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ICU OSCE > Definitions > Flashcards

Definitions Flashcards

1
Q

HELLP Syndrome

A

A triad of:

  • Hemolysis,
  • Elevated Liver Enzymes and
  • Low Platelets

It is considered to represent the extreme end of the pre-eclampsia spectrum of disease

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2
Q

DKA diagnosis

A
  • Blood sugar more 250
  • AG >10 -12
  • Hco3 <18
  • Positive ketone
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3
Q

TSS criteria

A
  • Fever / rash / hypotension and 3 organs involved
  • Organ involved: CNS/ GI/ renal / skin / muscle
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4
Q

Status epilepticus

A

Seizure for > 5 minutes or recurrent seizure with unresolved unconsciousness

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5
Q

Refractory status epilepticus

A

Seizure for more than 2 hours despite BDZ and non BDZ

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6
Q

Super refractory status epilepticus

A

Seizure more than 24 hrs despite GA

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7
Q

Delirium

A

Acute change in mental status with a fluctuating course characterized by inattention, an alteration in consciousness or disorganized thinking. It is a manifestation of brain dysfunction and occurs in up to 70% of the critically ill

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8
Q

Brain death prerequisites

A
  1. Clear cause of coma and irreversibility
  2. Normal core temperature (>36.5ºC)
  3. Normal SBP (>90 mmHg)
  4. Exclude confounding factors:
    a) CNS Depressants
    b) NMBA
    c) Electrolyte disorders (Na<160)
    d) Hypo, hyperglicemia
    e) Acid base disorders
    f) Uremia, hepatic failure
    g) Endocrine disorders
    - Panhypopituitarism
    - Adrenal cortical insufficiency
    - Mixedema coma
    h) Poisoning
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9
Q

Massive transfusion

A

Definitions vary, they include:

  • 10 unit transfusion in 24 h
  • Transfusion of an entire blood volume in 24 h
  • Replacement of 50% blood volume over 3 h
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10
Q

Damage control resuscitation

A

Damage control resuscitation has 3 components:

  • Permissive hypotension (aka minimal normotension)
  • Early hemostatic resuscitation
  • Damage control surgery.
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11
Q

Intra-abdominal hypertension (IAH)

A

A sustained or repeated pathologic elevation of IAP 12 mmHg

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12
Q

Abdominal compartment syndrome (ACS)

A

A sustained intra-abdominal pressure (IAP) > 20 mmHg (with or without an abdominal perfusion pressure (APP) < 60 mmHg) that is associated with new organ dysfunction/failure. (Note that the normal IAP is approximately 5–7 mmHg in critically ill adults, and APP = MAP – IAP.)

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13
Q

ARDS

A

The essential components required to diagnose ARDS according to Berlin definition are:

  • Development within one week of insult/worsening respiratory symptoms –acute
  • Bilateral opacities on radiological studies not explained by effusions, collapse, or nodules
  • Respiratory failure not explained by LVF or fluid overload
  • PaO2/FiO2 < 300 mmHg on PEEP/CPAP ≥ 5 cmH2O with mention of oxygenation criteria
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14
Q

Febrile neutropenia

A
  • Fever: single oral temp >38.3°C (101°F) or >38°C (100.4°F) for >1 h
  • Neutropenia: ANC <500 cells/pL or <1000 cells/j.iL with predicted nadir <500 cells/uL
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15
Q

Infective endocarditis (IE)

A

Modified Duke criteria

Link

Link

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16
Q

BPF

A
  • A leakage of inspired air from the airways into the pleural space for more than 24 hours
17
Q

Massive hemoptysis

A

> 600 ml of blood (hemoptysis) in 24 hrs

18
Q

Tumor lysis syndrome (TLS)

A

The diagnosis of TLS requires ≥ 2 of the following clinical abnormalities:

  • hyperuricemia (> 8 mg/dL)
  • hyperkalemia (> 6 mmol/L)
  • hyperphosphatemia (> 4.5 mg/dL)
  • hypocalcemia (< 7 mg/dL)

A TLS diagnosis also requires one of the following:

  • acute renal failure
  • cardiac arrhythmia
  • seizure
19
Q

Near miss (close call)

A

Errors that occur in the process of providing medical care that are detected and corrected before reaching the patient. (AHRQ).

20
Q

Medical error

A
  • Failure of a planned action to be completed as intended.
  • Preventable adverse medical offense.
  • Act (or omission of an act) that would have been judged wrong by knowledgeable peers at the time it occurred.
21
Q

Sentinel event

A

Any unanticipated event in a healthcare setting resulting in death or a serious physical or psychological injury to patient(s), that is not related to the natural course of illness.

22
Q

Simple weaning

A

Pass their first spontaneous breathing trial (SBT)

23
Q

Difficult-to-wean

A

Fail their first SBT and then require up to three SBTs or seven days to pass an SBT

24
Q

Prolonged weaning

A

Patients who require more than three SBT or 7 days of weaning after the first SBT.

25
Q

Eclampsia

A

The development of seizures in association with pre-eclampsia

26
Q

Pre-eclampsia

A

MedStudy
There are 4 categories of HTN in pregnancy:

  • Chronic HTN: preexisting HTN or HTN diagnosed before the 20th week of gestation
  • Preeclampsia: New onset of HTN + proteinuria or other significant organ dysfunction after the 20 week of gestation in a woman with no history of HTN
  • Gestational HTN: Onset after the 20th week and no proteinuria in a woman with no history of HTN
  • Chronic HTN with superimposed preeclampsia: worsening HTN new-onset proteinuria after the 20th week of gestation in a woman with history of chronic HTN

Uptodate

Mksap

27
Q

Autonomy

A

Respect for the patient’s right to self-determination

28
Q

Beneficence

A

The duty to ‘do good’

29
Q

Non-maleficence

A

The duty to ‘not do bad’

30
Q

Justice

A

To treat all people equally and equitably.

31
Q

Submassive PE

A

Signs of RV dysfunction plus elevated cardiac Troponin-I but without systemic shock/hypotension

It is intermediate-high risk

32
Q

Brain Death

A

A. Prerequisites before brain death exam

B. Neurologic assessment
1. Coma (absence of response to pain)
2. Absence of brain stem reflexes
3. Apnea test
a) Prerequisites:

  • Core temperature ≥ 36.5°C
  • Euvolemia. positive fluid balance in the previous 6 hours
  • Normal PCO2. arterial PCO2 ≥ 40 mm Hg
  • Normal PO2. preoxygenation to arterial PO2 ≥ 200 mm Hg
    b) Procedure
    c) Special situations

C. Ancillary Tests

D. Documentation
- time of death the time of completion of the first set of tests confirming brainstem death

33
Q

Acute severe asthma

A
  • PEFR 33-50% best or predicted
  • RR ≥25/min
  • HR ≥110 bpm
  • Inability to complete sentences
34
Q

CSW

A
  • Low or normal serum Na+
  • High or normal serum osmolality?
  • High or normal urine osmolality
  • Urinary sodium >40Meq

ICU OSCE (19 decks)

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