picu board card Flashcards
<p>main effect of BK virus infection</p>
<p>renal failure</p>
<p>anacrotic limb signifies what</p>
<p>aortic valve opening and onset of LV ejection</p>
<p>hepatopulmonary syndrome</p>
<p>pathological dilation of pulm vessels causing increased intrapulmonary shunt, hypoxemia</p>
<p>carb overfeeding causes \_\_\_\_ RQ</p>
<p>higher</p>
<p>what happens in carbon monoxide poisoning pulse oximetry reading?</p>
<p>the oxygen saturation is overestimated because it interprets carboxyhemoglobin to be oxyhemoglobin, this also occurs in hemolysis</p>
V/Q =
((8.63 x R(CaO2-CmvO2))/PACO2
<p>hyperammonemia with acidosis, yes urine ketones</p>
<p>organic aciduria</p>
<p>low lipid solubility, high protein binding, decreased tissue binding produce a \_\_\_ volume of distribution</p>
<p>low</p>
<p>CaO2 = </p>
<p>1.36 (amount of oxygen in ml that a fully saturated Hb can carry) x Hb (g/dL) x %sat x 0.003 (solubility coefficient of oxygen in ml of oxygen per dL of blood)</p>
<p>it is difficult/easy to remove a drug with large Vd by dialysis</p>
<p>difficult</p>
<p>immunodeficiency of older kids, B cell defect, increased risk autoimmune disease</p>
<p>CVID</p>
<p>risk ratio is similar to odds ratio if events are \_\_</p>
<p>rare</p>
<p>do neonates have a larger or smaller relative volume of distriubtion</p>
<p>larger</p>
<p>this is in cryo</p>
<p>8, 13, vWF, fibrinogen; 1 unit increases fibrinogen by 50 mg/dL</p>
<p>what facilitates the interaction of actin and myosin</p>
<p>an increase in cytosolic calcium</p>
<p>which type of diuretic is likely to cause kidney stones, esp in premature infants</p>
<p>loop diuretics</p>
<p>EKG signs hypercalcemia</p>
<p>prolonged PR, short QT, wide QRS</p>
<p>normal pyruvate and elevated lactate to pyrvate ratio</p>
<p>mitochondrial disorder</p>
<p>x linked recessive failure of neutrophil oxidative burst, NADPH oxidase deficiency</p>
<p>CGD</p>
<p>Lasix and bumex quickly increase \_\_\_ leading to improvement in heart failure</p>
<p>venous capacitance</p>
<p>antidote for serotonin syndrome</p>
<p>cyproheptadine; antihistamine and serotonin antagonist</p>
<p>infection after liver transplant after 4 weeks</p>
<p>viral</p>
<p>when is risk ratio similar to odds ratio, when events are rare or when events are frequent</p>
<p>when events are rare</p>
<p>risk of catheter related infection is lowest for \_\_\_</p>
<p>subclavian, but highest risk mechanical complications</p>
<p>PAO2 = </p>
<p>((Patm-PH20) x FiO2) - PaCO2/RQ</p>
<p>how does NO cause vasodilation</p>
<p>activation of guanylate cyclase to increase cAMP</p>
<p>effect of ATII and endothelin on afferent arteriole</p>
<p>constriction</p>
<p>DO2 (ml/min) =</p>
<p>CaO2 x CO x 10 dL/L</p>
<p>which muscles are most resistant to neuromuscular blockade in children/adults</p>
<p>larynx, diaphragm</p>
<p>high fever, diarrhea, severe encephalopathy, 50% mortality</p>
<p>hemorrhagic shock encephalopathy syndrome</p>
<p>administration of \_\_\_ is contraindicated in children with MCAD deficiency</p>
<p>MCT oil</p>
<p>is inhaled NO helpful in lung transplant dysfunction</p>
<p>yes</p>
<p>what is treatment for NMS</p>
<p>benzos and dopaminergic agents</p>
<p>v wave</p>
<p>atrium filling with blood again</p>
<p>dicrotic notch signifies what</p>
<p>reflected waves back from arteries when measured peripherally</p>
