakness
Decreased cardiac output
Respiratory failure
Encephalopathy
Hemolysis

Question 21

signs the of hypercalcemia

Answer 21

Lethargy
Stupor
coma

Question 22

Cerebral salt wasting

Answer 22

Diagnosis of exclusion
Renal sodium and chloride wasting
Seen in the face of dehydration

Question 23

Diabetes insipidus

Answer 23

ADH
dilute urine with hypernatremia
urine output 200 300 per hour

Question 24

high-output renal failure

Answer 24

Increase potassium
Increased BUN
Increased creatinine

Question 25

SIADH

Answer 25

ADH
Retention of free water
LOW urine output
can be seen with euvolemic or hyponatremic status and elevated urine sodium urine osmolarity

Question 26

Water intoxication

Answer 26

rapid decrease in serum sodium and cause death-cerebral swelling

Question 27

What causes RIGHT shift of oxygen dysociation curve

Answer 27

Right is right

CADET, face Right!” for CO2, Acid, 2,3-DPG, Exercise and Temperature

Question 28

Treatment for acute DT tachycardia hypertension postop with

Answer 28

diazepam

Question 29

Diagnosis of thyroid in the ICU criteria

Answer 29

nearly nondetectable TSH
elevated T3
Elevated T4
Elevated glucose

Question 30

Gross common cause of death from hepatic failure secondary to acetaminophen overdose

Answer 30

cerebral edema