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USMLE® Step 1 flashcards
1
Q

[Blood gas value] pH

A

7.35-7.45

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2
Q

[Blood gas value] PaCO2 value

A

4.7-6.0 kPa

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3
Q

[Blood gas value] PaO2 value

A

> 12 kPa

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4
Q

[Blood gas value] HCO3

A

21-27 mmol/L

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5
Q

[Blood gas value] Base excess

A

+/- 2

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6
Q

[Interpret this blood gas] Low pH and high PaCO2

A

Respiratory acidosis

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7
Q

[Interpret this blood gas] High pH and low PacO2

A

Respiratory alkalosis

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8
Q

[Interpret this blood gas] Low PaCO2

A

Hypoxaemia

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9
Q

[Interpret this blood gas] High PaSO2

A

Hypoxaemia

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10
Q

[Interpret this blood gas] Low pH + low HCO3 + low BE

A

Metabolic acidosis

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11
Q

[Interpret this blood gas] High pH + high HCO3 + high BE

A

Metabolic alkalosis

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12
Q

[Blood gas] What is PaO2?

A

Partial pressure of arterial oxygen

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13
Q

[Blood gas] What is PaCO2?

A

Partial pressure of arterial carbon dioxide

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14
Q

[Blood gas] What is SaO2?

A

Oxygen saturation

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15
Q

[Blood gas value] Sa02

A

> 95%

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16
Q

[Blood gas] What is HCO3?

A

Bicarbonate

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17
Q

What is hypoxaemia?

A

Lowered blood oxygen

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18
Q

[Oxygen delivery] Highest litre (L) of oxygen to be used with a nasal cannula (NC)

A

6L

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19
Q

[Oxygen delivery] Percentage of oxygen delivered with 1L of oxygen via nasal cannula?

A

21-24% (approx)

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20
Q

[Oxygen delivery] Percentage of oxygen delivered with 2L of oxygen via nasal cannula?

A

25-28% (approx)

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21
Q

[Oxygen delivery] Percentage of oxygen delivered with 3L of oxygen via nasal cannula?

A

29-32% (approx)

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22
Q

[Oxygen delivery] Percentage of oxygen delivered with 4L of oxygen via nasal cannula?

A

33-36% (approx)

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23
Q

[Oxygen delivery] Percentage of oxygen delivered with 5L of oxygen via nasal cannula?

A

37-40% (approx)

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24
Q

[Oxygen delivery] Percentage of oxygen delivered with 6L of oxygen via nasal cannula?

A

41-44% (approx)

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25
Q

[Oxygen delivery] Minimum litre (L) of oxygen to be used with a simple face mask (or Hudson mask)

A

5L

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26
Q

[Oxygen delivery] Another name for a simple face mask

A

Hudson mask

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27
Q

[Oxygen delivery] Appropriate litre (L) of oxygen to be used with a simple face mash (or Hudson mask)

A

6-10L

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28
Q

[Oxygen delivery] Highest percentage of oxygen delivered with a simple face mask (or Hudson mask)

A

60%

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29
Q

[Oxygen delivery] Approximate percentages of oxygen delivered using a simple face mask (or Hudson mask)

A

30-60%

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30
Q

[Oxygen delivery] True or false: Oxygen can be humidified with a simple face mask (or Hudson mask)

A

True

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31
Q

[Oxygen delivery] Which oxygen delivery device can be used with type 1 respiratory failure?

A

A simple face mask (or Hudson mask)

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32
Q

[Oxygen delivery] Which oxygen delivery device can be used with type 2 respiratory failure?

A

A fixed delivery mask (or Venturi)

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33
Q

[Oxygen delivery] How much litres (L) of oxygen should be used on a Blue Venturi attachment?

A

2-4L

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34
Q

[Oxygen delivery] What percentage of oxygen does a Blue Venturi attachment give with 2-4L?

A

24%

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35
Q

[Oxygen delivery] How much litres (L) of oxygen should be used on a White Venturi attachment?

A

4-6L

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36
Q

[Oxygen delivery] What percentage of oxygen does a White Venturi attachment give with 4-6L?

A

28%

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37
Q

[Oxygen delivery] How much litres (L) of oxygen should be used on a Yellow Venturi attachment?

A

8-10L

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38
Q

[Oxygen delivery] What percentage of oxygen does a Yellow Venturi attachment give with 8-10L?

A

35%

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39
Q

[Oxygen delivery] How much litres (L) of oxygen should be used on a Red Venturi attachment?

A

10-12L

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40
Q

[Oxygen delivery] What percentage of oxygen does a Red Venturi attachment give with 10-12L?

