FCCS Exam Questions And Answers Verified 100%
Correct
what are the 2 NM blockers to know for intubation? - ANSWER- sux, roc
drugs:
-lido p 28 - ANSWER- a
what periintubation drug has been shown to blunt response of increasing ICP in
someone whith a head injury? - ANSWER- lidocaine (1-1.5 mg/kg)
what is goal temp ranges for targeted temperature management? what are the 2
potential big SEs? - ANSWER- 32 to 36 C for at least 24 hours in comatose (GCS<8)
patients following ROSC
SEs: coagulopathy, increased risk of infxn
what percentage of normal CO does chest compressions produce? - CORRECT
ANSWER- 1/3
what is the goal CO2 following arrest? - ANSWER- 38-42 (normocapnea)
what are teh 3 broad types of respiratory failure? PNA is most often associated with
which one? drug OD? CHF? COPD? dead space ventillation? - ANSWER- hypoxemic
(PaO2 <60), hypercapneic (PaCO2 >50), mixed
hypoxemic (although can be mixed)
hypercapneic
hypoxemi
c
mixed
hypercapneic
define shunt physiology? waht is at the other end of the VQ spectrum? - CORRECT
ANSWER- no V, still adequate Q
dead space
what ratio is most useful in tracking hypoxia over time? - ANSWER- P:F
ratio, PaO2 and FiO2
,normal is 300-500
define minute ventilation (VA) - ANSWER- VA = RR* (VT - VD)
VD = dead
space
define paradoxical breathing? why does it occur - ANSWER- diaphragm is
flaccid b/c of fatigue and moves upward during
inspiration
what FiO2 is given with 2 L NC? 8 L facemask? - ANSWER- 28%, 60%
what are BiPAP settings to start a patient on (EPAP, IPAP, Vt, backup rate), at what
IPAP do you worry about gastric distention? - ANSWER- 5, 10, 6-8 mL/kg, 6
IPAP > 20
what are the 4 indications for invasive ventillation? - ANSWER- failure to
oxygenate, failure to ventilate, failure to protect, projected clinical course
what are teh ABCD of teh vent cycle? - ANSWER- A: triggering (initiation of
inspiration)
B: end of inspiratory flow
C: cycling (start of expiratory flow)
what is assist-control ventilation? - ANSWER- VT is guaranteed at present
flow rate with a minimum RR however pt can initiate breaths and trigger teh vent, so Pt
can breath at higher RR if he wants
can be either volume cycled or time cycled (pressure assist), volume is much more
common
what is PSV? - ANSWER- SPV provides a preset level of inspiratory
pressure with each vent detected pt effort
best for spontaneously breathign pt to offer increased comfort
what is SIMV? - ANSWER- synchronized intermittent manditory ventilation,
breaths may be triggered by the pt or time delapsed, vent will synch to pt breaths, if no
breath is detected vent will deliver preset VT at preset time
PSV is usually paired with what other vent mode for pt comfort and decrease in pt's
,WOB? - ANSWER- SIMV
volume assist control waveforms? - ANSWER-
pressure assist control ventilation waveforms? - ANSWER-
review advantages/disadvantages to different vent modes on p 77 - CORRECT
ANSWER- do it
after you intubate what is the first mode used? - ANSWER- AC, usally
volume controlled
what are best initial vent settings? (VT, FiO2, RR)? what is normal minute ventilation? -
ANSWER- VT = 4-8 mL/kg; closer to 8 for COPD, closer to 4 for ARDS
7-8 L/min
92-94%
what is peak airway pressure? inspiratory plateau pressure? which one corresponds
more to barotrauma? how can you decrease Pplat? - ANSWER- Ppeak = a measure of
airway resistance; < 40 is ideal
Pplateau = measure of compliance and alveolar distension, a static measurement; need
an inspiratory hold of 1 sec; normal < 30 cm H2O
Pplat
decrease PEEP, decrease VT
if you can't get FiO2 < 60 what should you do? - ANSWER- increase PEEP
waht is auto PEEP? how can tell its happening on tracing? - ANSWER- badness,
happens when expiratory time is too short to allow full exhalation. can decrease CO,
need to adjust vent. To get rid of increase peak flow and decrease RR
can see on tracing by if a breath is initiated below baseline
Most important indicator that a patient has a severe illness? - ANSWER-
Tachypnea
3 respiratory types, and their criteria - ANSWER- Hypoxemic (PaO2 <50-60)
, Hypercapnic (PaCO2 >50, pH <7.36)
Mixed
Delta gap (formula, when and why it's used) - ANSWER- Difference in AG
from normal - Difference in HCO3 from normal
In AG metabolic acidosis it's used. It tells you if there's underlying metabolic alkalosis or
respiratory acidosis with bicarb compensation IN ADDITION to the AG metabolic
acidosis. Both of those would result in a high bicarb to begin with, and a smaller change
in bicarb from normal.
