POM Flashcards
Is a throughout history always helpful in PAD pts?
No, some pt can have PAD but don’t exert themselves enough to present it
ABI = ?
Ankle systolic pressure/brachial systolic pressure
What is normal ABI?
1 to 1.2
What does ABI > 1.5 mean?
Medial calcification
How to calculate the max HR according to age?
220-age
Is LOS caused by trauma count as syncope?
No
Younger pt tend to have more __ type of syncope and ___ type for elderly
Vasovagal/cardiac
What is the mechanism of neurally mediated syncope?
Sudden withdraw of symp tone
What are the 3 main causes of syncope?
Neurogenic (e.g. sneeze/stress)/cardiac/orthostatic
Fall suddenly, what type of syncope?
Cardiac
The type of syncope with the shortest duration is? what about longest?
Cardiac/vasovagal
What type of syncope with the fastest recovery?
Cardiac
What should you check for syncope pt on physical examination?
Supine and standing BP/HR
HoTN/high HR/low Hb, what causes the syncope?
Anemia, probably GI bleed
How to distinguish cardiac and vasovagal syncope?
Cardiac: sudden
Vasovagal: usually a trigger
S3 (ventricular gallop) happens in early __? following which heart sound?
diastole/S2
What is an atrial gallop?
S4
Where is aortic stenosis radiate to? what about mitral regurgitation?
To the neck (carotid)/axilla
What grade of murmur is louder than the normal heart sound?
Grade III
Isometric exercise and squat would increase or decrease the murmur of aortic stenosis?
Decrease (less flow through the valve)
The murmur of aortic stenosis increases as S2 ?
Decreases
2 common examples of diastolic murmur?
Aortic regug/mitral stenosis
Isometric exercise and squat would increase of decrease the murmur of aortic regug?
Increase
What does the murmur sound like for aortic regug?
Sound like S2 is being dragged longer
What does mechanical ventilation mean?
Positive pressure ventilation
Positive pressure ventilation causes HTN or HoTN?
HoTN and decrease CO
PEEP increase or decrease preload?
Decrease
What are the indications for mechanical ventilation?
Hypoxic/hypercarbic (inadequate) respiratory failure
When do you use mask continous positive airway pressure for/what about bilevel positive airway pressure?
obstructive sleep apnea/COPD exacerbation
When shouldnt you give pt noninvasive positive pressure ventilation?
Coma/cardiac arrest/respiratory arrest (pt needs to be awake)
Prolonged ventilator use make pt at risk for?
Ventilator associated pneumonia
What can causes ARDS
any critical illness like sepsis or brain injury
P/F ratio low or high in ARDS?
Low
Ventilator induce lung injury is similar to ?
ARDS
Low or high TV should be used to prevent ventilator induce lung injury?
Low
Obstructive sleep apnea leads to 2 things?
Reduce O2 saturation
Brief arousal
What is the gold standard for diagnosing sleep apnea?
In lab/apnea hypopnea index
Sleep apnea increase risk for?
Cardiovascular disease
What hormone increase risks for sleep apnea?
Testosterone
Pre or post menopausal women has higher risk for sleep apnea? and what age group in general has a higher risk>
Post/middle age
What are the 3 risk factors for sleep apnea?
Obesity/small airway/more fluid shift at night
What questionnaire is for sleep apnea screening?
STOP-Bang
What is the best treatment for sleep apnea?
Positive airway pressure