<p>flexed upper extremities posturing is called</p>
<p>decorticate, comes before decerebrate</p>
<p>hallmark of community acquired MRSA</p>
<p>profound neutropenia</p>
<p>hyperammonemia without acidosis is the hallmark of the \_\_\_</p>
<p>urea cycle defects</p>
<p>this MRI mode uses the brownian movement of water molecules to identify acute and subacute edema, ischemic areas will be \_\_\_ on this method</p>
<p>DWI, bright</p>
<p>altered systemic \_\_\_\_ synthesis leads to decreaesd pulm clearance of ROS leading to ARDS in liver failure</p>
<p>glutathione</p>
<p>risk of infection with PICC is \_\_ than CVL</p>
<p>same, time to infection is longer however</p>
<p>in what zone of lung does PA catheter need to be for best measurement</p>
<p>in area least effected by alveolar pressure, zone 3</p>
<p>hereditary hemochromastosis has low levels of \_\_\_, a regular or iron homeostasis</p>
<p>hepcidin</p>
<p>in massive transfusion for every 5 units blood give </p>
<p>4 units plt and 1 unit FFP</p>
<p>this is the crunching sound during systole that suggests air or fluid abutting the heart signifying mediastinitis</p>
<p>hamman sign</p>
<p>neonatal airways are \_\_\_ than adults when normalized to BSA</p>
<p>larger</p>
<p>this disease has elevated pyruvate but normal lactate to pyruvate ratio, hypoglycemia</p>
<p>glycogen storage</p>
<p>this disease has decreased number of Ach receptors to not have an effective contraction</p>
<p>myasthenia gravis</p>
<p>on which MRI is CSF dark</p>
<p>T1</p>
<p>all alcohols are metabolized to \_\_\_</p>
<p>oxalic acids</p>
<p>TCA mechanisms</p>
<p>alpha 2 antagonists, block Na channels</p>
<p>biotin deficiency will result in a secondary deficiency in what enzyme</p>
<p>pyruvate carboxylase</p>
<p>type II HIT</p>
<p>antibody to plt factor 4, issue is thrombosis not bleeding; type I HIT self resolves</p>
<p>this is from reactivation of latent EBV after transplant leading to B cell hyperplasia/lymphoma</p>
<p>PTLD</p>
<p>TTP pentad</p>
<p>fever, AMS, microangiopathic hemolytic anemia, renal dysfunction, thrombocytopenia</p>
<p>EKG findings of propofol infusion syndrome</p>
<p>RBBB and ST elevations V1 to V3</p>
<p>person is awake but drowsy</p>
<p>alpha</p>
<p>symptoms of TRALI must appear within \_\_\_ hours of transfusion</p>
<p>6</p>
<p>do highly lipophilic oral meds absorb faster or slower</p>
<p>faster</p>
<p>this inhibits GABA release presynaptically</p>
<p>tetanus toxin</p>
<p>conditions where PAOP underestimates</p>
<p>LV non compliance, aortic regurg (mitral valve closes but retrograde flow continues and thus elevates LVEDP)</p>
<p>hyperammonenia with acidosis, no urine ketones</p>
<p>disorder of FA oxidation</p>
<p>anti inflammatory cytokines</p>
<p>IL-10, TGF-beta</p>
<p>how many half lives until steady state</p>
<p>4-5</p>
<p>this is a bath salt that causes seizures, hyperthermia, agitation, fever</p>
<p>mephedrone</p>
<p>higher gas flow at lower pressures is the \_\_\_ principle</p>
<p>bernoulli principele</p>
<p>K time long or shallow alpha angle in TEG</p>
<p>need plt, fibrinogen to help clot kinetics</p>
<p>side effect of cyclophosphamide</p>
<p>hemorrhagic cystitis</p>
<p>critical point of oxygen delivery</p>
<p>at this point tissues are supply dependent for oxygen delivery and consumption will fall with falling oxygen delivery</p>
<p>side effect of vincristine</p>
