CC Equipment Flashcards
Drag and drop the definitions to the associated term.
- Process capable of removing or destroying all viable forms of microbial life, including bacterial spores, to an acceptable assurance level
- Process of reducing the number of microbial contaminants to a relatively safe level
- Process capable of destroying most microorganisms but, as ordinarily used, not bacterial spores
- Process that renders inanimate items safe for handling by personnel who are not wearing protective attire.
A. Decontamination
B. Disinfection
C. Sanitization
D. Sterilization
- Sterilization
- Sanitization
- Disinfeciton
- Decontamination
The normal gradient between PaCO2 and ETCO2 is approximately:
A. 2 -5 mmHg
B. 7 - 10 mmHg
C. 10 - 13 mmHg
D. 15 - 17 mmHg
A. 2-5 mmHg
During the delivery of an anesthetic in the CT scanner, oxygen from the E-cylinder is being used. The patient is intubated and spontaneously breathing 94% FiO2 and 6% Des. 60 minutes into the case, the pressure of the E-regulator has fallen from 2000 to 1100 psi. From this information, what FGF is estimated to be running?
Answer: 4.95 L/min
1100 / 2000 =0.55 left
0.55 x 660 =363 left
660 - 363 =297 used
297/60 =4.95 L/min
The effect of methemoglobin on the pulse oximetry is to:
A. cause a reading of 85% regardless of the actual oxygen saturation
B. cause a reading that is 10% less than the actual saturation
C. have only minimal effect on the oxygen saturation
D. Maintain a reading of 99% regardless of the oxygen saturation
A.
Methemoglobin has the same
absorption coefficient at both
red and infrared wavelengths
causing a reading of 85%
regardless of the actual
hemoglobin saturation.
For accurate blood pressure measurement, the width of the BP cuff should be:
A. 10 - 15% greater than the diameter of the extremity
B. 20 - 50% greater than the diameter of the extremity
C. 20 - 50% greater than the circumference of the extremity
D. Equal to the circumference of the extremity
B
The accuracy of any method
of blood pressure
measurement depends on
proper cuff size. The cuff’s
bladder should extend at least
halfway around the extremity
and the width of the cuff
should be 20 - 50% greater
than the diameter of the
extremity.
Interchanging the position of the APL valve and the Fresh gas inlet transforms the mapelson A circuit into a
A. Mapelson B circuit
B. Mapelson C circuit
C. Mapelson D circuit
D. Mapelson E circuit
C. MAPELSON D CIRCUIT
Interchanging the position of
the APL and fresh gas inlet on
a Mapleson A circuit results
in the creation of the
Mapleson D circuit, which is
better suited for controlled
ventilation.
At or below which of the following pressure is it recommended that the E-cylinder be changed?
A. 250 psi
B. 500 psi
C. 750 psi
D. 1000 psi
D
Current anesthesia apparatus
checkout recommendations
state that the E-cylinder of
oxygen should be at least half
full corresponding to a
pressure of 1000 psi.
During the administration of GA for a laparoscopic hemiorrhapthy using a circle system, the capnogram below was obtained. This capnogram is consistent with:
A. A normal capnogram
B. An incompetent expiratory valve
C. Channeling in the carbon dioxide absorber
D. An incompetent inspiratory valve
D.
An incompetent inspiratory
valve causes part of the
expired gas to flow back into
the inspiratory limb and
allows these exhaled gases to
be inspired with the next
breath. This results in a delay
in the initiation of Phase IV of
the capnogram.
Concerning the use of lasers, as wavelength increases:
A. tissue penetration increases
B. The area of coagulation increases
C. Absorption by water increases
D. The risk of retinal damage increases
C.
As wavelength increases the
energy of the laser light
decreases. There is increased
absorption by water and
decreased tissue penetration
and coagulation. Corneal
damage is more likely with
longer wavelength lasers
(CO2 laser) and retinal
damage is more likely with
shorter wavelength lasers
(YAG laser).
Advantages of nondiverting (followthrough) capnographs include:
A. Light weight
B. No traction placed on the ETT
C. No aspiration of gas from the circuit
D. Direct delivery of aspirated gas to the scavenger
D
Nondiverting capnographs
measure carbon dioxide
passing through an adaptor
placed in the breathing
circuit. The weight of the
sensor can cause traction on
the tracheal tube. However,
since the sensor is in the gas
stream, no aspiration of gas is
required.
