CTU jeopardy Flashcards
Lights criteria
TRANSUDATIVE
Pleural Protein: serum protein <0.5
Pleural LDH: serum LDH <0.6
Pleural LDH<2/3 upper limit of normal
Examples of transudative pleural effusions
Liver failure Heart failure Kidney failure nephrotic syndrome peritoneal dialysis CSF leak into the pleural space
Examples of exudative pleural effusions
Connective tissue disease
infection
Malignancy
esophageal perforation
Differentials for hypomagnesia
Starvation PPI's Loop diuretics GI losses Renal losses
Define anuria
<0.3ml/kg/hr
define oliguria
> 0.3 - <0.5ml/kg/hr
Major nephrotoxic drugs to know
Acyclovir
NSAIDs
ACE/ARB
Lithium
what are the 2 types of ATN
Ischemic and toxic
Causes of Toxic ATN
PIPTAZO
Vancomycin
Aminoglycosides
Chemotherapy
Causes of ischemic ATN
Pre-renal AKI
Causes of acute interstitial nephritis
PPI ABx NSAIDs Allopurinol Antiepileptic agents (you can look for eosinophils in the urine if you are worried about AIN)
Causes of acute glomerulonephritis
Post Strep glomerulonephritis HIV Hep C Lupus glomerulonephrittis Systemic sclerosis Anti-GBM IgA ANCA vasculitis
What 2 questions should you ask on AKI history
Ins and outs
Symptoms of obstruction
What are cast cells in the urine? (brown casts)
Shedding of necrotic cells
What are cocci in clusters known as
Staphylococcus
What are gram positive in chains known as
Streptococcus
give an example of gram positive bacilli
Listeria
example of gram negative cocci
Neisseria
examples of atypical bacteria
legionella
Mycoplasma
Chlamydia
Antibiotics to cover skin
cephalexin or cefazolin
ABX to cover MRSA
Vancomycin Daptomycin Linezolid Septra Doxycycline
CLINDAMYCIN IS RESERVED FOR…
GAS GANGRENE
NECROTISING FASCIITIS
(as it is super high risk for C.diff)
Antibiotics to cover atypical infections (STI’s or respiratory)
tetracyclines (doxycycline)
Macrolides
fluoroquinolones
ahminoglycosides
Antibiotics to cover Pseudomonas
PIPTAZO Ciprofloxacin meropenem Levofloxacin ceftazadime
common bacteria causing UTI’s in order
E.coli
Staphylococcus saprophyticus
Proteus mirabilis
Enterococcus sp./ Kelbsiella (both 3%)
Mnemonic KEEPS
Antibiotics which cover ESBL
carbapanems nitrofurantoin Septra aminpglycosides fluoroquinolone
SPICE organisms
Serratia providentia (pseudomonas) Indole - positive proteus citrobacter Enterobacter (have beta lactam resistance despite having in vitro susceptibility)
antibiotics for cystitis
Nitrofurantoin
fosfomycin
Antibiotic to treat Klebsiella ESBL in the community
Fosfomycin
causes of hepatitis
HIV (acute conversion syndrome)
Alcohol
DILI (isoniazid, phenytoin, acetaminophen, chemotherapy)
metabolic such as Wilsons, hemochromatosis
ischemic - budd-chiari, shock,
HELLP
how do you define acute liver failure
coagulopathy with an INR>1.5
Encephalopathy
Elevated enzymes
causes of AST/ALT to be in the 1000’s
Viral
Autoimmune
viral screening for hepatitis includes:
CMV, EBV, VZV, HEP A, B, C
Screening Blood test for Wilsons
Ceruplasmin
Screening blood test for hemochromatosis
ferritin and iron saturation
for a diagnosis of cirrhosis you need
Stigmata of liver disease (spider nave, gynecomastia, caput medusa)
Portal hypertension
Indications for SBP prophylaxis
Previous SBP
Cirrhosis + low protein ascites <1.5g and either renal or hepatic impairment
Treatment for hepatorenal syndrome
midrodine
octreotide
albumin
treatment of vatical bleed
octreotide
panto infusion
abx
PMN count for diagnosis of SBP
> 250
cut off for proteinuria in nephrotic syndrome
3.5g
6 neurocognitive domains
planning Language Social motor memory complex attention
activities of daily living include
eating drinking bathing transferring dressing
examples of instrumental ADLs
shopping
laundry
housekeeping
using a phone
Lewy body dementia is caused by the deposition of which protein
cytoplasmic alpha-synuclein
Alzheimers disease is caused by the deposition of
Amyloid plaques
TAU proteins
protective factors for dementia
NSAIDs
Antioxidants
intellectual activity
quantified screening tests for dementia include
MoCA
MMSE
CAM criteria for delirium
- Acute onset and fluctuating.
- inattention -
- Disorganised thinking
- Altered L0C
I and 2 and either 3 or 4 needed.
causes for delirium
Infections Deficiencies Withdrawal Endocrinopatives Acute metabolic Acute vascular Trauma. Toxins or drugs. CNS pathology. Heavy metals. Hypoxia.
predisposing risk factors for delirium
over 60
depression
male
visual impairment
