PCCN review | COMPLETE QUESTIONS AND ANSWERS | 2025 LATEST
UPDATED | ALREADY GRADED A+
what type of WBC increases with anaphylaxis - (answers)basophils
what type of WBC increases with allergic reaction or parasite? - (answers)eosinophils
what are mature neutrophils? - (answers)segs
what are immature neutrophils? - (answers)bands
what are types of granulocytes? - (answers)neutrophils, eosinophils, and basophils
what are types of agranulocytes? - (answers)monocytes, lymphocytes (T and B lymphocytes)
what type of WBC "starts the war" or triggers an immune response? - (answers)monocytes
what is a shift to the left with neutrophils? - (answers)an increase in immature neutrophils
(bands). if bands > 10% start thinking infection or inflammation
what do basophils become when they leave the vessels and enter tissues for response? -
(answers)mast cells
what are common stress responses? - (answers)PE, pneumonia, GI bleed
normal platelet count - (answers)150,000-400,000
what is reversal agent for heparin? - (answers)protamine sulfate
what is reversal agent for coumadin? - (answers)vitamin K or FFP
,what are causes of DIC? - (answers)sepsis, blood or immuno disease, if greater than 4 units
PRBCs received in 24 hours, solid organ transplant, trauma, cancer
what is DIC? - (answers)unpredictable clotting, some progress to bleeding bc used up all of
clotting factors, always secondary diagnosis to something else
what are s/s of DIC? - (answers)dusky fingers/toes (clotting in capillaries), bleeding (gums,
oozing of IV sites), unexplained petechiae/bruising
lab changes in DIC - (answers)-decreased platelets < 100,000
-increased coags (PTT, INR, PT)
-decreased fibrinogen levels (protein precursor to fibrin which is essential to make the clot)
-increased FSPs (things that make the clot)
-increased D dimer
how to treat DIC - (answers)treat clotting phase with heparin
treat bleeding phase with cyroprecipitate - blood product of choice for hemorrhage related to
DIC - gives pt back clotting factors AND fibrinogen
What is HIT? - (answers)Heparin Induced Thrombocytopenia. platelets decrease 5-14 days after
receiving heparin. more likely to be caused by low molecular weight heparin (SQ). see
unpredictable clotting, more common in venous.
what is HIT treatment? - (answers)stop all heparin! including heparin flushes. stop coumadin!
don't want to give platelets because it will cause more clotting.
what is most common reason patients reject an organ/blood? - (answers)they develop antibodies
what are s/s of hypoglycemia? - (answers)pale, sweaty, cool/clammy, shaky, confusion, vision
changes (blurred or seeing spots)
what do cells start to break down when they dont have glucose for energy? what does this
produce? - (answers)proteins and fats, ketones
,what is DKA? - (answers)more commonly in type one diabetics who produce little to no insulin.
as glucose in blood increases, it causes osmotic diuresis and patient excretes large volumes of
urine. patient may become hypovolemic. patient will develop ketoacidosis and lactic acidosis.
what s/s of DKA? - (answers)blood sugar 250-800
sweet, fruity breath
postural hypotension
kusmol respirations (deep + labored) to decrease CO2 to attempt to normalize pH
nausea/vomiting
what are the hallmarks of DKA? - (answers)high blood sugars
ketones in urine and blood
acidosis with low bicarb
what is treatment for DKA? - (answers)fluid volume resusitation and insulin drip
what kills DKA patient? - (answers)hypokalemia
when can you stop insulin drip with DKA? - (answers)when no more ketones in urine
what is HHS? - (answers)hyperosmolar hyperglycemic state. more common in type two
diabetics. relative lack of insulin that leads to increase glucose production
what kills an HHS patient? - (answers)severe dehydration
what are s/s of HHS? - (answers)three Ps: polydipsia, polyurea, polyphasia
normal HHS blood sugar: 600-1200 (higher than DKA)
tongue looks like shoe leather
tenting of tissues
tachycardia
, hypotensive
rapid and shallow RRs
what is treatment for HHS? - (answers)fluid volume resusitation (8-12 L in first 24 hours) and
insulin drip with no bolus
what is diabetes insipidus? - (answers)complete or relative lack of antidiuretic hormone aka
vasopressin
what are causes of diabetes insipidus? - (answers)renal or neuro:
nephrogenic DI where renal tubules are desensitized to effects of ADH
central DI where ADH not being produced by posterior pituitary gland
most commonly caused by trauma (typically head) or pituitary tumor
what is the response of DI? - (answers)inability to concentrate urine, large urine volume
THINK DI = DRY
what are the s/s of DI? - (answers)thirsty, polyuria, dehydration, tenting, dry mucus membranes,
tachycardia, hypotension, increased plasma osmolality, decreased urine osmolality, increased
sodium levels d/t dehydration, decreased specific gravity of the urine
how to treat DI? - (answers)give vasopressin AKA ADH then fluid volume replacement
watch Is/Os and electrolytes
what is SIADH? - (answers)making too much ADH causing decreased urine production and
increased urine concentration
SIADH = sodium swimming in water
untreated can lead to water intoxication and death
s/s of SIADH? - (answers)decreased sodium levels
decreased blood osmolality