In order for leakage current to be perceptible to touch, the current must exceed:
A. 0.5 mA
B. 1.0 mA
C. 20 mA
D. 100 mA
B: 1.0 mA
A 78 year old female is scheduled to undergo a R TKA. Prior to induction, the rhythm strip below is obtained. At this time, the most appropriate course of action is:
A. Proceed with induction of GA
B. Postpone the procedure and obtain a cardiology consult
C. Perform a regional anesthetic with invasive monitoring
D. Proceed with RSI of GA
B.
postpone the case and obtain
a cardiology consultation.
3rd degree heart block
Small circuit leaks will have little effect on MV when using a
A. Time-cycled Ventilator
B. Pressure-cycled ventilator
C. Volume-cycled ventilator
D. Hanging Bellows Ventilator
B.
With pressure-cycled
ventilators, small leaks will
not cause a change in tidal
volume, and secondarily
minute ventilation, because
cycling will be delayed until
the pressure limit is met.
Hanging-bellows ventilators
are no longer approved for
use in the anesthesia circuit.
Some patients are at increased risk for hand ischemia secondary to radial artery catheterization because of an incomplete Palmer arch. The approximate percentage of patients with an incomplete palmar arch is:
A. 1%
B 5%
C. 10%
D. 15%
B. 5%
As compared to non-rebreathing circuits, disadvantages of the circle system include:
A. Higher fresh gas flow rates are needed
B. Decreased humidity of inspired gases as compared to mapelson D circuits
C. Higher system resistance
D. Higher inspiratory CO2 levels
C. Higher System Resistance
Higher system resistance
Disadvantages of the circle
system include: greater size,
decreased portability,
increased complexity,
increased risk of
disconnection, increased
system resistance and
difficulty in predicting
inspired gas concentrations
during low fresh gas flows.
With a properly functioning
carbon dioxide absorber,
inspired carbon dioxide levels
should approach zero in the
circle system.
The tracing below is noted during insertion of a PAC. As the catheter is advanced further:
A. The pulse pressure will increase
B. The systolic pressure will increase
C. The diastolic pressure will increase
D. The dicrotic notch will be lost
C. The diastolic pressure will be lost.
This tracing is of the RV. AS the catheter is advanced further, it will cross the pulmonic valve and the diastolic pressure will increase.
Determinants of Bobbin Position in the flowmeter include:
A. Gas density at low flow rates
B. Gas viscosity at high flow rates
C. Gas molecular weight at high flow rates
D. Changes in atmospheric pressure
E. Introduction of volatile agent
F. The use of Nitrous oxide in the gas mixture
Answer: C, D
At low (laminar) flow rates
the bobbin height is
determined by gas viscosity.
At high (turbulent) flow rates
the bobbin height is
determined by gas density.
Since gas density is directly
proportional to the molecular
weight of the gas, bobbin
height during high flows is
determined also by molecular
weight.
Problems inherent with the dye-dilution technique of measuring CO include:
A. The need for specialized pulmonary artery catheters
B. Mixed venous sampling is required
C. Background indicator buildup
D. Intrapulmonary shunting may cause measurement inaccuracies
Answer: C
The dye-dilution technique
introduces the problems of
indicator recirculation,
arterial blood sampling and
background indicator buildup.
The need for a return electrode to the electrocautery can be eliminated if:
A. Bipolar electrodes are used
B. The patient is properly grounded
C. An isolation transformer is used
D. Ultrahigh electrical frequencies are used
Answer: A
Bipolar electrodes confine
current propagation to a few
millimeters, eliminating the
need for a return electrode.
Pulse oximetry changes seen in carbon monoxide poisoning include:
A. Decreased SPO2 levels
B. Falsely increased SPO2 levels
C. SPO2 of 85% regardless of actual SPO2
D. Augmentation of pulsatile waveform
Answer: B
Because carboxyhemoglobin
and oxyhemoglobin absorb
light at 660 nm identically,
pulse oximeters will register a
falsely high reading in
patients with carbon
monoxide poisoning.
