Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Obstetrics > Critical Care / Medicine > Flashcards

Critical Care / Medicine Flashcards

1
Q

How do you estimate blood volume?

A

60cc / kg
Blood volume is approximately half of body weight in a normal adult

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Classification for blood loss

A

Class I - EBL <750, BP and P and UOP nl
Class II - EBL 750-1500, UOP decreased, HR elevated, BP nl
Class III - EBL >1500, BP dropping, oliguria
Class IV - loss of vital signs, no urine output

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Types of shock

A

Hemorrhagic
Septic/Distributive
Obstructive
Cardiogenic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Septic shock

A

Low systemic vascular resistance
High cardiac output
Low wedge pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Hemorrhagic shock

A

High systemic vascular resistance
Normal cardiac output
Low wedge pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Cardiogenic shock

A

High systemic vascular volume
Low cardiac output
High wedge pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What clotting factors are in FFP?

A

FFP provides factors II, V, VIII, IX, X, XI, and antithrombin III and fibrinogen (lower concentration than cryo)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What clotting factors are in cryoprecipitate?

A

fibrinogen (higher concentration), von Willebrand factor, factor VIII, factor XIII

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the massive transfusion protocol in OB?

A

1:1:6 - pRBC : plasma : platelets
(different in every hospital, may be 1:1:1 or 1:1:2)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the goal level for fibrinogen in a hemorrhage?

A

> 100 or >150

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What electrolyte abnormalities can occur with massive transfusions?

A

HypoCa
Hyper K
Due to citrate in pRBC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When to transfuse platelets?

A

<50 in massive bleeding
<10 for prophylaxis
<20 for procedures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the definition of massive transfusion?

A

> 6u within 2 hours
replacement of >50% of blood volumes
10U within 24h

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are adverse effects of massive transfusions?

A

Volume overload
HypoCa
HyperK
HypoMag
Hypothermia
Metabolic alkalosis (citrate)
DIC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the fluid resuscitation for septic shock?

A

30 cc/kg/hr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the goal for antibiotics administration in septic shock?

A

Broad spectrum antibiotics in <1hr
Blood cultures prior to antibiotics

17
Q

Virchow triad

A

Venous stasis
Endothelial injury
Hypercoagulability

Risk factors for PE

18
Q

What most affects nutritional status?

A

Weight > age > height

19
Q

Definition of malnutrition

A

albumin <3.4
loss of 15% of usual body weight

20
Q

What is the threshold for increased risk of low albumin?

A

Albumin <3
Associated with poor surgical outcomes, operative complications

21
Q

What is the mean survival after diagnosis after malignant bowel obstruction?

A

With TPN = 72days
Without TPN = 41days

TPN may buy about a month of time. No meaningful survival benefit.

22
Q

TPN complications

A

Infection
Cholestasis
Refeeding Syndrome
Overfeeding
Electrolyte abnormalities
Pneumothorax (with placement of line)

23
Q

Short bowel syndrome

A

<100-150cm of functional small bowel
Assoc with malabsorption, diarrhea, metabolic abnormalities, B12/fat soluble vitamin deficiencies
Caused by surgical resection AND radiation bowel injury

24
Q

Refeeding syndrome

A

Features:
- HypoPhos
- HypoK
- congestive heart failure
- peripheral edema
- hemolysis
- seizures

Due to aggressive nutrition replacement leading to fluid shifts/electrolyte imbalance

25
Q

Features of pre-renal etiology

A

FENA <1%
Ur/Pr Creat >20:1
BUN/Cr >20:1
UNa <10
Uosm >500

26
Q

Causes of Afib

A

Hypoxia
PE
Volume overload
Volume depletion

27
Q

A-fib with RVR treatment

A

Beta-blocker (first line)
Diltiazem/amiodarone (second line, call cards)

28
Q

Hypertensive urgency

A

Systolic >160
Diastolic >100
Asymptomatic

29
Q

Hypertensive emergency

A

Systolic >180
Diastolic >120
+ active endo-organ damage (encephalopathy, pulmonary edema, aortic dissection)

Need IV tx (nitroprusside, nitroglycerin; also nicardipine, labetalol, esmolol, hydralazine)

At risk for rebound hypoperfusion leading to stroke, MI, and blindness

30
Q

What antibiotics most commonly contribute to C diff?

A

Cipro
PCN
Cephalosporin

31
Q

Neutropenic Fever

A

T>38.3 x1
T >38.0 sustained over one hour

May be limited by chronic steroid use, elderly age (may be hypothermic)

ANC <1500

32
Q

Risks of neutropenia

A

ANC < 1500 = moderate risk

ANC < 500 = severe infection risk

ANC < 100 x3 weeks = 100% infection risk

33
Q

Tx of neutropenic fever inpatient

A

Zosyn or Cefepime

34
Q

Tx of neutropenic fever outpatient

A

Augmentin + Cipro

35
Q

What are the advantages of LMWH (lovenox) over unfractionated heparin?

A

More predictable therapeutic response
Longer half life
Lower risk of HIT
Less bone mineral density loss

36
Q

What’s the increase in cardiac output in pregnancy?

A

45%

37
Q

What’s the cardiac output changes postpartum?

A

60-80% increase immediately postpartum
then rapid decrease

38
Q

What is the change in HR in pregnancy?

A

20% increase

Obstetrics (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions