Critical Care

Question 1

ARDS definition

Answer 1

1. bilateral pulmonary infiltrates on CXR
2. PCWP < 18mmHg
3. PaO2/FiO2 < 300 is ALI, <200 is ARDS

Also widespread airway collapse from deficient surfactant and reduced lung compliance.

Question 2

AGMA

Answer 2

Methanol poisoning

Uremia

DKA

Paraldehyde

Isoniazid

Lactate

Ethylene glycol

Salicylates

Question 3

NAGMA

Answer 3

Hyperalimentation

Acetazolamide (carbonic anhydrase inhibitor and mild diuretic preventing NaCl + HCO3 reabsorption in proximal tubule)

RTA (loss of bicarb)

• Addison’s and spironolactone (both due to no aldosterone) resulting in distal RTA (Type I)

Diarrhea (loss of bicarb)

Ureterosigmoid fistula (loss of bicarb)

Pancreaticoduodenal fistula (loss of bicarb)

OTHER:

cholestyramine - binds bile salts, HCO3 and some other drugs