Winter's formula (equation, what it measures) - ANSWER- 1.5[HCO3] + 8
+/- 2
If compensation is adequate in acid/base issues
How AG changes with albumin changes - ANSWER- Decreases 2.5-3 for
every 1 decrease in albumin
Hemodynamic changes after intubation - ANSWER- Hypo/hypertension Arrhythmia
Tachycardia
Pressure support equation for BiPAP - ANSWER- IPAP - EPAP
3 types of vent cycles - ANSWER- Volume (preset tidal volume, relieves
WOB the most)
Time (constant pressure of time)
Flow (constant pressure until inspiratory flow is below 25% of peak)
Goal tidal volume - ANSWER- 10 cc/kg
Goal FiO2 on vent - ANSWER- Start at 1.0, then decrease as SpO2
tolerates (goal of 92-94 saturation)
Ppeak - ANSWER- Peak inspiratory pressure
Pplat (try to keep it below ?) - ANSWER- Inspiratory plateau pressure
(shows alveolar distention)
30
AutoPEEP (what it is, what it causes, how to fix it) - ANSWER- Breath stacking
Decreases preload to the heart with positive pressure on the lungs --> hypotension
Decrease RR, decrease inspiration time (goal is to have more time for the lungs to
exhale)
Correct
what are the 2 NM blockers to know for intubation? - ANSWER- sux, roc
drugs:
-lido p 28 - ANSWER- a
what periintubation drug has been shown to blunt response of increasing ICP in
someone whith a head injury? - ANSWER- lidocaine (1-1.5 mg/kg)
what is goal temp ranges for targeted temperature management? what are the 2
potential big SEs? - ANSWER- 32 to 36 C for at least 24 hours in comatose (GCS<8)
patients following ROSC
SEs: coagulopathy, increased risk of infxn
what percentage of normal CO does chest compressions produce? - CORRECT
ANSWER- 1/3
what is the goal CO2 following arrest? - ANSWER- 38-42 (normocapnea)
what are teh 3 broad types of respiratory failure? PNA is most often associated with
which one? drug OD? CHF? COPD? dead space ventillation? - ANSWER- hypoxemic
(PaO2 <60), hypercapneic (PaCO2 >50), mixed
hypoxemic (although can be mixed)
hypercapneic
hypoxemi
c
mixed
hypercapneic
define shunt physiology? waht is at the other end of the VQ spectrum? - CORRECT
ANSWER- no V, still adequate Q
dead space
what ratio is most useful in tracking hypoxia over time? - ANSWER- P:F
ratio, PaO2 and FiO2
,normal is 300-500
define minute ventilation (VA) - ANSWER- VA = RR* (VT - VD)
VD = dead
space
define paradoxical breathing? why does it occur - ANSWER- diaphragm is
flaccid b/c of fatigue and moves upward during
inspiration
what FiO2 is given with 2 L NC? 8 L facemask? - ANSWER- 28%, 60%
what are BiPAP settings to start a patient on (EPAP, IPAP, Vt, backup rate), at what
IPAP do you worry about gastric distention? - ANSWER- 5, 10, 6-8 mL/kg, 6
IPAP > 20
what are the 4 indications for invasive ventillation? - ANSWER- failure to
oxygenate, failure to ventilate, failure to protect, projected clinical course
what are teh ABCD of teh vent cycle? - ANSWER- A: triggering (initiation of
inspiration)
B: end of inspiratory flow
C: cycling (start of expiratory flow)
what is assist-control ventilation? - ANSWER- VT is guaranteed at present
flow rate with a minimum RR however pt can initiate breaths and trigger teh vent, so Pt
can breath at higher RR if he wants
can be either volume cycled or time cycled (pressure assist), volume is much more
common
what is PSV? - ANSWER- SPV provides a preset level of inspiratory
