Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Critical Care > Critical Care Modules part II > Flashcards

Critical Care Modules part II Flashcards

(95 cards)

Start Studying
1
Q

acetylcysteine efficacy in preventing AKI

A

may help but unclear. it increases Cr clearance by unknown mechanism

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

tx atrial tach

A

sotalol, amiodarone, or flecainide. DC cardiovert if unstable

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

tx pSVT

A

if stable - vagal, beta block, CCB

unstable - 6 mg adenosine. cardiovert if unsuccessful

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

tx vtach

A

stable - IV procainamide, amio, sotalol
unstable - sync cardiovert
pulseless - defib

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

tx WPW

A

stable - procainamide +/- amio

unstable - DC cardiovert

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

drugs to avoid in WPW

A

anything that inhibits AV node: adenosine, beta blockers, CCB, digoxin

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

tx polymorphic v tach

A

immediate defbi. add amio or lidocaine. consier beta blocker

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

tx torsades

A

stable - mag

unstable defib or transvenous pacing

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

tx irregular SVT w/ BBB (only one of its kind)

A

DC cardioversion

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

drugs to avoid in irregular SVT w/ BBB (only one of its kind)

A

CCB, beta blockers, adenosine, digoxin –> sudden death

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

tx sinus brady

A

if sx - atropine, dopamine or epi

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

tx sinus brady 2/2 drug toxicity

A

for CCB or beta blocker tox - calcium and glucagon

for dig tox or hyper k - digoxin antibody fragments

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

tx ventricular escape rhythm

A

use pacing. usually unstable

AVOID lidocaine –> asystole

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

what has higher water content, muscle or fat

A

muscle

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

infants have proportaionally (?more/less?) body water

A

more

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

volume loss for classes of hemorrhage shock

A

I < 750
II 750-1500
III 1500-3000
IV > 3000

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

where does buffering in LR come in

A

liver converts lactate to bicarb. thats why in liver transplant patients we avoid LR.. hard to tell real lactate elevation from impaired clearanc

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

transexamic acid MOA

A

blocks fibrinolysis to promote clotting

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

dosing of transexamic acid

A

given as loading dose w/in 8 hrs, and as driop over 8 hrs

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

clinical effect of transexamic acid

A

decreases mortality but doesn’t change transfusion requirement

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

how many liters can you transfuse in 1 hr for 16 G? 18 G?

A

13 L/hr w/ 16G

6 L/hr w/ 18G

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

glucose goals

A

<180 for most patients. <150 for cardiac.

