Respiratory

Question 1

If pCO2 is high, pH is

Answer 1

low (acidosis)

Question 2

If pCO2 is low, pH is

Answer 2

high (alkalosis)

Question 3

If HCO3 is high, pH is

Answer 3

high (alkalosis)

Question 4

If HCO3 is low, pH is

Answer 4

low (acidosis)

Question 5

pCO2 normal range

Answer 5

35-45 mmHg (respiratory)

Question 6

pO2 normal range

Answer 6

80-100 mmHg

Question 7

pH normal range

Answer 7

7.35-7.45 (metabolic)

Question 8

HCO3 normal range

Answer 8

22-26

Question 9

B-type natriuretic peptide (BNP) is

Answer 9

heart failure marker, released by an over-distention of the heart ventricles

Question 10

B-type natriuretic peptide (BNP) - normal, critical ranges

Answer 10

500 - heart failure

Question 11

Define PaO2

Answer 11

Pressure of arterial oxygen (mmHg)

Question 12

Bariobariatrauma

Answer 12

nitrogen release by obese patients at altitude - preoxygenate with NRB for at least 15 minutes prior to lift-off

Question 13

Three killers of vented patients during flight

Answer 13

tension pneumothorax pericardial tamponade hypovolemia

Question 14

Define SaO2

Answer 14

Saturation of arterial oxygen (%)

Question 15

Define SAO2

Answer 15

Saturation of alveolar oxygen (%)

Question 16

Proper site for chest tube insertion is

Answer 16

4-5th ICS anterior axillary line

Question 17

A patient in early shock will likely have what acid-base imbalance?

Answer 17

respiratory alkalosis (from hyperventillation)

Question 18

Appropriate sites for NCD insertion are

Answer 18

2d ICS mid-clavicular line 4-5th ICS anterior axillary line 5-6th ICS mid-axillary line

Question 19

Electrical alternans may be seen with

Answer 19

Pericardial tamponade (

Question 20

The antidote for malignant hyperthermia is

Answer 20

Dantroline

Question 21

Signs of malignant hyperthermia include

Answer 21

Tachycardia, muscle rigidity, rapid increase in ETCO2

Question 22

What is Hamman’s sign? What does it indicate?

Answer 22

Crunching sound heard with auscultation of anterior chest during heartbeats. Tracheobronchial injury

Question 23

The first step to increase PaO2 is

Answer 23

Increase FiO2

Question 24

Minute ventilation is

Answer 24

Respiratory Rate * Tidal Volume

Question 25

High pressure vent alarms can be caused by \_\_? What is the mnemonic?

Answer 25

D isplaced tube (Down, mainstem) O bstructed tube P neumothorax (Tension) E quipment failure S tacked breaths

Question 26

Low pressure vent alarms can be caused by \_\_?

Answer 26

Hypovolemia Displaced tube (extubated) Tubing Leaks Loose connections

Question 27

Normal tidal volume is

Answer 27

6-10 mL/kg

Question 28

Acute respiratory failure is defined as

Answer 28

PaO2 50mmHg

Question 29

Adult ideal weight (for vent) is calculated as

Answer 29

Men = 50kg, Women = 45kg Above + (2.3kg / 1" over 60") ex: 69" Male = 70.7kg

Question 30

A left shift in the oxyhemoglobin dissociation curve can be caused by?

Answer 30

Left = low "L" in "alkalosis" (low H+)

Question 31

A right shift in the oxyhemoglobin dissociation curve can be caused by?

Answer 31

Right = raised No "L" in "acidosis" (raised H+)

Question 32

A left shift in the oxyhemoglobin dissociation curve causes oxygen to be?

Answer 32

Increased affinity of oxygen to hemoglobin - oxygen is released less easily (at tissues), but bound more easily (in lungs)

Question 33

A right shift in the oxyhemoglobin dissociation curve causes oxygen to be?

Answer 33

Reduced affinity of oxygen to hemoglobin - oxygen is released more easily (at tissues), but bound less easily (in lungs)

Question 34

The defasiculating dose of a non-depolarizing neuromuscular agent is usually

Answer 34

10% of the normal RSI dose

Question 35

If PIP does not change on a vented patient, always increase

Answer 35

Tidal volume before rate

Question 36

An elevated anion gap may indicate what acid/base disturbance?

Answer 36

Metabolic acidosis

Question 37

Ketamine is the drug of choice for patients requiring intubation due to what problem?

Answer 37

Asthma

Question 38

A vented ARDS patient would require what unusual vent settings?

Answer 38

Low Vt High PEEP

Question 39

Excessive mucous secretions and chronic inflammation defines what disease process?

Answer 39

Chronic bronchitis

Question 40

What is the typical description of the chest x-ray for a COPD patient?

Answer 40

Hyperinflated lungs Narrow, elongated heart shadow Increase A-P diameter Flattened hemidiaphragm

Question 41

What is the typical description of the chest x-ray for an ARDS patient?

Answer 41

Widespread infiltrates "Ground-glass" appearance

Question 42

What is the typical description of the chest x-ray for a pneumonia patient?

Answer 42

Lobular infiltrates and consolidation

Question 43

What is the typical description of the chest x-ray for a CHF patient?

Answer 43

Cardiomegaly Pulmonary Congestion

Question 44

The nickname for patients with chronic bronchitis is

Answer 44

Blue bloaters (obstructed airflow leads to barrel chest and cyanotic appearance)

Question 45

The nickname for patients with emphysema is

Answer 45

Pink puffers (destruction of alveoli leads to increased hematocrit)

Question 46

Metabolic alkalosis may be caused by

Answer 46

Excessive vomiting Prolonged NG suctioning Diuretics

Question 47

An increase of 10 in the PaCO2 causes the pH to

Answer 47

Decrease by approximately 0.08

Question 48

A decrease of 10 in the PaCO2 causes the pH to

Answer 48

Increase by approximately 0.08

Question 49

Anion gap is calculated by

Answer 49

AG = (Na + K) - (Cl + HCO3) K is usually omitted since a low value

Question 50

Normal anion gap is

Answer 50

8 - 16

Question 51

An elevated anion gap suggests

Answer 51

Metabolic acidosis

Question 52

The causes of high anion gap acidosis are? What is the mnemonic?

Answer 52

M ethanol U remia D KA P araldehyde/Propylene glycol I Iron L actic Acidosis E thanol/Ethylene glycol R enal Failure/Rhabdo S alycylates/Starvation