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Maddy - CPR II - some pharm > Other DSA Stuff > Flashcards

Other DSA Stuff Flashcards

1
Q

stage 1 radiographic findings sarcoidosis

A

hilar adenopathy alone

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2
Q

stage 2 radiographic findings sarcoidosis

A

hilar adenopathy w/ parechymal involvement

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3
Q

stage 3 radiographic findings sarcoidosis

A

parenchymal involvement alone

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4
Q

stage 4 radiographic findings sarcoidosis

A

advanced fibrotic changes principally in the upper lobes

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5
Q

most prominent sx of IPF

A

progressive dyspnea

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6
Q

hallmark features on lung biopsy of IPF

A

heterogenous distribution of parenchymal fibrosis against background of mild inflammation

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7
Q

first tx in pts with UA/NSTEMI

A

aspirin

- clopidogrel if aspirin intolerant

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8
Q

initial conservative tx in pts with UA/NSTEMI

A

anticoag therapy

  • enoxaparin
  • fondaparinux (less common)
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9
Q

after initiating enoxaparin, what tx for pts w/ UA/STEMI in conservative tx

A

clopidogrel

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10
Q

initial invasive strategy in pts with UA/NSTEMI

A

anticoag thearpy

  • enoxaparin
  • bivalirudin
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11
Q

after initiating enoxaparin, what tx for pts w/ UA/STEMI in invasive tx

A

add second anticoag for precatheterization

  • clopidogrel
  • GP IIb/IIIa inhibitor (eptifibatide or tirofiban)
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12
Q

3 P2Y12 inhibitor antiplatelet therapies

A

clopidogrel
prasugrel
ticagrelor

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13
Q

3 GP IIB/IIIA inhibitors

A

tirofiban
epitifibatide
abciximab

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14
Q

MOA fondaparinus

A

Xa inhibitor

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15
Q

MOA bivalirudin

A

direct thrombin inhibitor

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16
Q

do you treat unstable angina with CCB

A

NO, third line therapy only

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17
Q

Killip classification 1-4 (part of GRACE score)

A

1: absence of rales and S3
2: rales that do not clear w/ coughing over 1/3 or less lung fields, or presence of S3
3: rales that do not clear w/ coughing more than 2/3 lung fields
4: cardiogenic shock (rales, hypotension, signs of hypoperfusion)

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18
Q

GRACE risk score

A

measure risk stratification for coronary angiography in pts w/ or w/o ST elevation

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19
Q

TIMI risk score is based on what factors

A
  • age 65 or older
  • 3 or more cardiac risk factors
  • prior coronary stenosis 50% or more
  • ST segment deviation
  • 2 anginal events in prior 24 hours
  • aspirin in prior 7 days
  • elevated cardiac markers
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20
Q

what type of shock is associated w/ pulmonary edema

A

cardiogenic

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21
Q

tension pneumothorax, cardiac tamponade, PE, and severe pulmonary HTN cause what type of shock

A

obstructive

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22
Q

elevated serum lactate is associated with what type of shock

A

septic shock

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23
Q

GI effects of hypotension

A

splanchnic vasoconstriction –>

  • oliguria
  • bowel ischemia
  • hepatic dysfunction
  • multiorgan failure
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24
Q

CNS effects hypotension

A
  • restlessness
  • agitation
  • confusion
  • lethargy
  • coma
25
Q

what to do with shock patients who become unresponsive

A

check glucose and if levels are low give 50% dextrose IV

26
Q

central venous pressure < 5 mmHg indicates

CVP > 18 mmHg indicates

A

hypovolemia

volume overload, cardiac failure, tamponade, pulm HTN

27
Q

PACs measure what

A
  • pulmonary artery pressure
  • left sided filling pressure
  • PCWP
28
Q

what can you use to distinguish b/w cardiogenic and septic shock

A

pulmonary artery catheters

29
Q

what does POCUS look at

A

inferior vena cava (intravascular volume status)

