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Serena Passes the CSC!!! With A+!! > Review Miscellaneous Deck > Flashcards

Review Miscellaneous Deck Flashcards

1
Q

What is a normal Protime?

A

11 - 13.5

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2
Q

What is a normal partial thromboplastin time? (PTT)

A

25-35 or 25-38

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3
Q

What is normal minute ventilation?

A

5- 8 LPM

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4
Q

Pulsus paradoxus is a sign of what surgical emergency?

A

Cardiac tamponade

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5
Q

What is pulsus paradoxus?

A

a drop of 10 pts or more in the SBP during inspiration.

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6
Q

Why is using the internal mammary artery (IMA) a risk for pleural effusion?

A

Dissection of pleural tissue can cause effusion. Pleural dissection required for harvesting the IMA.

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7
Q

Milrinone is what type of drug?

A

a Pulmonary vasodilator (Phosphodiesterase-3 inhibitor)

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8
Q

What is milrinone’s effect on contractility?

A

increases cardiac contractility

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9
Q

what is the indication for Intra-aortic baloon pump (IABP)?

A

Refractory cardiogenic shock, unstable angina, ventricular failure

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10
Q

What is IABP used for?

A

To reduce afterload and Myocardial O2 demand and improve coronary perfusion and cardiac output.

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11
Q

What is a normal hematocrit?

A

41-50 (men)
36-48 (women)
Roughly 35-45

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12
Q

Rapid overdrive pacing is indicated for what rhythm only?

A

Aflutter

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13
Q

What is the effect of desmopressin (DDAVP)?

A

promotes platelet adhesion and clot formation

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14
Q

Shivering and pain can lead to what metabolic state?

A

Respiratory ALKALOSIS (from rapid breathing)

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15
Q

What is the signs of cardiac tamponade? (in pressure)

A

Equalization and elevation of diastolic pressures

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16
Q

How to recognize an air leak?

A

continuous bubbling in the water seal chamber

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17
Q

signs of Malignant hyperthermia?

A

rapid respiratory rate, tachycardia, hyperthermia

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18
Q

Why must beta blockers be used with caution in COPD patients?

A

Due to the potential for bronchospasm

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19
Q

Clevidipine

A

calcium channel blocker that is selective for vascular (not myocardial) smooth muscle

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20
Q

What is clevidipine’s effect on the SVR?

A

it lowers it

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21
Q

What is the Number 1 risk for deep sternal wound infections?

A

Obesity

22
Q

Why are Aortic valves always replaced, not repaired?

A

Leaflet fibrosis and retraction occur with repair, leading to aortic regurg.

23
Q

The internal mammary artery (IMA) perfuses what part of the body?

A

The sternum and chest wall

24
Q

Benefits of off - pump CABG?

A

1) Lowered risk of bleeding
2) Lowered risk of anemia/need for transfusions
3) Lowered risk of AKI

25
Q

What is the treatment for unstable AF (AF with hypotension)

A

cardioversion

26
Q

Symptoms of papillary muscle rupture?

A
  • Holosystolic murmur
  • hypotension
  • elevated wedge pressure
  • -enlarged V waves on the PA waveform
  • decreased CO
27
Q

What are the indications for IABP?

A
  • Papillary muscle rupture
  • failure to wean from bypass
  • severe MR
  • VSD
  • Cardiogenic shock due to MI
28
Q

Contraindications for IABP

A

Aortic insufficency/regurg
Aortic/Thoracic dissection
bilateral carotid stenosis

29
Q

How much bleeding in the first hour is too much? Whta should you do?

A

Elevate the HOB

> 200 mL

30
Q

What is the mean airway pressure? Does it affect oxygenation or ventilation?

A

MAP -> average airway pressure of the total ventilator cycle time
Increase the MAP and you increase the surface area of the lung available for oxygenation.

31
Q

Von Willebrands Disease affects the function of which blood component?

A

Platelets adhesion

32
Q

What is bivalirudin? When is it used?

A

Anticoagulant (Thrombin inhibitor)

Used mainly in PCIs

33
Q

hemmhoragic shock profile

A 
Low CO
Low CVP
Low MAP
Low PAOP
Elevated SVR
Elevated Lactate
Low SvO2
34
Q

20-40% of people develop this complication after CABG.

A

Atrial fibrillation

35
Q

This neurological complication can occur in >25% of thoracic abdominal aneurism repairs.

A

Spinal ischemia

Lumbar pressure should be kept <10 mmHg

36
Q

Systolic BP differences of > 25 mmHg between arms should make you very suspicious of WHAT?

A

Aortic dissection (or aortic injury)

37
Q

Normal fibrinogen

A

150-400

38
Q

What is the treatment for low fibrinogen?

A

Cryoprecipitate

39
Q

What is the treatment for bleeding due to high INR, PT and PTT?

A

Fresh frozen plasma

40
Q

Nitroprusside Vs Nitroglycerin

A

Nitroglycerin is primary a venous vasodilator. Nitroprusside works for arterial and venous.

41
Q

In a pneumonectomy, should chest tubes be placed to suction?

A

No

42
Q

What does Pulsus alternans indicate?

A

Left ventricular systolic CHF

43
Q

Elevated LDH indicates what?

A

Tissue damage

44
Q

What does pulses paradoxus indicate?

A

Hypovolemia or tamponade

45
Q

How to calculate P:F ratio?

A

P = PaO2
F = FiO2
P/F

46
Q

What is the max dose for aminocaproic acid?

A

30g/day

47
Q

Tidaling in the chest tube is normal or no?

A

Normal - water level fluctuates with breathing

48
Q

Who gets GI prophylaxis?

A
  • mechanically ventilated>48h
  • h/o GIB < 1 year ago
  • coagulopathic
  • TBI
  • traumatic spinal cord injuries
  • burns
  • lots of steroids
  • ICU stay> 1 week
  • occult GIB > 6 days
49
Q

What should you do if there is bubbling in the water seal chamber?

A

Assess for air leak (pneumothorax)

You may need to place the chest tube to suction.

50
Q

How does VQ Mismatch appear in co2 readings?

What does it indicate? Why?

A

ETCO2 will be decreased
PCO2 will be increased

The difference between arterial and alveolar co2 indicates that the lungs are poorly perfused but well ventilated. (Dead space.)

Sign of a PE.

Serena Passes the CSC!!! With A+!! (7 decks)

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