Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

NAPLEX 21 > Acute & critical care medicine > Flashcards

Acute & critical care medicine Flashcards

(88 cards)

Start Studying
1
Q

Which fluid is less costly and has fewer adverse reactions?

A

crystalloids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

this liquid contains large molecules (proteins) that disperse in solutions that primarily remain in the intravascular space and INCREASE oncotic pressure

A

colloids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

these products are used when water is needed intracellularly as these products contain free water

A

dextrose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

the most common drugs/fluid used for volume resuscitation in shock states

A

LR and NS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

the most commonly used colloid

A

albumin

specifically useful when there is SIGNIFICANT EDEMA (cirrhosis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

D5W
NS
LR
Plasma-Lyte A

examples of

A

crystalloids

seep out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Albumin %5, 25%
dextran 40, 70
hydroxyethyl starch (Hespan, Hextend)

examples of

A

colloids ($$)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

this type of hyponatremia is caused by diuretics, salt-washing syndromes, adrenal insufficiency, blood loss or vomiting/diarrhea

A

hypotonic hypovolemic hyponatremia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How do you treat hypotonic hypovolemic hyponatremia

A

sodium chloride IV solutions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

this type of hyponatremia is caused by fluid overload (cirrhosis, HF, renal failure)

A

hypotonic hypervolumic hyponatremia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How do you treat hypotonic hypervolumic hyponatremia

A

diuresis with fluid restriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

this type of hyponatremia is caused by SIADH

A

hypotonic euvolemic hyponatremia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is used to treat SIADH and hypervolemic hyponatremia

A

arginine vasopressin (AVP) receptor antagonists (conivaptan or tolvaptan)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How should you correct sodium?

A

conservatively!

> 12mEq/L over 24 hours can cause osmotic demyelination syndrome (ODS) or central pontine myelinolysis which can cause paralysis, seizures, and death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Brand: Samsca

A

Generic: tolvaptan (PO)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Tolvaptan is limited to <30 days due to …

A

hepatotoxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Side effects of Tolvaptan

A

thirst, nausea, dry mouth, polyuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Hypernatremia is associated with a:

A

water deficit and hypertonicity

caused by: diarrhea, dehydration, vomitting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What drugs commonly decrease potassium?

A

amphotericin, insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Hyperkalemia is often due to what disease state?

A

CKD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

1mEq/L in serum K below 3.5 represents a total body deficit of:

A

100-400mEq

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Safe recommendations for IV K replacement through a peripheral line include a max infusion rate

A

<10mEq/hr

10mEq/100mL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what electrolyte is necessary for potassium uptake?

A

Mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Hyperphosphatemia (<1mEq SEVERE) is often due to what disease?

