Renal/Urology/GI and Sepsis/MODS Flashcards
What is the primary goal of urine production?
To maintain regulation of volume and composition of blood
Glomerular filtration rate (GFR) is defined as the amount of ________ produced by the kidneys each minute.
filtrate
T/F: Creatine is produced by the muscles and can be used as an indicator of renal insufficiency.
True
T/F: You are treating a patient with renal failure. You would expect to see a decrease in their creatine level.
False, you would expect them to have an increased creatine
T/F: BUN is a measurement of urea nitrogen in the blood and measures the metabolism of proteins in the liver and the removal by the kidneys.
True
T/F: High BUN is often seen in patients with liver problems, malnutrition, or a history of alcoholism.
False, low BUN is often seen in patients with liver problems, malnutrition, or a history of alcoholism
T/F: As ventilations increase, you would expect to see a resultant decrease in pH.
False, you would expect to see a resultant increase in pH
T/F: Immediately after a kidney injury, the only sign may be decreased urinary output.
True
Which of the following is NOT one of the three types of acute renal failure?
a) Prerenal
b) Postrenal
c) Intrinsic
d) Extrinsic
d) Extrinsic
What type of acute renal failure results from decreased blood flow to the kidneys and is the most common form of kidney injury?
Prerenal
Your patient has kidney stones. This patient is most at risk for what type of acute renal failure?
Postrenal
For a patient with an acute kidney injury, would this patient be at an increased risk of hypokalemia or hyperkalemia?
hyperkalemia
What is the most important concern for a patient with rhabdomyolysis?
blockage of the tubules and kidney failure
T/F: Patients with renal failure may become hypoglycemic due to insulin being renally cleared.
True
What electrolyte disturbance is most life-threatening in the hours following rhabdomyolysis?
hyperkalemia
What is the primary treatment for rhabdomyolysis?
aggressive fluid rehydration
Altered mental status from a urinary tract infection is most common in which age group?
elderly
T/F: Pain management is one of the most important treatments for patients with kidney stones.
True
The signs and symptoms of what mimic that of a kidney stone?
leaking aneurysm
T/F: Urethral trauma is a contraindication to the insertion of a foley catheter.
True
What is most often the cause of ischemic abdominal pain?
strangulated bowel
In which of the following patients is extreme abdominal palpation contraindicated?
a) A patient with rebound tenderness
b) A patient with suspected gastritis
c) A patient with a suspected aortic aneurysm
d) A patient with a suspected ruptured appendix
c) A patient with a suspected aortic aneurysm
You are treating a patient with an upper GI bleed with significant bleeding. After giving ___ liters of crystalloid, you should consider switching to fresh frozen plasma (FFP) or whole blood.
2
_______________ sign is bruising around the flanks and can be indicative of pancreatitis.
Grey Turner’s
____________ sign is bruising around the umbilicus and can be indicative of pancreatitis or an ectopic pregnancy.
Cullen’s
What medication is the primary offender in drug-related hepatoxicity?
Acetaminophen
Appendicitis pain will frequently migrate from the periumbilical area to which abdominal quadrant?
Right Lower Quadrant
Which of the following is NOT typical treatment of a patient with an AAA?
a) Give a 2L crystalloid bolus in preparation for rupture
b) insert a foley catheter
c) insert a NG tube
d) establish two large bore IVs
a) Give a 2L crystalloid bolus in preparation for rupture
You should prepare a 2L crystalloid bolus, but only administer it in the event of an AAA rupture
Which of the following is a contraindication of gastric lavage?
a) GI bleed
b) Ingestion of a strong alkali
c) Intentional drug overdose
d) Gastric distention
b) Ingestion of a strong alkali
What are the two types of long-term feeding tubes?
PEG, PEJ
You are treating an 8-year-old with a PEG tube. The PEG tube has come out. The tube must be reinstated within ______ hours or new surgery may be required.
24
You are treating a patient with SIRS and you are reviewing the ABGs. Which of the following would you expect for the patient’s PCO2?
a) Typically the PCO2 is grossly elevated >55
b) Typically the PCO2 is <35
c) There is generally no change in the PCO2 from the standard range.
d) The PCO2 is dependent on whether a bacteria or a virus caused the sepsis
b) Typically the PCO2 is <35
In patients with SIRS, _____glycemia is common and can significantly increase mortality if not tightly controlled.
hyper
In patients with severe sepsis, you would expect them to have _____ platelet levels and a _________ clotting time.
low, prolonged
T/F: Sepsis is the leading cause of non-coronary death in the ICU in the United States.
True
Sepsis is defined as a systemic infection with one or more signs of organ dysfunction. Which of the following is one of the markers for organ dysfunction?
a) PaO2 of 85
b) Hypotension including oliguria
c) Tachycardia with fever
d) Chest pain with dyspnea
b) Hypotension including oliguria
What is the most frequent cause of sepsis?
Respiratory infections (UTIs are the 2nd most common cause)
T/F: Colloids are preferred for volume resuscitation in severe sepsis to correct hypoalbuminemia.
False
T/F: Septic shock is defines are hypotension refractory to fluid resuscitation in the presence of sepsis.
True
Which of the following heralds irreversible septic shock?
a) Respiratory alkalosis with increased CO2
b) Abnormally high white blood count
c) Metabolic acidosis with hypotension
d) A fall in cardiac output with accompanying tachycardia
c) Metabolic acidosis with hypotension
You are transporting a patient with MODS. You have been elevating the patient’s blood pressure and MAP during transport. A MAP less than _____ mmHg indicates cardiovascular failure.
50