A 53 year old male is undergoing laparoscopic cholecystectomy. He is currently receiving 6% desflurane and oxygen at 3L/min. A ventilator lacking FGF compensation is set to TV = 700mL, Rate 9, I:E 1:2. The patients MV is:
Because the ventilator spill valve is closed during inspiration, FGF contributes to the MV.
With I:E 1:2, FGF contributes to the MV 33% of the time.
This results in an increase of MV of 1L/min.
The patients total MV is therefore (0.7L) x (9 breaths/min) + 1 = 7.3 mL
Central venous pressure measurements should be made:
A. During inspiration
B. During expriation
C. At the end of inspiration
D. At the end of expiration
Answer: B
Measurement of CVP is made
with a water column or
transducer. The pressure
should be measured during
end expiration.
During Exhalation, sticking of the spill valve of the ventilator can result in:
A. Inadequate patient ventilation
B. The application of PEEP
C. Elevated CO2 levels
D. The application of negative airway pressure during exhalation
Answer: B
The ventilator has its own
pressure-relief valve, called
the spill valve, which is
closed during inspiration and
open at the end of exhalation.
Sticking of this valve results
in abnormally elevated airway
pressure during exhalation.
The decline in core temperature during the first hour of general anesthesia is largely due to:
A. Conduction
B. Convection
C. Radiation
D. Redistribution of heat to cooler peripheral tissues
Answer: D
Temperature decreases during
general anesthesia can be
grouped into 3 phases. Phase I
is usually a decrease of 1 - 2o
C that occurs during the first
hour and is the result of
redistribution of heat to cooler
peripheral tissues.
Phase II
occurs over the next 3 - 4
hours and is a result of heat
loss to the environment.
During Phase III, a steady-
state equilibrium is
established between heat
production and loss to the
environment with little
change in core temperature.
The purpose of bimetallic strip, commonly found in the variable bypass vaporizer is to compensate for:
A. Variations in temp
B. Changes in Atmospheric pressure
C. Changes in FGF
D. Vaporizer output changes that occur with the induction of N2O
Answer: A
In the variable-bypass
vaporizer, temperature
compensation is achieved by
a strip composed of two
different metals welded
together. The metal strips
expand and contract
differently in response to
temperature changes and are
used to alter the flows in the
vaporizer.
Immediately after intubation, the capnogram below was obtained. The capnogram is consistent with:
A. bronchospasm
B. endobronchial intubation
C. Inadequate FGF
D. Inadequate MV
Answer: A
The sloping of Phase II and
III of the capnogram indicates
increased airway resistance
and is consistent with
bronchospasm or
endotracheal tube kinking.
When using the Des Tec 6 vaporizer at higher elevation,
A. the concentration of agent is decreased
B. The delivered partial pressure of the agent is decreased
C. The concentration of the agent is increased
D. The delivered partial pressure of the agent is increased
Answer: B
At high elevations, the Tec 6
vaporizer continues to deliver
the set concentration.
However, because of the
decrease in the ambient
pressure, the partial pressure
of desflurane is decreased.
During the administration of Ga for strabismus repair in a 4 year old using a mapelson D circuit, the capnogram below was obtained. The capnogram is consistent with:
A. Normal capnogram
B. Inadequate FGF
C. Hyperventilation
D. Partially closed APL Valve during spontaneous ventilation
Answer B
Carbon dioxide elimination is
entirely dependent on fresh
gas flow in the Mapleson
circuits. This capnogram
demonstrates rebreathing,
with a baseline that does not
approach zero and is the
result of inadequate fresh gas
flow.
The intergranular airspace of the CO2 absorber is approximately:
A. 10% of the total volume
B. 25% of the total volume
C. 50% of the total volume
D. 75% of the total volume
Answer: C
To guarantee complete
absorption, a patient’s tidal
volume should not exceed the
air space between absorbent
granules. To ensure this, the
carbon dioxide absorber has
an intergranular air space of
roughly 50% of the total
volume, or approximately
1000 mL of air space.