pressure with each vent detected pt effort
best for spontaneously breathign pt to offer increased comfort
what is SIMV? - ANSWER- synchronized intermittent manditory ventilation,
breaths may be triggered by the pt or time delapsed, vent will synch to pt breaths, if no
breath is detected vent will deliver preset VT at preset time
PSV is usually paired with what other vent mode for pt comfort and decrease in pt's
,WOB? - ANSWER- SIMV
volume assist control waveforms? - ANSWER-
pressure assist control ventilation waveforms? - ANSWER-
review advantages/disadvantages to different vent modes on p 77 - CORRECT
ANSWER- do it
after you intubate what is the first mode used? - ANSWER- AC, usally
volume controlled
what are best initial vent settings? (VT, FiO2, RR)? what is normal minute ventilation? -
ANSWER- VT = 4-8 mL/kg; closer to 8 for COPD, closer to 4 for ARDS
7-8 L/min
92-94%
what is peak airway pressure? inspiratory plateau pressure? which one corresponds
more to barotrauma? how can you decrease Pplat? - ANSWER- Ppeak = a measure of
airway resistance; < 40 is ideal
Pplateau = measure of compliance and alveolar distension, a static measurement; need
an inspiratory hold of 1 sec; normal < 30 cm H2O
Pplat
decrease PEEP, decrease VT
if you can't get FiO2 < 60 what should you do? - ANSWER- increase PEEP
waht is auto PEEP? how can tell its happening on tracing? - ANSWER- badness,
happens when expiratory time is too short to allow full exhalation. can decrease CO,
need to adjust vent. To get rid of increase peak flow and decrease RR
can see on tracing by if a breath is initiated below baseline
Most important indicator that a patient has a severe illness? - ANSWER-
Tachypnea
3 respiratory types, and their criteria - ANSWER- Hypoxemic (PaO2 <50-60)
, Hypercapnic (PaCO2 >50, pH <7.36)
Mixed
Delta gap (formula, when and why it's used) - ANSWER- Difference in AG
from normal - Difference in HCO3 from normal
In AG metabolic acidosis it's used. It tells you if there's underlying metabolic alkalosis or
respiratory acidosis with bicarb compensation IN ADDITION to the AG metabolic
acidosis. Both of those would result in a high bicarb to begin with, and a smaller change
in bicarb from normal.
Winter's formula (equation, what it measures) - ANSWER- 1.5[HCO3] + 8
+/- 2
If compensation is adequate in acid/base issues
How AG changes with albumin changes - ANSWER- Decreases 2.5-3 for
every 1 decrease in albumin
Hemodynamic changes after intubation - ANSWER- Hypo/hypertension Arrhythmia
Tachycardia
Pressure support equation for BiPAP - ANSWER- IPAP - EPAP
3 types of vent cycles - ANSWER- Volume (preset tidal volume, relieves
WOB the most)
Time (constant pressure of time)
Flow (constant pressure until inspiratory flow is below 25% of peak)
Goal tidal volume - ANSWER- 10 cc/kg
Goal FiO2 on vent - ANSWER- Start at 1.0, then decrease as SpO2
tolerates (goal of 92-94 saturation)
Ppeak - ANSWER- Peak inspiratory pressure
Pplat (try to keep it below ?) - ANSWER- Inspiratory plateau pressure
(shows alveolar distention)
30
AutoPEEP (what it is, what it causes, how to fix it) - ANSWER- Breath stacking
Decreases preload to the heart with positive pressure on the lungs --> hypotension
Decrease RR, decrease inspiration time (goal is to have more time for the lungs to
exhale)
