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4b32029b-e544-52c5-88aa-bf9d9bd2f30f
An admixture of room air in the waste gas disposal system during an appendectomy in a paralyzed, mechanically ventilated patient under general volatile anesthesia can best be explained by which mechanism of entry?
Positive-pressure relief valve
Negative-pressure relief valve
Soda lime canister
Ventilator bellows
4
B
2
null
null
null
null
null
470ce84f-c1a4-52e3-a183-8cfc120637d4
Automated noninvasive blood pressure (ANIBP) devices calculate which of the following using proprietary algorithms?
Systolic BP
Diastolic BP
Mean arterial BP
Both systolic and diastolic BPs
4
D
1
null
null
null
null
null
89969c1a-e521-5dab-962c-ab44b1a6903a
Currently, the commonly used vaporizers (e.g., GE-Datex-Ohmeda Tec 4, Tec 5, Tec 7; Dräger Vapor 19.n and 2000 series) are described as having all of the following features EXCEPT
Agent specificity
Variable bypass
Bubble through
Temperature compensated
4
C
1
null
null
null
null
null
a3d7c6a1-bfb0-5a9f-a93a-bb230e770c87
For any given concentration of volatile anesthetic, the splitting ratio is dependent on which of the following characteristics of that volatile anesthetic?
Vapor pressure
Molecular weight
Specific heat
Minimum alveolar concentration (MAC) at 1 atmosphere
4
A
1
null
null
null
null
null
70639b04-5e60-531a-a5f5-20f35d3c7932
On Monday morning the absorbent granules in your anesthesia machine, which was not used in the last 48 hours, are violet. In addition to rebreathing CO2 when exhausted, this form of absorbent also carries the risk of
Channeling
Fire
Compound A formation
Carbon monoxide production
4
A
1
null
null
null
null
null
b3431ca2-e226-58af-85a4-203d5a1165f0
During the pre-anesthesia checkout (PAC) of the anesthesia delivery system, the mounted oxygen E cylinder is shown to have a pressure of 1200 psi. Before proceeding with the next case, the most appropriate action would be:
Leave cylinder valve open and proceed with case
Close cylinder valve and proceed with case
Replace the cylinder, open valve to check pressure, then close and proceed with case
Replace the cylinder, open valve to check pressure, and proceed with case
4
B
2
null
null
null
null
null
f0d6a408-9188-53f4-abd6-80d2a671d6e9
ECG monitors utilize high- and low-frequency filters to reduce noise (artifact). Which of the following are reduced with low-frequency filtering?
Muscle fasciculation
Respirations
Tremor
Electromagnetic interference from other devices
4
B
1
null
null
null
null
null
bc3375b4-a277-5d6e-abce-705a22de466b
If the anesthesia machine is discovered Monday morning to have run with 5 L/min of oxygen all weekend long, the most reasonable course of
Administer 100% oxygen for the first hour of the next case
Place humidifier in line with the expiratory limb
Avoid use of sevoflurane
Change the CO2 absorbent
4
D
2
null
null
null
null
null
ed79b886-a872-51bf-a98c-ac1c05df8445
According to National Institute for Occupational Safety and Health (NIOSH) regulations, the highest concentration of volatile anesthetic contamination allowed in the OR atmosphere when administered in conjunction with N2O is
0.5 ppm
2 ppm
5 ppm
25 ppm
4
A
1
null
null
null
null
null
5fce774e-5d25-547d-9f07-7cab05f8c586
A ventilator pressure-relief valve stuck in the closed position can result in
Barotrauma
Hypoventilation
Hyperventilation
Low breathing circuit pressure
4
A
1
null
null
null
null
null
2b6c2863-e244-5da7-9fe4-1db4f6fecb04
A mixture of 1% isoflurane, 70% N2O, and 30% O2 is administered to a patient for 30 minutes. The expired isoflurane concentration measured is 1%. N2O is shut off, and a mixture of 30% O2 and 70% N2 with 1% isoflurane is administered. The expired isoflurane concentration measured 1 minute after the start of this new mix...
Intermittent back pressure (pumping effect)
Diffusion hypoxia
Concentration effect
Effect of N2O solubility in isoflurane
4
D
3
null
null
null
null
null
ae9d262b-5c63-55e1-a240-ae573716b19c
Select the FALSE statement.