A

CKD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
IVIG off-label uses include
MS, myasthenia gravis, guilliain-Barre *treatment with IVIG can impair response to vaccination
26
Brand: Carimune NF, Flebogamma DIF, Gammagard, Gamunex-C, Octagam, Privigen
generic: IVIG
27
Boxed warning for IVIG
acute renal dysfunction can occur (usually with products stabilized with sucrose) thrombosis
28
Side effects of IVIG
HA, nausea, diarrhea, inj sit reaction, flushing, chest tightness, fever, chills, hypotension, --- SLOW/STOP infusion
29
What scoring tool is APACHE II used for?
mortality risk in the ICU
30
Most vasopressors work by stimulating alpha receptors which causes: ______________ & increases ____________, which increases BP
vasoconstriction inc systemic vascular resistance (SVR)
31
Low dose of dopamine (1-4mcg/kg/min) results in
dopamine-1 agonist (renal vasopressor)
32
medium dose of dopamine (5-10mcg/kg/min) results in
beta-1 agonist (+ ionottropic HF)
33
high dose of dopamine (10-20mcg/kg/min) results in
alpha-1 agonist (vasopressor)
34
Boxed warnings for vasopressors
VESICANTS!! treated with phentolamine, an alpha-1 blocker use central line
35
Side effects of vasopressors
arrhythmias, tachy, necrosis, bradycardia (phenylephrine), inc BG (epinephrine)
36
Brand: Adrenalin
generic: epinephrine
37
Brand: Levophed
generic: norepinephrine
38
This vasopressor is an alpha-1, beta-1 and beta-2 agonist
epinephrine
39
this vasopressor is an alpha-1 agonist >beta-1 agonist
norepinephrine
40
this vasopressor is an alpha-1 agonist
phenylephrine
41
What kind of drugs are NTG, nitroprusside, and nesiritdie
vasodilators (DEC bp)
42
what vasodilator is limited after 24-48 hours due to tachyphylaxis (tolerance)
NTG
43
this is a mixed (equal) arterial and venous vasodilator at all doses. not to be used during an MI due to coronary steal
nitroprusside
44
what is administered with nitroprusside to reduce the risk of thiocyanate toxicity?
hydroxocobalamin
45
this is a recombinant B type natriuretic peptide that binds to vascular smooth muscle and increases cGMP
nesteridie
46
NTG low dose = _______ vasodilator
venous (preload)
47
NTG high dose = _______ vasodilator
arterial (after load)
48
Examples of inotropes
dobutamine milrinone
49
inrotropes increase/dec contractility of the heart
inc
50
beta-1 agonist inotrope
dobutamine
51
PDE-3 inhibitor inotrope
milrinone
52
What are the general principles for treating shock?
1) fluids (IV crystalloid bolus) 2) vasopressor to inc SVR 3) + inotrope to inc myocardial contractility and CO
53
hypovolemic shock not caused by hemmorhage: first line treatment
fluid resuscitation with crystalloids when hgb<7 give blood products
54
hypovolemic shock: second line
vasopressors HOWEVER, vasopressors will not be effective unless intravascular volume is adequate
55
examples of distributive shock
anaphylaxis, sepsis low SVR, initially high CO followed by low or normal CO
56
What are the two common causes of ICU infections?
mechanical ventilation - pseudomonas Foley catheters
57
what is the vasopressor of choice in septic shock?
norepinephrine
58
patients with HF may experience episodes of worsening symptoms: weight gain, inability to lie flat, decreasing functionality .. this is called:
acute decompensated HF (ADHF)
59
ADHF + hypotension + hypo perfusion =
cardiogenic shock STOP BETA BLOCKERS
60
Treatment of ADHF
VOLUME OVERLOAD: diuretics (loop +/- vasodilators NTG, nitroprusside) HYPOPERFUSION: inotropes (dobutamine, milrinone +/- vasopressor: dopamine, NE, PE) BOTH? combo above, look at SCr tho
61
first line agents for analgesia in the ICU
opioids given IV (morphine, hydromorphone, fentanyl)
62
Agitation is managed with (RASS) higher the score, more combative
benzos (Ativan, midazolam) but non-benzos are preferred (propofol, dexmedtomidine)
63
What is the only sedative approved for use in intubated and non-intubated patients?
dexmedetomidine (Precedex)
64
How to treat delirium?
no meds are recommended for prevention but sedation with non-benzos may decrease incidence or shorten duration quetiapine or haloperidol commonly used
65
Brand: Sublimaze
generic: fentanyl
66
Brand: diluadid
generic: hydromorphone
67
brand: duramorph, infumorph
generic: morphine
68
brand: Precedex
generic: dexmedetomidine alpha-2 adrenergic agonist
69
brand: diprivan
generic: propofol
70
This drug has a contraindication with egg or soy allergy
propofol
71
Brand: versed
generic: midazolam
72
Caution with those that have renal impairment contraindicated with potent cyp3A4 inhibitors
midazolam
73
Risk factors for development of stress ulcers?
mechanical ventilation >48H coagulapathy
74
Prevention for stress-related mucosal damage
PPI - c diff, fractures, nosocomial pneumonia or H2RAs - thrombocytopenia, AMS in elderly/renal/hepatic imapriment
75
What anesthetic can be fatal if administered IV?
bupivacaine (for epidurals)
76
injectable anesthetic
bupivacaine, ropivacaine
77
inhaled anesthetic
desflurane (Suprane), sevoflurane
78
local anesthetic
lidocaine (Xylocaine)
79
what is administered with lidocaine to keep the lidocaine localized?
epinephrine
80
these agents cause paralysis of the skeletal muscle
neuromuscular blocking agents
81
Examples NMBAs
succinylcholine, cisatracurium
82
when are NMBAs used?
to facilitate mechanical ventilation** (MUST BE VENTILATED WHEN USING THESE!!), to manage ICP, to treat muscle spasms
83
NMBA have NO effect on pain or sedation, thus..
adequate sedation and analgesia prior to starting an NMBA is needed
84
which NMBA is reserved for intubation?
succinylcholine (depolarizing) SHORT ACTING -- onset 30-60 seconds
85
What drug is used to reduce secretions during intubation?
glycopyrrolate (robinul) -- an anticholinergic
86
what is a long-acting agent for NMBA?
pancuronium
87
What agents are used to stop bleeding? (hemostatic agents)
tranexamic acid (Cyklokapron-INJ; Lysteda-PO, menstrual/menorrhagia) "TXA" Recominant Factor VIIa (NovoSeven RT) LOOK FOR CLOTS!!!!
88
How do systemic hemostatic drugs work?
inhibiting fibrinolysis or enhancing coagulation

NAPLEX 21 (60 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions