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**My Anesthesia ABA Advanced Study Cards > Critical Care COPY > Flashcards

Critical Care COPY Flashcards

1
Q

Calculate free water deficit

A

[(plasma Na/140)-1] x (weight in kg x 0.6)

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2
Q

SIADH labs

A

HypoNa + urine Na >20

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3
Q

Fire at tire factory poisoning and treatment

A

Cyanide = hydroxycobalamin

Sodium thiosulfate and nitrate not used because causes methHb and slow onset

High O2 on VBG (not using O2)
Prolonged SNP infusions can cause

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4
Q

Effect of Glycine solution for TURP

A

Transient blindness

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5
Q

Effect of distilled water for TURP

A

Hemolysis, fluid overload, dilution hypoNa and high chance of TURP syndrome

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6
Q

Effect of saline and other balanced salt solutions for TURP

A

Significant current dispersion

Normally used sorbitol/mannitol combination for TURP

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7
Q

Factors increasing likelihood of post-op ventilation following thymectomy for MG

A
  1. Duration of disease >6 years
  2. Hx of chronic respiratory disease (asthma, COPD)
  3. Pyridostigmine dose >750mg/day
  4. Vital capacity <2.9L or 40ml/kg
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8
Q

Type of shock:
PCWP >18
CI <2.2

A

Cardiogenic

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9
Q

Cause of oliguria:
FeNa 1%
BUN: Cr >20
Urine:Serum Cr >40
Urine Osm >500
Random Urine Na <20

A

Pre-renal
- hypovolemia

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10
Q

Cause of oliguria:
FeNa 2%
BUN: Cr <20
Urine:Serum Cr <20
Urine Osm <400
Random Urine Na >20

A

Intrinsic or post-renal

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11
Q

Formula to calculate FeNa

A

[(pCr x uNa) / (pNa x uCr)] x100

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12
Q

Causes of inc MvO2

A

Inc SaO2: supplemental O2

Dec VO2: Carbon monoxide, cyanide, hypothermia, sepsis

Inc CO: dobutamine, sepsis, thyroid storm, AV fistula, cirrhosis

Inc Hb: Transfusion

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13
Q

Cause of hypoPhos with TPN

A

Glucose loading w/ TPN –> intracellular shift of Phos

Other causes of hypophos:
Refeeding
DKA
Hyperventilation
Diuretics - aucetazolaimide (proximal tubule)

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14
Q

Toxin that travels via neuronal retrograde transport and enters inhibitory interneurons in the spina cord

A

Tetanus
- prevents release of GABA

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15
Q

Inhibitors of HPV

A

Hypocarbia
Vasodilators
Infection
Metabolic alkalosis
Volatiles >1MAC

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16
Q

Indications for hyperbaric O2

A

Air embolism
Carbon monoxide, brown recluse other poisoning
chronic infections
Acute ischemia from crush, CRAO
Burns
Lung lavage

Ability to deliver 1 MAC of N2O –> decompression sickness when suddenly stopped,
Higher Desflurane delivered = dial down

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17
Q

Causes of inc PIP + inc Pplateau

A

Compliance issue
- Abd insufflation
- Ascites
- Intrinsic lung disease
- Obesity
- Pulmonary edema
- PTX
- Trendelenburg

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18
Q

Causes of inc PIP + unchanged Pplateu

A

Airway resistance problem
- Airway compression
- Bronchospasm
- Foreign body
- Kinked ETT
- Mucous plug

19
Q

Predicts INC mortality following pneumonectomy

A
  1. VO2 Max <15ml/kg/min
  2. Inability to ascend 2 flights of stairs
  3. ppoFEV1 <30%
  4. Combined ppoFEV1 <35 + DLCO <35
20
Q

Cause of hypoxemia with normal A-a gradient

A

Hypoventilation

21
Q

Labs in Conn Syndrome

A

HypoK metabolic alkalosis
- primary hyperaldosteronism
- Fatigue, HA, HTN from hypervolemia
- Tx = spironolactone and K