If a Magill forceps is used for a nasotracheal intubation, the right nares is preferable for insertion of the nasotracheal tube
Extension of the neck can convert an endotracheal intubation to an endobronchial intubation
Bucking signifies the return of the coughing reflex
Postintubation pharyngitis is more likely to occur in female patients
4
B
1
null
null
null
null
null
48d78a4e-d5ef-5be7-a8ff-edf70ca3e492
Gas from an N2O compressed-gas cylinder enters the anesthesia
60 psi
45 psi
30 psi
15 psi
4
B
1
null
null
null
null
null
f1bddcd5-040f-5c27-bd8c-6f538401cf58
Eye protection for OR staff is needed when laser surgery is performed. Clear wraparound goggles or glasses are adequate with which kind of
Argon laser
Nd:YAG (neodymium:yttrium-aluminum-garnet) laser
CO2 laser
None of the above
4
C
1
null
null
null
null
null
364097ce-88c2-5fd2-ba72-bbabd9d9ccf9
Which of the following systems prevents attachment of gasadministering equipment to the wrong type of gas line?
Pin index safety system
Diameter index safety system
Fail-safe system
Proportion-limiting control system
4
B
1
null
null
null
null
null
ded20345-c460-5549-979e-607b6777263b
A 59-year-old pacemaker-dependent patient comes to surgery with the pacemaker programmed in the DDD mode. Extracorporeal shock wave lithotripsy (ESWL) is scheduled for fragmentation of several 3- to 5-mm kidney stones. What preparation is needed before undertaking ESWL in this setting to avoid inappropriate firing of t...
Program pacemaker to DVI
Program pacemaker to VVI
Program pacemaker to DOO
Proceed with the case
4
B
2
null
null
null
null
null
6f313712-0226-579e-a0da-d383b96525fe
The dial of an isoflurane-specific, variable bypass, temperaturecompensated, flowover, out-of-circuit vaporizer (i.e., modern vaporizer) is set on 2%, and the infrared spectrometer measures 2% isoflurane vapor from the common gas outlet. The flowmeter is set at a rate of 700 mL/min during this measurement. The output m...
Output will be less than 2% in both cases
Output will be greater than 2% in both cases
Output will be 2% at 100 mL/min O2 flow and less than 2% at 15 L/min flow
Output will be less than 2% at 100 mL/min and 2% at 15 L/min
4
A
2
null
null
null
null
null
004ccdc1-76b4-5870-bfb2-6a090677dcf6
Which of the following would result in the greatest decrease in the arterial hemoglobin saturation (Spo2 ) value measured by the dualwavelength pulse oximeter?
Intravenous injection of indigo carmine
Intravenous injection of indocyanine green
Intravenous injection of methylene blue
Elevation of bilirubin
4
C
1
null
null
null
null
null
631aceab-f2c1-5334-bf7a-e2d1b660c4fc
A 45-year-old patient recovering in the ICU after a motor vehicle accident is continuously being assessed with transcutaneous O2 and CO2 monitoring. Compared with conventional arterial blood gas values, those for transcutaneous oxygen (Ptco2 ) and transcutaneous carbon
Higher (both)
Ptco2 lower, Ptcco2 higher
Ptco2 higher, Ptcco2 lower
Lower (both)
4
B
1
null
null
null
null
null
2da3cfd5-7116-59f0-943a-4f7143cf3ab8
Which of the following combinations would result in delivery of a lower-than-expected concentration of volatile anesthetic to the patient?
Sevoflurane vaporizer filled with desflurane
Isoflurane vaporizer filled with sevoflurane
Sevoflurane vaporizer filled with isoflurane
All of the above would result in less than the dialed concentration
4
B
2
null
null
null
null
null
8c7eb745-c647-5cba-8ed6-a2c561fe0496
A patient presents for knee arthroscopy and tells his anesthesiologist that he has a VDD pacemaker. Select the true statement regarding this pacemaker.
It senses and paces only the ventricle
It paces only the ventricle
Its response to a sensed event is always inhibition
It is not useful in a patient with atrioventricular (AV) nodal block
4
B
1
null
null
null
null
null
b8d65058-3546-5628-a909-7b7778e8304b
All of the following would result in less trace gas pollution of the OR
Use of a high gas flow in a circular system
Tight mask seal during mask induction
Use of a scavenging system
Allow patient to breathe 100% O2 as long as possiblebefore extubation
4
A
2
null
null
null
null
null
1b3bfa47-8864-5d23-b5fb-b0c928f1d0f0
The greatest source for contamination of the OR atmosphere is leakage of volatile anesthetics
Around the anesthesia mask
At the vaporizer
At the CO2 absorber
At the endotracheal tube
4
A
1
null
null
null
null
null
17e61f75-dd3d-5cbb-9a42-2da27e5851eb
Uptake of sevoflurane from the lungs during the first minute of general anesthesia is 50 mL. How much sevoflurane would be taken up from the lungs between the 16th and 36th minutes?
