CFRN Exam 706 Questions with Verified Answers,100% CORRECT

CFRN Exam 706 Questions with Verified Answers Antidote for alkais - CORRECT ANSWER copious water antidote for anticholinergics - CORRECT ANSWER Physostigmine *keep atropine nearby antidote for atropine - CORREC ...

CFRN Exam 706 Questions with Verified Answers Antidote for alkais - CORRECT ANSWER copious water antidote for anticholinergics - CORRECT ANSWER Physostigmine *keep atropine nearby antidote for atropine - CORRECT ANSWER Physostigmine *same as for all anticholinergics antidote for phenergan overdose - CORRECT ANSWER physostigimine same as for all anticholinergics have atropine nearby antidote for benadryl overdose - CORRECT ANSWER physostigmine same as for all anticholinergics have atropine nearby antidote for asprin overdose - CORRECT ANSWER bicarbonate corrects acidosis rx for acidosis - CORRECT ANSWER bicarbonate pushing Flumazenil too fast - CORRECT ANSWER seizrues antidote for beta blocker overdose - CORRECT ANSWER glucagon antidote for calcium channel blocker overdose - CORRECT ANSWER calcium gluconate IVF for low bp[ rx for cocaine overdose - CORRECT ANSWER benzodiazepiens what rx should not be given in cocaine overdose - CORRECT ANSWER BB - leads to unopposed alpha adrenergic activityy antidote for coumadin overdose - CORRECT ANSWER vitamin K antidote for cyanide overdose - CORRECT ANSWER amyl nitrite sodium thiosulfate sodum nitrite digitalis overdose - CORRECT ANSWER yellow/green halos. life looks like a van gough paintng slurred up-slopes on QRS antidote for dilantin oversode - CORRECT ANSWER supportative car antidote for antifreeze overdose - CORRECT ANSWER IV ethanol or Antizol Antizol - CORRECT ANSWER for alcohol overdose like antifreeze antifreeze - CORRECT ANSWER ethylene glycol antidote for heparin overdose - CORRECT ANSWER protamine sulfate antidote for hydrocarbon overdose like gasoline/pain strippre - CORRECT ANSWER intubate antidore for hydrofluoric acid - CORRECT ANSWER calcium gluconate antidote for isoniazid - CORRECT ANSWER pyridoxine antidore for iron overdose - CORRECT ANSWER deferoxamine *pink/rose colored urine indicates therapeutic level of Deferoxamine wood alcohol - CORRECT ANSWER methanol antidote for pesticides - CORRECT ANSWER atropine - anticholinergic benzos - seizures 2-PAM: pulls the organophosphate off the ACh 2-PAM - CORRECT ANSWER for pesticide overdose. pulls the organophosphate off the ACh treatment for tricyclic antidepressant overdose - CORRECT ANSWER bicarbonate EKG of tricyclic antidepressant overdsoe - CORRECT ANSWER tachyardia wide QRS torsades prolonged QT problem of meconium - CORRECT ANSWER inactivates surfactant only indication for deep suction - CORRECT ANSWER newborn is not vigorous characteristic of meconium - CORRECT ANSWER sterile bolus of neonate/pediatrics - CORRECT ANSWER neo = 10ml/kg peds = 20ml/kg 2-3-4 rule - CORRECT ANSWER 2x ETT = NG/foley size 3 x ETT = ETT depth 4x ETT = chest tube size ETT depth formula - CORRECT ANSWER age/2 + 12 age that has higher CO2 - CORRECT ANSWER pediatrics have higher CO2 than adults 4-2-1 rule for maintence fluids - CORRECT ANSWER 4ml/kg for 0-10kg 2ml/kg for 11-20kg 1ml/kg for +20 kg pediatrics hypotensive formula - CORRECT ANSWER 70+ (2xage) pedatrics normotensive formula - CORRECT ANSWER 90 + (2xage) pedaitrics weight formula >1yo - CORRECT ANSWER (age x2) +8 = approximate age what respiratory problem is stridor - CORRECT ANSWER inhalation problem pediatrics glucose management - CORRECT ANSWER neonate = 2ml/kg of D10 pediatric = 2ml/kg of D25 child = 2ml/kg of D50 cardioversion doise for pediatrics - CORRECT ANSWER up to 1j/kg what happens in croup -3 - CORRECT ANSWER obstruction of larynx, horsenes, barking cough steeple sign on CXR - CORRECT ANSWER croup CXR of croup - CORRECT ANSWER steeple sign CXR of epiglottis pt - CORRECT ANSWER thumb print sign thumbprint sign on CXR - CORRECT ANSWER epiglottis treatment for epiglottis - CORRECT ANSWER ABX humidified O2 calm environment Waddel's Triad - CORRECT ANSWER how do pediatrics breath - CORRECT ANSWER natural belly breathers narrowest part of pediatric airway - CORRECT ANSWER cricoid age when the fontannels close - CORRECT ANSWER posterior -2m anterior-18m medicatical condition where succ should not be used - CORRECT ANSWER Duchenne muscular dystrophy characteristics of a cold child - CORRECT ANSWER obtuned bradycardiac hypotensive characteristics of a hot child - CORRECT ANSWER fussy irirtable tachypneic tachycardic peds dose of epinephrine - CORRECT ANSWER 0.01mg/kg using succ in pediatrics - CORRECT ANSWER bradycarida consensus burn formula - CORRECT ANSWER 2-4 x kg x %BSA = IVF over 24hrs Parkland Formula - CORRECT ANSWER 4 x kg x BSA = IVF in 24hrs 1/2 in first 8hrs, 1/2 next 16 IVF for burns - CORRECT ANSWER LR average urine output for adult - CORRECT ANSWER 0.5ml/kg/hr average urine output for pediatrics - CORRECT ANSWER `1ml/kg/hr average urien output for neonates - CORRECT ANSWER 2ml/kg/hr potential complication in burns over 20% BSA - CORRECT ANSWER adynamic ileus = decreased bowel movemnt electrolyte imbalance in burns - CORRECT ANSWER high K which gas law may negatively impact a adynamic ileus - CORRECT ANSWER Boyle's law voltage consider a high voltage burn injuyr - CORRECT ANSWER over 1K volts characteristic that is a better predictor of damage in an electrical injuyr - CORRECT ANSWER amperage characteristics of an alternating urrent - CORRECT ANSWER victim is unable to pull away explosive exit wound causes Vfib household electrical current characteristics of direct current - CORRECT ANSWER victim is able to D/C (pull away) form the curent discrete exit wound causes asystole electrical current injuries & effect on EKG - CORRECT ANSWER DC = asystole AC = ventricularco common lab finding in electrical injuries - CORRECT ANSWER myoglobinuria treatment of myoglobinuria - CORRECT ANSWER IVF NS diuresis sodium bicarbonate mannitol to increase urine output to minimize chance of acture tubular necorsis complication of mylglobinuria - CORRECT ANSWER risk of acute tubular necrosis % of carbon monoxide posioning that can cause coma - CORRECT ANSWER over 40% nursing intervention that should be done for all burn pts - CORRECT ANSWER needs a gastric tube to prevent adynamic ileus acids versus alkaoids on skin - CORRECT ANSWER acids = coagulation necorsis alkaloids = liquification needed for hydrofluoric acid - CORRECT ANSWER calcium gluconate effect of alkali burns on cells - CORRECT ANSWER saponification = liquifaction necorsis hypoxia caused by CO poisioning - CORRECT ANSWER hypemic non CO cause of poisioning - CORRECT ANSWER cyanide = nylon, wool, silk, asphalt, plastics, carpet, arylic treat cyanide toxicity - CORRECT ANSWER nitrite thiosulfate hydroxocobalamin acid-base balance in pregnancy - CORRECT ANSWER more basic heat changes in pregnancy - CORRECT ANSWER lifts anteriorly and turns leftwards best predictor of fetal well-being - CORRECT ANSWER variability #1 cause of poor fetal variability is - CORRECT ANSWER fetal hypoxia most common cause of preterm labor - CORRECT ANSWER hypovolemia true labor - CORRECT ANSWER contractsion with cervical change (dilation/effacement) 2 types of uterine contraction tocolytics - CORRECT ANSWER terbutaline & magnbesium sulfate SE of terbutaline - CORRECT ANSWER HYPERglycemia and mom/baby HR magnesium sulfate & labor - CORRECT ANSWER mag sulfate is an option w/terbutaline CNS depressant, smooth muscle relaxation magnesium toxicity - CORRECT ANSWER resp