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PGY-3 and 4 > Critical Care > Flashcards

Critical Care Flashcards

1
Q

BiPAP Numbers

A

IPAP/EPAP

10/5

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2
Q

Winter’s Formula

A

PCO2 = 1.5 x HCO3 + 8 +/- 2

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3
Q

Causes of HAGMA

A

Methanol, Uremia, DKA/drugs, phosphate/paraldehyde, ischemia/iron/isoniazid, lactate, ethylene glycol, starvation/salicylates

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4
Q

Causes of NAGMA

A

Diarrhea, ureteral division, RTA, hyperalimentation, Addision/Acetazolamide/ammonium, MISC

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5
Q

Mineralcorticoids and acid base issues

A

stimulate H+ excretion

metabolic alkalosis

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6
Q

Metabolic Alkalosis –> Low urinary chloride

A

Vomiting
NG Suction
Over-diuresis
Post-hypercapnia

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7
Q

Metabolic Alkalosis + HTN

A

Cushing Disease
Conn Syndrome
Renal Artery Stenosis
Renal Failure + Alkali

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8
Q

Metabolic Alkalosis with normal chloride and no HTN

A

hypomag, hypok
Laxative Abuse
Licorcie
Barter’s, Gietlmann’s

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9
Q

Delta Ratio

A

ag-12 / bicarb -24

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10
Q

Delta Ratio of 1-2

A

AGMA

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11
Q

Delta Ratio > 2

A

AGMA + metabolic alkalosis

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12
Q

Delta Ratio < 1

A

AGMA + NAGMA

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13
Q

Respiratory Acidosis Causes- Three Categories to Think About

A
  • chest cavity
  • central respiratory drive
  • lung/airways
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14
Q

PE causes respiratory ….

A

alkalosis

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15
Q

Hypovolemic Shock

A
  • Decreased Preload
  • Decreased CO
  • Increased SVR
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16
Q

Cardiogenic Shock

A
  • Increased Preload
  • Decreased CO
  • Increased SVR
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17
Q

Distributive Shock

A

(excessive vasodilation)
Decreased Preload
Increased CO
Decreased SVR

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18
Q

Causes of Distributive Shock

A

Anaphylaxis
Neurogenic
Sepsis

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19
Q

Obstructive Shock

A

decreased Preload, CO

increased SVR

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20
Q

Causes of Obstructive Shock

A 
PE
severe RHF
Tension PTX
Cardiac Tamponade
Restrictive CM
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21
Q

Cold Shock

A

increased SVR, decreased CO
clamped down (decreased pulses, long cap refill)
give Epi

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22
Q

Warm Shock

A

decreased SVR, increased Co
brisk cap refill, bounding pulses
give NE

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23
Q

alpha 1,2

A

blood vessels, vasoconstriction

24
Q

B1

A

myocardium, inotropy and chronotropy

25
Q

B2

A

blood vessels, vasodilation

26
Q

D1

A

renal vasodilation

27
Q

V1

A

vasculature, vasoconstrict

28
Q

NE

A

alpha 1, beta 1

vasoconstrict, increase CO, contractility

29
Q

Phenylephrine

30
Q

Epinephrine

A

low dose B1

high dose alpha 1

31
Q

Dopamine

A

low dose D1
Medium B1
High dose alpha 1

32
Q

Vasopressin

33
Q

Dobutamine

A

B1 (some B2)

cardiogenic shock w/ HTN

34
Q

Milrinone

A

PDE III Inhibitor

increased Co, , contractility

35
Q

Inspiratory stridor- location

A

above vocal cords

36
Q

ARDS definition

A

onset w/in 1 week of insult
bilateral opacities
not related to pulmonary edema or cardiac cause
Po2/Fio2 <300 on at least 5cm PEEP

37
Q

TV in ARDS

A

~6ml/kg

prevent volutrauma

38
Q

Full Expansion on CXR

A

9-10 posterior ribs

6-7 anterior ribs

39
Q

Diagphrams on Lateral CXR

A

right over left

40
Q

Size of pulmonary nodule (definition)

A

less than 3 cm

41
Q

Nodular Pattern on CXR

A
  • small discrete rounded opacities

- interstitial lung disease

42
Q

Air Space Disease on Imaging, ddx includes 5 categories

A 
water/pulm edema
pus
blood
cells (lymphoma)
lipoproteins (pulmonary alveolar proteinosis)
43
Q

Structures of Anterior Mediastinum

A

teratoma
thymoma
retrosternal thyroid
lymphoma

44
Q

IPAP

A

inspiration pressure

ventilation

45
Q

EPAP

A

expiration

oxygenation

46
Q

AC Mode

A
  • set volume and backup rate

- pressure is variable and related to compliance

47
Q

Compliance =

A

change in volume / change in pressure

48
Q

Pressure Control Mode

A

Select pressure

- TV, rate are variable, volume dependent on compliance

49
Q

PEEP and venous return

A

PEEP increases intrathoracic pressure which increases R atrium pressure
blood flows to heart due to gradient between which is decreased when you have increased R atrium pressure
–> decrease in Cardiac Output

50
Q

Peak Pressure

A

when there is airflow/airflow resistance

51
Q

What causes high peak pressures

A

bronchospasms, secretions, ETT occlusion/plugging, mucuous plugging

52
Q

Plateau Pressure

A

pressure when airflow stops/lung compliance

53
Q

Cardiac Output =

54
Q

Mixed Venous Oxygen Saturation

A

75-85
“oxygen left over”
oxygen bound to Hgb returning to heart

55
Q

Paraprotein Gap

A

Total protein - albumin

>4 significant

PGY-3 and 4 (13 decks)

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