25 mL
50 mL
100 mL
500 mL
4
C
2
null
null
null
null
null
9eb127ed-001f-561d-88e5-7c538687b40b
Which of the drugs below would have the LEAST impact on somatosensory evoked potentials (SSEPs) monitoring in a 15-year-old patient undergoing scoliosis surgery?
Midazolam
Propofol
Isoflurane
Vecuronium
4
D
2
null
null
null
null
null
49cc9efa-d329-531d-9f39-e7fad176ffd6
Which of the following is NOT found in the low-pressure circuit on an anesthesia machine?
Oxygen supply failure alarm
Flowmeters
Vaporizers
Vaporizer check valve
4
A
1
null
null
null
null
null
7e7089f9-8176-5332-9327-d4f44afc1de1
Frost develops on the outside of an N2O compressed-gas cylinder during general anesthesia. This phenomenon indicates that
The saturated vapor pressure of N2O within the cylinder israpidly increasing
The cylinder is almost empty
There is a rapid transfer of heat to the cylinder
The flow of N2O from the cylinder into the anesthesiamachine is rapid
4
D
2
null
null
null
null
null
5b2ec827-cf96-5fa5-9fe7-1e497a4a2465
The LEAST reliable site for central temperature monitoring is the
PA
Skin on the forehead
Distal third of the esophagus
Nasopharynx
4
B
1
null
null
null
null
null
3feb772f-3dec-57e2-834e-41d94428625b
Of the following medical lasers, which laser light penetrates tissues the most?
Argon laser
Helium–neon laser (He–Ne)
Nd:YAG laser
CO2 laser
4
C
1
null
null
null
null
null
360450a8-f873-5f10-8d21-a43779fabea5
Which of the following supraglottic airway devices features a built-in bite block, a channel for nasogastric suctioning, and a cuff modified to extend to the posterior surface of the mask?
LMA Fastrach
LMA Supreme
Air-Q
I-Gel
4
B
1
null
null
null
null
null
7d8264c0-2c82-5eeb-af60-4bd8b917bb2d
The maximum Fio2 that can be delivered by a nasal cannula is
0.30
0.35
0.40
0.45
4
D
1
null
null
null
null
null
107bb364-f889-57e2-a26f-dc00b9ecbaa6
General anesthesia is administered to an otherwise healthy 38-year-old patient undergoing repair of a right inguinal hernia. During mechanical ventilation, the anesthesiologist notices that the scavenging system reservoir bag is distended during inspiration. The most likely cause of this is
An incompetent pressure-relief valve in the mechanical ventilator
An incompetent pressure-relief valve in the patient's breathing circuit
An incompetent inspiratory unidirectional valve in thepatient's breathing circuit
An incompetent expiratory unidirectional valve in the patient's breathing circuit
4
A
2
null
null
null
null
null
572f02ba-de95-5737-a7e8-3291c7da8208
Which color of nail polish would have the greatest effect on the accuracy of dual-wavelength pulse oximeters?
Red
Yellow
Blue
Green
4
C
2
null
null
null
null
null
d0bd202b-603e-555d-8525-7179470e86aa
Kinking or occlusion of the transfer tubing from the patient's breathing circuit to the closed scavenging system interface can result in
Barotrauma
Hypoventilation
Hypoxia
Hyperventilation
4
A
2
null
null
null
null
null
b4ff93df-416b-5532-9534-59e2084645d5
The reason a patient is not burned by the return of energy from the patient to the ESU (electrosurgical unit, Bovie) is that
The coagulation side of this circuit is positive relative to the ground side
Resistance in the patient's body attenuates the energy
The exit current density is much less than…?
The exit current density is much less than that at the handpiece
4
C
1
null
null
null
null
null
6290773c-b47c-51be-b296-88aa959cddc1
Select the FALSE statement regarding noninvasive arterial BP monitoring devices.
If the width of the BP cuff is too narrow, the measured BPwill be falsely lowered
The width of the BP cuff should be 40% of the circumference of the patient's arm
If the BP cuff is wrapped around the arm too loosely, the measured BP will be falsely elevated
Frequent cycling of automated BP monitoring devices can result in edema distal to the cuff
4
B
1
null
null
null
null
null
109c7c8f-a0b7-5004-a92e-74416a84fef0
When electrocardiogram (ECG) electrodes are placed for a patient undergoing a magnetic resonance imaging (MRI) scan, which of the following is true?