deprssion los of DTR LOC low BP muscle eweak antidote for mangesium toxicity - CORRECT ANSWER calcium gluconate problem of pregnancy induced HTN - CORRECT ANSWER placental insufficiency shoulder dystocia 1st - CORRECT ANSWER McRoberts. pull woman's knees to chest to open pelvis s/s of HELLP - CORRECT ANSWER RUQ pain jaundic malaise treatment of eclampsia - CORRECT ANSWER mag sulfate for maintence valium only if actively seizing s/s of placental abruption - CORRECT ANSWER painful dark red blood placental exsanguination/palcental insufficiency painless red versus dark red vaginal bleeding if pregnat - CORRECT ANSWER placental abruption = painful dark placental previa = painless bright red NEVER VAGINAL EXAM - CORRECT ANSWER placental previa. over os painless bright red vaginal bleeding if pregnant - CORRECT ANSWER placental previa risk of pulling too hard on umbilical cord - CORRECT ANSWER uterine prolapse common cause of newborn seizures - CORRECT ANSWER low glucoser expected respiratory failure ABG - CORRECT ANSWER ph under 7.2 co2 over 55 paox under 60 LEMON - CORRECT ANSWER look evalute w/332 rule mallampati obstruction neck mobility Mallampati 2 - CORRECT ANSWER tonsillary pillars hidden behind the tongue Mallampati 3 - CORRECT ANSWER obly base of uvula and soft palate are visualized macintosh intubation blade - CORRECT ANSWER lifts the vallecula miller intubation blade - CORRECT ANSWER lifts the epiglottis preferred intubation blade for pediatrics - CORRECT ANSWER miller. lifts epiglottis distal tip of ETT should be where - CORRECT ANSWER T2-T3 2-3 cm above the carina pressure of the ETT cuff - CORRECT ANSWER 25mm hg 7 P's of ibtubatiob - CORRECT ANSWER preparation preoxygenate pretreat paralyze protect placemnt post intubation intubation pretreatment - CORRECT ANSWER LOAD lidocaine opiates atropine defasciculating dose apneuristic respirations - CORRECT ANSWER deep gasping inspiration followed by a pause at full instpraition followed by a brief insufficient release apneusteric respirations are associated with... - CORRECT ANSWER decerebrate posturing respirations that look like v-fib - CORRECT ANSWER ataxic respirations ataxic respirations - CORRECT ANSWER look like v-fib complete irregularity of breathing, irregular pauses, increased periods of apnea causes of ataxic respirations - CORRECT ANSWER looks like vfib on monitor damage to medulla from trauma/stroke BIot's respirations - CORRECT ANSWER groups of quick shallow inspriation follwoed by regular/irregular apnea associated w/Biots respirations - CORRECT ANSWER brainstem herniation respirations in herniation - CORRECT ANSWER Biots electrolyte imbalance with use of succ - CORRECT ANSWER high K who shouldn't receive succ - CORRECT ANSWER malignant hyperthermia high K burn or crush pt eye injuries glaucoma burn older than 24hrs guillain-barre/MG rx that should be avoided if malignant hyperthemia - CORRECT ANSWER CaChB. MH is b/c there is a problem with calcium removal from cells ABG in malignant hyperthermia - CORRECT ANSWER increaed ETCO2 Etomidate & vital signs - CORRECT ANSWER no changes in BP/CO/pain relief contraindications of etomidate - CORRECT ANSWER adrenal suppression NO septic shock, addison's disease NO in COPD/asthma b/c can cause vomiting antidote for rocuronium - CORRECT ANSWER Sugammadex amnesia w/versed - CORRECT ANSWER antegrade rx for a seizure - CORRECT ANSWER versed who should NOT receive propofol - CORRECT ANSWER head injury b/c decreased CPP and MAP propofol - CORRECT ANSWER hypnotic w/o analgesic properties decreases CPP/MAP NOT for head injury induction agent for head injury - CORRECT ANSWER NEVER PROPOFOL characteristics of Ketamine - CORRECT ANSWER hypnotic w/analgesic/amnesic properties stops pain impulses potent BronchoD hallucinations good induction agent for asthmatics - CORRECT ANSWER Ketamine b/c it is a bronchodilator Ketamine & airway secretions - CORRECT ANSWER increases airway secretions but also bronchodilates Ketamien & vital signs - CORRECT ANSWER sympathomimatic so increases HR/BP maneuvers to improve glottic visualization during intubation - CORRECT ANSWER BURP Sniffing position purpose of RSI - CORRECT ANSWER rapid intubation of a pt w/a full stomach intubation premedication w/atropine - CORRECT ANSWER for peds to help hypersalivation (anticholinergic) drug class of atrpine - CORRECT ANSWER anticholinergic earliest sign of malignant hyperthermia - CORRECT ANSWER rising ETCO2 levels unresponsive to increasing tidal volumes negative SE of PEEP - CORRECT ANSWER increases intrathoracic pressure which reduces venous return/preload so low bp calculate minute volume - CORRECT ANSWER tidal volume x RR Vt x f pH if low bicarbonate - CORRECT ANSWER low pH pH if high bicarbonate - CORRECT ANSWER high pH considered base excess/deficit - CORRECT ANSWER +/-2 negative base excess - CORRECT ANSWER the more negative your base excess is, the more acidotic you are positive base excess - CORRECT ANSWER the more positive your base excess is, the more alkalotic you are base excess replacement formula - CORRECT ANSWER 0.1 x BE x wt in kg = bicarbonate needed what should pO2 correlate w/ - CORRECT ANSWER PO2 should correlate w/FiO2 change of CO2 and K - CORRECT ANSWER CO2 changes by 10mm hg then K will change by 0.5 in the SAME direction if pH changes by 0.1, how will K change - CORRECT ANSWER by 0.6 in the OPPOSITE direction if pH changes by 0.15 then how will the bicarbonate change - CORRECT ANSWER by 10 in the SAME direction acid base mbalance in ASA poisioning - CORRECT ANSWER r. alkalosis b/c respiratory center stimulant acid base imbalance in pregnancy - CORRECT ANSWER r. alkalosis critical ABG values that require intubation - CORRECT ANSWER pH under 7.2 CO2 over 55 biarb over 60 O2 under 60 ETT size for children - CORRECT ANSWER 16 + age/4 intubation for under 8yo - CORRECT ANSWER needle cric 2 rx that cause angioedema - CORRECT ANSWER tPA lisonopril 2-3-4 rule - CORRECT ANSWER 2 x ETT is NG/foley size 3x ETT is ETT depth 4x ETT is chest tube size relationship between hydrogen ions and potassium - CORRECT ANSWER for ever 0.1 change in H+, K will change by 0.6 in the opposite direction relationship between mm hg CO2 and pH - CORRECT ANSWER for ever 10mm hg change in CO2, pH will change by 0.8 in the opposite direction relationship between meq bicarbonate and pH - CORRECT ANSWER for ever 10mEq change in bicarbonate, pH will change by 0.15 in the same direction hormones excreted by the posterior pituitary - CORRECT ANSWER oxytocin release and ADH releases E and NE - CORRECT ANSWER adrenal medulla labs in SIADH - CORRECT ANSWER dilutional hyponatremia = shifts fluid from outside cells to inside cells. concentrated urine under 1.030 specific gravity serum osmolarity under 270 cerebral edema b/c fluid shifts inside brain cells seizures intractable until Na corrected treatment of SIADH - CORRECT ANSWER fluid restriction hypertonic saline D5QW lasix slowly raise Nad 3 rx causes of diabetes insipitus - CORRECT ANSWER dilantin, lithium, amphoteriacin B labs of diabetes insipitus - CORRECT ANSWER increased NA serum osmoalarity increased specific gravity decreased HYPOVOLEMIC SHOCK rx for diabetes insipitus - CORRECT ANSWER vasopressin =synthetic ADH DDAVP 3 "musts" for DKA - CORRECT ANSWER hyperglycemia pH under 7.3 bicarbonate under 18 ketones over 5 in blood respiratory in DK - CORRECT ANSWER Kussmaul's in an attempt to blow off CO2 relationship between glucose and water - CORRECT ANSWER glucose pulls water towards it potassium in DKA - CORRECT ANSWER you want high K in DKA b/c hydrogen (strong ion) goes intot he cell to help correct acidosis. pushes K out of the cell to help maintain balance. as DKA progresses, you lose K in urine relationship between Na and glucose - CORRECT ANSWER for every 100mg/dl of glucose over 100, Na drops by 1.6 rapidly dropping glucose - CORRECT ANSWER don't drop glucose by more than 100mg/dl/hr. glucose is a large molecule and hyperosmolar. rapid drops will cause third-spacing of luid back into the tissue, especially the brain and cause cerebral edema cell movement when you give insulin - CORRECT ANSWER when giving insulin, you will drive glucose, K, and water back into the cell problem of too high thyroid - CORRECT ANSWER thyroid storm too high metabolism oxygen demands exceeds supply anaerobic state rx for thyroid storm - CORRECT ANSWER PTU (SE is decreased platelets) beta blockers no asprin b/c that will icnrease the amount of active circulating hormonbe treat fever w/tylenol severe low thyroid - CORRECT ANSWER myxema coma treatment for myxedema coma - CORRECT ANSWER IVF steroids b/c high stress state depleating cortisol levels IV thryroid replacement s/s of panreatitis - CORRECT ANSWER abd tender/guarding cullens grey turner Bohr Effect - CORRECT ANSWER hgb oxygen binding affinity is inversely related to both acidity and the concentration of carbon dioxide right shift - CORRECT ANSWER "right, raise, release" raised acid raised co2 raised PaO2 raised temp rule for correlating PaO2 and SpO2 - CORRECT ANSWER 4-5-6-7-8-9 RUle PaO2 40 = SpO2 70% PaO2 50 = SpO2 80% PaO2 60 = SpO2 90% vent settings for ARDS - CORRECT ANSWER high PEEP = to overcome alveolar collapse high FiO2 = lower tidal voleumes 6ml/kg ARDS criteria - CORRECT ANSWER bilateral infiltrates on CXR PAWP < 18 mm hg PaO2/FiOw under 200 = ARDS PaO2/FiO2 undre 300 = ALI xray of COPD-3 - CORRECT ANSWER flattened diaphragm should still see curve/costophrenic angle hyperinflation COPD capnography waveform - CORRECT ANSWER shark fin due to resistance to exhalation EKG changes with PE - CORRECT ANSWER deep S wave in lead 1 pathological Q wave in lead III T wave inversion in lead III RBBB peaked p wave in lead II nonspecific St segment and T wave changespathologic pathologic Q wave criteria in PE - CORRECT ANSWER 1mm or 0.04 seconds in width >2mm deep >25% of R wave hwight normal tidal volume (Vt) - CORRECT ANSWER 6-8ml/kg calculate minute ventilation - CORRECT ANSWER Vt x RR = VE vt tidal volume sudden drop in exhaled tidal volume (Vte) - CORRECT ANSWER leak gradula drp in exhaled tidal volume (Vte) - CORRECT ANSWER air trapping normal PIP - CORRECT ANSWER under 40cm water things that affect PIP - CORRECT ANSWER overall volume going down the airway how fast the volume is going in compliance how narrow the airway is size of ETT suctioning circuit most important pressure in a ventilated pt - CORRECT ANSWER plateau pressure target pPlat - CORRECT ANSWER uner 30 causes of increased Pplat - CORRECT ANSWER anything that would compress lung bases intervention for elevated Pplat - CORRECT ANSWER correct patho decrease by 1ml then recheck Pplat. if still high, decrease by 1 againff and reeval *consider changing from volume to pressure delivery absorptive atelectasis - CORRECT ANSWER nitroben sits in alveoli after O2 is diffused resulting in intrinsic PEEP 3-5. high concentraiton oxygen causes nitrogen washout. need to maintain PEEP to prevent absorptive atelectasis how do you change I:E ratio - CORRECT ANSWER change RR quickest way to increase oxygenation - CORRECT ANSWER PEEP gas laws related to PEEP = 2 - CORRECT ANSWER Henry's Law: make alveoli bigger for more diffusion potential fick's law: make alveolar membrane thinnger to allwo better diffusion Assist Control - CORRECT ANSWER delivers preset tidal volume & RR if the trigger/sensitivity is too low, can shake tubing/trigger vent. problem if on a shakey aircraft SIMV - CORRECT ANSWER pt receives set number of breaths at a preset tidal volume, allowign for spontaneous breathing between mandatory rbeaths pt can trigger own breaths based on sensitivyt *can add pressure support "boost" at the end" to help pt spontaneous breaths indications of SIMV = 3 - CORRECT ANSWER weaning increased comfort decreased chance of hyperventilation potential complication of SIMV - CORRECT ANSWER increased muscle fatigue indication for assist control - CORRECT ANSWER normal respiratory drive accompanied by conditions cuasing increased WOB -apneic pressure support - CORRECT ANSWER used w/assist control or SIMV gives pt a little "boost" when taking their own breaths" pressure alarm on ventilations - CORRECT ANSWER set at 35 as to not increase pressures beyond RCA supplies... - CORRECT ANSWER SA node AV node RA & RV mitral valve LAD supplies - CORRECT ANSWER bundle of his, BB, ventricular speptum RCA occlusion = - CORRECT ANSWER inferior wall SEMI sinus node = bradycardia AV node = 3rd HB RARV RV infrcaction mitral valve = MV insufficiency LAD occlusion - CORRECT ANSWER anterior septal wall STEMI Bundle of HIS = mobitz II bundle branches =RBBB ventricualr septum = VSD hemodynamics that are elevated in cardiogenic shock - CORRECT ANSWER elevated CVP SVR PCWP pulse pressure in cardiogenic shock - CORRECT ANSWER narrow pulse pressure when does the IABP inflate - CORRECT ANSWER balloon infaltes during diastole (diacrotic notch) deflates during systole absolute contraindications for IABP - CORRECT ANSWER aortic insufficiency pewripheral vascular diasese normal CO - CORRECT ANSWER 4-8 normal SVR - CORRECT ANSWER 800 - 1200 dynes increased SVR - CORRECT ANSWER vasoC, hypovolemic late septic shock dopamine neo-synephrine epi NE low SVR - CORRECT ANSWER early septic shock vasoD morphine nitrites hypercarbia NTG CCB ACEin dobutrex nicardipine nipride normal PVR - CORRECT ANSWER 37 - 250 dynes high PVR - CORRECT ANSWER pulmonary HTN pulmonary vascular diasesde, PE hypoxia meds that decrease PVR - CORRECT ANSWER CaChB oxygen normal caridac index - CORRECT ANSWER 2.5 - 4L/min increased SV - CORRECT ANSWER eary septic shock hyperthermia hypervolemia dopamine dobutamine digitalis decreased SV - CORRECT ANSWER CHF late septic shock BB MI lab for coumadin - CORRECT ANSWER PT normal PT - CORRECT ANSWER 11-12.5 sec normal PTT - CORRECT ANSWER 20-30 seconds measure heparin effectiveness - CORRECT ANSWER PTT normal INR - CORRECT ANSWER under 1.1 INR if on coumadind - CORRECT ANSWER 2-3 EKG in hyperkalemia - CORRECT ANSWER peaked T if over 6 prolonged PR if over 7 no p wave & wide RS if over 8 treatment for high K - CORRECT ANSWER calcium chloride to pretoect heart insulin, glucose sodium bicarbonate kexcelate to pull K out of cell and into bowellow K EKG if low K - CORRECT ANSWER peak/widened p prolnge dPR flat/inverted T wave u wave ventricualr rhythms U wave on EKG - CORRECT ANSWER low K how does heparin work - CORRECT ANSWER inhibits conversion of prothrombin to httombvin inhibits conversion fo firbinogen to fibrin heparin knowck out the intrinsic pathway - it knowck out free-ciruclating thrombin ACE inhibitor electrolyte imbalnce - CORRECT ANSWER high K indication of pulsus paradoxus - CORRECT ANSWER abnormal large decrease in SBP durign inspiration drop more than 10mm hg sign of cardiac tamponade, pericarditis, ODA, croup, asthma, COPD pulsus alternans - CORRECT ANSWER arterial pulse waveform showing alternating strong/weak beats almost always indicates left ventricualr systolic impairment RBBB identification criteria - CORRECT ANSWER QRS over 0,12 