SCCM Textbook Flashcards
Myesthenia gravis 20/30/40 rule
Vital capacity < 20 mL/kg, maximal inspiratory pressure < 30 cm H2O, maximal expiratory pressure < 40 cm H2O.
Nocardiosis CXR findings
Cavitation
Trigger, target, cycle for PSV
Patient, pressure, flow
Morbid obesity effect on Pplat
Overestimates (due to high pleural pressures caused by low chest wall compliance). Thus higher pressures could be used in obese patients.
Heliox percent O2, indications, and contraindications
30% O2 (70% helium); indicated to improve flow in obstruction (reduce CO2) (asthma, COPD) until bronchodilators and steroids can take effect; hypoxia with patient requiring higher than 30% FiO2.
Ketamine effects on airways
Bronchodilates
Sensitivity and specificity of lung sliding for PTX
95%, 91% (more sensitive than specific)
Maximum flow of the distal brown port on a TLC, compared to 20 gauge peripheral
52 mL/min compared to 60 mL/min
Dynamic compliance equation
Tidal volume/ (peak pressure - PEEP)
Static compliance equation
Tidal volume / (Pplat - PEEP)
Increases in PIP without change in Pplat indicate what?
Airway obstruction (PTX, mainstem intubation, and air trapping all would have increased Pplat)
True indication for lytics in PE
Massive PE with hemodynamic instablity
Risk of Linezolid with SSRIs
Serotonin syndrome
Daptomycin cannot be used to treat this due to binding to surfactant
Pneumonia
Typical goal Vanc trough
10-15 µg/mL
Ampicillin coverage in meningitis is used to cover this organism
Listeria (pregnancy) (soft cheese)
Leptospirosis treatment
doxycycline
Must monitor this lab when prescribing daptomycin
CK levels
Lemierre syndrome
Septic thrombophlebitis of IJV, usually caused by fusobacterium, diagnosed with neck CT and thrombus in IJV
Regimen for infected prosthesis
VAnc, Gent, Rifampin
Signs of severe C. diff colitis
ICU admission, hypotension, fever > 38.5, ileus, MS changes, WBC > 35, lactate < 2.2, end organ failure.
Indications for eval for transplant in acetaminophen overdose
Ingestion > 30g, acetaminophen level > 500
Diagnosis of SBP
> 250 PMN/ mL ascitic fluid (corrected by decreasing 1 PMN for every 250 RBCs/mL)
Contraindications to rtPA
INR > 1.7, SBP > 185
GBS CSF
high protein, low cell count
Indications for ICP monitoring in GCS 3-8 with normal head CT
AGe > 40; SBP < 90; posturing.
Winters formula
PaCO2 = (1.5 x HCO3) + 8
delta pH
0.008 (New PCO2 - baseline)
