CCSET2 Flashcards
(44 cards)
What does the sweep gas flow on an ECMO circuit affect?
CO2
What are the clinical and laboratory signs associated with LVAD pump thrombosis?
Rising LDH level, increasing power output on the device, worsening heart failure sx and evidence of hemolysis (high LDH, low haptoglobin, anemia)
In an LVAD, what is pump power?
The number of watts required by the device to pump blood at the required RPM
What is the classic triad of antimalarial overdose? Also seen with what medicine?
Hypotension, hypokalemia, and QTc prolongation; hydroxychloroquine
What are some basic steps to prevent having a retained guidewire?
Don?t go too deep; 20 cm is sufficient, maintain contact with the wire the whole time
What does APRV stand for? Where does most of the pressure go to in the lung?
Airway Pressure Release Ventilation; most goes to areas of lung that are already recruited which is somewhat of an issue but that?s kind of always the case
What 3 classes of antibiotics should be avoided in myasthenia gravis? Why?
Quinolones, macrolides, and aminoglycosides (affect transmission across the neuromuscular jxn); cephalosporins are safe
What is the expected rise in PCO2 for a metabolic alkalosis?
The PCO2 should rise by 0.7 for every 1 increase in HCO3 (for acidosis it is 1 of HCO3 for every 10 mmHg PCO2 acutely and 3-4 chronic)
How do simple pleural effusions and complex pleural effusions look on US?
Simple = black and anechoic fluid; complex pleural effusions have echogenic debris (i.e. empyema and parapneumonic effusions)
What is QB and QD on a dialysis machine?
QB = blood flow; QD = dialysate flow
How does a Stent Graft Collapse present in a pt with TEVAR?
With distal aortic occlusive symptoms; i.e. leg weakness and no pulses etc.
A retained guidewire is most common at what anatomic location?
Femoral; probably bc these are done more emergently and no XR done afterwards.
What is the best way to manage pulmonary edema in a patient with CHF w/ HTN emergency?
Improve the BP to decrease the afterload (as the cause is increased afterload, diuretics not as helpful here)
In DKA, what do you do when the glucose is <200?
Decrease the rate of the insulin gtt (is usually 0.1-0.14 u/kg/hr) so go to 0.02-0.05 u/kg/hr and switch to D5 1/2S until the AG normalizes
When should potassium be added to the fluid for DKA?
Add 20-30 mEq of KCl once the K is <5.2 (or if that?s what it is on the original lab draw)
What should be on the DDx if thinking about septic emboli in pt with oropharyngeal problems (aside from endocarditis)
Lemierre syndrome- septic thrombophlebitis of IJ w/ Fusobacterium necrophorum; often with pulmonary infiltrates 1st line - pip/tazo or amp/sulbactam
A bite from a Lone Star tick may cause what issue with food in the future?
Red Meat Allergy- it’s weird but on the rise; IgE mediated anaphylaxis against an epitope of mammalian oligosaccharide galactose-alpha-1,3-galactose
What is the difference between phentolamine and phenoxybenzamine?
Phentolamine is a rapid acting alpha blocker and phenoxybenzamine is a long acting alpha blocker
What should the initial IVF rate be for patients with DKA/HHS?
15-20 cc/kg/hr (prob get a couple boluses too) so that?s like 150-200 for a 100 kg person
If you think that someone has a pump thrombosis of their LVAD what should you do next?
Start heparin gtt (this text says to DC warfarin as well in preparation for explantation)
For an acute respiratory acidosis, what is the expected increase in serum bicarbonate?
Increase by 1 for every 10 mmHg PCO2 is above 40 (normal PCO2 = 40, normal bicarb = 25)
What serologic test can help to diagnose myasthenia gravis?
Acetylcholine receptor antibodies
What are the modalities to diagnose ischemic colitis?
Often they start with AXR (may show thumbprinting) but really you need a colonoscopy; contrast CT can help but not if AKI which is often present given the mechanism of ischemic colitis is HoTN
When do patients with DKA need bicarbonate?
If pH is less than 6.9
