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Written Boards - Final > Trauma/SICU > Flashcards

Trauma/SICU Flashcards

1
Q

Burn percent rules

A
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2
Q

concerning compartment P cutoff?

what is delta P?

A

30mmhg

diastolic - comp P (<30 is bad)

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3
Q

Decubitus Ulcer staging

A

Stage I: Superficial injury with intact skin, characterized by nonblanching erythema (in darker-skinned patients, the injury may simply appear darker without blanching), with possible tenderness
Stage II: Partial-thickness injury, with loss of dermis presenting as a shallow ulceration with a red or pink wound bed or intact blister or bullae
Stage III: (see above)
Stage IV: Full-thickness skin loss with exposed muscle, tendon, and bone, which is often accompanied by undermining and tunneling

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4
Q

Most important first step for snake bite

A

local wound care

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5
Q

Pancreas injury Grading and treatments

A

I - Drain
II - Drain
III- STaple
Iv - Panc J
V - Whipple

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6
Q

What is an acceptable pH when trying to prevent ARDS in burn patients?

A

7.2

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7
Q

Venous connection for hemorrhoids in Cirrhosis

Umbilical vein connects with these 2

A

IMV and SH connects with pudendal and inf hem

L portal and epigastric — cap medusae

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8
Q

How is ascites created from portal htn

A

increased splanchnic arterial inflow from dilation leading to increased hydrostatic P in lymph

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9
Q

Side effects of the burn medications:

Ag Sulf

Ag Nit

Mafenide acetate

A

Neutropenia

methemoglobinemia and low electrolytes

Metabolic acidosis

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10
Q

Distance rule of thumb for choice of repair in vessel laceration

A

2cm without tension — primary anastomosis

otherwise contralateral vein with interpostition

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11
Q

Pt with pain in anatomical snuffbox after fall. Neg XR. Next step and overall tx

A

CT or repeat radiographs in 2 weels

immobilization

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12
Q

Which pathways go with PTT v PT/INR respectively

A

Intrinsic

extrinsic

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13
Q

What is SvO2?

What is a normal %?

What is expected in each type of shock?

A

venous oxygen saturation

75% and up

All decreased except for distributive which decrease

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14
Q

First line afib med in icu
What consideration must be taken and what is the alternatve

A

BB
amio

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15
Q

What is the new med for alcohol withdrawal syndrome — proven benefit

A

barbs

less vent days

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16
Q

Go to fungal coverage med for sick perfed gastric ulcers

benefit

A

micafungin(echinocandin)

mortality

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17
Q

type 1 2 and 3 NSTI bugs

who gets what

A

1 - multi, T1DM/immun comp/alcohol/renal — fourniers and ludwig
2- GA strep pyogenes —TSS
3 - c perfringings — IV drugs and surgery

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18
Q

tx for mucor

A

ampho b

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19
Q

hepatorenal syndrome mech

3 part treatment

A

portal htn leads to splanchnic dilation and overal poor systemic art flow, poor renal perfusion

levo, octreotide, vol expansion

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20
Q

West prospective findings on CT clearance
Who can we not clear

A

98.5% sensitivity for CT
3 had FN and central cord , presented with motor changes

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21
Q

new thoughts on TPN causing more infection, trials?

what is a overall benefit?

A

no difference according to CALORIES and NUTRIREA

dec hypoglycemia

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22
Q

New recs for lovenox dosing

A
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23
Q

overall anti thrombotic ppx for patients

A

lovenox and SCDs

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24
Q

necrotizing pneumonia is usually due to what bug

associated toxin

A

staph

panton-valentine leukocidin

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25
Q

recommendation for oxygen support post intubation for moderate risk patients

A

HFNC

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26
Q

Preferred regional rib block on anticoag?

A

paravertebral

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27
Q

mech of heparin

if main substrate is deficient in patient

A

antithrombin binding and enhancement

add ffp

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28
Q

common infection after liver transplant in first 4 weeks

after?

A

bacterial

viral(cMV)

29
Q

got to colon prep

A

high volume poly glycol

30
Q

NG tube syndrome?