Burst suppression patterns become evident when the BIS:
A. Is between 80 and 90
B. Is between 60 and 80
C. Is between 40 and 60
D. Below 40
Answer: D
At sea level, the capacity of a full E cylinder of air is:
A. 500L
B. 625 L
C. 660 L
D. 1590L
Answer C
The pulse oximeter corrects to absorption of light by nonpulating venous blood and tissues by
A. using two separate wavelength of light emitting diodes
B. Calculating a ratio of red and infrared light absorption
C. Detecting thermal changes from the sensor diodes
D. Identifying arterial pulsations with plethysmography
Answer: D
To eliminate the effects of
light absorption from tissues
and venous blood, arterial
pulsations are identified by
plethysmograph.
During the delivery of an anesthetic in Endo, E-cylinders are being used as gas supply. The anesthetic being delivered is Sevo 2% in a 3:2 L/min mixture of N2O and oxygen. If fresh E-cylinders were present iat the start of the case, after three hours of anesthetic delivery, the expected pressure of nitrous oxide cylinder would be:
Answer: Tank pressure of 745 psi
Unlike the oxygen E-cylinder,
the nitrous oxide E-cylinder is
90-95% filled with liquid
nitrous oxide when full. The
tank pressure of 745 psi
represents the vapor pressure
of liquid nitrous oxide. The
cylinder gauge will remain at
745 psig until all of the liquid
is gone and at this point the
tank is less than 25% full.
Since the nitrous oxide E-
cylinder contains 1590 L of
nitrous oxide, the
consumption of 540 L during
the described case will not
cause any change in the tank
pressure.
An electrocardiogram is shown. Match each letter with the corresponding anatomic structure:
A, B, C, D
Right A
Right V
Left A
Left V
A: Right A
B: Left A
C: Left V
D Right V
The nitrous cut-off valve, formerly known as the fail-safe valve:
A. reduces pressure of N2O to the flow meter to below that of O2
B. prevents barotrauma from high-flow delivery of N2O
C. Alarms if the oxygen supply falls below 20 psig
D. discontinues nitrous oxide flow if the pressure of oxygen to the machine falls below 20 psi
Answer: D
If the pressure from the
oxygen supply declines,
usually below 20 psig, the
shut-off valve will
discontinue the flow nitrous
oxide to prevent the
accidental delivery of a
hypoxic mixture as a result of
oxygen supply failure.
Using TEE and a pulsed doppler, cardiac output can be determined by:
A. Measuring aortic flow velocity and cross-sectional area
B. Measuring distention of the aorta during ventricular contraction
C. Measuring diastolic and systolic ventricular dimensions
D. Measuring ventricular ejection fraction
Answer: A
The FDA universal negative pressure leak test:
A. Must be done with the machine on
B. Tests both low pressure and high pressure circuitry
C. Should be repeated with each vaporizer individually turned on
D. Can detect leaks of as little as 10 mL/min
Answer: C
When using a modified V5 (CS5) lead, the proper lead selection on the monitor is:
Answer: A
When using a 3-lead ECG
monitor and positioning the
electrodes in a modified V5
placement, the appropriate
lead selection for monitoring
is lead I.
The line isolator monitor:
A. Measures the potential for line current flow to the ground
B. Measure the current flow through the ground line of equipment
C. Measures total current flow into and out of the OR
D. Measures the potential for isolation transformer current flow to the ground
Answer: D
Electrosurgical units use high-frequency alternating current. The high frequency causes an increase in circuit:
A. inductance
B. impendence
C. Resistance
D. Voltage
Answer: A
Increasing frequency in an
AC circuit decreases both
capacitance and impedance in
the circuit. Inductance,
however, is increased with
increased frequency.
Electrosurgical units, such as
the Bovie, use frequencies in
excess of 500,000 Hz. This
can cause current inductance
in other electrical equipment
in the OR and explains the
excessive electrical
interference seen with the use
of these devices.
The addition of tubing and stopcocks to a transducer measuring arterial BP:
A. increases the natural frequency of the system,
B. Decreases the natural frequency of the system,
C. Causes underdampening
D. Causes overestimation of the SBP
Answer: D
The addition of tubing,
stopcocks and air in the line
all decrease the natural
frequency of the system. If
the frequency response is too
low, the system will be
overdamped and will not
faithfully reproduce the
arterial waveform,
underestimating the systolic
pressure.