<p>peripheral neuropathy</p>
<p>location of phlebostatic axis</p>
<p>junction of 4th intercostal space and mid axillary line</p>
<p>this dopamine receptor is on renal tubules and mediates naturiesis</p>
<p>DA-1, also cause vasodilation postsynaptic</p>
<p>with decreasing GFR there is an \_\_\_\_ in Cr secretion</p>
<p>increase, thus further overestimating GFR</p>
<p>as the arterial pulse is transmitted distally the \_\_\_ peak increases, the \_\_\_ pressure decreases</p>
<p>systolic, diastolic</p>
<p>equation for renal plasma flow</p>
<p>RPF = (renal artery pressure-renal vein pressure)/RVR</p>
<p>pompes EKG</p>
<p>biventricular strain, short PR</p>
<p>this is the volume of plasma from which drug is removed over a period of time and equals k x Vd</p>
<p>clearance</p>
<p>combo of neutropenia, panc insufficiency, resp infection</p>
<p>schwachmann diamond</p>
<p>high spinal cord injury can cause autonomic \_\_\_</p>
<p>dysreflexia, episodes of hypertension</p>
<p>this metabolic disorder has cardiomyopathy, myopathy, myoglobinuria</p>
<p>fatty acid oxidation</p>
<p>plt adhesion is \_\_\_\_ in liver failure</p>
<p>increased</p>
<p>proximal RTA type II</p>
<p>decreased ability of proximal tubule to absorb bicarb, low urine pH</p>
<p>response of large pulm arteries to hypoxia</p>
<p>vasodilation</p>
<p>significant slowing on eeg</p>
<p>delta</p>
<p>this impairs release of Ach at NMJ</p>
<p>botulinum toxin</p>
<p>name of decreased and delayed arterial upstroke seen in aortic stenosis</p>
<p>pulsus parvus et tardus</p>
<p>infant chest wall has \_\_ compliance, \_\_\_ elastance</p>
<p>increased, decreased</p>
<p>these are the most prevalent immune deficiences</p>
<p>antibody defects</p>
<p>the point where inhaled gas becomes 100% humidified in mechanical ventilated patients</p>
<p>isothermic saturation boundary</p>
<p>this medication inhibits acetylcholinesterase and improves muscle strength in MG in 1 min</p>
<p>edrophonium</p>
<p>most mineralocorticoid steroid</p>
<p>hydrocortisone</p>
<p>GFR plasma inulin formula</p>
<p>GFR x Pin = V x Uin</p>
<p>conditions where PAOP overestimates LVEDP</p>
<p>catheter in west zone 1 or 2, excessive positive mean airway pressure, mitral valve disease as only the high LA pressure is reflected not the actual LVEDP, increased PVR</p>
<p>whats the primary cytokine for macrophages</p>
<p>RANTES</p>
<p>infant lungs have \_\_\_ elastance</p>
<p>decreased</p>
<p>when focal vascular injury occurs due to the trauma the initial response is </p>
<p>vasoconstriction</p>
<p>anterior spinal cord is responsible for ...</p>
<p>pain, temperature</p>
<p>this elimination has constant amount eliminated per unit time</p>
<p>zero order</p>
<p>risk of clot in HIT persists for how long</p>
<p>weeks</p>
<p>fast component of nystagmus with warm water is away/toward the warm water</p>
<p>away</p>
<p>alkalinization of urine in TCA overdose does/does not effect excretion</p>
<p>does not, it increases the binding of free drug</p>
<p>milrinone half life is \_\_\_ in infants than children</p>
<p>longer</p>
<p>a wave</p>
<p>atrial contraction</p>
<p>in what phase of CPR does the RA pressure fall faster than aortic pressure allowing the coronaries to perfuse</p>
<p>decompression phase, need at least 15 mm Hg difference</p>
<p>what is the effect of hypothermia on cerebral blood flow</p>