Electrodes should be as close as possible and in the periphery of the magnetic field
Electrodes should be as close as possible and in the center of the magnetic field
Placement of electrodes relative to field is not important as long as they are far apart
ECG cannot be monitored during an MRI scan
4
B
1
null
null
null
null
null
16eb4c82-c885-5b70-a789-b86746323c54
The most frequent cause of mechanical failure of the anesthesia delivery
Attachment of the wrong compressed-gas cylinder to the O2 yoke
Improperly assembled O2 rotameter
Fresh-gas line disconnection from the anesthesia machine to the in-line hosing
Disconnection of the O2 supply system from the patient
4
D
1
null
null
null
null
null
006fbbbb-5c2b-55a3-ad3a-8e32f16affa4
The esophageal detector device
Uses a negative-pressure bulb
Is especially useful in children younger than 1 year of age
Requires a cardiac output to function appropriately
Is reliable in morbidly obese patients and parturients
4
A
1
null
null
null
null
null
5bd4bf86-69ea-529d-bdc6-07dfdeb48ce2
The reason CO2 measured by capnometer is less than the arterial Paco2 value measured simultaneously is
Use of ion-specific electrode for blood gas determination
Alveolar capillary gradient
One-way values
Alveolar dead space
4
D
1
null
null
null
null
null
adfbd4b2-db6a-5972-b7de-de785a176f8c
Which of the following arrangements of rotameters on the anesthesia machine manifold is safest with left-to-right gas flow?
\O_{2},\C O_{2},\N_{2}O,\a i r}$$$$\mathrm{
\CO_{2},\O_{2},\N_{2}O,\a i r}$$$$\mathrm{
\Air,\CO_{2},\O_{2},\N_{2}O}$$
Air, CO2 , N2O, O2
4
D
1
null
null
null
null
null
4d8f0de9-0395-5d58-a432-ff4bcc57cc62
A Datex-Ohmeda Tec 4 vaporizer is tipped over while being attached to the anesthesia machine but is placed upright and installed. The soonest it can be safely used is
After 30 minutes of flushing with dial set to "off"
After 6 hours of flushing with dial set to "off"
After 30 minutes with dial turned on
Immediately
4
C
2
null
null
null
null
null
b691639f-8631-5143-b896-8f0bb7616601
In the event of misfilling, what percent sevoflurane would be delivered from an isoflurane vaporizer set at 1%?
0.6%
0.8%
1.0%
1.2%
4
A
2
null
null
null
null
null
3c1740cb-ff83-5d90-97b8-91ab6617dfa4
How long would a vaporizer (filled with 150 mL volatile) deliver 2% isoflurane if total flow is set at 4.0 L/min?
2 hours
4 hours
6 hours
8 hours
4
C
2
null
null
null
null
null
2be25c7a-66db-588e-b314-00bc274ac0a7
Raising the frequency of an ultrasound transducer used for line placement or regional anesthesia (e.g., from 3 MHz to 10 MHz) will result in
Higher penetration of tissue with lower resolution
Higher penetration of tissue with higher resolution
Lower penetration of tissue with higher resolution
Higher resolution with no change in tissue penetration
4
C
1
null
null
null
null
null
d4eceaa0-c702-5193-bd2b-ab51d528e8d5
The fundamental difference between microshock and macroshock is related to
Location of shock
Duration
Voltage
Lethality
4
A
1
null
null
null
null
null
49b1da00-13c2-5f56-af78-647c15cf379e
Intraoperative awareness under general anesthesia can be eliminated by closely monitoring
Electroencephalogram
BP/heart rate
Bispectral index (BIS)
None of the above
4
D
1
null
null
null
null
null
d1f88d57-e1fb-5106-a0a4-b1a52c9af534
A mechanically ventilated patient is transported from the OR to the ICU using a portable ventilator that consumes 2 L/min of oxygen to run the mechanically controlled valves and drive the ventilator. The transport cart is equipped with an "E" cylinder with a gauge pressure of 2000 psi. The patient receives a tidal volu...
20 minutes
40 minutes
60 minutes
80 minutes
4
D
2
null
null
null
null
null
f96d8ab9-6c9c-5275-9577-254b74e262f6
A 135-kg man is ventilated at a rate of 14 breaths/min with a VT of 600 mL and positive end-expiratory pressure (PEEP) of 5 cm H2O during a laparoscopic banding procedure. Peak airway pressure is 50 cm H2O, and the patient is fully relaxed with a nondepolarizing neuromuscular blocking agent. How can peak airway pressur...