The CO2 absorption capacity of 100g of soda lime is approximately:
Answer: 26:
The chemical reaction of soda
lime with carbon dioxide
would allow the absorption of
26 L of carbon dioxide per
100 grams of absorbent under
ideal conditions. In practice,
the absorption capacity of 100
grams of soda lime is about
15 - 23 L of CO2.
In determining the CO from the thermodilution curve, the CO monitor calculates the output by:
A. determining the slope at the peak of the curve
B. determining the duration of the temperature change
C. determining the slope of the curve immediately after injection
D. determining the area under the curve
D. determining the area under the curve
In 1963, Egar Et al. showed that the proper placement of the flowmeters could help prevent the delivery of a hypoxic mixture if a leak in the flowmeter occurred. A proper flometer sequence is:
Answer: D ( Air –> N2O –> O2)
Visual detection of cyanosis usually occurs when the SPO2 falls below:
A. 60%
B. 70%
C. 80%
D. 90%
Answer: C
In contrast to the pulse
oximeter, which can detect
very small changes in
saturation, visual detection of
cyanosis occurs only when
more than 5 g of hemoglobin
is desaturated or at about a
SpO2 of 80%.
Components of the low-pressure circuit in the anesthesia machine include thee:
A. Oxygen supply failure alarm
B. Oxygen failure cut off valve
C. Flowmeters
D. Vaporizers
E. Second stage oxygen pressure regulator
E. Oxygen flush valve
Vaporizers and Flowmeters
The Vacuum control on an active scavenging system should be adjusted to allow the evacuation of:
A. 5-10 L/min
B. 10 - 15 L/min
C. 25-30 L/min
D. > 30 L/min
B : 10-15 L/min
In the TEE 4-Chamber view shown below, the mitral valve is best represented by which X:
Answer: Upper Right XA
Automated BP monitors electronically measure BP by:
A. using an acoustic to detect blood flow
B. Using a doppler monitor to detect blood flow
C. Using pressure transducers over the artery to sense compression changes
D. Using oscillations in cuff pressure
Answer: D
Automated blood pressure
monitors measure the
pressures at which oscillation
amplitudes change. From this,
a microprocessor derives
systolic, mean and diastolic
pressures.
Airway pressure curves from the same patient, one hour apart, are shown below. Likely cause for the change from Curve A to Curve B include:
A. change in I:E ratio from 1:2 to 1:1
B. Increased Airway resistance
C. Decreased ventilatory rate
D. Increased Tidal volume
Answer: Increased Tidal Volume
An increase in both peak
inspiratory pressure and
plateau pressure, with the
difference between the two
remaining constant, indicates
a change in tidal volume or a
change in compliance.
Increases in peak inspiratory
pressure with large difference
in plateau pressure indicates
an increase in inspiratory flow
or an increase in airway
resistance.
The largest P wave voltages are seen in lead:
A. I
B. II
C. III
D. V5
B
On a normal capnogram, exhalation of pure dead space gas is seen during phase:
A. 1
B. 2
C. 3
D. 4
Answer: 1
The expiratory portion of the
capnogram can be divided
into 3 phases. Phase 1 is the
exhalation of dead space
gases. Phase 2, sometimes
called the transition phase, is
the introduction of carbon
dioxide as the dead space
gases are washed away. Phase
3 is the alveolar gas plateau.
Phase 3 often has an upward
slope as alveolar units with
lower V/Q ratios empty.
Inhalation can be seen on the
capnogram as Phase 4.
The advantage of motor evoked potentials as opposed to SSEP for spinal cord monitoring is that MEP:
A. Monitor the ventral cord
B. Are unaffected by volatile anesthetic agents
C. Are unaffected by intraoperative hypothermia
D. Are unaffected by high-dose opioid anesthetics
Answer: A
In contrast to SEP’s, MEP’s
monitor the ventral aspect of
the spinal cord and can
predict postop motor deficit.
MEP’s are affected by volatile
agents, benzodiazepines,
opioids and moderate
hypothermia.
The oxygen supply from E-cylinders
A. Uses a diameter-index safety system
B. Should be left on in case of pipeline failure
C. Is regulated to a pressure exceeding that of the pipline
D. Has a check valve to prevent cross-filling of tanks
D.
