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Medical/Surgical > NU 454 FINAL EXAM > Flashcards

NU 454 FINAL EXAM Flashcards

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USMLE® Step 1 flashcards
1
Q

Small square on ECG

A

0.04 seconds

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2
Q

Large square on ECG

A

0.2 seconds

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3
Q

Normal QRS complex

A

0.04-0.12 seconds

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4
Q

Normal QT interval

A

< 0.4 seconds (10 boxes)

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5
Q

300, 150, 100, 75, 60, 50

A

300 method to count HR

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6
Q

Normal PR interval

A

0.12-0.2 seconds (3-4 boxes)

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7
Q

SA node pace

A

60-100 bpm

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8
Q

AV node pace

A

40-60 bpm

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9
Q

Purkinje fibers pace

A

20-40 bpm

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10
Q

Physiologic Q wave

A

normal variance; no problem

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11
Q

Pathologic Q wave

A

shows previous infarction

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12
Q

II, III, aVF

A

Inferior view of the heart

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13
Q

I, aVL, V5, V6

A

Lateral view of the heart

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14
Q

V1, V2

A

Septal view of the heart

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15
Q

V3, V4

A

Anterior view of the heart

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16
Q

Sinus Bradycardia Tx if symptomatic

A
  • Maintain airway/oxygenate
  • S/S: changed mental status, chest pain, cool, clammy, hypotension
  • Prepare for transcutaneous pacing
  • Atropine 0.5 mg q 3-5 min (max 3 mg)
  • Dopamine 2-10 ug/kg/min
  • Epinephrine 2-10 ug/min
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17
Q

“Pre-excitation”; type of SVT

A

Wolf Parkinson White Syndrome

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18
Q

SVT tx

A
  • Vagal maneuvers
  • Adenosine
  • BBs, CCBs
  • Cardioversion
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19
Q

Atrial flutter and fibrillation tx

A
  • BBs, CCBs,

- Amiodarone, antidysrthymics

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20
Q

Junctional Rhythm rate

A

40-60 bpm

-normal QRS

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21
Q

Ventricular Escape Beat/Idioventricular Rhythm rate

A

20-40 bpm

-wide QRS

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22
Q

First degree AV block

A

prolonged PR interval (>.2 seconds)

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23
Q

Second degree AV block Type I

A

Prolonged PR interval and then DROPPED

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24
Q

Second degree AV block Type II

A

Ratio of P to QRS

-Needs permanent pacemaker!

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25
Q

Third degree AV block

A

No consistency between P and QRS

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26
Q

Common electrolyte imbalance in Torsades

A

Magnesium

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27
Q

The pacemaker does not recognize normal beats and fires inappropriately

A

Failure to sense

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28
Q

The chamber has not responded to a pacing stimulus

A

Failure to capture

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29
Q

PEA/Asystole tx

A
  • no pulse
  • unshockable rhythm
  • CPR
  • Epinephrine 1mg q 3-5 min
  • Consider Vasopressin for first or second dose of epinephrine 40U
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30
Q

If hypotension is < 60

A

Give epinephrine for bradydysrthymias

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31
Q

6 H’s

  1. Hypovolemia
  2. Hypoxia
  3. Hydrogen ions (acidosis)
  4. Hyperkalemia/Hypokalemia
  5. Hypothermia
  6. Hypoglycemia
A

Differential diagnoses

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32
Q

5 T’s

  1. Tablets (overdose)
  2. Tamponade
  3. Tension Pneumothorax
  4. Thrombosis (heart)
  5. Thrombosis (lungs)
A

Differential diagnoses

33
Q

If known hyperkalemia or overdose of TCAs

A

Give sodium bicarbonate

34
Q

Pulseless VF/VT tx

A
  • Oxygen
  • Shockable rhythm
  • Defibrillate
  • CPR
  • Epinephrine 1 mg q 3-5 minutes
  • Vasopressin 40 U can be replaced for first or second dose; given ONCE
  • Amiodarone 300 mg; second dose 150 mg
  • Mag if Torsades
35
Q