Increase the inspiratory flow rate
Take off PEEP
Reduce the I:E ratio (e.g., change from 1:3 to 1:2)
Decrease VT to 300 and increase rate to 28
4
C
3
null
null
null
null
null
adbf1178-c312-5575-9a8e-399aee66f9ef
The pressure and volume per minute delivered from the central hospital oxygen supply are
2100 psi and 650 L/min
1600 psi and 100 L/min
75 psi and 100 L/min
50 psi and 50 L/min
4
D
1
null
null
null
null
null
03d65210-860d-5cfc-9d87-bc94b7b6fec5
During normal laminar airflow, resistance is dependent on which characteristic of oxygen?
Density
Viscosity
Molecular weight
Temperature
4
B
1
null
null
null
null
null
884b6fcf-8dac-51a0-bfee-f1dfc767d2d2
If the oxygen cylinder were being used as the source of oxygen at a remote anesthetizing location and the oxygen flush valve on an anesthesia machine were pressed and held down, as during an emergency situation, each of the items below would be bypassed during 100% oxygen delivery EXCEPT
O2 flowmeter
First-stage regulator
Vaporizer check valve
Vaporizers
4
B
2
null
null
null
null
null
24e4d733-353a-541a-a30e-e6f5c1dedc32
After induction and intubation with confirmation of tracheal placement, the O2 saturation begins to fall. The O2 analyzer shows 4% inspired oxygen. The oxygen line pressure is 65 psi. The O2 tank on the back of the anesthesia machine has a pressure of 2100 psi and is turned on. The oxygen saturation continues to fall. ...
Exchange the tank
Replace pulse oximeter probe
Disconnect O2 line from hospital source
Extubate and start mask ventilation
4
C
3
null
null
null
null
null
1e874551-a9a5-583e-8cbb-262b8cce8203
The correct location for placement of the V5 lead is
Midclavicular line, third intercostal space
Anterior axillary line, fourth intercostal space
Midclavicular line, fifth intercostal space
Anterior axillary line, fifth intercostal space
4
D
1
null
null
null
null
null
d23806d6-a00a-5951-b6c7-5e2750407271
The diameter index safety system refers to the interface between
Pipeline source and anesthesia machine
Gas cylinders and anesthesia machine
Vaporizers and refilling connectors attached to bottles of volatile anesthetics
Both pipeline and gas cylinders interface with anesthesia machine
4
A
1
null
null
null
null
null
f963c69a-7696-5efd-9595-ca5d037f3f81
Each of the following is cited as an advantage of calcium hydroxide lime (Amsorb Plus, Drägersorb) over soda lime EXCEPT
Compound A is not formed
CO is not formed
More absorptive capacity per 100 g of granules
It does not contain NaOH or KOH
4
C
1
null
null
null
null
null
7f38dad2-aa63-5d31-a875-6ce7d5ddc0de
During a laparoscopic cholecystectomy, exhaled CO2 is 6%, but inhaled CO2 is 1%. Which explanation could NOT account for the 1% inhaled CO2?
Channeling through soda lime
Faulty expiratory valve
Exhausted soda lime
Absorption of CO2 through peritoneum# Anesthesia Equipment and Physics
4
D
2
null
null
null
null
null
bdb09808-ca5b-5cc6-ac7f-b24d2947a9f8
A 29-year-old man is admitted to the intensive care unit (ICU) after a drug overdose. The patient is placed on a ventilator with a set tidal volume (Vt) of 750 mL at a rate of 10 breaths/min. The patient is making no inspiratory effort. The measured minute ventilation is 6 L, and the peak airway pressure is 30 cm H2O. ...
$$\mathrm{~2~mL/(cm~H_{2}O)}$$
$$\mathrm{~3~mL/(cm~H_{2}O)}$$
$$\mathrm{~4~mL/(cm~H_{2}O)}$$
$$\mathrm{~3~mL/(cm~H_{2}O)}$$
4
D
2
null
null
null
null
null
67679114-7d88-5fb4-9c27-7211a92d92a3
A 65-year-old patient is mechanically ventilated in the intensive care unit (ICU) after an open nephrectomy. How far should the suction catheter be inserted into the endotracheal tube for suctioning?
To the midlevel of the endotracheal tube
To the tip of the endotracheal tube
Just proximal to the carina
Past the carina
4
B
1
null
null
null
null
null
9e1d1784-9352-51d2-87be-1a467a4e3a5b
Maximizing which of the following lung parameters is the most important factor in prevention of postoperative pulmonary complications?