A 25- year old female is undergoing Right knee arthroscopy. Prior to induction, the rhythm below is obtained. This rhythm is consistent with:
A. NSR
B. AFib
C. Pre-excitation syndrome
D. Second Degree AV Block
Answer: C
This rhythm strip shows a
short PR interval with an
initial up-sloping of the QRS
complex, also known as a
delta wave. This strip is
consistent with the pre-
excitation syndrome known
as Wolff-Parkinson-White
(WPW) syndrome. Digoxin
should be avoided in patients
with WPW syndrome.
Known as the pumping effect, the concentration delivered by some vaporizers during controlled or assisted ventilation is higher than when the vaporizer is used with free flow in the atmosphere. This change is most pronounced when: (select 2)
A. The carrier gas is high
B. There is less agent int eh vaporizing chamber
C. Peak inspiratory pressure
D. There is a Rapid ventricular rate
E. The dial setting is high
Answer: B, D
In the circuit diagram below, the patient can receive an electric shock if contact is made with:
A. Ground
B. The neutral line
C. Line 2
D. Earth
Answer: Line 2
Enhancement of flow direction of the PA catheter can be achieved by
A. Asking the patient to forcibly exhale
B. Positioning the patient in a head down position
C. Placing the patent in the left lateral tilt position
D. injecting iced saline through the catheter
A. Injecting iced saline through the catheter
Flow directed flotation of the
pulmonary artery catheter can
be enhanced by maneuvers
that increase cardiac output,
increase venous return or
elevate the position of the
pulmonary artery.
A 58M is undergoing a craniotomy. In a semi-sitting position. The patient’s head is 30 cm above the radial artery where his BP is being measured. If the patient’s MAP is found to be 100 mmHg, it can be estimated that the MAP at the cranial vault is ____?
Answer: 78 mmHg
30 cm H2O x 0.74mmHg/cmH2o = 22 mmHg
100 - 22mmHg = 78 mmHg
Output from a variable bypass sevoflurane vaporizer is shown below. Possible causes for the transient reduction in vaporizer output at point A include:
A. Introduction of N2O into the FGF
B. Increased GFG
C. Decreased FGF
E. a 5C increase in ambient temp
Answer: Introduction of Nitrous Oxide to the FGF
The accuracy of pulse oximeter is:
A. Greatest at saturations > 70%
B. Greatest at saturations under 60%
C. Same for all measurable satruations
D. Bimodal, with greatest accuracies between 50-60% and 90-99%
Answer: AA
Advantages of paramagnetic oxygen analyzers include:
A. Lower initial cost
B. Self-calibration
C. Easily replaceable consumable parts
D. Requires no electric input for operation
Answer: B
Although the initial cost of
paramagnetic sensors is
higher, the devices are self-
calibrating and have no
consumable parts. In addition,
their response time is fast
enough to differentiate
between inspired and expired
oxygen concentrations.
When using an arterial catheter to measure blood pressure, the optimum dampening coefficient is:
A. 0.1 - 0.2
B. 0.4 - 0.5
C. 0.6 - 0.8
D. > 1
Answer: C – 0.6 - 0.7
Signs of a leak in the bellows-in-box ventilator include:
A. Decreased inspired anesthetic concentration
B. Increased ETCO2
C. Decreased tidal volume
D. Decreased PIP
Answer: A
Duration of the twitch stimuli should be from a peripheral nerve stimulator is approximately
A. 50 micros
B. 200 micros
C. 50 ms
D. 200 ms
Answer: B
All stimuli from the
peripheral nerve stimulator
are 200 μs in duration, of
square-wave pattern and of
equal intensity.
To prevent rebreathing of CO2 in the classic circle system: (select 2)
A. Unidirectional valves must separate the patient and the reservoir bag
B. FGF must enter the circuit between expiratory valve and patient
C. The CO2 absorber must be between the patient and the reservoir bag
D. the APL cannot be located between the patient and the inspiratory alve
E. the inspiratory valve must separate the patient from the FGF
F. Output to the scavenging system must be located between the patient and the expiratory valve
Answer: A, D
When using a doppler and a BP cuff to measure BP,
A. Only SBP can be reliably determined
B. Only Diastolic pressure can be reliably determined
C. Both systolic and diastolic measures can be reliably determined
D. the MAP is most accurately determined
Answer: A
Resuscitation bags are unlike mapelson non-rebreathing circuits in that resuscitation bags:
A. Incorporate CO2 absorption
B. Can use very low O2 flows and still deliver high FiO2
C. Incorporate a non-rebreathing valve
D. Has an adjustable pressure limited expiratory valve
Answer: C
A resuscitator is unlike a
Mapleson circuit because it
contains a non-rebreathing
valve. High flows of oxygen
are required to deliver a high
FiO2 since resuscitator bags
entrain room air.
