Critical Care/Nutrition

Question 1

Negative property of elemental tube feed formulas

Answer 1

Hyperosmolar

Question 2

Amino acid formula for someone with hepatic dysfunction limits these

Answer 2

Aromatic amino acids and methionine. Have higher concentration of branched chain amino acids

Question 3

Essential fatty acid deficiency symptoms

Answer 3

Waxy skin, dermatitis, thrombocytopenia

Question 4

Secondary active transport (relying on sodium gradient for transport) describes absorption of what molecules in intestine

Answer 4

glucose and galactose

Question 5

Difference between marasmus and kwashiokor

Answer 5

Kwashiokor has edema and anasarca

Question 6

B12 deficiency (usually associated with loss of intrinsic factor from gastrectomy, or resection of terminal ileum) symptoms

Answer 6

beefy tongue, megaloblastic anemia, neuropathy, hypercoagulability

Question 7

Zinc deficiency symptoms

Answer 7

rash and hair loss

Question 8

Chromium deficiency symptoms

Answer 8

hyperglycemia

Question 9

Pantothenic acid deficiency

Answer 9

burning feet

Question 10

Biotin deficiency

Answer 10

AMS, dermatitis, anorexia, myalgia

Question 11

Niacin (B3) deficiency

Answer 11

Dermatitis (areas exposed to sun), diarrhea, dysphagia (due to ulcers, sores), dementia

Question 12

Thiamine (B1) deficiency

Answer 12

Beri beri (wet) - heart failure; Wernicke encephalopathy ( nystagmus, ataxia) confusion, or coma

Question 13

Vitamin E deficiency

Answer 13

Peripheral neuropathy, ataxia

Question 14

Vitamin deficiency associated with carcinoid syndrome (tryptophan metabolized to serotonin instead of this)

Answer 14

Niacin (get pellagra)

Question 15

Common TPN formulations

Answer 15

25% or 50% dextrose, 1.5 g/kg/day protein, 10% to 20% lipid emulsion, 30 cc/kg fluid admin

Question 16

Omega 3 and omega 6 fatty acids are mono or poly unsaturated

Answer 16

poly

Question 17

Prealbumin half life

Answer 17

2-3 days

Question 18

transferrin half life

Answer 18

8-10 days

Question 19

albumin half life

Answer 19

20 days

Question 20

Direct thrombin inhibitors and approximate half life

Answer 20

Dabigatran (Pradaxa) - 12 hours
Bivalirudin - 20-30 min
Argatroban - < 1 hour

Question 21

3 methods drugs have to inhibit platelet aggregation

Answer 21

ADP receptor
Thromboxane A2
Glycoprotein (G2b3a) receptor

Question 22

4 ADP receptor (P2Y12) blockers (reversible or irreversible)

Answer 22

Clopridurgrel (Plavix) (irreversible)
Prasugrel (Effient) (irreversible)
Ticagrelor (Brilinta) (reversible)
Cangreglor (reversible)

Question 23

Type I vWD

Answer 23

partial deficit; treat w desmopression or cryoprecipitate

Question 24

Type II vWD

Answer 24

Qualitative defect; treat w cryoprecipitate

Question 25

Type III vWD

Answer 25

Complete deficit; treat w cryoprecipitate

Question 26

Drug used to treat AVMs

Answer 26

thalidomide

Question 27

Initial dose of flumanezil for benzo overdose

Answer 27

0.2 mg IV

Question 28

Contraindications for ketamine use

Answer 28

myocardial ischemia; gluacoma

Question 29

Brooke formula for burn resuscitation

Answer 29

2 cc/kg/TBSA over 24 hours with 1/2 in first 8 hours (titrated to UOP 0.5-1 cc/kg/hr)

Question 30

Rule of 10s for burn resuscitation

Answer 30

10 x TBSA for 24 hours with 1/2 in first 8 hours

Question 31

Indications for ICP monitoring

Answer 31

GCS 8 or less with abnormal head CT | normal head CT with 2 of : age > 40, hypotension, posturing.

Question 32

LR is ...

Answer 32

Na 130, K 4, Cl 109, ca 2.7, lactate 28

Question 33

``` Output from Saliva stomach small bowel biliary pancreas ```

Answer 33

``` 1.5L 1-2L 1.5L 500 cc 1.5 L ``` (small bowel reabsorbs > 8L)

Question 34

winters forumla

Answer 34

expected Pco2 = 1.5 x serum bicarb + 8

Question 35

free water deficit

Answer 35

sodium - 140/140 x total body water