Ultrasonography in Critical Care

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What is the primary function of M-mode in ultrasound?

To isolate a single line and follow changes over time

What type of ultrasound is focused on a specific area or question and does not replace comprehensive exams?

POCUS (Point-of-Care Ultrasound)

What is the term for the property of certain materials that generate an electric charge in response to mechanical stress?

Piezoelectric effect

What is the term for the brightness of a structure on an ultrasound image, with hypoechoic being less bright and hyperechoic being more bright?

Echogenicity Signup and view all the answers

What is the purpose of gain adjustment in ultrasound?

To optimize the image quality by adjusting the amplitude of the sound waves Signup and view all the answers

What is the term for the movement of ultrasound waves reflecting off of moving objects, such as red blood cells?

Color Doppler Signup and view all the answers

Why are normal lungs not visible on ultrasound?

Because ultrasound beams do not travel through air and lungs are mostly air. Signup and view all the answers

What does the presence of lung sliding confirm?

Normal pleural apposition. Signup and view all the answers

What is the diagnosis when lung sliding is absent?

Pneumothorax. Signup and view all the answers

What do B Lines correlate with?

Extravascular lung water (EVLW). Signup and view all the answers

What is the significance of A Lines in thoracic ultrasound?

They are normal artifacts. Signup and view all the answers

What is the purpose of assessing B Lines in thoracic ultrasound?

To assess Extravascular Lung Water (EVLW). Signup and view all the answers

What is the principle behind Color Doppler US, which helps in indicating the movement of objects?

Frequency of signal return indicates objects moving closer (frequency ↑) or away (↓) Signup and view all the answers

What does the patient's thoracic ultrasound suggest, given the appearance in all fields?

The patient has lung consolidation or pleural effusion, suggesting a diagnosis of cardiogenic pulmonary edema. Signup and view all the answers

What is the most likely cause of the patient's dyspnea and hypoxemia, given the recent echo and FEV1 results?

The patient's dyspnea and hypoxemia are likely due to his underlying CHF and COPD, which are exacerbated by cardiogenic pulmonary edema. Signup and view all the answers

What is the significance of the patient's creatinine level, given the recent change?

The patient's creatinine level has increased from 1.0 to 1.2, indicating possible kidney dysfunction or worsening renal function. Signup and view all the answers

What is the most appropriate therapy for the patient's diagnosis, based on the data provided?

B. CPAP and diuresis Signup and view all the answers

How does the patient's tachypnea and tachycardia relate to his underlying diagnosis?

The patient's tachypnea and tachycardia are likely compensatory responses to his underlying cardiogenic pulmonary edema and CHF, which are causing respiratory distress and cardiac strain. Signup and view all the answers

What is the most appropriate therapy for a patient with a diagnosis suggested by thoracic ultrasound data showing pleural effusion and consolidation?

CPAP and diuresis Signup and view all the answers

What is the significance of B lines in a lung ultrasound?

B lines are not specific and can be caused by any alveolar filling or septal thickening, such as edema, ARDS, or interstitial lung disease. Signup and view all the answers

What are the essential questions to ask when performing a focused cardiac ultrasound?

Is LV function normal or reduced?, Is RV size/function normal?, Is there a pericardial effusion?, Are there gross valvular abnormalities? Signup and view all the answers

What are the four views of a focused cardiac ultrasound?

Parasternal Long Axis (PLAX), Parasternal Short Axis (PSAX), Apical 4 Chamber (A4C), and Subcostal Signup and view all the answers

What is the purpose of a focused cardiac ultrasound in assessing a patient's response to fluid?

To determine if the patient's cardiac function will improve with fluid administration. Signup and view all the answers

What is the significance of a 'curtain sign' in a thoracic ultrasound?

It indicates a normal finding at the inferior posterior location with no effusion. Signup and view all the answers

What is the significance of an IVC diameter variation of >12-33% on inspiration and expiration in a patient?

It is likely that the patient is not breathing spontaneously. Signup and view all the answers

What is the normal diameter of the IVC in a spontaneously breathing patient?

2.5 cm Signup and view all the answers

What is the purpose of rotating the probe during POCUS examination of the RUQ and LUQ?

To align with the intercostal space and avoid rib shadow. Signup and view all the answers

What is the significance of identifying complex ascites on POCUS?

It is a critical finding that may impact patient management. Signup and view all the answers

Why is Doppler ultrasound performed before paracentesis?

To avoid bleeding. Signup and view all the answers

What is the optimal position of the probe for examination of the Pelvis, specifically the Bladder?

Just superior to the pubic symphysis, with the indicator cephalad (long axis) and the patient's right (short axis). Signup and view all the answers