rsR' pattern M in V1 and V2 wide, slurred S wave in I and V6 LBBB identification criteria - CORRECT ANSWER QRS over 0.12 seconds wide notched R wave in V5 and V6 wide QS in V1 33 ft under wter - CORRECT ANSWER 2atm 66ft under water - CORRECT ANSWER 3atm time of useful consciousness at 18K ft - CORRECT ANSWER 20-30min time of useful consciousness at 27K ft - CORRECT ANSWER 2-3min normal base excess - CORRECT ANSWER +-2 BE over -4 - CORRECT ANSWER indication fo rpossible blood transfusion normal Vt - CORRECT ANSWER 6-8ml/kg bicarbonate replacement - CORRECT ANSWER .1 x BE x kg ICP assoicated w/high mortality - CORRECT ANSWER over 20 ketamine drip - CORRECT ANSWER 1-2mg/kg/hr versed drip - CORRECT ANSWER 0.5-1mkg/kg/hr IABP timing is based off... - CORRECT ANSWER EKG and a-line dicritoic notch EKG trigger for the IABP balloon - CORRECT ANSWER middle of T wave (diastole) trigger for IABP balloon deflation - CORRECT ANSWER start of systole is R wve. triggers deflation IABP deflation trigger if a-fib - CORRECT ANSWER R wave IABP mode used in asystole - CORRECT ANSWER asynchronous timing effect of IABP delfation - CORRECT ANSWER decrease aortic prssure theraby decreasing afterload decreases cardiac workload/oxygen consumption effect of IABP inflation - CORRECT ANSWER diastolic augmentation thus improves coronary blood flow result of early balloon infaltion - CORRECT ANSWER increases afterload result of late balloon inflation - CORRECT ANSWER decreased diastolic augmentation result of early balloon delfation - CORRECT ANSWER fails to decrease myocardial oxygen demand result of late balloon deflation - CORRECT ANSWER increases afterload Brudzinski's sign - CORRECT ANSWER severe neck stiffness causes a pt's hips/knees to flex whne the neck is flexed indication of Babinski's sign - CORRECT ANSWER pyramidal dysfunction normal CPP - CORRECT ANSWER 70-90 cause of epidural hematoma - CORRECT ANSWER middle miningeal artery cranial nerve associated w/pupillary change - CORRECT ANSWER CN III head bleed w/venous lake - CORRECT ANSWER subdrual venous bleed in the brain - CORRECT ANSWER subdural subdural hematoma - CORRECT ANSWER venous bleed "thunderclap" aka "worst headache of my life" - CORRECT ANSWER subarachnoid hemorrhage Cushing's reflex - CORRECT ANSWER mechanism to maintain tissue perfusion in which a complex cascade of events resultsin increase d bp/irregular breathing/bradycardia saved/lost in anterior cord syndrome - CORRECT ANSWER saved : proprioception lost: motor, pain, temp central cord syndrome - CORRECT ANSWER hyperextension injury to cervical area lost = function in upper extremities variable lower extremity, sensation, and pain Brown-sequard syndrome - CORRECT ANSWER hemi-section of the cord from penetration ipsilateral: paralysis/loss of proprioceptioN contralateral: pain/temp ipsilateral in BRown-Sequard sydnroem - CORRECT ANSWER paralysis and proprioception lost on same side contralateral loss in Brown-Sequard syndrome - CORRECT ANSWER temp and pain sensation decrease BP in hypertensive crisis - CORRECT ANSWER lower by no more than 25% BP contraindication for tPA - CORRECT ANSWER 185/110 Kehr's sign - CORRECT ANSWER referred pain down left shoudler ruptured spleen Chance fracture - CORRECT ANSWER horizontal racture through verebral body. tears posterior spinous ligament *accel-decel injiry of a mobile person moving forward into a fixed seatbelt Hangman's fracture - CORRECT ANSWER bilateral fracture of C2 due to hyperextension fraction from axial loading - CORRECT ANSWER Jefferson's fracture Jefferson's fracture - CORRECT ANSWER fracture from axial loading *fracture of the C1 vertebrae of the neck duet o compression of hte head on the neck hallmark sign of uncal herniation - CORRECT ANSWER ipsilateral pupil dilation ipsilateral pupil dilation - CORRECT ANSWER uncal herniation *herniation of the temporal lobe bilateral pupil dilation - CORRECT ANSWER centerlal herniation of the temporal lobe s/s of herniation - CORRECT ANSWER LOC changes changes in pupil sizereaction posturing Cushing's reflex Cushing's triad - CORRECT ANSWER bradycardia HTNwide pusle pressure changes in respiratory pattern prevent herniation - CORRECT ANSWER c-collar w/eyes forwarrd HOB 15-30 limit noxious stimuli euvolemia and normothermia sedation/neuromuscular blockers to rpevent the pt from moving in ways to increase ICP normal ICP - CORRECT ANSWER 0-10mm hg caluclate CPP - CORRECT ANSWER MAP - ICP how to ensure CPP if you dont' have a way to measure ICP - CORRECT ANSWER if you are unable to measure ICP directly, aim to keep minimum MAP by ensureing CPP is 80-100mm hg transducer for ICP - CORRECT ANSWER Forament of MOnro 3 rx to decrease ICP - CORRECT ANSWER manitol NaCL 7.5% barbiturates which decrease brain cell metabolism/oxygen demand GCS motor - CORRECT ANSWER obeys commands localizes pain withdraws from pain flexion to pain extension to pain no responsde GCS verbal response - CORRECT ANSWER oriented confused inappropriate words incomprehensive sounds No response GCS for moderate head injury - CORRECT ANSWER 9-13 location of subdural hematomas - CORRECT ANSWER venous blood colection between dura and arachnoid mater subdural hematoma in infant - CORRECT ANSWER bulging fontannels suture separation shock retinal hemorrhage *infants w/subdural hemotamas die from blood loss/hemorrhage rather than ehrniation choanal atresia - CORRECT ANSWER closure of nasal cavity by bony/soft tissue during development babies pink when crying and blue when quiet - CORRECT ANSWER choanal atresia treatment for neonate respiratory distress syndrome - CORRECT ANSWER ARDS for babies surfactant via ETT rx for PDA - CORRECT ANSWER PGE1 to keep PDA open rx to close PDA - CORRECT ANSWER Indomethacin and oxgyen hepatomegaly & cardiomegaly in a child - CORRECT ANSWER they have CHF stop IVF and give digitalis most common cardiac defect - CORRECT ANSWER VSD = hole between the ventricles ventricular septal defect - CORRECT ANSWER large hole between two ventricles lets venous blood pass from teh right to the left ventricel a dn out to the aorta w/o xogyenation coarctation of the aorta - CORRECT ANSWER narrowing of the aorta *give oxygen, lasix, digoxin Tetraology of Fallot includes - CORRECT ANSWER VSD pulmonary stenosis aortic coarctation transportion of the great vessels Tet spells - CORRECT ANSWER sudden cyanosis and syncope treatment for a tet spell - CORRECT ANSWER knee to chest morphine to vasoD pulmonary arteries if unresolved: RSI, intubate, high flow oxygen what kind of problem is DKA what kind of problem is HHKN - CORRECT ANSWER insulin problem glusose problem insulin therapy in DK - CORRECT ANSWER 0.1units/kg as a bolus and driop classic electroyte imbalance in SIADH - CORRECT ANSWER low Na high urine osmolarity treat SIADH - CORRECT ANSWER restrict fluids hypertonic saline diuresis how fast should you raise serum Na levels - CORRECT ANSWER no more than 1mEq/hr urine osmolarity in diabetes insipitus - CORRECT ANSWER low urine osmolarity treat DI - CORRECT ANSWER aggressive IVF DDAVP vasopressin use of DDAVP - CORRECT ANSWER treat diabetes insipitus how fast shoudl you lower glucose in DKA/DDHS - CORRECT ANSWER no more than 100mg/hr rx that causes thyroid stomr - CORRECT ANSWER amidarone often associated w/low thyroidism - CORRECT ANSWER adrenal insufficiency rx you shoudl never give to someone w/adrenal insufficiency/addison's disease - CORRECT ANSWER Etomidate risk of acute acute withdrawl of prednisone - CORRECT ANSWER adrenal insufficiency problem of addisons