30
Q

cardiac index < 2L/min/m2 means

cardiac index > 4L/min/m2 in hypotensive pt means

A

<2: needs inotropic support

>4: early septic shock

31
Q 
systemic vascular resistance low (<800):
SVR high (>1500):
A

low: sepsis and neurogenic shock
high: hypovolemic and cardiogenic shock

32
Q

what fluid is used for volume replacement in shock

A

crystalloid solution

33
Q

compare fluid replacement in cardiogenic and septic shock

A

cardiogenic: smaller fluid challenges in increments of 250 mL
septic: large volumes of fluid (usually more than 2L)

34
Q

compare vasoactive therapy in:
pt w/ hypotension and high CO after volume resuscitation

pt with low CO w/ high filling pressure

A

pt 1: vasopressor support to improve vasomotor tone

pt 2: inotropic support to improve contractility

35
Q

what vasoactive therapy to give in pts with vasodilatory shock

A

NE and E

36
Q

vasopressor of choice in septic shock

A

NE

- phenylephrine can also be used

37
Q

1st line vasopressor agents in cardiogenic shock

A

NE or dopamine

38
Q

tx of choice for pts with shock secondary to adrenal insufficiency

A

corticoteroids

39
Q

what endogenous pyrogens mediate fever

A

IL-1, TNF, interferon a

40
Q

elevation of temperature related to inability of body to dissipate heat

A

hyperthermia

41
Q

5 categories of fever

A 
hypersensitivity rxns
altered thermoregulatory mechanisms
related to administration of drug
direct extensions of pharmacologic action of drug
idiosyncratic (we don't know)
42
Q

near universal agreement that core body temp of ___ represents a fever

A

38.3 (100.9)

43
Q

most common causes of fever of unknown origin

A

tuberculosis and intra-abdominal abscesses

44
Q

malignancies associated with fever of unknown origin

A

hodgkin’s dz, non-hodgkin’s lymphoma

45
Q

inflammatory conditions associated w/ fever of unknown origin

A

SLE
giant cell arteritis
IBD

46
Q

very high fever, consider —>

A

CNS infections
NMS
heat stroke

47
Q

fever w/ rash, consider –>

A

meningitis
bacteremia w/ septic shock
rickettsial dz
bacterial endocarditis

48
Q

fever w/ change in mental status, consider –>

A 
meningitis
encaphlitis
NMS
heat stroke
bacterial infections w/ septic shock
49
Q

fever w/ dizziness or light-headedness, consider –>

A

bacterial infection w/ septic shock
adrenal insufficiency
PE

50
Q

fever w/ recent chemotherapy, consider –>

A

nosocomial infection w/ neutropenia

51
Q

fever w/ SOB and CP, consider –>

A

PE, pneumonia, empyema

52
Q

tertian fever and quartan fever are associated w/:

A

tertian: malaria due to plasmodium vivas or ovale
quartan: malaria due to plasmodium malariae

53
Q

DUKE criteria for infectious endocarditis

A
  • positive blood culture
  • persistent positive blood culture
  • echo positive for IE
    minor criteria:
  • fever
54
Q

criteria for fever of unknown origin:

A

fever >101 on at least two occasions

illness duration of > 3 weeks

55
Q

maculopapular rash in a sparse distribution over the anterior trunk in the groin and upper legs
- intermittent fever

A

rickettsial infection

56
Q

sx of human monocytotropic erlichiosis (HME)

A
  • fever
  • headache
  • myalgia
  • malaise
  • 8 day illness
  • thrombocytopenia, leukopenia, elevated serum aminotransferases
57
Q

sx rocky mountain spotted fever

A
  • fever, rash, hx of tick exposure

- rash characterized by macules appearing on wrists and ankles and then spreading to rest of extremities and trunk

58
Q

sx lyme dz

A

erythema marginatum, fever, chills, myalgia

Maddy - CPR II - some pharm (18 decks)

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