A

posterior cricoarytenoid ulcer vocal cord paralysis

31
Q

oral vs j tube determinants for esophagectomy

A

pref oral but if frail, immun comp, poor conduit then j tube

32
Q

BIS measures …..

A

level of concsiousness

33
Q

5 detriments of hypothermia periop

A

increased blood loss and transfusion requirements,

cardiac morbidity,

surgical site infection,

increased hospital length of stay.

increases the effects of paralytics during surgery.

34
Q

Dg of HIT, also has CKD, tx choice

A

argatroban

35
Q

3 effects of hyperbarics physio

A
36
Q

Safe alternative to epidrual anesth

A

On Q pump

37
Q

how long can whole blood be stored

A

4 weeks

38
Q

frost bite grading

recs for grade 3 and 4 tx

A

thrombolytics

39
Q

conventional vs contingency vs crisis level descriptions for icu capacity

A
40
Q

greatest risk with whole blood

A

taco

41
Q

in disaster situation, which interventions are deemed too time consuming/costly

A

whole blood transfusion, intubation

42
Q

when talking about teg for trauma what specific alternative phrase is there

A

viscoelastic testing

43
Q

rattlesnake treatment?

A

crofab

44
Q

target CPP

A

50

45
Q

cell mediated killing CD

the other

assigned mhc classees?

A

8

4

8-1
4-2

46
Q

what ig goes across placenta?

through milk?

A

G

A

47
Q

what ig is suppressed by splenectomy

A

M

48
Q

4 ‘other’ long term risks following splenectomy

A

DVT, PE, pneumonia, meningitis

49
Q

uremias effect on immune system

A

depresses both

50
Q

SEs:
steroids
tac
cyclosporine
mycophenolate
sirolimus

A

wounds and adrenals
nephro, neuro
seizures, arrythmias
pancytopenia, GIB
wounds

51
Q

supplement for wound healing in steroid users

A

vit a

52
Q

mechs:
infliximab
adalimumab
rituximab

A

TNFI
TNFI
B cell antag

53
Q

transplant viruses and their treatments

A

CMV - gang
EBV, post lymphoproliferative dis – red immmun suppression

54
Q

what is the only muscle recurrent laryngeal does not innervate

A

cricothyroid

55
Q

greatest RF for pancreatitis post valve replacemt

A

prolong pump time

56
Q

Gram neg bacteremia abx duration

A

7 days -

57
Q

fastest cooling technique

A

arctic sun

58
Q

new sepsis end goals

A

ANDROMEDA — cap refill and LA for resus end goals

uop not as hot now

59
Q

urinary insulin-like growth factor-binding protein (IGFBP-7) and tissue inhibitor of metalloproteinase (TIMP-2).

what are they good for

A

early aki detection

60
Q

intitial labs for aki

how are these read

A

fena

FEna - <1 is prerenal
FEur- < 35% is prerenal

61
Q

When is the earliest we can start TPN in ICU?

late group benefits?

Thoughts on energy dense formulas

A

8 days

significantly reduced infectious complications (22.8% vs 26.2%, p = .008), cholestasis, duration of mechanical ventilation, duration of renal replacement therapy, and healthcare costs.

na dawg

62
Q

COVID trach timing

A

21 days from dg

63
Q

onyl thing to do for NOMI

operative?

A

papaverine

no mortality benefit

64
Q

straight leg raise method

what is the pathophys behind this

change expected if hypoV

A

autotransfusion of 500ml

more than 10% change in CO

65
Q

new ppi recs in icu

famotidine?

enteral feeding?

A

shock
coag
liver
dialysis
vent
tbi

not good enough

only a small trial so far

66
Q

SMART trial rec

A

ALWAYS LR

67
Q

new c diff test

A

tcdB gene perirectal swab

68
Q

When to consider operation for extraperitoneal bladder injury

A

open book pelvis needing dissection, penetrating, neck of bladder, bony fragments or FBs, persistent hematuria

69
Q
A

Written Boards - Final (21 decks)

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