Critical Care

Catheter Associated Urinary Tract Infection

Catheter Associated Urinary Tract Infection (CAUTI) Definition A Catheter-Associated Urinary Tract Infection (CAUTI) is a UTI occurring in a patient with: An indwelling urinary catheter in place for >2 calendar days OR Catheter removed within the previous 48 hours with: Compatible symptoms/signs of UTI AND Significant bacteriuria.  Catheter-Associated Asymptomatic Bacteriuria (CA-ASB) Bacteria in urine without […]

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Pyelonephritis

Upper UTI/Pyelonephritis Pyelonephritis is a bacterial infection of the renal pelvis and renal parenchyma causing inflammation of the kidney. It represents the upper spectrum of urinary tract infection (UTI). Acute Pyelonephritis Acute suppurative bacterial infection involving: Renal pelvis/Collecting system/Renal interstitium/Renal tubules Usually occurs due to: Ascending infection from lower urinary tract Less commonly hematogenous spread

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Portopulmonary Hypertension

Portopulmonary Hypertension (PoPH) Definition Portopulmonary Hypertension (PoPH) is a form of pulmonary arterial hypertension (PAH, Group 1 PH) that develops in patients with: Portal hypertension (with or without cirrhosis) Increased pulmonary vascular resistance due to pulmonary arteriopathy Normal left-sided filling pressures Diagnosis requires: 1. Portal Hypertension Evidence of: Cirrhosis Non-cirrhotic portal hypertension Portosystemic shunts AND

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Acute Cholangitis

 Acute Cholangitis  1. Definition Acute cholangitis is a life-threatening ascending infection of the biliary tree occurring due to biliary obstruction + bacterial infection. Classic triad = Charcot’s triad Fever Jaundice Right upper quadrant pain Severe disease = Reynolds pentad Charcot triad Hypotension Altered mental status Charcot triad present in ~50–70% only → absence does NOT

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Peritonitis

Peritonitis  Definition Peritonitis is inflammation of the peritoneum caused by infection, chemical irritation, ischemia, foreign material, or sterile inflammatory processes. Anatomy Relevant to Peritonitis The peritoneum is a serous membrane consisting of: Layer Description Parietal peritoneum Lines abdominal wall Visceral peritoneum Covers abdominal organs The peritoneal cavity normally contains:<50–100 mL sterile fluid Classification of Peritonitis

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NON ST ELEVATION ACUTE CORONARY SYNDROME

NON ST ELEVATION ACUTE CORONARY SYNDROME (NSTE-ACS)  Definition NSTE-ACS includes: NSTEMI (Non-ST Elevation Myocardial Infarction) → myocardial necrosis + ↑ troponin Unstable Angina (UA) → ischemia(ECG CHANGES) without necrosis (normal troponin)  PATHOPHYSIOLOGY  Plaque rupture/erosion → platelet activation → thrombus formation Partial or intermittent occlusion (NOT complete like STEMI) Leads to subendocardial ischemia Feature NSTE-ACS STEMI

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Amiodarone

Amiodarone  1. CLASSIFICATION  Amiodarone = Class III antiarrhythmic (Vaughan-Williams classification)    2. MECHANISM OF ACTION  K⁺ channel blockade (Phase 3) ↑ repolarization time ↑ QT interval ↑ refractory period → prevents re-entry circuits Na⁺ channel blockade ↓ conduction velocity (especially in ischemic tissue) Ca²⁺ channel blockade ↓ AV node conduction Non-competitive β-blockade ↓ sympathetic drive

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Acute Kidney Injury

Acute Kidney Injury (AKI) AKI is a rapid decline in kidney function (hours to days), resulting in the accumulation of nitrogenous waste, electrolyte imbalance, and dysregulation of volume and acid-base status. Category Definition / Time Course Acute Kidney Injury (AKI) Abrupt decline in kidney function occurring within ≤7 days. KDIGO AKI is identified by an

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Ventilator Associated Pneumonia

Ventilator Associated Pneumonia (VAP)  Pneumonia occurring ≥48 hours after endotracheal intubation and initiation of invasive mechanical ventilation Infection not present or incubating at the time of intubation Related Terms (CDC Surveillance) Term Definition VAP Clinical diagnosis Ventilator-Associated Event (VAE) Surveillance definition VAC Ventilator-associated condition IVAC Infection-related VAC Possible VAP IVAC + microbiology  Exams focus: Clinical

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