disease/adrenal insufficiency - CORRECT ANSWER low catecholamines/glucocortiocids treat adrenal insufficiency - CORRECT ANSWER glucocorticoids NO ETOMIDATE presentation of pancreatitis - CORRECT ANSWER dull/RUQ p cullens fever N/V bladder pressure that defines abdominal compartment syndrome - CORRECT ANSWER over 40 is severe under 20 is not svere most common sign of spleen rupture - CORRECT ANSWER Kehr's sign prerenal failrue - CORRECT ANSWER blood can't get to the kdineys far extreme problem of prerenal failure - CORRECT ANSWER acute tubular necorsis trement of pre renal failure - CORRECT ANSWER fluids bloods vasopressors treatment of renal failure - CORRECT ANSWER fluid restricftion hemodia,ysis BUN ratio - CORRECT ANSWER 10:1 BUN/creatinine ratio over 20:1 - CORRECT ANSWER prerenal failure labs that indicate prerenal failure - CORRECT ANSWER BUN/Creatine ratio over 20:1 initial hemodynamics in septic shock - CORRECT ANSWER increased CO decreased SVR massive vasoD response s/s of meningitis - CORRECT ANSWER kernig brudzinski sign of acute pancreatitis - CORRECT ANSWER CUllen's sign referred pain to left shoulder - CORRECT ANSWER rputured spleen Kehr's sign sign w/chole - CORRECT ANSWER Murphy's sing Murphy's sign - CORRECT ANSWER sign of chole HR and hypothermai - CORRECT ANSWER decreased depolarization of cardiac pacemaker cells so bradycardia increased PAWP -4 - CORRECT ANSWER volume overload cardiac tamponade restrictive cardiomyopathy LV dysfunction only clinically significant reason for decreased PAWP - CORRECT ANSWER hypovomia PAWP in hypovolemia - CORRECT ANSWER low PAWP PAWP in overhydration - CORRECT ANSWER hgih PAWP shock & afterload - CORRECT ANSWER distributive shocks/vasoD = decreased afterload cardio/hypov/ = increased afterload SVR - CORRECT ANSWER best indicator of left sided afterload best indicator of left sided afterload - CORRECT ANSWER SVR normal SVR - CORRECT ANSWER 800 -1200 SVR decreased - CORRECT ANSWER generally SVR only decreases as a pathological response to inflammatory conditions (sepsis/fever) PVR - CORRECT ANSWER afterload/resistance in teh right side of hte heart pumping to the lungs normal PVR - CORRECT ANSWER 50-250 overdampened waveform - CORRECT ANSWER "weak wave" results from air/blood in tubing underdampened waveforma - CORRECT ANSWER "strong wave" excessive tubign dampening if excessive tubing - CORRECT ANSWER underdampened dampening if air/blood in tubing - CORRECT ANSWER overdampened PA catheter direction - CORRECT ANSWER R atrium, tricupsid valve, right ventricle, left atrium, pulmonic valve, to PA how do you get the CVP - CORRECT ANSWER proximal port of the PA catheter/tip of the central venous catheter high CVP - CORRECT ANSWER right sided HF/hypervolemia low CVP - CORRECT ANSWER hypovolemia fix low CO states caused by left ventricualr dysfunction - CORRECT ANSWER increase contractility decrease preload decrease afterload msot common afterload reduction agent - CORRECT ANSWER nitroprusside causes of increased CO - CORRECT ANSWER sepsis neurogenic mediated vasoD common cause of decreased SVR - CORRECT ANSWER sepsis compensatory decrease in SVR - CORRECT ANSWER a decrease in SVR causes a compensatory increase in CO how do you measure preload - CORRECT ANSWER PAWP for LV CVP for RV how is afterload measured - CORRECT ANSWER by SVR PVR presentation of mitral insufficiency - CORRECT ANSWER orthopnea elevated PAWP pulmonary HTN presentation of aortic insufficiency - CORRECT ANSWER orthopnea elevated PAWP LV failrue appearence of a PA waveform - CORRECT ANSWER high amplitude waveform notch on right side most dangerous IABP timing error - CORRECT ANSWER late deflation 3 causes of increased PVR - CORRECT ANSWER acidosis hypercapnia hypoxia 2 causes of decreased PVR - CORRECT ANSWER alkalosis vasodilator shock that increases SVR - CORRECT ANSWER hypovolemic cardiogenic shocks that decrease SVR - CORRECT ANSWER anaphyalxctic septic shock absolute contraindication to IABP - CORRECT ANSWER aortic valve disease inflation/deflation of IABP - CORRECT ANSWER inflates during diastole deflates during systole hemodynaic benefits of an inflated IABP - CORRECT ANSWER increase blood flow to coronary arteriies via retrograde effect hemodynamic benefits of deflated IABP - CORRECT ANSWER increased forward blodo flwo via vaccuum effect decreases afterload temp where you stop shiver reflex - CORRECT ANSWER 32C risk of rewarming if hypothermic - CORRECT ANSWER afterdrop = temperature dips back down as cold blood ciruclates after rewarming main physiologic response of heat emergency - CORRECT ANSWER cellular breakdwon oxygen supply cannot meet oxygen demnad what can cause a MI in pt w/a heat emergency - CORRECT ANSWER high CO respiratory distrubance in heat emergencies - CORRECT ANSWER respiratory alkalosis (hyperventilation) neuro problem that can be caused by heat emergencies - CORRECT ANSWER cerebral edema due to failure of hte Na-K pump which can lead to seizures rx that can cause a hyperthermic resonspe - CORRECT ANSWER cocaine neurloeptic malignant suydnroem decrease metabolism in heat stroke - CORRECT ANSWER intubate sedate paralyze intervention for heat stroke if you don't intubate - CORRECT ANSWER Thorazine Thorazien - CORRECT ANSWER rx for heat stroke which can prevent shivering prevent GI bleed in heat stroke - CORRECT ANSWER NG H2 blockers tube feedings what medication can help tthe pt assume the temperature around them - CORRECT ANSWER phenergan how do you raise teh Na levels in a pt w/hyponatremia - CORRECT ANSWER 1meq per horu 3 treatment for rhabdo - CORRECT ANSWER IVF alkalinize urine w/na bicarb osmotic dieuretic K emergency in heat emergenceis - CORRECT ANSWER both too high and low 3 classic s/s of malignant hyperthermia - CORRECT ANSWER masseter spasm increased ETCO2 tachycardia drug that is NEVER given in malignant hyperthermia - CORRECT ANSWER CaChB msot dangerous electrolyte imbalance in malignant hyperthermia - CORRECT ANSWER high K freshwater versus saltwater drownign - CORRECT ANSWER fersh: hemodilution, hypoxia w/res. acidosis salt: resp alkalosis, co2 retention, p. edema type II decompression illness - CORRECT ANSWER neuro = spinal cord, HA, visual distrubance,s LOC, movement respiratory = burnign substernal pain, SOB hypovolemic shock rx treatment of diving inuuries - CORRECT ANSWER includes asprin for anticoagulation position for diving emergenceis - CORRECT ANSWER NEVER TRENDELENBERG hallmark sign of hypoxia - CORRECT ANSWER paradoxical undressing due to LCO EKG hypothermia - CORRECT ANSWER osboirn/J wave osborn wave on EKG - CORRECT ANSWER hypothermia lab increased in dehydration - CORRECT ANSWER hct BUN reflex in dorwning - CORRECT ANSWER Mammalian diving reflex apnea bradycardia bradyC vasoC shunting of blood to coroanary/cerebral circualtion metabolic disturbance in hypothermia cpt - CORRECT ANSWER mixed metabolic/respiratory acidosis electrolyte disturba ce when rewarming pt - CORRECT ANSWER high K low glucose electrolyte disturbance when cooling pt - CORRECT ANSWER low K low Mg high glucose benefit of active internal rewarming - CORRECT ANSWER doesn't cause afterdrop risk of hypotermia transport - CORRECT ANSWER throwing/verticle lifting can precipitate v-fib in hypotermic pt preferred solution for hypothermic pt - CORRECT ANSWER D5 in NS only indication of CPR in a hypothermic pt - CORRECT ANSWER vfib/asystole core temperature in order for defibrillation to be effective - CORRECT ANSWER over 28C atmospheric pressure and ft of sea water - CORRECT ANSWER