keep >100 in neuro pts. >70 in most others

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

tx hypoglycemia

A

stop insulin
10-20 g D50w
repeat glucose check and dextrose q15 min until >70

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

Kussmaul respiration

A

deep slow hyperventilation of DKA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
focal neuro deficits are seen in (?DKA/HHNC?)
hyperosmolar hyperglycemic nonketotic coma
26
weaning off SIMV
decrease number of machine given breaths
27
weaning off AC
increase time on trach collar, then let them rest with AC
28
weaning off PS
decrease pressure over time
29
what lyte disorder is an under dx cause of inability to wean off vent
hypo phos - causes weakness
30
indications for ICP monitoring
``` Salvageable pt w/ severe TBI (GCS 3-8) AND... abnormal CT scan OR normal CT scan but w/ 2 or 3 of these - age > 40 - motor posturing - SBP < 90 ```
31
sedatives to use to prevent elevated ICP
benzos, prophofol, opiates. in refractory cases, paralytics, barbiturates.
32
medical tx elevated ICP
sedation, hypertonic saline or mannitol, optimize MAP, therapeutic hypothermia. for refractory cases, barbirturate coma, paralytic, hyperventilation
33
scales for SAH prognosis
Hunt and Hess scale. | World Federation of Neurologic surgeons scale.
34
triple H therapy for SAH
hypervolemia, hypertension, hemodilution - prevents delayed cerebral ischemia
35
midaz AE
accumulates in kidney dysfunction --> prolonged sedation
36
propofol-related infusion syndrome
acidosis, arrhythmia, ARF, shock
37
pentobarbital AE
hypotension, myocardial depression, immunocompromise
38
only acute stroke tx that improves mortality
decompressive craniectomy after malignant large vessel territory infraction w/ cerebral edema
39
immunonutrition
use in burn or trauma patients. glutamine, arginine, antioxidants, omega-3 fatty acids
40
lyte distrubance in refeeding syndrome
low phos, mag, k
41
early TPN shows benefit only in these cases
1) malnourished patients who will have major upper GI surgery in 5-7 days 2) ICU patients malnourished on admission
42
indications for stress ulcer GI ppx
resp failure, TBI, coag disorder, burn/major trauma, hypotension, hx GIB, transplant
43
AE PPI
N/V/D, rebound acid hypersecretion, osteoporosis, c diff
44
AE H2 blockers
HA, constipation, diarrhea
45
AE sucralfphate
low k, low phs, aluminum tox
46
RASS score range
-5 to +4
47
RASS -5
unarousable
48
RASS -4
any movement to physical stim
49
RASS -3
any movement to voice
50
RASS -2
wakes for less than 10 secs
51
RASS +2
Frequent nonpurposeful movement or patient–ventilator dyssynchrony
52
RASS +3
Pulls on or removes tube(s) or catheter(s) or has aggressive behavior toward staff
53
RASS +4
overly combative/violent
54
pain med to avoid in kidney injury
morphone. metabolites are toxic and accumulate
55
pain med that causes qt prolongation
methadone
56
dosing equivalents for fent, dilaudid, morphine
100 ug fentanyl = 1.5 mg dilaudid = 10 mg morphine
57
AE propofol
propofol infusion syndrome - asystole/brady, rhabdo, severe metabolic acidosis. note that prop has no analgesia
58
AE for atypicla antipsych
qt prolongation and hypotension. no strong evidence they even work well for delirium but we use anyway
59
AE etomidate
adrenal insufficiency
60
SIRS criteria
temp >38/<36 HR >90 RR >20 or PCO2<32 WBC <4/>12 or >10% bands
61
SvO2 in septic patients
under-resuscitated have low SvO2. resuscitated patients have high SvO2 (textbook answer at least)
62
lactate and mortality in septic shock
if >4 and does not correct w/in 6 hrs of resuscitation, increases mortality
63
initial fluid challenge sepsis
30 mL/kg
64
goal directed therapy
1. fix CVP 8-12 w/ fluids 2. fix MAP >65 w/ pressors if needed 3. fix ScVO2 >65% with RBCs if needed
65
how is procalcitonin used in empiric therapy
low procal can be use to stop abx if no infection identified. should be high w/ bacterial infection
66
pressors in septic schock
1st line nore. 2nd vasopressin in addition (lowers nore requirements). epi can be added or replace nore. AVOID dopamine (more AEs, icnreases mortality)
67
when to use steroids in shock
vasopressin resistant shock
68
surviving sepsis bundle w/in 3 hrs
blood cx, abx, measure lactate, 30cc/kg bolus
69
surviving sepsis bundle w/in 6 hrs
pressors if MAP <65 if in septic shock or lactate >4 despite resus, measure CVP and ScVO2 remeasure lactate if first was elevated
70
ASIA scale A
complete neuro loss in spinal cord injury
71
ASIA scale E
normal
72
ASIA scale B
sensory intact, but no motor
73
ASIA scale C
sensory intact, motor barely preserved
74
ASIA scale D
sensory intact, motor preserved more than C
75
type of SCI caused by extension injury es/ in pre-existing stenosis
central cord syndrome
76
s/s central cord syndrome
greater impairement of upper extremities. distal more than proximal. urinary retntion. sparing of sacral sensation
77
SCI caused by flexion injury w/ vasc compromise
anterior cord syndrome. also caused by ASA occlusion
78
s/s anterior cord syndrome
loss of pain and temp and motor. maintained vibrationa nd position
79
in brown-sequard loss of proprioception is (ipsi/contra?)
ipsilateral loss below lesion
80
in brown sequard loss of pain/temp is (ipsi/contra)
contra below lesion | may be ipsi @ level
81
conus medullaris vs. cauda equina
equina is LMN. CMS more likely bilateral
82
pathogenesis of autonomic dysrefelxia
SCI above T5 prevents descending inhibition from brainstem centers, so adrenal glands presumably release catecholamines
83
s/s autonomic dysreflexia
HTN and profuse sweating in resposne to distended viscus
84
SCI where can cause paradoxical movement on inspiration
between C4 and T6. paralyzes intercostal contraction
85
SCI where can cause bronchospasm and why
between C4 and T6, loss of sympathetic innervation
86
DVT algorithm, low pretest
proximal compression u/s is enough to rule out. d-dimer can also help r/o if really low suspicion
87
DVT algorithm, high pretest
whole leg u/s can rule out immediately. proximal can r/o if repeated in 1 week
88
PE algorithm, low pretest
can wait to start a/c if you want | get spiral CT or V/Q. negative CT, or low or nl V/Q is enough to r/o. if inadequate, do DVT u/s
89
PE algorithm, high pretest
start anticoagulation | get spiral CT or V/Q. if negative, still get DVT u/s. if those negative, can even consider conventional angio
90
DVT algorithm, mod pretest
same as high pretest algorithm: whole leg u/s can rule out immediately. proximal can r/o if repeated in 1 week
91
PE algorithm, intermediate pretest
hybrid of low and high | definitely start anticoagulation (like high) but can rule out with negative CT
92
DVT ppx nonsurgical
LMWH or heparin preferred. if high bleeding risk, then mechanical can be a substitute
93
DVT surgical
mod risk is LMWH or heparin or mechanical high risk both chemical and mechanical if cancer, definitely LMWH if high bleeding risk, only mechanical
94
ECG PE
S1 q3 t3
95
contraindications LMWH
renal failure or expected need for thrombolysis

Critical Care (2 decks)

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