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NSER 7210 > Module 2 > Flashcards

Module 2 Flashcards

1
Q

What is the onset of alcohol withdrawal

A

6-24 hours

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2
Q

Onset of DTs

A

48-72 hours

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3
Q

DT symptoms

A

Malignant HTN
Hyperthermia
LOC fluctations
Delerium

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4
Q

Alcohol withdrawal symptoms

A 
increased BP
increased temp
increased HR
tremors 
diaphoresis
nausea and vomiting
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5
Q

First-line treatment for alcohol withdrawl

A

benzos

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6
Q

Sepsis

A

dysregulated host response to infection causing life-threatening organ dysfunction

Massive vasodilation
leaky vessels
decreased perfusion
using up clotting factors to make micro clots

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7
Q

septic shock

A

need for vasopressors to maintain map >65

Lactate > 2 despite fluid resus

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8
Q

SIRS

A 
systemic inflammatory response system
overwhelming unregulated inflammatory response resulting in:
-uncontrolled coagulation
-widespread vessel leakage
-poor distribution of circulating volume
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9
Q

Goals of sepsis management (3)

A

early recognition
Manage BP
treat the cause (early abx)

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10
Q

Oxygen Dissociation curve

A

the ability of Hgb to bind with oxygen in the lungs and release oxygen to the tissues

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11
Q

Oxygen Dissociation curve shift LEFT

A

LOVE - High affinity
Hgb will pick up O2 readily from the lungs but holds on to it

results in decreased tissue perfusion/oxygenation

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12
Q

Oxygen Dissociation curve RIGHT

A

RELEASE- Low affinity
Hgb will pick up less O2 from the lungs but release it easily to tissues

results in decreased tissue perfusion/oxygenation

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13
Q

Causes of an Oxygen Dissociation curve shift LEFT

A

Decreased temp
Decreased H+ (high PH)
Decreased CO2 (hyperventilation)
Decreased 2-3 DPG

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14
Q

Causes of an Oxygen Dissociation curve shift RIGHT

A

Increased temp
Increased H+ (low PH)
Increased CO2 (hypoventilation)
Increased 2-3 DPG

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15
Q

Anaphylaxis vs allergic reaction

A

Anaphylaxis involves 2 or more body systems

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16
Q

State the hallmark symptoms of septic shock and brief patho

A

Warm, flushed skin - Exaggerated inflammatory response causing vasodilation
Depleted intravascular volume with normal total fluid volume , fluid distributed where it cant be accessed
Early malfunctioning of coagulation and depleted clotting factors = bleeding

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17
Q

Briefly describe the patho of sepsis

A

Bacteria in the blood causes release of endotoxins (gram neg) and exotoxins (gram pos) causing pro-inflammatory cytokines
Cytokines activate the complement and coagulation system, kinin system and neutrophils, monocyte/macrophage activity, causing more cytokines
Causes endothelial cell dysfunction causing vasodilation and vascular leaking

18
Q

HIV disease Patho

A

Human immune deficiency virus

HIV targets and attacks WBC (primarily T helper (CD4) cells) by fusing to them and injecting its RNA

When infected T-helper cells die they release more replicated copies of HIV into the bloodstream

These take over more CD4 cells and within a few weeks the infected person experiences influenza-like symptoms as the body tries to fight the infection

as the viral load increases, there are few CD4 cells left to combat the disease and AIDS sets in

19
Q

Role of T-helper cells (CD4)

A

T-helper cells (CD4) move through the body looking for and destroying viruses and germs

20
Q

Latency stage

A

Viral replication stabilizes and the immune system is able to reduce viral levels

this can last up to a decade

21
Q

AIDS

A

final stage of HIV

Severe state of immunodeficiency

22
Q

Norm CD4 count

A

500-1500

<200 = aids

23
Q

Viral load

A

How much HIV RNA is in a persons blood

the higher the viral load the more HIV symptoms a person will expirence

24
Q

HIV symptoms

A

Rash
Pneumonia
Peripheral neuropathy
LOC changes

25
Q

HAART

A

Highly active antiretroviral therapy (HAART) is a medication regimen used to manage and treat HIV

26
Q

Normal Inflammatory response

A

Mast cells release histamines

Histamines cause vasodilation and vascular permeability

Vascular permeability is needed to bring the key players to the site of infection

Neutrophils (phagocytes) are recruited

Platelets recruited and clotting starts

27
Q

Lactate

A

Released when cells arent getting enough oxygen

Biproduct of anaerobic metabolism when cells don’t have enough O2 they create energy with out it and lactate is the byproduct

norm <2

28
Q

Fluid resuscitation in adults

A

30cc/KG

29
Q

Things that impact oxygen supply

A

Cardiac output
Hemoglobin
Arterial O2
ventilation

30
Q

Things that impact oxygen demand

A

Tachycardia
Fever
Activity
Stress

31
Q

Cardiac output in sepsis

A

Decreased preload due to decreased circulating volume

Decreased afterload due to dilated vessels

increased myocardial oxygen demand and decreased supply causes decreased contractility

32
Q

Chronotropes:

A

drugs that change the heart rate, some may also change heart rhythm

33
Q

Inotropes:

A

Inotropes change the contractile force of the heart. Positive inotropes increase contractile force.
Negative inotropes decrease the contractile force

34
Q

Beta 2:

A

Beta2- lungs bronchiodilation

35
Q

Beta 1:

A

Beta 1 receptors- heart.

increases cardiac output and stroke volume by increasing heart rate, contractility.

36
Q

Alpha 1:

A

Activation of alpha 1 adrenergic receptors cause smooth muscle contraction which induces vasoconstriction.

37
Q

Phenylephrine

A

Acts quickly to squeeze the pipes

38
Q

Vasopressin

A

alpha 1- vasoconstriction

39
Q

Dobutamine

A

positive inotrope- increases contractility

Primary used for cardiogenic shock

40
Q

Epinephrine

A

works on alpha 1 and beta 1 and beta 2
Alpha 1- vasoconstriction
Beta 1 increases contractility
Beta 2- Bronchiodilation

41
Q

Norepinephrine

A

potent Vassopressor

used for sepsis and trauma

42
Q

Dopamine

A

Inotropic increases contractility and vassopressor

good for cardiogenic shock with hypotension

NSER 7210 (8 decks)

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