CCU/ICU week

CCU - Coronary Care Unit

Both the CCU & the ICU are located next to each other, so depending on what kind of cases we get, we'll see patients from either the CCU or ICU. The residents try to give us a different patient everyday or every other day depending on the presentation. The one lab that is often ordered in the ICU are ABGs (arterial blood gases) which they usually draw from the radial artery on the wrist. They basically stick a needle in where they feel the radial pulse (which makes me cringe a little just b/c blood is drawn from the artery). This is checked because a lot of patients are in respiratory failure and have to be ventilated (check how much O2 is actually getting to the blood), or are in respiratory/metabolic acidosis/alkalosis.



Case 1
62 yo african american male with CC of SOB, chest pain, & hemoptysis (~ 2 teaspoons) times 2 days. PMH includes HTN, COPD, & CHF.

pimp question: what's the most common cause of hemoptysis?

Labs - WBC 14.2 with left shift, BNP >5000, D-dimer elevated at 9.7

CXR reveals R-sided pulmonary consolidation in middle lobe.

CT reveals bilateral pulmonary embolism, reticulonodular opacification in R-middle lobe - pulmonary infarction.

btw, the answer is: infection (bronchitis, pneumonia, Tb) "Infection causes superficial mucosal inflammation and edema that can lead to the rupture of the superficial blood vessels".

Diagnosis? well, the CT scan gave it away.