Tidal volume (Vt)
Inspiratory reserve volume
Vital capacity
Functional residual capacity (FRC)
4
D
1
null
null
null
null
null
b2f43a5e-f00c-54c1-9d21-b351b8caefc8
An 83-year-old woman is admitted to the ICU after coronary artery surgery. A pulmonary artery catheter is in place and yields the following data: central venous pressure (CVP) 5 mm Hg, cardiac output (CO) 4.0 L/min, mean arterial pressure (MAP) 90 mm Hg, mean pulmonary artery pressure (PAP) 20 mm Hg, pulmonary artery o...
40 dyne-sec/cm5
80 dyne-sec/cm5
160 dyne-sec/cm5
200 dyne-sec/cm5
4
C
2
null
null
null
null
null
979b648e-cea6-596b-b27a-452a2dfcc5d0
A 72-year-old man with a history of myocardial infarction 12 months earlier is scheduled to undergo elective repair of a 6-cm abdominal aortic aneurysm under general anesthesia. When would this patient be at highest risk for another myocardial infarction?
During placement of the aortic cross-clamp
Upon release of the aortic cross-clamp
24 hours postoperatively
On the third postoperative day
4
D
3
null
null
null
null
null
1bd2d8ad-66ac-53c5-9440-e37cd792fea8
Calculate the body mass index (BMI) of a man 200 cm (6 feet 6 inches) tall who weighs 100 kg (220 lb).
20
25
30
35
4
B
2
null
null
null
null
null
98ec5b5d-7297-52eb-95e1-9bf484436352
The normal FEV1 /FVC ratio is
0.99
0.80
0.60
0.50
4
B
1
null
null
null
null
null
309e832b-1eca-5db0-806e-4232de081d1f
Direct current (DC) cardioversion is not useful and, therefore, NOT indicated in an unstable patient with which of the following?
Supraventricular tachycardia in a patient with Wolff-- Parkinson-White syndrome
Atrial flutter
Multifocal atrial tachycardia (MAT)
New-onset atrial fibrillation
4
C
1
null
null
null
null
null
b192cff7-2e15-5f1d-9540-59ceec61b64b
During the first minute of apnea, the Paco2 will rise
2 mm Hg/min
4 mm Hg/min
6 mm Hg/min
8 mm Hg/min
4
C
1
null
null
null
null
null
bd6df80b-ec30-517e-9664-3f19cb804f25
Potential complications associated with total parenteral nutrition (TPN) include all of the following EXCEPT
Ketoacidosis
Hyperglycemia
Hypoglycemia
Hypophosphatemia
4
A
1
null
null
null
null
null
3cb6259e-f26f-5f6c-aa51-e0b313903155
O2 requirement for a 70-kg adult is
150 mL/min
250 mL/min
350 mL/min
450 mL/min
4
B
1
null
null
null
null
null
c26775bd-38ef-58c6-9d18-08ecd9dbbf60
The FRC is composed of the
Expiratory reserve volume and residual volume
Inspiratory reserve volume and residual volume
Inspiratory capacity and vital capacity
Expiratory capacity and Vt
4
A
1
null
null
null
null
null
4a6eae29-b6ce-53b6-b30c-aaf50fff2af7
Which of the following statements correctly defines the relationship between minute ventilation , dead space ventilation and Paco2?
If is constant and increases, then Paco2 will increase
If is constant and increases, then Paco2 will decrease
If is constant and increases, then Paco2 will increase
If is constant and decreases, then Paco2 will decrease
4
A
2
null
null
null
null
null
070d7325-fdbb-56fd-b6a0-d4f10bab4a57
A 22-year-old patient who sustained a closed head injury is brought to the operating room (OR) from the ICU for placement of a dural bolt. Hemoglobin has been stable at 15 g/dL. Blood gas analysis immediately before induction reveals a Pao2 of 120 mm Hg and an arterial saturation of 100%. After induction, the Pao2 rise...
