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Fosforilados > Critical Care Medicine > Flashcards

Critical Care Medicine Flashcards

1
Q

Diagnosis suggested by hyperthermia, mental status changes, dysautonomia, muscle rigidity, neuroleptic drug use

A

Neuroleptic malignant syndrome

MKSAP 20

Neuroleptic malignant syndrome is a life-threatening condition associated with the use of antipsychotic medications.

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2
Q

First-line vasopressor for septic shock

A

Norepinephrine

MKSAP 20

Norepinephrine is preferred due to its effectiveness in increasing blood pressure.

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3
Q

Most common cause of cardiogenic shock

A

Myocardial infarction

MKSAP 20

Myocardial infarction leads to decreased cardiac output, causing cardiogenic shock.

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4
Q

Role of procalcitonin in initiation of antibiotics

A

None

MKSAP 20

Procalcitonin levels do not influence the initiation of antibiotic therapy.

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5
Q

Target MAP in septic shock

A

60-65 mm Hg

MKSAP 20

Mean arterial pressure (MAP) is a critical parameter to monitor in septic shock management.

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6
Q

Strategies to decrease delirium during mechanical ventilation

A

Daily interruptions of sedation and analgesia; protocolized light sedation

MKSAP 20

These strategies help minimize the risk of delirium in critically ill patients.

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7
Q

Carboxyhemoglobin level indication for hyperbaric therapy

A

≥25%

MKSAP 20

Hyperbaric oxygen therapy is indicated for severe carbon monoxide poisoning.

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8
Q

Preferred agents for continuous sedation during mechanical ventilation

A

Propofol, dexmedetomidine

MKSAP 20

These agents are favored for their rapid onset and short duration of action.

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9
Q

Only indications for benzodiazepines in delirium treatment

A

Alcohol withdrawal, seizures

MKSAP 20

Benzodiazepines are primarily used for specific indications rather than general delirium.

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10
Q

Treatment for shock refractory to fluids and vasopressors

A

Hydrocortisone

MKSAP 20

Hydrocortisone may be used in cases of adrenal insufficiency contributing to shock.

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11
Q

Treatment for isopropyl alcohol ingestion

A

Supportive care

MKSAP 20

Isopropyl alcohol poisoning typically requires supportive measures rather than specific antidotes.

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12
Q

Type of IV catheter with highest flow rate

A

Peripheral wide-bore catheter

MKSAP 20

These catheters allow for rapid fluid administration.

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13
Q

Initial fluid resuscitation bolus for sepsis

A

30 mL/kg of crystalloid solution

MKSAP 20

This volume is recommended to restore perfusion in septic patients.

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14
Q

Drug treatment for methanol and ethylene glycol poisoning

A

Fomepizole

MKSAP 20

Fomepizole acts as an alcohol dehydrogenase inhibitor.

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15
Q

Basic strategies to minimize ICU-acquired weakness

A

Early mobilization, avoidance of early parenteral nutrition, glucose control

MKSAP 20

These strategies aim to maintain muscle strength and function in ICU patients.

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16
Q

Timing of initiation of enteral nutrition in ICU

A

24-48 hours after admission

MKSAP 20

Early enteral nutrition is associated with better outcomes in critically ill patients.

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17
Q

Common bacterial causes of pneumonia after smoke inhalation

A

Staphylococcus and Pseudomonas species

MKSAP 20

These organisms are often implicated due to the inhalation injury.

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18
Q

Measures in ventilatory assessment of neuromuscular weakness

A

Maximum inspiratory and expiratory pressures, positional changes in FVC

MKSAP 20

These assessments help evaluate respiratory muscle function.

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19
Q

Diagnosis suggested by hyperthermia, hyperreflexia, dysautonomia, mental status changes

A

Serotonin syndrome

MKSAP 20

Serotonin syndrome can occur due to excess serotonergic activity.

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20
Q

Clinical features of acute hypercapnic respiratory failure with CO2 narcosis

A

Somnolence, myoclonic jerks

MKSAP 20

These symptoms indicate significant respiratory compromise.

