CTU jeopardy Flashcards by Lisa Hubbs

Lights criteria

TRANSUDATIVE
Pleural Protein: serum protein <0.5
Pleural LDH: serum LDH <0.6
Pleural LDH<2/3 upper limit of normal

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Examples of transudative pleural effusions

Liver failure
Heart failure
Kidney failure
nephrotic syndrome
peritoneal dialysis 
CSF leak into the pleural space

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Examples of exudative pleural effusions

Connective tissue disease
infection
Malignancy
esophageal perforation

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Differentials for hypomagnesia

Starvation
PPI's
Loop diuretics
GI losses
Renal losses

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Define anuria

<0.3ml/kg/hr

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define oliguria

> 0.3 - <0.5ml/kg/hr

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Major nephrotoxic drugs to know

Acyclovir
NSAIDs
ACE/ARB
Lithium

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what are the 2 types of ATN

Ischemic and toxic

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Causes of Toxic ATN

PIPTAZO
Vancomycin
Aminoglycosides
Chemotherapy

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Causes of ischemic ATN

Pre-renal AKI

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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)

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Causes of acute glomerulonephritis

Post Strep glomerulonephritis
HIV
Hep C
Lupus glomerulonephrittis
Systemic sclerosis
Anti-GBM
IgA
ANCA vasculitis

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What 2 questions should you ask on AKI history

Ins and outs

Symptoms of obstruction

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What are cast cells in the urine? (brown casts)

Shedding of necrotic cells

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What are cocci in clusters known as

Staphylococcus

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What are gram positive in chains known as

Streptococcus

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give an example of gram positive bacilli

Listeria

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example of gram negative cocci

Neisseria

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examples of atypical bacteria

legionella
Mycoplasma
Chlamydia

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Antibiotics to cover skin

cephalexin or cefazolin

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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

1. Acute onset and fluctuating. 2. inattention - 3. Disorganised thinking 4. 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