Vitals

Question 1

Hypotension, pallor, sweating, nausea, and dizziness that occur in pregnant woman (usually >20 wks) when she lies supine; Sx improve upon sitting, standing up, or lying on the left lateral decubitus position; IVC compression - dec VR - dec PL - dec CO = hypotension

Answer 1

Supine Hypotension syndrome (aortocaval compression syndrome)

Question 2

Insufficient peripheral vasoconstriction in response to orthostatic stress; increase risk with prolonged recumbency; Etiology: hypovolemia, elderly, autonomic neuropathy, medications

Answer 2

orthostatic hypotension

Question 3

Increase SANS, increase SA node depolarizations between 100 - 160 with regular rhythm; Causes: exercise, anxiety, hyperthyroidism, anemia, fever, pregnancy, B-adrenergic meds, and deconditoning

Answer 3

sinus tachycardia

Question 4

Rate is slow due to vaginal stimulation or diseased SA pacemaker cells; Causes: expected in well conditioned athletes, sever hypothyroidism, sick sinus syndrome

Answer 4

sinus bradycardia

Question 5

AV blocks with grouped beats

Answer 5

regular irregular

Question 6

Atrial fibrillation

Answer 6

irregular irregular

Question 7

Rate accelerates during inspiration and decelerates during expiration

Answer 7

respiratory sinus arrhythmia

Question 8

Increased respiratory rate; Seen in exertion, fear, fever, cardiac insufficiency, pain, pulmonary embolism, acute respiratory distress from infections, pleurisy, anemia, hyperthyroidism

Answer 8

tachypnea

Question 9

Decreased respiratory rate; seen in use of CNS depression, uremia, increase ICP

Answer 9

bradypnea

Question 10

Shallow breathing; caused from decreased medullary respiratory center drive, weakness if respiratory muscles, airway obstruction, restrictive dz/ decrease effective lung volume

Answer 10

hypopnea

Question 11

Increased depth of breathing

Answer 11

hyperpnea

Question 12

Increased rate or depth or combo of both

Answer 12

hyperventilation

Question 13

Increased rate and death over a prolonged period of time; seen in hypoxia, salicylates, metabolic acidosis, sever anemia

Answer 13

kussmauls breathing

Question 14

Gradual increase in volume and frequency, followed by a gradual decrease in volume and frequency, with apnea, periods of 10 - 30 sec. between cycles; crescendo - decrescendo pattern; cyclic waxing and waning ventilation with apnea; seen in disorders of cerebral circulation, incr ICP, brain injury, HF, high altitude, opiates, barbs, alcohol

Answer 14

cheyne stokes breathing

Question 15

Short episodes of rapid, deep inspirations (equal depth) followed by 10 - 30 sec apnea period; seen in increase ICP (meningitis)

Answer 15

biots breathing

Question 16

Prolonged expiratory phase; seen in COPD, bronchial asthma

Answer 16

obstructive breathing

Question 17

Normal breathing that is interrupted by pain caused by movements of the chest; seen pleurisy, injured/inflamed muscles, fractured ribs or cartilage or subphrenic inflammation

Answer 17

pleuritic breathing (painful)

Question 18

Normal respiratory rhythm at rest that is occasionally interrupted by long, deep sigh; in anxious px

Answer 18

sighing respiration

Question 19

Core temp > 40 (>104); significant mental status changes; seen in CNS injury, heat stroke, anticholinergic poisoning, serotonin syn, endocrine, NMS, malignant hyperhtemia, sympathomimetic poisoning/OD

Answer 19

hyperthermia

Question 20

Older, poor, sedentary, immobile; skin - anhidrosis; CNS dysfunction, oliguria, coagulopathy; lab - normal K and normal glucose, Ca

Answer 20

classic heat stroke

Question 21

younger, exercising, more active; skin - diaphoresis; myocardial/hepatic injury, acute renal failure, DIC, rhabdomyolysis; lab - marked lactic acidosis, hyperkalemia, hypoglycemia, hypocalcemia

Answer 21

extertional heat stroke

Question 22

Core temp > 40; no coma or seizures; water depletion or sodium depletion

Answer 22

heat exhaustion

Question 23

sx: hyperthermia, dry mouth, mydriasis, flushing, altered mental status, urinary retention

Answer 23

anticholinergic poisoning

Question 24

Disturbances in thermoregulation; recreational drug user; hyperthermia, mental status change, evidence of adrenergic stimuli

Answer 24

sympathomimetic poisoning

Question 25

Overstimulation 5HT1A; hyperthermia, confusion, tremor, hyperrflexia, clonus, evolves rapidly

Answer 25

serotonin syndrome

Question 26

Caused by antipsychotic drugs; hyperthermia, rigidity, bradykinesia over several days, altered mental status, myoglobinuria and acute renal failure, No clonus

Answer 26

neuroleptic malignant syndrome

Question 27

Genetic disorder - causes: inhalation and general anesthetics; hyperthermia, fever, muscle rigidity post surgery under GA, tachycardia, HTN, hyperkalemia, mmyoglobinemia

Answer 27

malignant hyperthermia

Question 28

Mild - vigorous shivering & tachycardia; moderate - no shivering, bradycardia, Osborn waves (J waves), pupils dilated; severe - comatose, cardiovascular collapse, pupils fixed

Answer 28

hypothermia