ICU

Question 1

How do you calculate cerebral perfusion pressure?

Answer 1

CPP= mean arterial pressure - intracranial pressure

Question 2

Function of vasopressin(ADH) is:

Answer 2

Causes water reabsorption in the distal tubules and collecting duct. Effect is mediated by V2 receptors

Question 3

Vasopressin acts on V1, V2, and V3 receptors. What are the resultant physiologic effects in V1 and V3 receptors?

Answer 3

V1: vasoconstriction and resultant increase in BP

V3: causes release of factor VIII and vWB factor from endothelium

Question 4

What are the stimulants of release of vasopressin?

Answer 4

Hypovolemia and hyper-osmolarity

Question 5

Where is ADH synthesized? Where is it released from?

Answer 5

Synthesized in the hypothalamus

Released from posterior pituitary

Question 6

What is the SIRS-sepsis spectrum?

Answer 6

SIRS->sepsis->severe sepsis->septic shock->multiorgan dysfunction syndrome

Question 7

What is the SIRS Criteria?

Answer 7

A patient must have two of the following:
1. Heart rate >90
2. WBC count greater than 12k, less than 4k, or >10% bands
3. Temperature greater than 38•C or less thank 36•C
RR>20 or PACO2<32

Question 8

What is the criteria for sepsis?

Answer 8

SIRS+ source of infection (suspected or confirmed)

Question 9

What’s the criteria for severe sepsis?

Answer 9

Sepsis + (organ dysfunction, hypoperfusion, or hypotension)

Question 10

What’s the criteria for septic shock?

Answer 10

Severe sepsis + hypotension despite adequate fluid resuscitation

Question 11

What’s the criteria for multi organ dysfunction syndrome?

Answer 11

Septic shock + (evidence of two or more failing organs)