<p>reduced, also decreases response to changes in CO2</p>
<p>triscupid valve stenosis, PS, PA, pulm htn, non complaint RV causes these waves</p>
<p>cannaon a waves</p>
<p>chemotaxis neutrophil failure, recurrent staph infection of lung, eczema, increased Ige</p>
<p>hyper IgE (job syndrome)</p>
<p>side effect of amyl nitrite, sodium nitrite</p>
<p>methemoglobinemia</p>
<p>gold standard for HIT</p>
<p>C-serotonin assay</p>
<p>works through cGMP to activate Ca sensitive K channels, K goes into cell and Ca is inhibited resulting in relaxation</p>
<p>NO</p>
<p>which way does oxyhemoglobin dissociation curve go with increased 2,3 DPG, acidosis, increased temp, decreased pH</p>
<p>to the right</p>
<p>risk of significant LV dysfunction is minimized in duchennes patients who have received \_\_\_</p>
<p>steroids</p>
<p>this receptor activates adenylate cyclase to increase cAMP, increase protein kinase, increased cytosolic Ca</p>
<p>beta 1</p>
<p>this is a deficiency of acid alpha glucosidase, a lysosomal hydrolase responsible for degradation of a small amount of glycogen</p>
<p>pompes</p>
<p>decreased respiratory system elastance \_\_\_ closing volume </p>
<p>increases; volume in infants is above FRC so there is atelectasis in quiet breathing</p>
<p>this is a reflex where an increase in atrial volume causes an increase in HR and contractility</p>
<p>bainbridge</p>
<p>complication of silver sulfadizene</p>
<p>leukopenia due to neutrophils going to the site</p>
<p>anion gap acidosis with normal lactate and high ketones</p>
<p>disorder of ketolysis or aminoacidopathy like MSUD</p>
<p>infection after liver transplant common in first 4 weeks</p>
<p>bacterial</p>
<p>GFR using bedside Schwartz equation</p>
<p>GFR = (0.41 x height in cm)/Cr</p>
<p>positive and negative predictive value are influenced by the \_\_\_ of disease in the population</p>
<p>frequency</p>
<p>coronary steal</p>
<p>when coronary blood flow redistributes from endocardial to epicardial muscle</p>
<p>PVR = </p>
<p>(MPAP-PAOP)/CO x 80</p>
<p>absent dolls eye reflex</p>
<p>eyes turn with head and never deviate back to midline</p>
<p>channels between alveoli that allow for collateral ventilation</p>
<p>pores of kohn (not present until 3-4 years of age)</p>
<p>which is better for variceal bleeding, octreotide or vasopressin</p>
<p>octreotide</p>
<p>this drug inhibits PDE III</p>
<p>milrinone</p>
<p>which has a higher sat in normal conditions, Smv or Scv</p>
<p>Smv because its in PA and avoids coronary sinus blood</p>
<p>normal lysis at 30 min in teg is \_\_\_\_</p>
<p>less than 5%</p>
<p>whats the primary cytokine for neutrophils</p>
<p>IL-8</p>
<p>eczema, thrombocytopenia, immunodeficiency</p>
<p>wiskott aldrich</p>
<p>if there is no difference between therapies but investigators conclude there is</p>
<p>type I error, alpha</p>
<p>Qs=</p>
<p>VO2/Cao-Cpa</p>
<p>response of peripheral chemoreceptors in carotid and aorta to hypoxemia less than 60 mm Hg</p>
<p>increase minute ventilation, increase sympathetic tone</p>
<p>which waves become more prominent in tricuspid regurg</p>
<p>c and v</p>
<p>drugs with poor tissues penetration have a small/large Vd</p>
<p>small</p>
<p>this equals 0.693/k</p>
<p>T1/2</p>
<p>Reynolds number = </p>
<p>(2vrp/n); less than 2000 is laminar, over 4000 is turbulent</p>
<p>which curve is linear for elimination, first order or zero order</p>
