FCCS Exam Guide with accurate solution

FCCS Exam Guide with accurate solution right ventricular dysfunction- what meds are CI? - morphine, diuretics, nitrates new onset a flutter after reperfusion surgery could be caused by these three things - electrolyte abnormalities, perioperative myocardial ischemia, PE when is perioperative MI most seen - 3rd day post-op less bleeding occurs with this anticoagulant - bivalirudin new onset ___ or ___ should be considered possible evidence of ACS esp. in women and diabetics - SOB, LBBB most common coagulation abnormality in sepsis - isolated thrombocytopenia empiric therapy for meningitis due to S. pneumoniae or N. meningitidis - 3rd gen cephalo +/- vanc if PCN resistant S. pneumo is suspected if S. pneumo is isolated in meningitis what should be done about abx - 3rd generation cephalo continued until PCN sensitivity is confirmed then switch to high dose Pen G what abx if N. meningitidis is isolated from blood cx or CSF in meningitis - parenteral high-dose pen g particularly in pneumococcal meningitis ___ is also recommended along with abx - dexamethasone (0.15 mg/kg q 6 hours for 4-6 days) patients with suspected listeria w/ meningitis should be treated with __ - ampicillin in patient with confirmed methicillin susceptible s. aureus meningitis ___ is the DOC - naficillin tx HSV encephalitis - parenteral acyclovir tx of CMV encephalitis - IV ganciclovir or foscarnet initial antimicrobial therapy in brain abcess - metronidazole, vanco, 3rd gen cephalo treatment of CA PNA in immunocompetent patient in ICU - B-lactam + either a macrolide or respiratory fluoroquinolone Respiratory fluoroquinolones - Levofloxacin Moxifloxacin Gemifloxacin Anti-pseudomonal beta-lactams - pip/taz, ticar/clav, ceftazidime, cefepime, imipenem, meropenem, doripenem nosocomial and ventilator-associated pneumonia can usually be covered with these abx (5) - 3 or 4th gen cephalo, B-lactam/B-lactamase inhibitor combo, or a carbapenem + fluoroquinolone or aminoglycoside 4 abx for urinary tract infections in ICU - 1. 3rd gen cephalos 2. aminoglycosides 3. piperacillin-tazobactam 3. trimethoprim-sulfamethoxazole ___ should be avoided as monotherapy in an immunocomprimised or neutropenic pt with infection - 3rd gen cephalo MAP= - 2/3 DBP + 1/3 SBP SIRS critera - 1. temperature > 100.4 (38) or < 98.6 (36) 2. HR > 90 3. RR > 20 or PaCo2 < 32 4. > 12000 WBC, < 4000 or > 10% bands hypokalemia= K < __ - 3.5 ___ increases the urgency of potassium replacement in hypokalemia - presence of acidosis tx of hyperkalemia (7) - 1) *hemodialysis* = ultimate 2) *IV Calcium* = cardio protective 3) *50% Dextrose + Insulin* (pushes K into cells) 4) sodium bicarb 5) inhaled B2 agonists 6) polystyrene sulfate 7) diuretic ECG findings in hypokalemia - Flattened T waves, prominent U waves, widened QRS, prolonged QT, "wide-complex tachycardia" potassium repletion in- K< 2.5 with life-threatening sx K< 2.5 non-life-threatening sx