Hyperkalemia

A

Bradydysrhythmias

36
Q

Hypokalemia

A

Tachydysrhymias

37
Q

Monophasic defibrillation

A

360 Joules

38
Q

Biphasic defibrillation

A

120-200 Joules

39
Q

Stable narrow/regular tachycardia tx

A
  • no s/s
  • vagal maneuvers (cough)
  • adenosine 6 mg in 1-3 seconds; repeat dose 12 mg in 1-2 minutes if needed
  • repeat 12 mg of adenosine only once
  • Diltiazem, beta blockers
40
Q

Unstable tachycardia

A

CARDIOVERT

41
Q

Stable narrow/irregular tachycardia tx

A
  • probably afib or aflutter

- Diltiazem, beta blockers

42
Q

Stable wide/regular tachycardia tx (>.12 seconds)

A

-adenosine if regular and monomorphic

43
Q

Stable wide/irregular tachycardia

A

Antidysrthymics

44
Q

Procainamide

A
  • stable wide/irregular tachy
  • 20-50 mg/min
  • 17 mg/kg MAX
  • Maintenance 1-4 mg/min
45
Q

Amiodarone

A
  • stable wide/irregular tachy
  • 150 mg over 10 minutes
  • Maintenance 1 mg for 6 hours
46
Q

Sotalol

A
  • stable wide/irregular tachy

- 100 mg over 5 min (1/5 mg/kg)

47
Q

Synchronized Cardioversion

  • Narrow Regular
  • Narrow Irregular
  • Wide Regular
A
  • 50-100
  • 120-200
  • 100
48
Q

Required MAP for adequate perfusion of brain

A

50-500

49
Q

Normal CPP

A

60-100

50
Q

Cushing’s Triad

A

HTN, bradycardia, widened pulse pressure, irregular respirations

51
Q

Result of interruption of voluntary motor tracts in the cerebral cortex

A

Decorticate Posture

52
Q

Results from disruption of motor fibers in the midbrain and brainstem

A

Decerebrate Posture

53
Q

Normal jugular venous bulb catheter pressure

A

55% to 75%

54
Q

LICOX catheter

A
  • 20-40 mm Hg

- measures oxygen, brain tissue temperature, and ICP

55
Q

Calculating CPP

A

MAP-ICP

56
Q

Calculating MAP

A

SBP + 2DSP / 3

57
Q

Osmotic diuretic given through a filter to decrease CSF

A

Mannitol (Osmitrol)

58
Q

Reduce inflammation but you have to monitor hyperglycemia

A

Corticosteroids for tx of ICP

59
Q

Hypotonic Solution

A

5% Dextrose

  1. 45% Sodium Chloride
    - cause swelling
60
Q

Neurologic emergency; initial period of unconsciousness, then lucid interval, followed by a decrease in LOC

A

Epidural hematoma

61
Q

Worst HA of life, decreased LOC, nucal rigidity, brudinski’s reflex

A

Subarachnoid hemorrhage

62
Q

Chin tuck causes knees to lift

A

Brudinski’s reflex

63
Q

Brain tumors make a patient at risk for

A

seizures and increased ICP

64
Q

HA, N/V, papilledema, visual symptoms, seizures, and changes in mentation

A

s/s brain tumor

65
Q

Hemiplegia, seizures, memory deficit, personality changes

A

frontal lobe

66
Q

Speech disturbances

A

parietal lobe

67
Q

Blindness and seizures

A

occipital lobe

68
Q

Seizures and dysphagia

A

temporal lobe

69
Q

Cranial nerve V

A

Trigeminal neuralgia

70
Q

Cranial nerve VII

A

Bell’s palsy

-herpes vesicles

71
Q

Descending paralysis

A

botulism poisoning

72
Q

Passive immunity for tetanus

A

IG

73
Q

Active immunity for tetanus

A

Tetanus vaccine

74
Q

Flexing thigh and knee causes back pain

A

Kernig’s sign

75
Q

Polymorphonuclear WBC’s > 1,000

Protein > 500

A

Bacterial Meningitis

76
Q

If the patient attempts to breath, ventilator will ventilate each breath attempted

A

Assist-Control

77
Q

Delivers preset rate and depth, but patient can breath on their own in between ventilator breaths

A

Synchronized intermittent mandatory ventilation

78
Q

Acute respiratory infection caused by coronavirus

-s/s: fever, sore throat, rhinorrhea, chills, rigors, myalgia, headache, diarrhea

A

severe acute respiratory syndrome (SARS)

Medical/Surgical (3 decks)

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