ENDOCRINE AND KIDNEY
This diabetic emergency presents with hyperglycemia, ketones, metabolic acidosis, and Kussmaul respirations.
What is diabetic ketoacidosis (DKA)?
Rationale:
Insulin deficiency → fat breakdown → ketone production → metabolic acidosis with compensatory deep respirations.
This is a key complication of rapid rewarming in hypothermic patients.
What is cardiovascular instability/arrhythmias?
Rationale:
Rewarming too quickly can cause dangerous shifts, so rewarm gradually.
This value, when less than 4 mmHg, indicates hypovolemia or decreased venous return.
What is central venous pressure (CVP)?
Rationale:
Low CVP = low preload → possible dehydration or shock; high CVP = fluid overload or heart failure.
This stage of shock has compensatory mechanisms maintaining perfusion. Patient may have normal vital signs.
What is preshock (compensated) ?
This early sign in a burn patient with inhalation injury may indicate hypoxia and requires immediate assessment.
What is agitation?
Rationale:
Agitation is an early sign of hypoxia and should be prioritized before other symptoms in suspected inhalation injury.
This condition is caused by excess ADH, leading to water retention and dilutional hyponatremia.
What is SIADH (Syndrome of Inappropriate Antidiuretic Hormone)?
Rationale:
Excess ADH causes water reabsorption → dilution of sodium → hyponatremia and concentrated urine.
This phase includes head-to-toe assessment, diagnostics, and wound care after initial stabilization.
What is the secondary survey?
Rationale:
Primary survey = ABCs
Secondary survey = full assessment
This bedside test must be performed before arterial line insertion to ensure adequate collateral circulation.
What is the Allen test?
Rationale:
Confirms ulnar artery flow to prevent ischemia if radial artery is compromised.
By the time this vital sign drops, damage has already began at cellular and tissue levels.
What is blood pressure?
This is the first phase of burn care, focusing on airway, breathing, circulation, and preventing shock.
What is the emergent (resuscitative) phase?
Rationale:
Immediate priorities include ABCs, fluid resuscitation, and stabilization.
This condition is caused by excess cortisol, leading to moon face, buffalo hump, and hyperglycemia.
What is Cushing syndrome?
Rationale:
High cortisol causes fat redistribution, glucose elevation, and immune suppression.
This is a key safety precaution before giving activated charcoal.
What is ensuring the patient has a protected airway?
Rationale:
Charcoal can cause aspiration. do NOT give if decreased LOC without airway protection.
1.) This sedative is commonly used in ventilated ICU patients and has rapid onset but risk of over-sedation with prolonged use.
2.) This IV sedative is preferred for continuous sedation in mechanically ventilated patients.
1.) What is midazolam (Versed)?
Rationale:
Versed is a benzodiazepine used for sedation, but it accumulates → requires close monitoring.
2.) What is propofol (Diprovan)?
Rationale:
Propofol provides controlled sedation for ventilated patients, helping synchronize breathing with the ventilator
This complication occurs when infection leads to widespread organ dysfunction.
What is multiple organ dysfunction syndrome (MODS)?
Rationale:
Severe sepsis → systemic inflammation → organ failure cascade
This burn classification is dry, painless, and involves complete destruction of the dermis.
What is a full-thickness burn?
Full-thickness burns destroy nerve endings, making them painless and requiring grafting since they cannot heal spontaneously.
This life-threatening complication of hypothyroidism presents with hypothermia, bradycardia, and altered mental status.
What is myxedema coma?
Rationale:
Severe hypothyroidism depresses metabolic and respiratory function.
This emergency procedure is performed when intubation is not possible to establish an airway.
What is a cricothyroidotomy?
Rationale:
This is a last-resort airway intervention. It involves creating an airway through the cricothyroid membrane in the neck.
This invasive line provides continuous blood pressure monitoring and arterial blood sampling.
What is an arterial line (art line)?
Rationale:
Art lines give real-time BP and are essential in unstable ICU patients.
This type of shock is caused by spinal cord injuries or damage that disrupts the nervous system's ability to control vessel width.
What is Neurogenic shock?
This is the priority fluid used in burn resuscitation because it helps buffer metabolic acidosis.
What is Lactated Ringer’s (LR)?
Rationale:
LR is preferred because lactate converts to bicarbonate, helping correct acidosis in burn shock.
This condition involves massive protein loss in urine, low albumin, and edema.
What is nephrotic syndrome?
Rationale:
Nephrotic syndrome is a set of symptoms indicating kidney damage, characterized by the glomeruli (filters) leaking excessive protein into the urine (heavy proteinuria). It causes severe swelling (edema) due to low blood protein levels (hypoalbuminemia), high cholesterol (hyperlipidemia), and increased risk of infection and blood clots.
This antidote is used for acetaminophen overdose.
What is N-acetylcysteine (NAC)?
Rationale:
Prevents liver damage if given early
This anatomical reference point is used to level transducers for accurate hemodynamic measurements.
What is the phlebostatic axis?
Rationale:
Leveling at the right atrium ensures accurate CVP and arterial pressure readings.
Common causes of this type of shock include pulmonary embolism, cardiac tamponade, and tension pneumothorax.
What is Obstructive shock?
This type of burn causes liquefaction necrosis, creating a gelatinous wound that allows deeper tissue penetration.
What is an alkali (base) chemical burn?
Rationale:
Alkalis penetrate deeper than acids because liquefaction necrosis allows continued tissue destruction, making them more severe.