It has increased by 10%
It has increased by 5%
It has increased by less than 1%
Cannot be determined without Paco2
4
C
2
null
null
null
null
null
d803828b-8002-5e3b-a6fa-e32623c07810
Inhalation of CO2 increases by
0.5 L/min/mm Hg increase in Paco2
1 to 1.5 L/min/mm Hg increase in Paco2
2 to 2.5 L/min/mm Hg increase in Paco2
Greater than 3 L/min/mm Hg increase in Paco2
4
B
1
null
null
null
null
null
9ebfcb99-8099-540a-905f-d42f211fece9
The RIFLE criteria are designed to predict mortality from
Renal failure
Sepsis
Hepatic failure
Acute respiratory distress syndrome
4
A
1
null
null
null
null
null
4befeb4f-1add-587f-80f8-0499abb4f9ce
The P50 for normal adult hemoglobin is approximately
15 mm Hg
25 mm Hg
35 mm Hg
45 mm Hg
4
B
1
null
null
null
null
null
d2eb695c-b0bb-5302-872a-5e3e6a3bc5f1
During a normal VT (500-mL) breath, the transpulmonary pressure increases from 0 to 5 cm H2O. The product of transpulmonary pressure and Vt is 2500 cm H2O-mL. This expression of the pressure-volume relationship during breathing determines what parameter of respiratory mechanics?
Lung compliance
Airway resistance
Pulmonary elastance
Work of breathing
4
B
2
null
null
null
null
null
09df25d3-f2f6-512a-965d-a59486d48b32
Select the true statement regarding palliative care
It increases in-hospital cost
It is reserved for patients with life expectancy less than 6 months
It is not appropriate for patients in the ICU
It can be used in conjunction with "aggressive" care
4
D
1
null
null
null
null
null
0e241120-54c7-54a0-a56d-8fe3f69261b8
The normal vital capacity for a 70-kg man is
1 L
2 L
5 L
7 L
4
C
1
null
null
null
null
null
1cc2af1d-5d1f-582b-a90e-f89054af083b
A 32-year-old man is found unconscious by the fire department in a room where he has inhaled 0.1% carbon monoxide for a prolonged period. His respiratory rate is 42 breaths/min, but he is not cyanotic. Carbon monoxide has increased this patient's minute ventilation by which of the following mechanisms?
Shifting the O2 hemoglobin dissociation curve to the left
Increasing CO2 production
Causing lactic acidosis
Decreasing Pao2
4
C
3
null
null
null
null
null
b1fafbe6-7816-53c6-97fb-16723829be61
An acute increase in Paco2 of 10 mm Hg will result in a decrease in pH
0.01 pH unit
0.02 pH unit
0.04 pH unit
0.08 pH unit
4
D
1
null
null
null
null
null
5c30d07a-21b4-598e-b39e-a6105b52cb0e
A 22-year-old college student with a history of complex regional pain syndrome (CRPS) in the left foot and ankle after a football injury is anesthetized for laparoscopic cholecystectomy. He reports allergy to penicillin and is treated for chronic pain with paroxetine (Paxil) and gabapentin (Neurontin) and indomethacin ...
Repeat meperidine
Labetalol
Lorazepam (Ativan)
Dantrolene
4
C
3
null
null
null
null
null
e57d257a-c2c6-5f76-b625-234e52d8c372
The P50 of sickle cell hemoglobin is
19 mm Hg
26 mm Hg
31 mm Hg
35 mm Hg
4
C
1
null
null
null
null
null
59968382-870a-59cc-b839-f9523513bef7
Data from the ARDS network trial (ARDSNet) showed increased mortality from
Atelectrauma
Volutrauma
Barotrauma
Inhaled nitric oxide
4
B
1
null
null
null
null
null
67622d0b-8bb9-5f8a-b473-12539956cbdc
Each of the following is decreased in elderly patients compared with their younger counterparts EXCEPT
Closing volume
FEV1
Ventilatory response to hypercarbia
Vital capacity
4
A
1
null
null
null
null
null
cf86b44a-8028-51be-bd21-31c872e9e67b
Calculate the VD/Vt ratio (physiologic dead space ventilation) based on the following data: Paco2 45 mm Hg, mixed expired CO2 tension (PEco2 ) 30 mm Hg.
0.1
0.2
0.3
0.4
4
C
2
null
null
null
null
null
a3b4276d-1233-5bf0-af29-74e04f749f31
Which of the following statements concerning the distribution of O2 and CO2 in the upright lungs is TRUE?
Pao2 is greater at the apex than at the base
Paco2 is greater at the apex than at the base
Both Pao2 and Paco2 are greater at the apex than at the base
Both Pao2 and Paco2 are greater at the base than at the apex
4
A
1
null
null
null
null
null
a74f611d-4941-5328-9ede-4749a9cb4f7f
Which of the following acid-base disturbances is the least wellcompensated?