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21
Q

Treatment for cardiac arrest with hypothermia

A

Prolonged CPR and active rewarming

MKSAP 20

Active rewarming is crucial to improve outcomes in hypothermic cardiac arrest.

22
Q

Assessment test before liberation from mechanical ventilation

A

Spontaneous breathing trial

MKSAP 20

This trial assesses the ability to breathe independently.

23
Q

Common causes of systemic toxicity in smoke inhalation

A

Carbon monoxide, cyanide

MKSAP 20

These toxins can cause significant morbidity and mortality.

24
Q

Evidence-supported ventilation type in neuromuscular disease

A

NPPV

MKSAP 20

Non-invasive positive pressure ventilation is effective for respiratory support.

25
Q

Diagnosis suggested by hyperthermia, rigidity, inhaled anesthetic

A

Malignant hyperthermia

MKSAP 20

Malignant hyperthermia is a genetic disorder triggered by certain anesthetics.

26
Q

What is the recommended tidal volume for ARDS?

A

4-8 mL/kg of predicted body weight

MKSAP 20

27
Q

What is the most common complication of smoke inhalation injury?

A

Pneumonia

MKSAP 20

28
Q

What test is indicated in suspected acute hypercapnic respiratory failure?

A

Arterial blood gas

MKSAP 20

29
Q

What is a risk of flumazenil treatment in benzodiazepine overdose?

A

Life-threatening CNS activation, including seizures

MKSAP 20

30
Q

What is the timing of antibiotic therapy in suspected sepsis?

A

Within first hour

MKSAP 20

31
Q

What is the preferred treatment for benzodiazepine overdose?

A

Supportive care (not flumazenil)

MKSAP 20

32
Q

What is the treatment for PE with hemodynamic collapse?

A

Thrombolytic therapy

MKSAP 20

33
Q

What diagnosis is suggested by CNS depression, increased anion gap metabolic acidosis, and increased osmolal gap?

A

Ethylene glycol or methanol ingestion

MKSAP 20

34
Q

What is the physiology of hypoxemic respiratory failure not improving with oxygen?

A

Ventilation-perfusion mismatch

MKSAP 20

35
Q

What is the preferred route for nutrition in critically ill patients?

A

Enteral

MKSAP 20

36
Q

What is an indicator of impending respiratory failure in asthma?

A

Normal or elevated Pco2

MKSAP 20

37
Q

What is the prevention strategy for extubation failure in high-risk patients?

A

Early NPPV

MKSAP 20

38
Q

What is the treatment for nonexertional heat stroke?

A

Evaporative cooling

MKSAP 20

39
Q

What is the ventilatory treatment of acute hypercapnic respiratory failure from OHS?

A

BPAP

MKSAP 20

40
Q

What is the treatment for cyanide poisoning?

A

Hydroxocobalamin

MKSAP 20

41
Q

What is the recommended timing of fluid resuscitation in sepsis-induced hypoperfusion?

A

Initial bolus given in first 3 hours, initiated in first hour

MKSAP 20

42
Q

What is the primary treatment for ARDS?

A

Mechanical ventilation with low tidal volume and PEEP

MKSAP 20

43
Q

What is the diagnostic test for carbon monoxide exposure?

A

Arterial blood gases, including co-oximetry

MKSAP 20

44
Q

What is a nonventilatory oxygen support for acute hypoxemic respiratory failure?

A

High-flow nasal cannula

MKSAP 20

45
Q

What diagnosis is suggested by CNS depression, increased osmolar gap, and normal anion gap?

A

Isopropyl alcohol ingestion

MKSAP 20

46
Q

What are contraindications to NPPV?

A
  • Altered mental status
  • Increased secretions
  • Vomiting
  • Inability to protect airway

MKSAP 20

47
Q

What is the treatment for malignant hyperthermia?

A

Discontinue triggering agent, begin active cooling, administer dantrolene

MKSAP 20

48
Q

What is the treatment for anaphylaxis?

A

Epinephrine

MKSAP 20

49
Q

What is the recommended plateau pressure in ARDS?

A

<30 cm H2O

MKSAP 20

50
Q

What is the treatment for opioid overdose?

A

Naloxone

MKSAP 20

Fosforilados (16 decks)

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