<p>first order</p>
<p>anion gap acidosis with normal lactate and low ketones</p>
<p>disorder of fatty acid oxidation</p>
<p>elevated BUN and elevated bili can \_\_ free fraction of drug</p>
<p>increase</p>
<p>color of full thickness burn</p>
<p>white or black</p>
<p>the area of the LV pressure volume curve represents \_\_\_</p>
<p>stroke work</p>
<p>closing capacity</p>
<p>the volume at which small airway closure occurs during expiration</p>
<p>reverse Fick VO2 = </p>
<p>(CaO2 - CmvO2) x CO</p>
<p>anacrotic limb</p>
<p>initial sharp upstroke of arterial waveform</p>
<p>where is v/q ratio highest</p>
<p>apex of lung</p>
<p>most immunosuppressive steroid</p>
<p>decadron</p>
<p>this is the neurotransmitter at all sympathetic ganglia, the post gang neurotransmitter is \_\_\_</p>
<p>ach, norepi</p>
<p>antidote for calcium channel blocker overdose</p>
<p>calcium, then insulin</p>
<p>what distinguishes PA waveform from RV waveform</p>
<p>PA waveform has a higher diastolic pressure</p>
<p>what is the response of the coronaries to acidosis</p>
<p>vasodilate</p>
<p>BNP acts via \_\_\_</p>
<p>cGMP</p>
<p>which type of cardiac muscle gets more blood flow, endocardial or epicardial ?</p>
<p>endocardial at ratio of 1.25:1</p>
<p>HIV diagnosis greater than 18 months</p>
<p>HIV ab</p>
<p>another word for accuracy ie close to the truth</p>
<p>validity</p>
<p>in hypervolemic (zone III) conditions an increase in abdominal pressure with diaphragm descent caused a \_\_\_ in venous return</p>
<p>increase (non splanchnic blood flow is not inhibited), splanchnic flow increases</p>
<p>symp pregang neurotransmitter is \_\_\_, post gang is \_\_\_</p>
<p>ach, norepi</p>
<p>this is equal to (total amount of drug in the body)/(concentration in the plasma)</p>
<p>volume of distribution</p>
<p>TLR3 recognizes \_\_\_\_</p>
<p>dsDNA viruses</p>
<p>highly protein bound drugs are/are not readily filtered</p>
<p>are not</p>
<p>Qpul = </p>
<p>VO2/Cpv-Cpa</p>
<p>antidote for ethylene glycol</p>
<p>fomepizole to inhibit alcohol dehydrogenase; dialysis to remove the oxalic acid</p>
<p>when is intraaortic balloon pump inflated</p>
<p>during diastole</p>
<p>c wave</p>
<p>tricuspid valve displacement toward atrium during isovolumic contraction</p>
<p>this toxic overdose blocks Na-K ATPase in myocardium</p>
<p>TCAs</p>
<p>what accounts for over 50% liver transplants</p>
<p>biliary atresia with failed kasai</p>
<p>auto recessive impaired neutrophil phagocytosis, neuropathy, albinism</p>
<p>chediak higashi</p>
<p>antidote for methanol toxicity</p>
<p>folinic acid</p>
<p>if there is a difference but investigators conclude there is not</p>
<p>type II, beta</p>
<p>fetal Hb has \_\_\_ O2 affinity, \_\_\_\_\_ p50</p>
<p>higher, lower</p>
<p>distal RTA type I</p>
<p>decreased urine proton excretion, high urine pH</p>
<p>anion gap acidosis with high lactate and normal pyruvate(elevated lactate to pyruvate ratio)</p>
<p>mitochondrial disorder</p>
<p>lymphomatous transformation when infected with EBV, see lymphadenopathy, hepatic/BM failure</p>
<p>X linked lymphoproliferative disease</p>
<p>flail chest</p>
<p>chest collapses with inspirations</p>
<p>drug is eliminated as a fixed amount over time</p>
<p>zero order</p>
<p>this elimination kinetic has rate of elimination directly proportional to concentration of drug</p>
<p>first order</p>
