Elderly have a blunted fever response to infection due to an impairment in which body
system? - CORRECT ANSWER-Nervous system
Prophylactic treatment of
... [Show More] Pneumocystis jirovecii - CORRECT ANSWER-Co-trimoxazole
(trimethoprim-sulfamoxazole)
ECG changes in hypokalemia - CORRECT ANSWER-broad T wave and prominent U
waves
Atypical UTI symptoms usually found in elderly pts - CORRECT ANSWER-lethargy
decreased appetite
incontinence
acidosis and hyperthermia have what affect on the oxyhemoglobin dissociation curve -
CORRECT ANSWER-oxygen has a decreased affinity for hemoglobin shifting the curve
to the right + to the tissues
alkalosis and hypothermia have what effect on the oxyhemoglobin dissociation curve -
CORRECT ANSWER-oxygen has a greater affinity for hemoglobin shifting the curve to
the left = to the blood
What does it mean when there is a right shift in the oxyhemoglobin dissociation curve? -
CORRECT ANSWER-means that a higher PO2 is required to achieve hemoglobin
saturation compared to baseline
*oxygen is more willing to unload into the tissues
What does it mean when there is a left shift in the oxyhemoglobin dissociation curve? -
CORRECT ANSWER-it means that less PO2 is required to achieve hemoglobin
saturation compared to baseline
*oxygen is less willing to unload into the tissues
JNC 8 threshold for treatment of HTN in the elderly - CORRECT ANSWER-150/90
Immediate treatment after diagnosis of pheochromocytoma is what? - CORRECT
ANSWER-Phentolamine to stabilize before surgery
Criteria for diminished renal reserve - CORRECT ANSWER-nephron loss of 50% and
double baseline Cr
Criteria of renal insuficiency - CORRECT ANSWER-nephron loss of 75% and mild
azotemia
Treatment of bacterial vaginosis - CORRECT ANSWER-metronidazole or clindamycin
End-stage renal disease criteria - CORRECT ANSWER-90% nephron loss, azotemia,
and metabolic alterations
American Burn Association: Burn Center Referral Criteria - CORRECT ANSWER-1.
Partial thickness >10% TBSA
Burns that involve the face, hands, feet, genitalia, perineum, or major joints
3. 3rd degree
4. electrical
5. chemical
6. inhalation injury
7. burns with preexisting medical disorders that could complicate
8. burn + trauma
9. burned children
10. burns that will require special social, emotional, or rehabilitation intervention
dislocation - CORRECT ANSWER-displacement of a bone from its joint
subluxation - CORRECT ANSWER-partial dislocation
Labs in temporal arteritis - CORRECT ANSWER-high ESR
normal WBC
Temporal arteritis treatment - CORRECT ANSWER-High-dose steroids
Normal CVP - CORRECT ANSWER-2-6
CVP is elevated in conditions that cause a(n) ___________ in the amount of fluid in the
right atrium - CORRECT ANSWER-increase
Shock states that cause an elevated CVP - CORRECT ANSWER-cardiogenic shock
obstructive shock
*also FVO
CVP is decreased in conditions that cause a(n) ___________ in the amount of fluid in
the right atria - CORRECT ANSWER-decrease
Shock states that cause a decreased CVP - CORRECT ANSWER-distributive shock
hypovolemic shock
MAP formula - CORRECT ANSWER-(SBP + 2DBP)/3
Normal pulmonary wedge pressure - CORRECT ANSWER-6-12
Shock states with elevated PWP - CORRECT ANSWER-cardiogenic
low then high - septic
Shock states that cause low PWP - CORRECT ANSWER-hypovolemic
obstructive
anaphylactic