Metabolic alkalosis
Respiratory alkalosis
Increased anion gap metabolic acidosis
Normal anion gap metabolic acidosis
4
A
1
null
null
null
null
null
73991c40-130d-5b1b-a16b-a3d5605a3a3a
What is the (calculated) Pao2 of a patient on room air in Denver,
80 mm Hg
90 mm Hg
100 mm Hg
110 mm Hg
4
A
2
null
null
null
null
null
fe2e571c-8ecf-5462-85e0-6ea7a21573e2
A venous blood sample from which of the following sites would correlate most reliably with Pao2 and Paco2?
Jugular vein
Subclavian vein
Antecubital vein
Vein on posterior surface of a warmed hand
4
D
1
null
null
null
null
null
9a2610e3-bd5c-5987-8017-27ddcc4ff0dc
Which of the following pulmonary function tests is LEAST dependent on patient effort?
Forced expiratory volume in 1 second (FEV1 )
Forced vital capacity (FVC)
FEF 800 to 1200
FEF 25% to 75%
4
D
1
null
null
null
null
null
818be8a4-f52a-5a9a-8336-97cde7481eb6
A 33-year-old woman with 20% carboxyhemoglobin is brought to the ER for treatment of smoke inhalation. Which of the following is
Cyanosis
Pao2 105 mm Hg, oxygen saturation 80% on initial room air arterial blood gases (ABGs)
98% oxygen saturation on dual-wavelength pulse oximeter
Oxyhemoglobin dissociation curve shifted far to the left
4
A
2
null
null
null
null
null
ea5996f3-0796-599b-8dd8-5ed56b0a3bcc
Each of the following will alter the position or slope of the CO2 ventilatory response curve EXCEPT
Hypoxemia
Fentanyl
N2O
Ketamine
4
D
1
null
null
null
null
null
8f9239dd-e336-5c6c-a005-342a0b3dcaa0
Which of the following statements concerning the distribution of alveolar ventilation ( ) in the upright lungs is TRUE?
The distribution of is not affected by body posture
Alveoli at the apex of the lungs (nondependent alveoli) are better ventilated than those at the base
All areas of the lungs are ventilated equally
Alveoli at the base of the lungs (dependent alveoli) are better ventilated than those at the apex
4
D
1
null
null
null
null
null
eb3ff5a1-8f51-5950-ad53-195b41ad00d8
In the resting adult, what percentage of total body O2 consumption is due to the work of breathing?
2%
5%
10%
20%
4
A
1
null
null
null
null
null
f0c5e319-f794-5d5b-a651-85c33ebf6a76
The anatomic dead space in a 70-kg man is
50 mL
150 mL
250 mL
500 mL
4
B
1
null
null
null
null
null
ff140226-eade-5b6d-96f9-61cd791deaf1
The most important buffering system in the body is
Hemoglobin
Plasma proteins
Phosphate
[HCO3 − ]
4
D
1
null
null
null
null
null
a25e278d-0191-5802-a393-e3757e047c37
A decrease in pH of 0.1 unit will result in
A decrease in serum potassium concentration [K+ ] of 0.1 mEq/L
A decrease in [K+ ] of 1.0 mEq/L
An increase in [K+ ] of 1.0 mEq/L
An increase in [K+ ] of 2.0 mEq/L
4
C
1
null
null
null
null
null
3f55f994-979a-589f-824a-1a3f258bbfb5
A 28-year-old, 70-kg woman with ulcerative colitis is receiving a general anesthetic for a colon resection and ileostomy. The patient's lungs are mechanically ventilated with the following parameters: 5000 mL and respiratory rate 10 breaths/min. Assuming no change in , how would change if the respiratory rate were incr...
Increase by 500 mL
Increase by 1000 mL
Decrease by 750 mL
Decrease by 1500 mL
4
D
2
null
null
null
null
null
1a469abe-2e52-540a-9fc0-62cccc8cd03a
Each of the following will shift the oxyhemoglobin dissociation curve to the right EXCEPT
Volatile anesthetics
Decreased Pao2
Decreased pH
Increased temperature
4
B
1
null
null
null
null
null
b49305e4-8648-5a66-a1a9-9f4d1690c7fd
The half-life of carboxyhemoglobin in a patient breathing 100% O2 is
5 minutes
1 hour
2 hours
4 hours
4
B
1
null
null
null
null
null
a9184a94-a376-5cdb-abf1-a605a2c2c6b3
A disadvantage of using propofol for prolonged sedation (days) of intubated patients in the ICU is potential
Alkalosis
Hypokalemia
Hypolipidemia
Bradycardia
4
D
1
null
null
null
null
null