atmospheric pressure increased by 1 atm for every 33 ft sea water gas breathed by scuba divers - CORRECT ANSWER Scuba divers breathe a nitrogen=xogyen misture rather than pure compressed oxygen in order to avoid nitrogen narcosis/oxygen toxicity atmospheric pressure if you dive 33ft - CORRECT ANSWER 2 ATM classic presentation of arterial gas embolism - CORRECT ANSWER sudden onset of unconsciousness after reaching surface after a dive how do you prevent complications when resurfacing - CORRECT ANSWER ascend slowign while exhaling continuously easiest way to remember how arterial gas embolism presents - CORRECT ANSWER like CVA common treatments for high altitude sickness -3 - CORRECT ANSWER diamox decdron hyperbaric chamber treat asprin poisioning - CORRECT ANSWER bicarb hemodialysis s/s of asprin poisioning - CORRECT ANSWER N/V tinnitis presentation of dilantin oversoe - CORRECT ANSWER Diabetes insipitus antidote for Fe toxicity - CORRECT ANSWER Deferoxamine how do you knwo Deferoxamine is effective - CORRECT ANSWER for Fe toxicity rose colored urine Beta Blocker antidote - CORRECT ANSWER glucagon CaChB antidote - CORRECT ANSWER calcium gluconate green/yellow visual halos - CORRECT ANSWER digitalis overdose antidote for TCA - CORRECT ANSWER bicarbonate transportion/positioning of flail chest - CORRECT ANSWER injured lung down s/s of cardiac tamponade -4 - CORRECT ANSWER AMS decreased CO JVD rising CVP Beck's Triad - CORRECT ANSWER narrow PP JVD muffled HS initial treatment for suspected cardiac tamponade - CORRECT ANSWER IVF ejergent pericardiocentesis classic sign of aortic rupture - CORRECT ANSWER upper extremity BP CXR of aortic rupture - CORRECT ANSWER widened mediastinum loss aortic knob treatment of mycoardial contusion - CORRECT ANSWER same as MI trauma often associated w/flail chest - CORRECT ANSWER pulmoanry contusion treatment of diaphragmic rupture - CORRECT ANSWER NG classic sing of tracheobronchial rupture - CORRECT ANSWER perisistnet air leak hemoptysis treatment of tracheobronchial rupture - CORRECT ANSWER mainstream intubation treamtne for esophageal perforration - CORRECT ANSWER NG IV abx anatomic location for pericardiocentesis - CORRECT ANSWER left of pt sub-xyphoid process absence of bowel soudns - CORRECT ANSWER paralytic ileus peritonitis intervention for absence of bowel sounds - CORRECT ANSWER NG/OG standard intervention for abdominal injuries - CORRECT ANSWER G tube intervention for evisceratied bowel contents - CORRECT ANSWER co er w/sterile saline solution what happens to a kidney when it gets show - CORRECT ANSWER explodes - nephroectomy ST segment - CORRECT ANSWER early ventreicualr repolarization J point - CORRECT ANSWER where QRS and ST segment meet time of QT interval - CORRECT ANSWER should not exceed 0.45 seconds class I antiarrhythmics - CORRECT ANSWER Na ChB = lidociane class II antiarrhythmics - CORRECT ANSWER BB class III antiarrhythmis - CORRECT ANSWER K channel blockers = amidarone class IV antiarrhythmics - CORRECT ANSWER CaChB pulsus paradoxus - CORRECT ANSWER cardiac tamponade decrease greater than 10 mm hg in SBP during inspiration decrease greater than 10 mm hg in SBP during inspiration - CORRECT ANSWER pulsus paradoxus cardiac tamponade RCA supplis - CORRECT ANSWER S node supplies the budnel of HIs - CORRECT ANSWER LAD when is IABP inflated - CORRECT ANSWER diacrotic notch beginning of idastole elevated leads in inferior MI - CORRECT ANSWER II III avF leads elevated in lateral MI - CORRECT ANSWER I V5 V6 leads elevated in septal MI - CORRECT ANSWER V1 V2 leads elevated in anterior MI - CORRECT ANSWER V3 V4 diagnose posterior MI - CORRECT ANSWER ST depression V1 - V4 ST selvation in reverse EKG supplies SA node - CORRECT ANSWER RCA supplies bundle of his - CORRECT ANSWER LAD when do you measure hemodynamic parameters - CORRECT ANSWER end of exhalation vessel supplied in posterior MI - CORRECT ANSWER circumclex anteriorseptal MI - CORRECT ANSWER ST elevations in V1-V4 rx for pt who have cardiac cath - CORRECT ANSWER GP2B3a inhibitors antiplt like integrellin vessel obstruciton in inferior MI - CORRECT ANSWER RCA RCA blocked - CORRECT ANSWER inferior MI how to tell if a PA cathetr tip is in the PA - CORRECT ANSWER dicrotic notch is on the right side of hte waveform measuresments by the PA catheter - CORRECT ANSWER right heart afterload left herat preload what do you do if the PA is in the RV - CORRECT ANSWER infalte cuff w/air cough lay on side root cause of esophageal varices - CORRECT ANSWER cirrhosis most common cause of lower GI bleeds - CORRECT ANSWER diverticulosis most common cause of pancreatitis - CORRECT ANSWER gallstones causes of ascities in liver failure - CORRECT ANSWER low albumin effect of tylenol overdose on liver - CORRECT ANSWER most common cause of fulminate hepatic failure is tylenol overdose narrowest part of trachea in children - CORRECT ANSWER crociod ring where is the liver/spleen normal palpated in children - CORRECT ANSWER below the costal margin infant urine ouptut - CORRECT ANSWER 2ml/hr leading cause of death in pediatrics - CORRECT ANSWER head trauma V/Q ratio - CORRECT ANSWER measurement of how much blood flow must be presenta t the alveolar capillary membrane for perfusion to take place ETCO2 elevated - CORRECT ANSWER hyperventilate pt using Sellick maneuver for intubation - CORRECT ANSWER use of the Sellick maneuver helps reduce risk of aspiration positive deflection in the aVR lead - CORRECT ANSWER indicates that a lead is misplaced extreme right axis deviation - CORRECT ANSWER suspect ventricualr tachyardia left axis deviation - CORRECT ANSWER normal in pregnancy EKG in pericarditis - CORRECT ANSWER low voltage with ST segment elevation and T wave inversion in all leads right shift of oxygen-hemoglobin curve - CORRECT ANSWER decreased affinity for oxygen by hemoglobin lef shift of oxgyen-hemoglobin curve - CORRECT ANSWER increased affinity for oxygen by hemoglobin burns & intubatiobn w/Succs - CORRECT ANSWER no Succ if burn injury is over 48hrs old cause of heat cramps - CORRECT ANSWER water-sodium imbalance K & rhabdo - CORRECT ANSWER destruction of muscule tissue causes excess K cause of malignant hyperthermia - CORRECT ANSWER succ gas law that explains why a pneumo increases at altitude - CORRECT ANSWER Boyle's law gas law that deals w/diffusion of gas across the alveolar membrane - CORRECT ANSWER Fick's law Fick's law - CORRECT ANSWER diffusion of gas across the alveolar membrane reduction of atmospheric pressure causing a reduced alveolar PaO2 is a exampel of - CORRECT ANSWER hypoxic hypoxia 4 types of hypoxia - CORRECT ANSWER hypoxic histotoxic stagnat hypemic communication technique during critical phases of flight - CORRECT ANSWER sterile cockpit how to fly a plane during poor weather - CORRECT ANSWER IFR = instrument flight rules goal of manageing acute renal failure - CORRECT ANSWER focus on increasing the GFR lympocytes if viral verus bacterial illness - CORRECT ANSWER typically have decreased lymphocytes in viral icnreased in bacterial 4 assessment areas for START tirage - CORRECT ANSWER ability to walk respirations perfusions mental status dicrotic notch - CORRECT ANSWER aortic valve closure coronary perfusion time w/HR changes - CORRECT ANSWER icnreased HR causes decreased coronary perfusion time mechanical meas of balance in use IABP - CORRECT ANSWER balances oxygen supply and demand how do you correct IABP timing w/balloon inflation - CORRECT ANSWER inflate the balloon when the coronary arteries are fillign deflation