Critical Care

Question 1

Acute adrenal insufficiency tx

Answer 1

IVF, hydrocortisone

Question 2

T1DM, BG=500

Kussmaul resp

Answer 2

DKA

Question 3

Psuedohyponatremia

Answer 3

For every 100 ↑ BG, Na ↓ 1.6

Question 4

Why do you need to worry about K in acidotic pt?

Answer 4

Acidotic pt w/ normal or low K, VERY depleted (in acidosis K is driven extracellularly)

Question 5

DKA tx

Answer 5

IVF (5 L), electrolytes, CORRECT ACIDOSIS w/ insulin

Question 6

T2DM, BG=700

++polyuria, ++dehydration

Answer 6

HHS

Question 7

HHS tx

Answer 7

IVF (7 L), insulin slowly

Question 8

If you correct hyperglycemia too quickly, risk of what?

Answer 8

Cerebral edema

Question 9

↑ intraocular pressure

Halos, unilateral red eye w/ vomiting

Answer 9

Acute glaucoma

Question 10

Acute glaucoma tx

Answer 10

Timolol drops, mannitol (osmotic diuresis), acetazolamide

Question 11

Virchow’s triad

Answer 11

Hypercoagulable state, endothelial injury, stasis

Question 12

Pulmonary embolism tx

Answer 12

Heparin 1st → enoxaparin or warfarin for minimum 3 months

Question 13

Mediastinal shift (tracheal deviation)
Absent breath sounds on one side

Answer 13

Tension PTX

Question 14

Tension PTX tx

Answer 14

Needle decompression + chest tube

Question 15

HTN urgency BP

Answer 15

S >220 or D >125

Question 16

HTN emergency BP

Answer 16

D >130

Question 17

HTN emergency tx

Answer 17

IV meds (nitroprusside or nicardipine), gradual reduction
Must reduce in 1 hr to avoid end organ damage

Question 18

HTN urgency tx

Answer 18

Oral meds (labetalol, clonidine, captopril)

Question 19

Sign of ↑ intracranial pressure in HTN emergency

Answer 19

Papilledema

Question 20

Causes of variceal and non-variceal UGIB

Answer 20

Variceal = cirrhosis
Non-variceal = PUD, cancer

Question 21

BUN is ↑↑↑ and creatinine is ↑

Answer 21

UGIB

Question 22

Tx for variceal and non-variceal UGIB

Answer 22

Variceal: octreotide

Non-variceal: PPI

Question 23

Causes of steady, well-localized abd pain

Answer 23

Ischemia, perforation, inflam, bleed

Question 24

Cause of colicky, poorly-localized abd pain

Answer 24

Obstruction

Question 25

Free air under diaphragm

Answer 25

GI tract perf and peritonitis

Question 26

RLQ pain, fever, vomiting

Answer 26

Appendicitis

Question 27

Epigastric pain, radiates to back, amylase, lipase

Answer 27

Acute pancreatitis

Question 28

When does acute pancreatitis need surgery?

Answer 28

If infxn or necrosis

Question 29

Best test to evaluate gallbladder and biliary tree? | Best test to evaluate gallbladder function?

Answer 29

US is best to evaluate gallbladder and biliary tree | HIDA is best to evaluate gallbladder function

Question 30

Dilated loops of bowel, air fluid levels

Answer 30

SBO

Question 31

Pain out of proportion | GI bleed

Answer 31

Mesenteric ischemia

Question 32

Beck's Triad | Sign of?

Answer 32

JVD, hypoTN, muffled heart sounds | Pericardial effusion/tamponade

Question 33

Pericardial effusion/tamponade tx

Answer 33

EMERGENT, IVF, pericardiocentesis

Question 34

Status epilepticus lasts how long?

Answer 34

>5 min

Question 35

Risk of status epilepticus

Answer 35

Brain damage

Question 36

Risk of correcting hypernatremia too fast

Answer 36

Cerebral Edema

Question 37

Risk of correcting hyponatremia too fast

Answer 37

Central pontine myelinitis