dark, concentrated urine
UPDATED | ALREADY GRADED A+
what type of WBC increases with anaphylaxis - (answers)basophils
what type of WBC increases with allergic reaction or parasite? - (answers)eosinophils
what are mature neutrophils? - (answers)segs
what are immature neutrophils? - (answers)bands
what are types of granulocytes? - (answers)neutrophils, eosinophils, and basophils
what are types of agranulocytes? - (answers)monocytes, lymphocytes (T and B lymphocytes)
what type of WBC "starts the war" or triggers an immune response? - (answers)monocytes
what is a shift to the left with neutrophils? - (answers)an increase in immature neutrophils
(bands). if bands > 10% start thinking infection or inflammation
what do basophils become when they leave the vessels and enter tissues for response? -
(answers)mast cells
what are common stress responses? - (answers)PE, pneumonia, GI bleed
normal platelet count - (answers)150,000-400,000
what is reversal agent for heparin? - (answers)protamine sulfate
what is reversal agent for coumadin? - (answers)vitamin K or FFP
,what are causes of DIC? - (answers)sepsis, blood or immuno disease, if greater than 4 units
PRBCs received in 24 hours, solid organ transplant, trauma, cancer
what is DIC? - (answers)unpredictable clotting, some progress to bleeding bc used up all of
clotting factors, always secondary diagnosis to something else
what are s/s of DIC? - (answers)dusky fingers/toes (clotting in capillaries), bleeding (gums,
oozing of IV sites), unexplained petechiae/bruising
lab changes in DIC - (answers)-decreased platelets < 100,000
-increased coags (PTT, INR, PT)
-decreased fibrinogen levels (protein precursor to fibrin which is essential to make the clot)
-increased FSPs (things that make the clot)
-increased D dimer
how to treat DIC - (answers)treat clotting phase with heparin
treat bleeding phase with cyroprecipitate - blood product of choice for hemorrhage related to
DIC - gives pt back clotting factors AND fibrinogen
What is HIT? - (answers)Heparin Induced Thrombocytopenia. platelets decrease 5-14 days after
receiving heparin. more likely to be caused by low molecular weight heparin (SQ). see
unpredictable clotting, more common in venous.
what is HIT treatment? - (answers)stop all heparin! including heparin flushes. stop coumadin!
don't want to give platelets because it will cause more clotting.
what is most common reason patients reject an organ/blood? - (answers)they develop antibodies
what are s/s of hypoglycemia? - (answers)pale, sweaty, cool/clammy, shaky, confusion, vision
changes (blurred or seeing spots)
what do cells start to break down when they dont have glucose for energy? what does this
produce? - (answers)proteins and fats, ketones
,what is DKA? - (answers)more commonly in type one diabetics who produce little to no insulin.
as glucose in blood increases, it causes osmotic diuresis and patient excretes large volumes of
urine. patient may become hypovolemic. patient will develop ketoacidosis and lactic acidosis.
what s/s of DKA? - (answers)blood sugar 250-800
sweet, fruity breath
postural hypotension
kusmol respirations (deep + labored) to decrease CO2 to attempt to normalize pH
nausea/vomiting
what are the hallmarks of DKA? - (answers)high blood sugars
ketones in urine and blood
acidosis with low bicarb
what is treatment for DKA? - (answers)fluid volume resusitation and insulin drip
what kills DKA patient? - (answers)hypokalemia
when can you stop insulin drip with DKA? - (answers)when no more ketones in urine
what is HHS? - (answers)hyperosmolar hyperglycemic state. more common in type two
diabetics. relative lack of insulin that leads to increase glucose production
what kills an HHS patient? - (answers)severe dehydration
what are s/s of HHS? - (answers)three Ps: polydipsia, polyurea, polyphasia
normal HHS blood sugar: 600-1200 (higher than DKA)
tongue looks like shoe leather
tenting of tissues
tachycardia
, hypotensive
rapid and shallow RRs
what is treatment for HHS? - (answers)fluid volume resusitation (8-12 L in first 24 hours) and
insulin drip with no bolus
what is diabetes insipidus? - (answers)complete or relative lack of antidiuretic hormone aka
vasopressin
what are causes of diabetes insipidus? - (answers)renal or neuro:
nephrogenic DI where renal tubules are desensitized to effects of ADH
central DI where ADH not being produced by posterior pituitary gland
most commonly caused by trauma (typically head) or pituitary tumor
what is the response of DI? - (answers)inability to concentrate urine, large urine volume
THINK DI = DRY
what are the s/s of DI? - (answers)thirsty, polyuria, dehydration, tenting, dry mucus membranes,
tachycardia, hypotension, increased plasma osmolality, decreased urine osmolality, increased
sodium levels d/t dehydration, decreased specific gravity of the urine
how to treat DI? - (answers)give vasopressin AKA ADH then fluid volume replacement
watch Is/Os and electrolytes
what is SIADH? - (answers)making too much ADH causing decreased urine production and
increased urine concentration
SIADH = sodium swimming in water
untreated can lead to water intoxication and death
s/s of SIADH? - (answers)decreased sodium levels
decreased blood osmolality
dark, concentrated urine