22
Q

change in pH for every degree decrease

pH 7.25 @ 37 when drawn from 27 degree patient

A

1 degree decrease = pH increase 0.017

pH –> 7.42 (10 x 0.017)

23
Q

Changes at high altitude

A

Hyperventilation - dec PaCO2 (PaCO2 30, PaO2 55)

Kidneys compensate in a few days to normalize pH but still have dec PaCO2

H moves from CSF to plasma (inc CSF pH)

Left shift oxygen-Hb curve (hypocarbia) —> right shift from hypoxia and inc 2,3 DPG

Chronic hypoxia inc PVR

Inc Hb –> inc viscosity and risk of clotting
Brief inc in CO

24
Q

Signs of cyanide toxicity

A

Cyanosis only very late, typically no cyanosis present

Inc PaO2 d/t inability to utilize O2

SvO2 inc

Anion gap metabolic acidosis

25
Q

Labs for ATN:
Urine Na
Urine Osm
Spec Grav
FeNa

A

Urine Na >40 (can’t reabsorb)
Urine Osm <350
SG very low ~1.0035
FeNa >1%

26
Q

Tx Sarin gas poisoning

A

Atropine and Pralidoxime

Organophsphates inhibit Ach-esterase = excess Ach –> bradycardia, mitosis, salivation, respects distress

27
Q

Wavelengths for pulse ox

A

DeoxyHb - 660
OxyHb - 940

28
Q

Bezold-Jarisch Reflex

A

apea, bradycardia, hypotension

following inferior and posterior MIs as a result of dec preload or stretch of the ventricles mediated by vagal

Commonly seen with spinal anesthesia

29
Q

MELD score

A

Cr (greatest effect)
Yea/No Dialysis
Na
INR
Bilirubin

30
Q

Childs-Pugh score

A

Bilirubin
INR
Albumin
Ascities
Hepatic encephalopathy

31
Q

Features of TRALI

A

Pulmonary edema - high protein content
Transient leukopenia
Normal cardiac filling pressures
Multiparous donors
Inc temp

32
Q

Calculate A-a gradient

A

PAO2 = (FiO2 x 713) - (PaCO2/.8)

If <20 = hypoxemia is due to hypoventilation or dec fio2

33
Q

Post-thyroidectomy complication time course:
1. immediate
2. within 6 hours
3. 24 hours

A

immediate = b/l recurrent laryngeal injury
within 6 hours = hematoma
24 hours = hypocalcemia

34
Q

Volume of total dead space

A

2ml/kg

35
Q

Labs in Cushing syndrome

A

HypoK metabolic alkalosis + hyperglycemia

36
Q

Labs with vomiting/pyloric stenosis

A

7.51
PCO2 47
HCO3- 31
Na 130
K 2.9
Cl 93

37
Q

Most predictive of pulmonary complications following wedge resection

A

FEV1 <60% of predicted
DLCO<60% of predicted
PPO FEV1 <800ml
PPO FEV1% >40%
VO2 Max <15ml/kg/min

38
Q

Mechanism of high altitude pulmonary edema

A

excessive uneven HPV
2-4 days after ascent
Tx = rapid descent, O2, hyperbaric

39
Q

ICU feeding strategies

A

Enteral w/o antioxidants
Protein-based full feeds

40
Q

Pulmonary changes with obesity

A

Inc Tv

Dec everything else

41
Q

Electrolyte dec in ESRD

A

Calcium

42
Q

Initial compensation for acute respiratory acidosis

A

Plasma protein buffer (including Hgb)

43
Q

Factor for calculating qSOFA

A

0-3
-AMS
-RR >22
-SBP <100

44
Q

How does hyperbaric oxygen work?

A

Increases amount of dissolved oxygen

**My Anesthesia ABA Advanced Study Cards (35 decks)

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