MS4 Midterm last minute
What conditions cause a V/Q mismatch
COPD, pneumonia, pulmonary embolism (PE), asthma
What coditions cause a Shunt?
ARDS, pulmonary edema, congenital heart defects
what conditions cause a diffusion limitation?
Pulmonary fibrosis, emphysema, interstitial lung disease
What conditions cause alveolar hypoventilation?
Neuromuscular disorders, obesity hypoventilation, drug overdose
What to know about o2 therapy and a shunt?
patients with shunts will continue to have hypoxemia even when oxygen therapy is initiated
Thoracic aortic aneurysm + JVD, facial swelling, hoarseness=?
Sueprior vena cava syndrome. Not from rupture but from aneuryism putting pressure
signs of cardiac tamponade
Becks Triad- JVD, hypotension, muffled heart sounds
Injury location for autonomic dysreflexia
T6 or higher
autonomic dysreflexia vs neurogenic shock vs spinal shock vs autonomic nervous system dysfunction
dysreflexia- hypertension.
Neurogenic- loss of vascualr tone- hypotension.
Spinal- paralysis, relfexes etc
NS dysfunction- involuntary functions (hypotnesion, GI, Temp. Chronic)
SS hypoxemia vs hypercap
Hypoxemia: Look for signs like restlessness, anxiety, confusion, rapid breathing, and low oxygen
saturation (SpO2).
Hypercapnia: Look for signs like drowsiness, lethargy, headache, confusion, and shallow breathing.
SVT
stable patient with SVT, vagal maneuvers (e.g., Valsalva, coughing, carotid massage) should be
attempted first. Adenosine is given if vagal maneuvers fail. Synchronized cardioversion is reserved
for unstable SVT.
Afib
If new onset, immediate cardiovert
If A-fib has been present for >48 hours, immediate cardioversion is contraindicated due to the high
, risk of stroke. The patient should be anticoagulated for at least 3-4 weeks before elective
cardioversion. Diltiazem (a calcium channel blocker) helps control rate, and warfarin prevents clot
formation.
Heary blocks get? Dysrhythmias get?
HB: Pacing. If symptomatic type 2/1, atropine but not for 2/2 or three.
Dys: cardioversion
ACLS VFib/VTach
After the first shock fails in V-fib, administer epinephrine every 3-5 minutes to enhance perfusion.
Defibrillation is repeated every 2 minutes.
relationship between hydrigen and potassium
When hydrogen levels are high (acidosis), potassium levels tend to be high as well (hyperkalemia).
Conversely, when hydrogen levels are low (alkalosis), potassium levels tend to be low (hypokalemia)
C3-C5 injuries
Injuries in the C3-C5 range can all impact diaphragm function and potentially require mechanical
ventilation
STEMI interventions
Aspirin and nitro first, priority is PCI
NSTEMI intervnetions
Aspirin, nitro, anticoags first. Priority is antiPLT or PCI if necessary.
AFib and cardioversion
if within 48 hours of onset, they can cardiovert immediately. If over, they need to do 3 weeks of
anticoags to ensure clots arent sent through
treatment for SVT
Vagal maneuver. maybe adenosine if unstable
- Tachy and cant see p waves
Treatment for A Flutter
- Bblockers or cardioversion if unstable.
- normal qrs, regular flutter waves
Treatment for A Fib
- normal ish QRS and chaotic p wave
- Bblockers or cardioversion if unstable. Anticoags!
tx 2nd degree type 1
- monitor, atropine if brady and symptomatic. Pacing unlikely
- longer longer longer drop
Tx second degree type 2
What conditions cause a V/Q mismatch
COPD, pneumonia, pulmonary embolism (PE), asthma
What coditions cause a Shunt?
ARDS, pulmonary edema, congenital heart defects
what conditions cause a diffusion limitation?
Pulmonary fibrosis, emphysema, interstitial lung disease
What conditions cause alveolar hypoventilation?
Neuromuscular disorders, obesity hypoventilation, drug overdose
What to know about o2 therapy and a shunt?
patients with shunts will continue to have hypoxemia even when oxygen therapy is initiated
Thoracic aortic aneurysm + JVD, facial swelling, hoarseness=?
Sueprior vena cava syndrome. Not from rupture but from aneuryism putting pressure
signs of cardiac tamponade
Becks Triad- JVD, hypotension, muffled heart sounds
Injury location for autonomic dysreflexia
T6 or higher
autonomic dysreflexia vs neurogenic shock vs spinal shock vs autonomic nervous system dysfunction
dysreflexia- hypertension.
Neurogenic- loss of vascualr tone- hypotension.
Spinal- paralysis, relfexes etc
NS dysfunction- involuntary functions (hypotnesion, GI, Temp. Chronic)
SS hypoxemia vs hypercap
Hypoxemia: Look for signs like restlessness, anxiety, confusion, rapid breathing, and low oxygen
saturation (SpO2).
Hypercapnia: Look for signs like drowsiness, lethargy, headache, confusion, and shallow breathing.
SVT
stable patient with SVT, vagal maneuvers (e.g., Valsalva, coughing, carotid massage) should be
attempted first. Adenosine is given if vagal maneuvers fail. Synchronized cardioversion is reserved
for unstable SVT.
Afib
If new onset, immediate cardiovert
If A-fib has been present for >48 hours, immediate cardioversion is contraindicated due to the high
, risk of stroke. The patient should be anticoagulated for at least 3-4 weeks before elective
cardioversion. Diltiazem (a calcium channel blocker) helps control rate, and warfarin prevents clot
formation.
Heary blocks get? Dysrhythmias get?
HB: Pacing. If symptomatic type 2/1, atropine but not for 2/2 or three.
Dys: cardioversion
ACLS VFib/VTach
After the first shock fails in V-fib, administer epinephrine every 3-5 minutes to enhance perfusion.
Defibrillation is repeated every 2 minutes.
relationship between hydrigen and potassium
When hydrogen levels are high (acidosis), potassium levels tend to be high as well (hyperkalemia).
Conversely, when hydrogen levels are low (alkalosis), potassium levels tend to be low (hypokalemia)
C3-C5 injuries
Injuries in the C3-C5 range can all impact diaphragm function and potentially require mechanical
ventilation
STEMI interventions
Aspirin and nitro first, priority is PCI
NSTEMI intervnetions
Aspirin, nitro, anticoags first. Priority is antiPLT or PCI if necessary.
AFib and cardioversion
if within 48 hours of onset, they can cardiovert immediately. If over, they need to do 3 weeks of
anticoags to ensure clots arent sent through
treatment for SVT
Vagal maneuver. maybe adenosine if unstable
- Tachy and cant see p waves
Treatment for A Flutter
- Bblockers or cardioversion if unstable.
- normal qrs, regular flutter waves
Treatment for A Fib
- normal ish QRS and chaotic p wave
- Bblockers or cardioversion if unstable. Anticoags!
tx 2nd degree type 1
- monitor, atropine if brady and symptomatic. Pacing unlikely
- longer longer longer drop
Tx second degree type 2
