critical care and shock stuff

Question 1

Swanz ganz tells you what?

Answer 1

Left atrial pressure. Balloon into pulmonary artery and pressure tip just distal to the balloon

Basically make a small embolus

Question 2

NE use in shock and mechanism?

Answer 2

Septic shock

Alpha 1 agonist more periph

Beta one agonist faster heart

Question 3

Epinephrine affects what?

Answer 3

All alphas and betas!

Low dose more beta, high dose is alpha.

Give for anaphylaxis or septic if NE is not working

Question 4

When do you give albumin?

Answer 4

After large volume paracentesis (so fluids don’t just go into those third spaces again!)

Or in shock after hypoalbuminemia

Question 5

Transusion reaction

Nonhemolytic febrile reaction?

Answer 5

caused by cytokines from WBCs while in storage

Fever, chills, malaise (tylenol)

Question 6

Acute hemolytic reaciton

Answer 6

Due to ABO incompatibility

Onset during transfusion
Antibdy mediated fever, chills, Nausea, tachy, hypotension

tx: supportive!

Question 7

Delayed hemolytic rxn?

Answer 7

2-10 days later
From antibodies to Rh antigens or other races

2-10 days, mild hemolysis, mild hyperbili

Question 8

Anaphylactic reaction in transfusion is what? INTERESTING

Answer 8

Caused bu anti IgA IgG in IgA deficiency

(people just think they have allergy and frequent URI)

Tx epinephrine and airway

NEED extra wash!

Question 9

Minor allergic rxn in tranfsufion?

Answer 9

Plasma in blood coming over causing urticaria

Give diphenhydramine

Question 10

Post transfusion pupura?

Answer 10

thrombocytopenia in people who have been pregnant 5-10 days after infusion

Question 11

Cryoprecipitate?

Answer 11

Clotting factor and von willebrand!