<p>wall tension T = ; aka law of LaPlace</p>
<p>(P x r)/2w</p>
<p>this inhibits IL-2, is nephrotoxic</p>
<p>calcineurin inhibitors like cyclosporin</p>
<p>this is the best load independent measure of contractility because it measures contractility at different preloads and afterloads</p>
<p>end systolic pressure volume relationship ie slope of the curve</p>
<p>need to rule out this disorder in nonaccidental trauma</p>
<p>glutaric aciduria type I, tx is L carnitine, retinal hemorrhages not seen</p>
<p>FeNa</p>
<p>(UnaxPna)/(UcrxPcr)</p>
<p>\_\_\_ and \_\_\_\_ stimulate gastric empyting</p>
<p>ghrelin and motilin</p>
<p>SIRS criteria must include \_\_\_ or \_\_\_</p>
<p>abnormal temp or WBC count</p>
<p>to diagnose organophosphate toxicity measure this</p>
<p>RBC cholinesterase</p>
<p>clue that pt may develop malignant hyperthermia</p>
<p>sustained masseter muscle rigidity</p>
<p>myoglobin precipitates when it interacts with</p>
<p>tamm-horshall protein</p>
<p>the receptor activates adenylate cyclase to increase cAMP, increase protein kinase, decreased cytosolic Ca</p>
<p>beta 2</p>
<p>most common type of TEF</p>
<p>esophageal atresia plus distal fistula between esophagus and trachea getting air into stomach</p>
<p>this is a class III antiarrythmic that blocks K channels on the sarcolemma of cardiac myocytes</p>
<p>adenosine</p>
<p>sympathetic pregang neurons are located from \_\_\_\_ and release Ach</p>
<p>T1-L2, Ach</p>
<p>what is treatment for varicella exposure</p>
<p>varicella immune globulin up to 10 days after</p>
<p>term for the percentage of drug that reaches the systemic circulation after administration</p>
<p>bioavailability</p>
<p>in critical illness both protein synhesis and breakdown are increased but there is still net \_\_\_ protein balance</p>
<p>negative</p>
<p>phase 2 of myocardial depol</p>
<p>calcium enters cell via L type channels, triggers Ca release from SR via ryanodine receptors (ca induced ca release), Ca binds to Tn-C, allowing actin and myosin to interact</p>
<p>which factor during CPR correlates with return of spontaneous circulation</p>
<p>coronary perfusion</p>
<p>anion gap acidosis with high lactate and high pyruvate (ie normal lactate:pyruvate ratio) but hypoglycemia</p>
<p>glycogen storage I or disorder of gluconeogenesis</p>
<p>a wave</p>
<p>atrial contraction at the end of diastole</p>
<p>this receptor has adenylate cyclase inhibited pre synaptically to decrease cAMP and PKA and decrease norepi leading to vasodilation</p>
<p>alpha 2</p>
<p>time based billing codes are used for patients older than _</p>
<p>6 years</p>
<p>this is the neurotransmitter for parasymp</p>
<p>ach</p>
<p>pressures the define pulm htn</p>
<p>over 25 at rest, over 30 in exercise</p>
<p>which area has highest O2ER in body</p>
<p>coronary sinus (its about 0.6), so decreased ability to increase thus vulnerable to ischemia</p>
<p>this has low WBC count with low levels of T cell surface markers CD3, CD8, CD4 and gets infected with P jiroveccii</p>
<p>SCID</p>
<p>fast component of nystagmus with cold water is away/toward the ice water</p>
<p>toward</p>
<p>response of small pulm arteries to hypoxia</p>
<p>vasoconstriction</p>
<p>when Pra is less than 0 venous return is still limited by the collapse of \_\_\_</p>
<p>extrathoracic blood vessels</p>
<p>medication of choice for cocaine intoxication</p>
<p>benzos</p>