of IABP balloon - CORRECT ANSWER balloon deflates at the end of diastole just prior to ventricualr enection most reliable IABP trigger - CORRECT ANSWER EKG transport IABP tubing - CORRECT ANSWER never tape the tubing together intervention if significant movement of hte IABP during transprot - CORRECT ANSWER consider d/c IABP thearpy after consulting w/MD minute ventilation - CORRECT ANSWER f x Vt (tidal volume use in conjunction w/SIMV - CORRECT ANSWER pressure support 2 hallmarks of DKA - CORRECT ANSWER high RR fruity breath NEXUS criteria - CORRECT ANSWER SIRS criteria - CORRECT ANSWER s/s of Duchenne Muscular Dystrophy - CORRECT ANSWER waddling gait frequent falls dialted cardiomyopathy secondary brain injury - CORRECT ANSWER hypoxia hypercarbia hyponatremia CPP should be - CORRECT ANSWER 50-70 blow to the temple - CORRECT ANSWER epidural heamtoma = middle meningeal artery s/s of increased ICP - CORRECT ANSWER cushing's triad wide PP bradycardia abnormal resp pattern plexus - CORRECT ANSWER nerve root cluster types of incomplete cord syndromes - CORRECT ANSWER anterior central Brown-Sequard gas law responsible for decompression sickness - CORRECT ANSWER Henry's Law rx that makes air crew more susceptible to high G force - CORRECT ANSWER atenolol gas law resopnsible for soft tissue swelling - CORRECT ANSWER Dlton's law when does Barosinusitis occur - CORRECT ANSWER descent whend does barondontoalgia occur - CORRECT ANSWER ascention when does barotitis media occcur - CORRECT ANSWER on descent, air shirnks, space becomes negative treat barotitis media/barosinusitis - CORRECT ANSWER valsalva neo-styngmine treat barobariatriauma - CORRECT ANSWER obese need to be pre=xoygenated for 15 minutes prior to flight with 100% FiO2 intervnetion for GI injuires prior to flight - CORRECT ANSWER NG tube Graha's law - CORRECT ANSWER thicker/larger a molecule is, the hearder it is to diffuse law that dictates gas exchange at the cellular level - CORRECT ANSWER Graham's law gases always move down the concentration gradient - CORRECT ANSWER Grham's law Graham's law - CORRECT ANSWER gases always move down the concentration gradient causes of histotoxic hypoxia = 3 - CORRECT ANSWER cyandide ETOH CO only type of hypoxia that shows a reduction of SpO2 - CORRECT ANSWER hypoxic hypoxia *NORMAL SpO@ in stagnic, hypemic, histotoxic hypoxias stage of hypoxia where you have decreased nigh vision - CORRECT ANSWER indiffernet what stage of hypoxia do critical thinking skills diminsh - CORRECT ANSWER compensatory stage of hypoxia where task performance decreases - CORRECT ANSWER compensatory stage of hypoxia where you get dizzy/sleepy - CORRECT ANSWER disturbance stage of hypoxia where you become incapacitated - CORRECT ANSWER critical formula to get the same anoutn of oxygen at different altitudes - CORRECT ANSWER % FiO2 x current ATM divide by the ATM you want to get to gas law responsible for areterial gas embolism - CORRECT ANSWER Boyle's law complication of high G forces - CORRECT ANSWER stagnant hypoxia when do you get arterial gas embolism - CORRECT ANSWER breath holdign on ascent during dive air pushes through alveoli and enters neck/chest respiratory problenm of air gas embplism - CORRECT ANSWER pneumoT gas law involved in arterial gas embolism - CORRECT ANSWER boyle's law 1 atm = - CORRECT ANSWER 760 torr 33ft atm at sea level - CORRECT ANSWER 760 mm hh treat arterial gas embolism - CORRECT ANSWER hyperbaric transportation of decompression sickness pt - CORRECT ANSWER ground 4 stages of hypoxia - CORRECT ANSWER indifferent compensatory disturbance critical normal serum osmolarity - CORRECT ANSWER 275-295 Succ & electrolyte - CORRECT ANSWER causes high K breathing in DKA - CORRECT ANSWER Kussmaul excretes morphine - CORRECT ANSWER kidneys DKA and K - CORRECT ANSWER K is falsely elevated truly low average fluid deficit in DKA - CORRECT ANSWER 3-6L rapid correction of hyperglycemia - CORRECT ANSWER rapid correction of hyperglycemia may cause fluid shifts taht lead to cerebral edema hypoglycemic type I pt takng BB - CORRECT ANSWER early s/s will never exhibit early s/s of hypoglycemia - CORRECT ANSWER palpitaitons tachyardia irritability diaphoresis late s/s of hypoglycemia - CORRECT ANSWER confusion lethargy seizure coma ethiology of SIADH - CORRECT ANSWER over[production of ADH what causes release fo ADH - CORRECT ANSWER increased serum osmolarity normal urien specific gravity - CORRECT ANSWER 1.010 to 1.030 ADH action - CORRECT ANSWER works on teh distal convoluted tubules and collecting duct to reasoarb water 3 s/s of SIADH - CORRECT ANSWER dilutional hyponatremia decreaed urine output hypOosmaliarity (ubder 275) treat SIADH - CORRECT ANSWER fludi restriction 3% hypertonic salien demeclocycline dilantin rx cause of diabetes insipitus - CORRECT ANSWER head injury dilantin 3 s/s of diabetes insipitus - CORRECT ANSWER high Na hyperosmalarity over 295 elavated urine oputu treat DI - CORRECT ANSWER ADH DDAVP vasporessin IVF s/s of esophageal varices - CORRECT ANSWER bright red diarrhea syncoep AMS r/t hypovolemia treat esophageal varices - CORRECT ANSWER Octreotide to reduce spleen/liver blood flow and reduce variceal pressure NG tube & esophageal varices - CORRECT ANSWER NO NG TUBE IN ESOPHAGEAL VARICES can cause a lethal rupture intervention for esophageal varices - CORRECT ANSWER Balakemore tube to prevent direct pressure on bleeding intubate first smal tears in the esophagus r/t vomiting - CORRECT ANSWER Mallry-Weiss Boerhave's tear Boerhave - CORRECT ANSWER small tear in the esophagus r/t vomiting gold standard for x Malloary-Weiss tear - CORRECT ANSWER EGD Grave's diseae - CORRECT ANSWER Hyperthyrodisim aka hyperthyroidism - CORRECT ANSWER Grave's disease common EKG of hyperthyroidsims - CORRECT ANSWER afiub buldign eyes - CORRECT ANSWER graves disease/HYPERTYROIDIMS drug to avoid in graves disease - CORRECT ANSWER asprin rx for hyperthyrodisim - CORRECT ANSWER IVF b/c dehydation antipryretics (no asprin) t reduce fever steroids to supress adrenal response BB to lower HR goiter - CORRECT ANSWER hypothyroidism emergeny hypothyroidsm - CORRECT ANSWER graves disease when does myxedema coma manifest - CORRECT ANSWER hypothyroidsm with AMS treat hypothyroidsm - CORRECT ANSWER levothyroxine contraindication for Etomidate - CORRECT ANSWER hypothyroidsm why shouldn't you abruptly stop steroids - CORRECT ANSWER risk of Cushing's syndrome low in Addisoins disease - CORRECT ANSWER cortisol aldosterone s/s of addisons disease - CORRECT ANSWER low cortisol/aldosterone deprssion malaise salt cravings Bronze colored skin hypoglycemia INR in liver failure - CORRECT ANSWER over 1.5 liver breakdown - CORRECT ANSWER liver breakds down ammonia which increases ICP liver failure rx - CORRECT ANSWER lactulose to remove ammonia 2 causes of pancreatitis - CORRECT ANSWER ETHOH abuse biliary stoen diseae pain location in pancreatitis - CORRECT ANSWER LUQ/LMQ pain when laying flat on back - CORRECT ANSWER pancreatitsi electorlyte abnormality in pancreatitis - CORRECT ANSWER hypocalcemia treat pancreatitis - CORRECT ANSWER fluid restirict NOP demoral for pain morphine spasms sphincter of oddi involunary flapping of hte hands - CORRECT ANSWER asterixis indicatio of asterixis - CORRECT ANSWER hepatic encephalopahty treat hepatic encephalopathy - CORRECT ANSWER lactulose why should you stop GI bleeding in liver disease - CORRECT ANSWER blood breakdown creates ammonia. A is already elevated and lactulose to get out electrolyte that needs to be corrected in hepatic