neurogenic
PWP is a measure of what - CORRECT ANSWER-left ventricular function
end-diastolic left ventricular pressure
PWP is increased in conditions that ____________ the pressure in the left ventricle at
the end of diastole - CORRECT ANSWER-increase
Conditions that increase PWP - CORRECT ANSWER-FVO
decreased elasticity of the left ventricle
PWP is decreased in conditions that _______________ the pressure in the left ventricle
at the end of diastole - CORRECT ANSWER-decrease
Normal CVP - CORRECT ANSWER-2-6 mmHg
Normal PWCP - CORRECT ANSWER-6-12 mmHg
Cardiac Output - CORRECT ANSWER-HR x SV
Normal CO - CORRECT ANSWER-4-8 L/min
Normal CI - CORRECT ANSWER-2.5-4
SVR - CORRECT ANSWER-the resistance of systemic circulation
Normal SVR - CORRECT ANSWER-800-1200
Where is SvO2 measured? - CORRECT ANSWER-Pulmonary artery
What is SvO2 - CORRECT ANSWER-a measurement of effectiveness of O2 delivery
Normal SvO2 - CORRECT ANSWER-60-80%
What does low SvO2 indicate - CORRECT ANSWER-increased tissue extraction of O2
decreased O2 supply (decreased CO, decreased FiO2, anemia)
increased O2 demand (fever, shivering, increased WOB)
What does high SvO2 indicate? - CORRECT ANSWER-decreased tissue extraction of
O2
increased O2 supply (FiO2 > need)
decreased O2 demand (hypothermia)
decreased effectiveness of O2 delivery and uptake by cells (sepsis, shift of
oxyhemoglobin dissociation curve to the left)
Hypovolemic shock hemodynamics - CORRECT ANSWER-SVR HIGH, everything else
low
CO/CI - low
CVP - Low
PWP - low
SVR - HIGH
SvO2 - low
Cardiogenic shock hemodynamics - CORRECT ANSWER-LOW CO/CI & SvO2
everything else high
CO/CI - low
CVP - HIGH
PWP - HIGH
SVR - HIGH
SvO2 - low
septic shock hemodynamics - CORRECT ANSWER-CO/CI: High then low (only shock
state with high CO)
everything else: low then high
Anaphylactic shock hemodynamics - CORRECT ANSWER-everything low
obstructive shock hemodynamics - CORRECT ANSWER-LOW CO/CI and normal to
low PWCP; everything else HIGH
CO/CI - low
CVP - HIGH
PWP normal/low
SVR - HIGH
SvO2 - HIGH
Neurogenic shock hemodynamics - CORRECT ANSWER-everything low
Herbal agents that increase risk of bleeding - CORRECT ANSWER-if it starts with G it
increases bleeding
Ginger
Ginko Biloba
Garlic
Ginseng
Herbal agents that increase clotting - CORRECT ANSWER-St. Jon's Wart
Use of St. Johns wart - CORRECT ANSWER-depression
BPH
Sleep
Normal Plts - CORRECT ANSWER-150,000-400,000/mm3
Lower UTI drugs - CORRECT ANSWER-trimethoprim-sulfamethoxazole (Bactrim)
<20% resistance
nitrofurantoin (Macrobid) >20% resistance
Fosfomycin (expensive)
Upper UTI drugs - CORRECT ANSWER-Ciprofloxacin
Levofloxacin
Ceftriaxone (IV)
Prerenal Diagnostics - CORRECT ANSWER-Serum BUN:Cr - >10:1
urine Na - <20 mmol
SG - >1.015
Fractional Excretion of Na <1
Urinary Sediment - normal/few hyaline casts
Intrarenal diagnostics - CORRECT ANSWER-Serum BUN:Cr - 10:1
Urine Na - >40 mmol
SG <1.015
Fractional Excretion of Na >3
Urine Sediment Granular with white casts
Postrenal diagnostics - CORRECT ANSWER-Serum BUN:Cr - 10:1
Urine Na - >40 mmol
SG <1.015
Fractional Excretion of Na - usually >3
Management of Prerenal AKI - CORRECT ANSWER-expand volume
Management of intrarenal AKI - CORRECT ANSWER-maintain perfusion, stop
nephrotoxic drugs, RRT
Management of post renal AKI - CORRECT ANSWER-remove obstructio [Show Less]