Respiratory Failure

Question 1

Respiratory failure

Answer 1

It is case where there is not enough oxygen in the body or there is too much carbon dioxide in the body. It CAN be life threatening

Question 2

Types of respiratory failure

Answer 2

1 acute respiratory failure
May need intensive care

2 chronic respiratory
Can be treated at home, of not severe

Question 3

Symptoms, diagnosis of respiratory failure

Answer 3

Symptoms can include: trouble breathing, confusiom, blue colored lips or face
Diagnosis can be done through: physical exams and chest X-rays

Question 4

Treatment options for respiratory failure

Answer 4

1 oxygen therapy
2 ventilator support
3 medications
4 tracheostomy

Question 5

What is multiple organ dysfunction syndrome

Answer 5

It is a severe condition characterized by the dysfunction of 2 or more organ systems simultaneously.
It has higher mortality rates

Question 6

What is the treatment of MODS like

Answer 6

The treatment of MODS require immediate medical treatment and address the reversible physiological abnormalities associated with MODS

Question 7

What is the pathophysiology
List out the treatment of MODS

Answer 7

1. Antibiotics for sepsis control
   2 hemodynamic management
   4 close monitoring of vital signs and laboratory monitoring
   The pathophysiology : sepsis, trauma or infection

Question 8

What is syncope and diagnosis

Answer 8

It is the loss of consciousness and postural tone followed by spontaneous recovery
Can be diagnosed through: medical history, physical examinations, ECG

Question 9

Causes for syncope

Answer 9

Reflex syncope: about 35-48% of the cases in emergency medicine
Orthostatic hypotension
Cardiac trauma

Question 10

Treatment of syncope

Answer 10

Depends on what type of syncope it is
cardiac arrhythmic syncope : would use antiarythmic drugs or pacemaker placement
Situational synocpe: can be treated through patient knowledge

Question 11

what is heat shock not needed

Answer 11

It is a critical protective mechanism that prevents the cell from damage

Question 12

What is the mechanism of heat shock dobt need

Answer 12

When proteins are faced with stressor, eg: heat. Heat shock occurs as a cellular response by increasing the molecular chaperons to protect the proteins in the cell from the negative effects of these stressors
It is a molecular reaction that protects the protein homeostasis from disruption through increasing the levels of molecular chaperones

Question 13

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Question 14

How long does heat cramps last and what is their treatment

Answer 14

Heat cramps last from a few seconds to 15minutes
Treatment can be drinking fluids and eating food rich in essential minerals

Question 15

In serious conditions, heat cramps can potentially be

Answer 15

Heat exhaustion or heat stroke

Question 16

What is shock and it’s cause

Answer 16

It is a life threatening condition characterized by inadequate blood supply to the body’s tissue.
It can be caused by 1 blood loss, 2 infection, 3 heart failure, 4 allergic reactions

Question 17

Briefly describe the mechanisms of cardiac defibrillation

Answer 17

It is a mechanism where controlled electric shock is administered to TREMINATE life threatening arrhythmias;ventricular defibrillation, and to restore normal cardiac rhythm by

Question 18

More details on cardiac electrical defibrillation

Answer 18

The shock is intended to depolarize the myocardium and let the pacemaker of the heat to re-control the normal heart rhythm
The process entails transmembrane potential cells, energy of the shock and current flow through the cell

Question 19

Briefly describe the treatment principles of shock.

Answer 19

The treatment principles of shock are
1 restoring intravascular volume,
2 supporting vital function recovery,
3 using mechanical adjuncts(if applicable).
4 Infusing vasoactive drugs until full recovery
5 replenish some of the lost fluid and the fluid lost continues to be lost that day

Question 20

The key components for the treatment of shock

Answer 20

Is the administration of catecholamines(epinephrine, norepinephrine and dopamine) and vasopressor agent

Question 21

What are three main types of shock

Answer 21

1 cardiogenic shock
2 disruptive shock
3 hypovolemic shock

Question 22

Diagnosis of acute pancreatitis

Answer 22

BASED on the atlanta criteria
1-abdominal pain that suggests pacreatitis
2 serum amylase and/or amylase levels being 3* higher than normal
3 charachteristic CT findings

It is based on the clinical findings, serum lipase and/or serum amylase levels, and imaging techniques like ultrasound MRI and CT

Question 23

▪︎ In late springtime, a 61-year-old male was admitted to hospital emergency department (ED) unconscious. According
to his partner, he did not get up as usual in the morning and there was an empty diazepam bottle bedside. He was
found not responding to voice and physical stimuli. The patient was diagnosed and chronically treated for
endogenous depression. He was treated for several years with fluoxetine, but he interrupted this treatment a few
weeks before the hospitalization. He also had a history of COPD and emphysema for 20 years. At the time of
admission to ED, the patient was in a deep coma (Glasgow Coma Scale 4 points), did not respond to voice or pain
stimuli, had pin-pointed, equal pupils, his blood pressure was 130/70 mmHg, his respiration was effort. Body
temperature was 37.7°C, heart rate was 127/min.
▪︎ What is your diagnosis?
▪︎ What is the possible differential diagnosis? (List the names of differential diagnosis, at least three points).
▪︎ What body examinations should be done for the patient immediately? (The most important three points).
▪︎ What are the key and initial treatments? (At least four points

Answer 23

Diagnosis: considering the empty diazapam bottle beside his bed the diagnosis would be overdoes on diazapam, a benedict medication.
His state of deep coma, pinpointed pupils and unresponsiveness proves consistent with the diagnosis

The possible diagnosis would be
1 carbonmonoxide poisoning
2 drug overdose due to other agents
3 central nervous system infection
4 brain trauma
5 drug abuse related issues
Immediate examination
Venous blood sample
Examine gas analysis, serum, electrolytes and glucose levels
Neurological exam
To examine kerning’s and brudzinski’s sign and to rule out possible meningitis
Conduct pupillary assessment and fundoscopic exam to rule out CNS related issues like hemorrhage and ischemia
The key and initial treatment
Airway management
Given the patient’s deep state coma, need to make sure if there is a clear othwaybfor air circulation. Might need to intubate in some conditions
Fluid resucistation
Intravenous administration of fluid to maintain perfusion and balance any electrolyte imbalances
Cardiac monitoring
Monitor heart beat and blood pressure
Psychiatric support
Given the fluxo- , let psychiatrist have a look to see the effects of the drug or its interruption has caused any effect
Diazapam antidote
Administer a diazapam antagonist called flumazenil to combat any adverse effect of the drug

Question 24

How to treat patients with acute coronary disease

Answer 24

Is to stabilize the patient relieve them from the ischemic pain and provide antithrombotic therapy to reduce myocardial damage prevent further ischemia
Use asprin or beta blockers
2 Interventional therapy if they coronary artery blockage is severe, can insert a catheter into the artery and inflate a balloon to open up the blockage
Surgical treatment: surgically bypassing the blocked artery with a graft or stent

Question 25

Pralidoxime treatment of Organophosphate Toxicity

Answer 25

Pralidoxime is a medication used to treat organophosphate poisoning. It binds to the inhibited acetylcholinesterase enzymes and reverses their inhibition, allowing the enzymes to resume their normal function. Administered under medical supervision, pralidoxime can be given intravenously or by injection. It is most effective when administered promptly after exposure but may still be beneficial even if symptoms have already begun