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Back to Basics - Critical Care Transport Review > Respiratory > Flashcards

Respiratory Flashcards

1
Q

If pCO2 is high, pH is

A

low (acidosis)

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2
Q

If pCO2 is low, pH is

A

high (alkalosis)

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3
Q

If HCO3 is high, pH is

A

high (alkalosis)

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4
Q

If HCO3 is low, pH is

A

low (acidosis)

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5
Q

pCO2 normal range

A

35-45 mmHg (respiratory)

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6
Q

pO2 normal range

A

80-100 mmHg

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7
Q

pH normal range

A

7.35-7.45 (metabolic)

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8
Q

HCO3 normal range

A

22-26

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9
Q

B-type natriuretic peptide (BNP) is

A

heart failure marker, released by an over-distention of the heart ventricles

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10
Q

B-type natriuretic peptide (BNP) - normal, critical ranges

A

500 - heart failure

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11
Q

Define PaO2

A

Pressure of arterial oxygen (mmHg)

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12
Q

Bariobariatrauma

A

nitrogen release by obese patients at altitude - preoxygenate with NRB for at least 15 minutes prior to lift-off

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13
Q

Three killers of vented patients during flight

A

tension pneumothorax pericardial tamponade hypovolemia

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14
Q

Define SaO2

A

Saturation of arterial oxygen (%)

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15
Q

Define SAO2

A

Saturation of alveolar oxygen (%)

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16
Q

Proper site for chest tube insertion is

A

4-5th ICS anterior axillary line

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17
Q

A patient in early shock will likely have what acid-base imbalance?

A

respiratory alkalosis (from hyperventillation)

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18
Q

Appropriate sites for NCD insertion are

A

2d ICS mid-clavicular line 4-5th ICS anterior axillary line 5-6th ICS mid-axillary line

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19
Q

Electrical alternans may be seen with

A

Pericardial tamponade (

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20
Q

The antidote for malignant hyperthermia is

A

Dantroline

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21
Q

Signs of malignant hyperthermia include

A

Tachycardia, muscle rigidity, rapid increase in ETCO2

22
Q

What is Hamman’s sign? What does it indicate?

A

Crunching sound heard with auscultation of anterior chest during heartbeats. Tracheobronchial injury

23
Q

The first step to increase PaO2 is

A

Increase FiO2

24
Q

Minute ventilation is

A

Respiratory Rate * Tidal Volume

25
Q

High pressure vent alarms can be caused by __? What is the mnemonic?

A

D isplaced tube (Down, mainstem) O bstructed tube P neumothorax (Tension) E quipment failure S tacked breaths

26
Q

Low pressure vent alarms can be caused by __?

A

Hypovolemia Displaced tube (extubated) Tubing Leaks Loose connections

27
Q

Normal tidal volume is

A

6-10 mL/kg

28
Q

Acute respiratory failure is defined as

A

PaO2 50mmHg

29
Q

Adult ideal weight (for vent) is calculated as

A

Men = 50kg, Women = 45kg Above + (2.3kg / 1” over 60”) ex: 69” Male = 70.7kg

30
Q

A left shift in the oxyhemoglobin dissociation curve can be caused by?

A

Left = low

“L” in “alkalosis” (low H+)

31
Q

A right shift in the oxyhemoglobin dissociation curve can be caused by?

A

Right = raised

No “L” in “acidosis” (raised H+)

32
Q

A left shift in the oxyhemoglobin dissociation curve causes oxygen to be?

A

Increased affinity of oxygen to hemoglobin - oxygen is released less easily (at tissues), but bound more easily (in lungs)

33
Q

A right shift in the oxyhemoglobin dissociation curve causes oxygen to be?

A

Reduced affinity of oxygen to hemoglobin - oxygen is released more easily (at tissues), but bound less easily (in lungs)

34
Q

The defasiculating dose of a non-depolarizing neuromuscular agent is usually

A

10% of the normal RSI dose

35
Q

If PIP does not change on a vented patient, always increase

A

Tidal volume before rate

36
Q

An elevated anion gap may indicate what acid/base disturbance?

A

Metabolic acidosis

37
Q

Ketamine is the drug of choice for patients requiring intubation due to what problem?

A

Asthma

38
Q

A vented ARDS patient would require what unusual vent settings?

A

Low Vt

High PEEP

39
Q

Excessive mucous secretions and chronic inflammation defines what disease process?

A

Chronic bronchitis

40
Q

What is the typical description of the chest x-ray for a COPD patient?

A

Hyperinflated lungs

Narrow, elongated heart shadow
Increase A-P diameter

Flattened hemidiaphragm

41
Q

What is the typical description of the chest x-ray for an ARDS patient?

A

Widespread infiltrates

“Ground-glass” appearance

42
Q

What is the typical description of the chest x-ray for a pneumonia patient?

A

Lobular infiltrates and consolidation

43
Q

What is the typical description of the chest x-ray for a CHF patient?

A

Cardiomegaly

Pulmonary Congestion

44
Q

The nickname for patients with chronic bronchitis is

A

Blue bloaters (obstructed airflow leads to barrel chest and cyanotic appearance)

45
Q

The nickname for patients with emphysema is

A

Pink puffers (destruction of alveoli leads to increased hematocrit)

46
Q

Metabolic alkalosis may be caused by

A

Excessive vomiting Prolonged NG suctioning Diuretics

47
Q

An increase of 10 in the PaCO2 causes the pH to

A

Decrease by approximately 0.08

48
Q

A decrease of 10 in the PaCO2 causes the pH to

A

Increase by approximately 0.08

49
Q

Anion gap is calculated by

A

AG = (Na + K) - (Cl + HCO3) K is usually omitted since a low value

50
Q

Normal anion gap is

A

8 - 16

51
Q

An elevated anion gap suggests

A

Metabolic acidosis

52
Q

The causes of high anion gap acidosis are? What is the mnemonic?

A

M ethanol

U remia

D KA

P araldehyde/Propylene glycol

I Iron

L actic Acidosis

E thanol/Ethylene glycol

R enal Failure/Rhabdo

S alycylates/Starvation

Back to Basics - Critical Care Transport Review (10 decks)

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