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Ultrasonography in Critical Care

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30 Questions

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

What is the purpose of gain adjustment in ultrasound?

To optimize the image quality by adjusting the amplitude of the sound waves

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

Color Doppler

Why are normal lungs not visible on ultrasound?

Because ultrasound beams do not travel through air and lungs are mostly air.

What does the presence of lung sliding confirm?

Normal pleural apposition.

What is the diagnosis when lung sliding is absent?

Pneumothorax.

What do B Lines correlate with?

Extravascular lung water (EVLW).

What is the significance of A Lines in thoracic ultrasound?

They are normal artifacts.

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

To assess Extravascular Lung Water (EVLW).

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 (↓)

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.

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.

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.

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

B. CPAP and diuresis

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.

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

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.

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?

What are the four views of a focused cardiac ultrasound?

Parasternal Long Axis (PLAX), Parasternal Short Axis (PSAX), Apical 4 Chamber (A4C), and Subcostal

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.

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.

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.

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

2.5 cm

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.

What is the significance of identifying complex ascites on POCUS?

It is a critical finding that may impact patient management.

Why is Doppler ultrasound performed before paracentesis?

To avoid bleeding.

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).

Test your knowledge on the applications of ultrasonography in critical care. Learn about the principles of image interpretation, 2D and M-mode, and more. Evaluate your understanding of bedside ultrasound usage.

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