CEN Review: Questions With A+ Solutions, Expert
Verified
Distributive shock - decreased cellular profusion why? Right Ans -
Maldistribution of the oxygen to periphery (hallmark symptom is
vasodilation, sepsis, anaphylaxis, neurogenic)
Obstructive shock - decreased cellular profusion why? Right Ans -
Obstruction of blood into or out of ventricles (ie pulmonary embolism,
pericardial tamponade)
Hypovolemic shock - decreased cellular profusion why? Right Ans - Lack of
circulating volume (increase volume and stop bleeding)
Cardiogenic shock - decreased cellular profusion why? Right Ans - Failure
of central pump
Sympathetic Nervous System definition Right Ans - Fight or flight response
or the adrenergic system
Sympathetic Nervous System - alpha receptors Right Ans - Cause
vasoconstriction
glycogenolysis
diaphoresis
Sympathetic Nervous System - Beta one receptors Right Ans - Increased
heart rate
Increased contractility
Increased automaticity
Sympathetic Nervous System - Beta two receptors Right Ans - Increased
respiratory rate
Bronchodilation
Renin-angiotensin system Right Ans - Increased water and sodium
reabsorption
CMS of Alpha Receptors - 4 Right Ans - Increased BP
,Narrow pulse pressure
Cool, clammy skin
Increased CBG
CMS of Beta one receptors Right Ans - Tachycardia
Arhythmias
CMS of Beta two receptors Right Ans - Increased oxygenation
Tachypnea
CMS of RAS system Right Ans - Decreased urine output
Parasympathetic Nervous System definition Right Ans - Rest and digest, or
cholinergic system
Parasympathetic Nervous System - Alpha Receptors Right Ans -
Vasodilation
Glucogenesis
Dry Skin
Parasympathetic Nervous System - Beta one receptors Right Ans -
Decrease heart rate
Decrease contractility
Decrease automaticity
Parasympathetic Nervous System - Beta two receptors Right Ans -
Decrease respiratory rate
Bronchoconstriction
Memory tip of beta receptors Right Ans - we have ONE heart and beta ONE
receptors mainly affect the heart
we have TWO lungs and beta TWO receptors affect the lungs
Hyponatremia (over hydration) Right Ans - Symptoms of water retention
( generalized swelling, confusion, apathy, impending doom, cramps)
Mild hyponatremia tx Right Ans - Water restriction, oral sodium
replacement
,Severe hyponatremia tx Right Ans - Slow replacement (over 48-72 hours)
with hypertonic saline (3-5% solution)
What happens if you correct sodium too rapidly? Right Ans - Can cause
central pontine myelinolysis (flaccid parralysis, dysarthria, dysphagia,
hypotension)
Hypernatremia (associated with dehydration) Right Ans - AMS (fatigue,
lethargy, confusion, coma, weakness, diarrhea)
Hypernatremia tx Right Ans - Correct hypovolemia (NS)
Treat underlying cause
Sodium and chloride relationship? Right Ans - Tend to elevate and
decrease together
Hyperkalemia signs (early, late, cardiovascular) Right Ans - Early - muscle
excitability, NVD
Late - muscular weakness, fatigue
Cardiovascular in order - PEAKED T WAVE, elongated PR interval, absent P
wave, enlarging QRS, sine wave
Hyperkalemia tx Right Ans - Stabilize cardiac membrane (calcium chloride
or calcium gluconate)
Shift potassium into the cells (albuterol, insulin)
Remove potassium from cells (dialysis, lasix, kayexalate)
Common causes of hyperkalemia Right Ans - Renal failure
cellular death (ie rhabdomyolysis, tumor lysis, crush injury, burns)
Acidosis
*cells contain potassium, anything that causes cell death
Hypokalemia - ekg changes Right Ans - Often asymptomatic
Weakness
Prominent U wave
Hypokalemia tx Right Ans - Oral or IV potassium replacement
, Hypokalemia and hypomagnesium Right Ans - Often co exist so correct
both
Hypermagnesemia Right Ans - Causes neuromuscular depression
(depressed reflexes, constipation, NV, fatigue)
Hypermagnesemia tx - 3 Right Ans - Reduce serum magnesium (fluid
admin, loop diuretics)
Reduce ingestion (diet)
Dialysis (give calcium while awaiting dialysis)
Hypomagnesemia Right Ans - Mild - asymptomatic
Severe low - neuromuscular excitability (cramping, tetatny, positive chvosteks
sign, positive trousseau's sign) prolonged PR
Chvostek's Sign Right Ans - When facial nerve tapped, facial or eye muscle
twitching elicited
Trousseau's sign Right Ans - When BP cuff inflated to 20 mmHg above
systolic pressure for 3 min carpal spasms induced
Hypocalcemia / hyperphosphatemia (coexist) Right Ans - Causes
neuromuscular excitability (muscle cramping, tetanic contractions,
hyperreflexia, chvostek's sign, troussea's sign)
Hypercalcemia / hypophosphatemia (Coexist) Right Ans - Neuromuscular
depression (depressed tendon reflexes, constipation, nausea, fatigue)
Hypercalcemia tx - 4 Right Ans - Underlying cause
Normal NS
Glucocorticoids
Calcitonin
Hypophosphatemia Right Ans - High phosphate diet
Oral potassium phosphate
IV sodium phosphate (watch for hypocalcemia)
What happens when you OD on antacid - electrolytes Right Ans -