A

40%

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41
Q

[Oxygen delivery] How much litres (L) of oxygen should be used on a Green Venturi attachment?

A

12-15L

42
Q

[Oxygen delivery] What percentage of oxygen does a Green Venturi attachment give with 12-15L?

A

60%

43
Q

[Oxygen delivery] True or False: the fixed delivery masks (or Venturi) offers an accurate percentage of oxygen delivery

A

True (as long as flow rate is set correctly)

44
Q

[Oxygen delivery] When would a non re-breath mask be strongly recommended?

A

In patients who are critically ill, severely hypoxaemic (spO2 <85%) or septic

45
Q

[Oxygen delivery] Which oxygen delivery device delivers the highest percentage of oxygen?

A

Non re-breath mask

46
Q

[Oxygen delivery] What litre (L) of oxygen should be used with a non re-breath mask during a medical emergency?

A

15L

47
Q

[Oxygen delivery] True or false: the non re-breath mask prevents the rebreathing of CO2 during high flow delivery?

A

True

48
Q

[Oxygen delivery] Percentage of oxygen delivered with 6L of oxygen via non re-breath mask?

A

60% (approx)

49
Q

[Oxygen delivery] Percentage of oxygen delivered with 7L of oxygen via non re-breath mask?

A

70% (approx)

50
Q

[Oxygen delivery] Percentage of oxygen delivered with 8L of oxygen via non re-breath mask?

A

80% (approx)

51
Q

[Oxygen delivery] Percentage of oxygen delivered with 9L of oxygen via non re-breath mask?

A

90% (approx)

52
Q

[Oxygen delivery] Percentage of oxygen delivered with 10-15L of oxygen via non re-breath mask?

A

95-100% (approx)

53
Q

[Respiratory] What is Forced Vital Capacity?

A

The volume that can be exhaled forcefully from a single full inspiration

54
Q

[Respiratory] What is Forced expiratory volume in 1s (FEV1)?

A

The volume achieved in the first 1 second of FVC (forced vital capacity)

55
Q

[Respiratory] What is Peak Expiratory Flow (PEF)?

A

The maximal flow (or speed) achieved during the maximally forced expiration initiated at full inspiration, measured in litres per minute

56
Q

[Respiratory] Classification of type 1 respiratory failure

A

Hypoxaemia (low spO2) but no Hypercapnia (cO2 retention)

57
Q

[Respiratory/Blood gas] How will type 1 respiratory failure present on an ABG?

A

PaO2: ≤ 10.0kPa (low)
PaCO2: normal or low
SpO2: less than 90% (low)

58
Q

[Respiratory] Classification of type 2 respiratory failure

A

Hypercapnia (co2 retention) always present. pH may be compensated

59
Q

[Respiratory/Blood gas] How will type 2 respiratory failure present on an ABG?

A

PaCO2: ≥6.0kPa (high)
PaO2: normal or low

60
Q

[NEWS] If a patient is scoring a NEWS of 0, how often should observations be taken and what should be done?

A

Minimum 12 hourly.

Continue routine NEWS monitoring

61
Q

[NEWS] If a patient is scoring a NEWS of 1-4, how often should observations be taken and what should be done?

A

Minimum 4–6 hourly
Inform registered nurse, who must assess the patient
Registered nurse decides whether increased frequency of monitoring and/or escalation of care is required

62
Q

[NEWS] If a patient is scoring a NEWS of 3 in a single parameter, how often should observations be taken and what should be done?

A

Minimum 1 hourly
Registered nurse to inform medical team caring for the patient, who will review and decide whether escalation of care is necessary

63
Q

[NEWS] If a patient is scoring a NEWS of 5 or more, how often should observations be taken and what should be done?

A

Urgent response threshold
Minimum 1 hourly
Registered nurse to immediately inform the medical team caring for the patient
Registered nurse to request urgent assessment by a clinician or team with core competencies in the care of acutely ill patients
Provide clinical care in an environment with monitoring facilities

64
Q

[NEWS] If a patient is scoring a NEWS of 7 or more, how often should observations be taken and what should be done?