encephalopathy - CORRECT ANSWER K is retained so fix rx NOT to use in septic shock - CORRECT ANSWER no Etomidate in septic shock b/c adrenal suppression septic shock treatment goasl = 5 - CORRECT ANSWER CVP 8-12 MAP over 65 warm extremities urine ouput over 0.5ml/kg/hr decrease lactate Virchow's Triad - CORRECT ANSWER Hypercoagulability, Endothelial damage, venous stasis venous occlusion - CORRECT ANSWER warm, red, flushed, swollen arterial occlusion - CORRECT ANSWER cold, pale Homan's sign - CORRECT ANSWER dorsiflexion of the foot causing calf pain 3 late s/s of arterial occlusion - CORRECT ANSWER poikothermia puselessness paralysis gallbladder test - CORRECT ANSWER Murphy's sing inspiratory arrest when pushing up on liver insiratory arrest when push up on liver - CORRECT ANSWER Murphy sign. gallbladder MURDER mneumonic for high K - CORRECT ANSWER muscle weakness urine low resp depression decreased cardiac contractility KEG changes reflexes high K EKG findings - CORRECT ANSWER peaked T wide QRS treat high K - CORRECT ANSWER push K into cells by bicarbonate, insulin, D50, albuterol Kayexelate/lasix to excrete K calcium gluonate to prevent V-tach rx to prevent v-tach - CORRECT ANSWER calcium gluconate low K s/s SHALL PC - CORRECT ANSWER shallwo respirations/thready pulse hypoactive BS absent/decreased reflexes leg/abd cramps lethargy/weakness copnfusion most common iatrogenic cause of low K - CORRECT ANSWER lasix low K EKG findings - CORRECT ANSWER flat T u wave u wave - CORRECT ANSWER low K hypocalcemia s/s CATS - CORRECT ANSWER convulsions arrythmias tetany spasms/stridor treat lwo Ca - CORRECT ANSWER calcium gluconate/chloride why do all passengers on plances get briefing cards - CORRECT ANSWER requirement for Part 135 area of orientation hrs before pilot accepts solo mission - CORRECT ANSWER 5hrs and 2 must be at night total hours of flight time a pilot needs to have - CORRECT ANSWER 2K horus of night flight a pilot needs to have - CORRECT ANSWER 100hrs training parts for pilots - CORRECT ANSWER part 91 part 135 how often does safety comittee meet per CAMTS - CORRECT ANSWER once per quarter only phase of flight where seatbelts can be unbuckled - CORRECT ANSWER cruise flight minimum medical equipment on board aircarft - CORRECT ANSWER 3 restrainet 3 IV pumps 2 sources of oxygen/suction what does AMRM focus on - CORRECT ANSWER team communication and joint decison making in-flight emergency procedures - CORRECT ANSWER lay pt flat secure seatbelts/equipment turn off oxygen visiors down crash positions crash procedures - CORRECT ANSWER emergency transmit activate ELT disengage throttle fuel, battery disengage order in crash procedures - CORRECT ANSWER throttle fuel battery *TFB 2 highest crash survival priorities - CORRECT ANSWER shelter, fire compensatory hypoxia - CORRECT ANSWER 10-15K incrase in vitals impaired mental acuity disturbance hypoxia stage - CORRECT ANSWER 15-20K ft dizzi sleepy tunnel vision Cyanosis critical hypoxia stage - CORRECT ANSWER 20-30K marked mental confusion/incapication hypoxic hypoxia - CORRECT ANSWER reduced alveolar oxygen level reduced pO2 hypoxia where you have a decrease in teh boood's oxygen carrying capacity - CORRECT ANSWER anemia, blood loss, CO stagnant hypoxia causes - CORRECT ANSWER high G forces HF PE shock extreme temps sitting tourniquetes time of useful consciousness above 30K ft - CORRECT ANSWER less than 90 seconds time of useful consciousness at 18K ft - CORRECT ANSWER 30 minutes time of useful consciousness at 25K ft - CORRECT ANSWER 3-5min physical zone of cabinpressurization - CORRECT ANSWER seal level up to 10K ft 5 types of decompression sickness - CORRECT ANSWER bends = limb/joint pain chokes = respiratory distrubances creeps = skin irritaiotn stagers = nervous system disturbnces syncope = CV collapse mechanism of decompression sickness - CORRECT ANSWER supersaturation of tissue w/nitrogen forms bubbles of gas Henry s law law in decompression sickness - CORRECT ANSWER Henry's Law 3 treat decompression sickness - CORRECT ANSWER descend ASAP 100% oxygen hyperbaric chamber LZ for HAZMAT sites - CORRECT ANSWER land upwind can air medical crew participate in decontamination - CORRECT ANSWER NO 3 universal distress frquencies for ELT broadcasts - CORRECT ANSWER 121.5 243 406 when doe sthe PAIP get activated - CORRECT ANSWER unschedule landing missed/overdue aircraft declared emergency confirmed accident hwo long do flame resistant fabrics like Nomex withstand high temperatures - CORRECT ANSWER under 20m sec decibels of helicopters - CORRECT ANSWER OSHA says hearting protection is needed for sound over 85 helicopter sound is 90-100db safest approch to heilos - CORRECT ANSWER 3 or 9 how do you make an emergency call - CORRECT ANSWER Mayday, Mayday, Mayday. aircraft (tail number) is makign emergency landing at (location) due to (nature of injury) frequency that transmits a signal that also identifies the aircrafts location - CORRECT ANSWER 406 how to do an emergency helicopter landing in water - CORRECT ANSWER emergency water landing, you should wait until the helicopter has capsized prior to exigting how do you prevent pulmonary barotrauma when swiming tot he surface after an emergency water landign - CORRECT ANSWER exhalign slowly during ascent can help repvent pulmonary barotrauma rule of 3s for survival - CORRECT ANSWER 3 min w/o oxygen 3hrs w/o shelter 3 days without water 3 wks w/o food first choice for shelter post accident - CORRECT ANSWER aircraft maximum length of duty for pilots - CORRECT ANSWER Part 135 says 14 hrs considered a long-range flight - CORRECT ANSWER over 3hrs aproach/departure headings for unsecured HLZ - CORRECT ANSWER 1 approach/departure not from above approach/departure headings for secured HLZ - CORRECT ANSWER 2 each S3 - CORRECT ANSWER Kentucky excessive filling of hte ventricules CHF S4 - CORRECT ANSWER Tenissee blood fbeign forced ito a stilff noncompliant ventricle hypertrophyc cardiomyopathy HTN sick sinus syndrome - CORRECT ANSWER plaque in RCA which supplies SA node Non-SteMI - CORRECT ANSWER positive trop ST depression normal right arterial pressure - CORRECT ANSWER 0-8 normal right ventricular pressure - CORRECT ANSWER SBP 20-30 DBP 0-8 normal Pulmonary Artery PRessure - CORRECT ANSWER PA systolic 20-30 PA diastolic 6-12 normal PAWP - CORRECT ANSWER 4-12 how to take a PAWP - CORRECT ANSWER at end of expiration never take readings longer than 15 seconds or 3 breaths when is systolic pulmonary artery rpessure elevated - CORRECT ANSWER any factor that increases pulmanry vscular resistance (any lung problem) Pulmonary HTN, hypxia copd, ards pe increases diastolic pulmonary artery pressru - CORRECT ANSWER any factor that increases pulmonary venous pressure )(any heart problem) cardiac tamponade left ventricular failure mitral valve disease quickest way to determine location of PA balloon - CORRECT ANSWER diacrotic notch on the LEFT = right ventricle diacrotic notch on right = you are in the PA calculate coronary perfusion prssure - CORRECT ANSWER DBP = wcwp normal is 50-60 problem of RBBB - CORRECT ANSWER delay in the RV systole, reducing the pressrue in the pulmonary artery when do you read the pulmonary artery pressure waveform - CORRECT ANSWER at the end of expiration take the pressure right before the drip what does PAWP measure - CORRECT ANSWER right heart afterload left herat preload supplies sinus node - CORRECT ANSWER RCA RCA occlusion causes... - CORRECT ANSWER inferior wall STEMI HOB for IABP - CORRECT ANSWER not over 15