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62 Cards in this Set
- Front
- Back
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Normal lung cardiac changes in proning |
reduced SV and CI Increased PVR and SVRI IVC obstruction |
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Normal resp changes in proning
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Not Much Increased FRC |
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ARDS changed in proning
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Cephalad heart anddiaphragm leads to less compression. Homogenous alveolar inflation. Possible decreased thoracic/abdo compliance. Secretion mobilisation |
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Brainstem death Preconditions
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NMB Glucose and electrolytes Temp 35 One eye and ear Realistic catastrophe observed for 4h Ability to apnoea test - no hypoxia or high spinal lesion Sedatives BP |
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Brainstem death cranial nerves |
II,III - Light reflex V, VII - corneal reflex III, IV, VI, VIII - vestibulocochlear IX and X - gag X - cough |
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Additional test for brainstem death |
Coma (noxious stimulus) Apnoea |
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Apnoea test expected CO2 rise, target CO2
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expect 3mmhg/min, target 60mmhg or normal +20mmhg |
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Levels of organs C1 to T10
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C3 Hyoid C4 Top of thyroid C6 cricoid T2 sternal notch, lung apices T4 aortic arch T6 carina T10 liver |
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Levels of organs T10 to Sacrum
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T12 Coeliac axis, pancreas, kidney, adrenals L1 SMA, kidneys, spleen, gallbladder L2 Renal arteries L3 Renal Pelvises, IMA L5 Aortic Bifurcation |
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Normal number of anterior ribs seen
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6 |
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Multiple CXR opacities
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Tumours Foreign bodies Infx - TB, fingi, parasites Inflamation - sarcoid, wegeners Congenital AVMs |
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Mediastinal mass on CXR cause (need lat CXR)
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Anterior: 4Ts - thymus, thyroid, teratoma, terrible lymphoma Middle: lymphadenopathy, lymphoma, aortic aneurysm Posterior: Descending aneurysm, oesophagus mass, hiatus hernia |
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Aortic dissection classic CXR
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Wide mediastinum,
blunt aortic knob, left Apical cap, trach deviation, low L mainstem, left effusion |
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Interstitial disease description |
Reticular, honeycomb on CT |
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Alveolar disease description
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Fluffy
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CT Head raised ICP |
Effacement of cisterns eg basal Loss gray white differentiation Herniation cerebellar tonsils Posterior cerebellar artery compression with infaction of territory |
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Le fort Classifications |
I - palate II - Anterior face III - Craniofacial dysjunction
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C-Spine Lines of alignment |
Anterior and posterior vertebral Spinolaminal line Posterior Spinous Processes |
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Jefferson Fracture |
Blow out of ring of C1 |
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Hangman Fracture |
Base of pedicles of C2 |
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Pelvis max pubic symph and SI joint width |
SIJ 4mm, Symphysis 5mm |
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Right Axis Dev |
Downward complex in I left posterior hemiblock |
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Left axis Dev and causes |
Downward complex in II left anterior hemiblock |
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Brugada |
RSR and downward STE in V1-2 |
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PE on ECG |
S1Q3T1 Lat t inv RAD RBBB |
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Tall R in V1 |
dextrocardia WPW type A RVH Posterior MI |
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Normal CVP trace |
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CVP dominant A wave |
Pulm Hypertension, Tricuspid/Pulm Stenosis |
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CVP cannon A wave |
Complete heart block, nodal rhythm, ventricular pacing |
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CVP dominant V Wave (common) |
TR |
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High SvO2 |
Sedation / Analgesia Hypothermia Cytotoxic dysoxia Microcirculation shunts Left to right shunt |
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IABP Cheat Sheet |
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PAC Cheat Sheet |
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Well timed IABP
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Inflate just before dicrotic notch
deflate on qrs post assisted SBP less than unassisted SBP Balloon assisted DBP less than unassisted DBP |
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Flow volume loops with intra/extra obstructions |
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Causes of increased DLCO |
Pulm haemorrhage Polycythaemia Cardiac shunt High output states |
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Primary resp acidosis expected HCO3 rise |
0.1 x rise in CO2 acute 0.4 x rise in CO2 chronic |
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Primary resp alkalisis expected HCO3 drop |
0.2 X decrease in CO2 acute 0.5 x decrease in CO2 chronic |
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Met acidosis expected CO2 |
Last two decimals of pH or 1.5 x HCO3 +8 |
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Mat Alkalosis expected CO2 |
last two decimals of pH |
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Resp Acidosis Causes |
CNS Spinal Cord Peripheral nerve NM Junction Chest Wall Pleural Space Pulmonary Airway |
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Resp Alk Causes |
Hypoxia sepsis progesterone / theophylline Brainstem problems Fear and pain Mechanical |
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Met alk causes |
GI Loss of Hydrogen - vomit, villous adenoma Conns, cushings steroids, liquorice, thiazide, loop post-hypercapnoea syndrome
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HAGMA |
Lactic - hypoxia, critical illness, metformin, jej ileal bybass toxins - methanol ethanol ethylene glycol Keto - Diabetic, alc, starvation Renal Pyroglutamate
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NAGMA |
Loss HCO3 lower GIT renal - RTA, acetazolamide NaCl |
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Alveolar gas eqn |
PAo2 = FiO2(760-47) - PCO2 /0.8 FiO2 x 710 - 1.25 CO2 |
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Anion Gap |
Na - HCO3 plus Cl 6-15 normal Correct for alb +0.25 (44-alb) |
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Lactate gap |
Diff between lactate oxidase bedsise and lab lactate dehydrogenase method
Ethylene glycol toxicity |
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Na corrected for Glycaemia |
Drops 1 for every 3mM glucose |
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Wegeners granulomatosis / Polyarteritis |
c-anca Wegeners p-ance Polyarteritis |
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Anticardiolipin |
Antiphospholipid synd, SLA |
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CREST syndrome blood test |
anti centromere |
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Goodpastures blood test |
Anti GBM |
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Myaesthenia gravis Blood test |
Anti ACh Receptor |
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Autoimmune liver blood tests |
Anti SM - Autoimmune hepatitis Anti mitochondrial - PBS, chronic active hepatitis, idiopathic cirrhosis |
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Euthyroid sick synd |
Low T3, normal low T4 and TSH. Inc reverse T3 |
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Iron deficiency Vs Chronic Disease blood tests |
Fe Def - Low iron and ferritin, high TIBC
Chronic disease - Low normal serum Fe, high ferritin, Low TIBC |
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Serum ACE raised in |
Sarcoid Lymphoma TB Silicosis Asbestosis |
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c1 esterase inhibitor level |
Low in hereditary angioneurotic oedema |
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Thrombocytosis causes |
Primary: Essential Reactive: Inflammation - Rheum, bleeding, etc |
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Thrombocytopaenia causes |
Production - Alcohol, viral, pancytopenia Consumption - Immune - ITP, drugs, viral Consumption - non immune - DIC, TTP, CPB Splenic pooling
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HITS 4 T's max ratings |
Thrombocytopenia >50% drop Timing 5-10 days Thrombosis - new or skin necroses Theres nothing else |