A

Emergency response threshold
Continuous monitoring of vital signs
Registered nurse to immediately inform the medical team caring for the patient – this should be at least at specialist registrar level
Emergency assessment by a team with critical care competencies, including practitioner(s) with advanced airway management skills
Consider transfer of care to a level 2 or 3 clinical care facility, ie higher-dependency unit or ICU
Clinical care in an environment with monitoring facilities

65
Q 
[Interpret this blood gas] 
PaO2: 7.0 
pH: 7.29 
PaCO2: 9.1 
HCO3–: 26 
Base excess: +1
A

Respiratory acidosis

66
Q 
[Interpret this blood gas] 
PaO2: 14 
pH: 7.49 
PaCO2: 3.2 
HCO3–: 22 
BE: +2
A

Respiratory alkalosis

67
Q 
[Interpret this blood gas]  
PaO2: 12.7 
pH: 7.50 
PaCO2: 5.5 
HCO3-: 29
BE: +3
A

Metabolic alkalosis

68
Q 
[Interpret this blood gas]  
PaO2: 9.1 
pH: 7.30 
PaCO2: 8.4 
HCO3-: 29 
BE: +4
A

Respiratory acidosis with metabolic compensation

69
Q 
[Interpret this blood gas]  
PaO2: 12.4 
pH: 7.29 
PaCO2: 5.5
HCO3-: 15 
BE: – 4
A

Metabolic acidosis

70
Q 
[Interpret this blood gas]  
PaO2: 7.9 
pH: 7.31 
PaCO2: 7.1 
HCO3-: 22 
BE: +1
A

Respiratory acidosis with type 2 respiratory failure.

71
Q 
[Interpret this blood gas]  
PaO2: 6 
pH: 7.51 
PaCO2: 3.1 
HCO3-: 21 
BE: 0
A

Respiratory alkalosis and type 1 respiratory failure.

72
Q 
[Interpret this blood gas] 
PaO2: 9.5 
pH: 7.14 
PaCO2: 8.1 
HCO3-: 15.2 
BE: – 9.7
A

Mixed respiratory and metabolic acidosis.

73
Q

[Blood gas] If pH and paCO2 are both acidic what does this indicate?

A

respiratory acidosis

74
Q

[Blood gas] If pH and paCO2 are both alkaline what does this indicate?

A

respiratory alkalosis

75
Q

[Blood gas] If HCO3 is low what does this indicate?

A

Acidosis, with some metabolic compensation

76
Q

[Blood gas] If HCO3 is high what does this indicate?

A

Alkalosis, with some metabolic compensation

77
Q

[ACS] What is unstable angina?

A

Chest pain with little to no trigger

78
Q

[ACS] What is stable angina?

A

Chest pain where there is a trigger (such as stress or exercise). Chest pain will go after a few minutes of rest

79
Q

[ACS] True or false: Unstable angina is more serious that stable angina?

A

True

80
Q

[ACS] What does PQRST stand for?

A 
Precipitating Factors 
Qualitative Factors 
Region and Radiation
Severity 
Timing
81
Q

[Blood gas] If pH or PaCO2 are normal, but HCO3 is abnormal, what could this indicate?

A

Compensation

82
Q

[Blood results] What is the normal range for Haemoglobin (Hb)?

A

Male: 130-180 g/L
Female: 115-165 g/L

83
Q

[Blood results] What is the normal range for White Cell Count (WBC)?

A

4-11

84
Q

[Blood results] What is the normal range for Platelet Count (PLT)?

A

150-450

85
Q

[Blood results] What is the normal range for Red Blood Cells (RBC)?

A

Male: 4.5-6.5
Female: 3.8-5.8

86
Q

[Blood results] What is the normal range for INR?

A

0.2-1.8 (<2)

87
Q

[Electrolytes] Normal Sodium (Na+) levels

A

135-145 mmol/L

88
Q

[Electrolytes] Normal Potassium (K+) levels

A

3.5-5.0 mmol/L

89
Q

[Electrolytes] Normal Calcium (Ca+) levels

A

8.5-10.5 mmol/L

90
Q

[Electrolytes] Normal Magnesium (Mg+) levels

A

1.5-2.5 mmol/L

91
Q

[Electrolytes] Normal Chloride levels

A

98-108

92
Q

[Electrolytes] Normal Bicarbonate levels

A

22-30

93
Q

[Electrolytes] Normal Creatine levels

A

0.8-1.3 mg/dL

94
Q

[Electrolytes] Normal Urea levels

A

8-23 mg/dL

95
Q

Normal capillary refill time?

A

Less than 2 seconds

96
Q

Give names of Antiplatelet drugs

A

Asprin
Clopidogrel
Tricagrelor

97
Q

What do Antiplatelet drugs do?

A

They make the platelets (disc shaped blood cells) less sticky and prevent blood clots

98
Q

Give names of Anticoagulant drugs

A

Heparin
Warfarin
Rivaroxaban
Apixaban

99
Q

What do anticoagulant drugs do?

A

“Blood thinners” - prevent blood clots

100
Q

How to work out urine output?

A

Urine output = amount of urine X number of hours ÷ weight of patient in kg

Acute Medical Conditions (1 decks)

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