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20 Cards in this Set
- Front
- Back
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Effect of Distributive shock on hemodynamic parameters
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BP decr
HR Incr PA no change PCWP no change CO incr! SVR decr DO2 incr/decr SVO2 incr |
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Cardiogenic shock's effect on hemodynamic parameters
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HR incr
BP decr PA incr PCWP incr CO decr SVR incr DO2 decr SVO2 decr |
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Effect of PE on hemodynamic parameters
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BP decr
HR incr PA incr PCWP decr CO decr SVR incr SVO2 decr DO2 decr |
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How do you calculate the DO2
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CaO2 * CO * 10
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How do you calculate CaO2
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CaO2 = Hb * FiO2 * 1.34
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How do you calculate how much sodium to replete in hypernatremi?
How much hypertonic saline to deliver? |
MeQ = (Na1-NaGoal) x TBW
TBW = 0.6 x TBweight NaMeQ/(513meQ/L) = Liters of hypertonic saline needed Replace Sodium at 0.5 - 1 mEq/hr |
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Which therapies should be given to patients with ACS?
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ASA (33% reduction in mortality)
Beta-Blocker (20-25% reduction in mortality) Nitroglycerin Statin Suppl O2 (Integralin if going to cath) |
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If someone comes in with NSTEMI, should you cath them?
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if + troponins or CK+, yes
if not, then do a stress test |
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What are bad signs during a stress test
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8-10 minutes is normal
amount of ST depression is a prognostic indicator Decr BP is a very bad sign |
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Why do you do an Echo after an ECG in patients who present with HF
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want to rule out cor pulmonale. If in cor pulmonale do not want to give afterload reducers as they will decrease preload
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What drugs have been shown to decrease mortality and hospital admissions in people with systolic HF
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Beta-blockers and ACE I
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Why are IV diuretics favored over po diuretics in HF
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do not absorb po meds due to lack of perfusion of gut
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How do you treat A/ Fib
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FIX UNDERLYING CONDITION!!!
-get TSH, ECHO(structural HD), TEE to rule out clot |
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WHAT IS CHADS score
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C: HF
H: TN A: ge>75 D: M S: troke/TIA if >2-->coumadin if 0-1: ASA |
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Digoxin toxicity
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A. fib with complete heart block
(Bidirectional V. tach)-->PVCs with alternating morphology |
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Living Will (protects practitioner)
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-Strongest statement of wishes; least vulnerable to change
-Requires incapacitated AND terminal or chronic vegetative state -Deals with life support systems defined to include artificial means of nutrition and hydration |
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Durable Power of Attorney
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Cannot make withdrawal of life support, nutrition/hydration and comfort decisions
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Health Care Agent
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Conveys wishes about witholding or withdrawal of life suppost systems
-Ensures wishes are carried out -Cannot provide other decisions -Cannot be attending physician |
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Conservator
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Appointed by probate Courst
-Cna be predesignated but still requires court -Living will does not require conservator's consent |
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How do calculate TIMI score
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1) elevated cardiac biomarkers
2) Hx of 3 + conventional cardiac risk factors (DM, smoking, incr LDL, HTN, Fam Hx premature CAD) 3) >65 yrs 4) known CAD (>50% stenosis of one major CA) 5) ASA use within one week of presentation 6) 2 + episodes of resting angina in 24 hrs prior to presentation 7) new ST-segment deviation (persistent depression or transient elevation no meeting fibrinolytic criteria) of 0.5mm + |