Hypercalcemia
Verified
Distributive shock - decreased cellular profusion why? Right Ans -
Maldistribution of the oxygen to periphery (hallmark symptom is
vasodilation, sepsis, anaphylaxis, neurogenic)
Obstructive shock - decreased cellular profusion why? Right Ans -
Obstruction of blood into or out of ventricles (ie pulmonary embolism,
pericardial tamponade)
Hypovolemic shock - decreased cellular profusion why? Right Ans - Lack of
circulating volume (increase volume and stop bleeding)
Cardiogenic shock - decreased cellular profusion why? Right Ans - Failure
of central pump
Sympathetic Nervous System definition Right Ans - Fight or flight response
or the adrenergic system
Sympathetic Nervous System - alpha receptors Right Ans - Cause
vasoconstriction
glycogenolysis
diaphoresis
Sympathetic Nervous System - Beta one receptors Right Ans - Increased
heart rate
Increased contractility
Increased automaticity
Sympathetic Nervous System - Beta two receptors Right Ans - Increased
respiratory rate
Bronchodilation
Renin-angiotensin system Right Ans - Increased water and sodium
reabsorption
CMS of Alpha Receptors - 4 Right Ans - Increased BP
,Narrow pulse pressure
Cool, clammy skin
Increased CBG
CMS of Beta one receptors Right Ans - Tachycardia
Arhythmias
CMS of Beta two receptors Right Ans - Increased oxygenation
Tachypnea
CMS of RAS system Right Ans - Decreased urine output
Parasympathetic Nervous System definition Right Ans - Rest and digest, or
cholinergic system
Parasympathetic Nervous System - Alpha Receptors Right Ans -
Vasodilation
Glucogenesis
Dry Skin
Parasympathetic Nervous System - Beta one receptors Right Ans -
Decrease heart rate
Decrease contractility
Decrease automaticity
Parasympathetic Nervous System - Beta two receptors Right Ans -
Decrease respiratory rate
Bronchoconstriction
Memory tip of beta receptors Right Ans - we have ONE heart and beta ONE
receptors mainly affect the heart
we have TWO lungs and beta TWO receptors affect the lungs
Hyponatremia (over hydration) Right Ans - Symptoms of water retention
( generalized swelling, confusion, apathy, impending doom, cramps)
Mild hyponatremia tx Right Ans - Water restriction, oral sodium
replacement
,Severe hyponatremia tx Right Ans - Slow replacement (over 48-72 hours)
with hypertonic saline (3-5% solution)
What happens if you correct sodium too rapidly? Right Ans - Can cause
central pontine myelinolysis (flaccid parralysis, dysarthria, dysphagia,
hypotension)
Hypernatremia (associated with dehydration) Right Ans - AMS (fatigue,
lethargy, confusion, coma, weakness, diarrhea)
Hypernatremia tx Right Ans - Correct hypovolemia (NS)
Treat underlying cause
Sodium and chloride relationship? Right Ans - Tend to elevate and
decrease together
Hyperkalemia signs (early, late, cardiovascular) Right Ans - Early - muscle
excitability, NVD
Late - muscular weakness, fatigue
Cardiovascular in order - PEAKED T WAVE, elongated PR interval, absent P
wave, enlarging QRS, sine wave
Hyperkalemia tx Right Ans - Stabilize cardiac membrane (calcium chloride
or calcium gluconate)
Shift potassium into the cells (albuterol, insulin)
Remove potassium from cells (dialysis, lasix, kayexalate)
Common causes of hyperkalemia Right Ans - Renal failure
cellular death (ie rhabdomyolysis, tumor lysis, crush injury, burns)
Acidosis
*cells contain potassium, anything that causes cell death
Hypokalemia - ekg changes Right Ans - Often asymptomatic
Weakness
Prominent U wave
Hypokalemia tx Right Ans - Oral or IV potassium replacement
, Hypokalemia and hypomagnesium Right Ans - Often co exist so correct
both
Hypermagnesemia Right Ans - Causes neuromuscular depression
(depressed reflexes, constipation, NV, fatigue)
Hypermagnesemia tx - 3 Right Ans - Reduce serum magnesium (fluid
admin, loop diuretics)
Reduce ingestion (diet)
Dialysis (give calcium while awaiting dialysis)
Hypomagnesemia Right Ans - Mild - asymptomatic
Severe low - neuromuscular excitability (cramping, tetatny, positive chvosteks
sign, positive trousseau's sign) prolonged PR
Chvostek's Sign Right Ans - When facial nerve tapped, facial or eye muscle
twitching elicited
Trousseau's sign Right Ans - When BP cuff inflated to 20 mmHg above
systolic pressure for 3 min carpal spasms induced
Hypocalcemia / hyperphosphatemia (coexist) Right Ans - Causes
neuromuscular excitability (muscle cramping, tetanic contractions,
hyperreflexia, chvostek's sign, troussea's sign)
Hypercalcemia / hypophosphatemia (Coexist) Right Ans - Neuromuscular
depression (depressed tendon reflexes, constipation, nausea, fatigue)
Hypercalcemia tx - 4 Right Ans - Underlying cause
Normal NS
Glucocorticoids
Calcitonin
Hypophosphatemia Right Ans - High phosphate diet
Oral potassium phosphate
IV sodium phosphate (watch for hypocalcemia)
What happens when you OD on antacid - electrolytes Right Ans -
Hypercalcemia