Falsely low BP measurements can occur when:
A. the cuff is applied too loosely
B. The extremity is below the heart
C. The cuff is too large
D. Cuff deflation is slow
Answer: C
Falsely low blood pressure
measurements result when
cuffs are too large, the
extremity is above the heart
level or after quick deflations.
Falsely elevated
measurements result when
cuffs are too small, applied
too loosely or the extremity is
below the heart level.
Chemicals found in freshly opened soda lime include:
A. Calcium Carbonate
B. Sodium Carbonate
C. Carbonic Acid
D. Water
Answer: Water
When using a PAC to measure PAP, system dynamics can be improved by:
A. using tubing at least 1 meter long
B. Using as few stopcocks as possible
C. Using high compliance tubing
D. Achieving a dampening coefficient > 1.5
Answer: B
According to the American National Standards, essential features of the anesthesia machine include:
A. Vaporizers that increase concentration with clockwise rotation
B. An unshielded and easily accessible oxygen flush control
C. An Exhaled volume monitor
D. A separate low-flow Oxygen control valve
Answer: C
When using a peripheral nerve stimulator, the most sensitive test of neuromuscular function is:
A. Train of 4
B. Double Burst Stimulation
C. 5 second tetanic stimulation at 50Hz
D. 5 second tetanic stimulation at 100 Hz
Answer D
When using a circle system, the dead space is
A. Distal to the Y piece
B. Distal to the inspiratory piece
C. Physiologic dead space plus the volume of the circuit hoses
D. Physiologic dead space + the volume of the circuit hoses and reservoir bag
Answer: A
The galvanic cell measures inspired oxygen concentration by examining
A. the electrical frequency of the cell
B. The voltage and current produced by the cell
C. Capacitance changes in the cell
D. Change in gas flow when the magnetic field is applied
B
Compliance for standard adult breathing circuits is:
A. 2 ml/cmH20
B. 5 ml/cmH2O
C. 8 ml/cmH2O
D. 12 ml/cmH2O
Answer: C
One hour after a RSI with propofol and succinylcholine for an appendectomy, the TOF stimulaton was obtained. These results are consistent with:
A. Normal recovery from DMR
B. Normal recovery from NDMR
C. Phase II Block
D. Pseudocholinesterase deficiency
Answer: D
To obtain the best accuracy in determining the patient’s tidal volume, the spirometer should be:
A. At the Y piece
B. Just distal to the inspiratory valve
C. Just proximal to the expiratory valve
D. Distal to the expiratory valve but proximal to the inspiratory valve
Answer: A – At the Y Piece
When proper placement of a central venous catheter, the catheter tip lies
A. in the RA
B. In the RV
C. In the IVC
D. At the junction of the SVC and RA
Answer: D
The National Institute for Occupational Safety and Health (NIOSH) recommends limiting the operating room concentrations of anesthetic agents to
A. N2O < 50ppm, halogenated agent < 2 ppm
B. N2O < 25 ppm, halogenated agent < 5 ppm
C. N2O < 50 ppm, halogenated agent < 0.5 ppm
D. N2O < 25 ppm, Halogenated agent < 0.5 ppm
Answer D
Desirable characteristics of a peripheral nerve stimulator used to assess the level of NMB include
A. The stimulator should have a fixed voltage
B. The stimulator should vary its output to adjust for changing skin resistance
C. Stimualator should be able to deliver biphasic wave pattern
D. Duration of stimulation should exceed 0.5 msec
Answer: B
Spongiform encephalopathies, such as Creutzfiedt Jakob disease, are caused by prions, which demonstrate resistance to sterilization. Effective methods of prion inactivation include:
A. Normal autoclave cycles
B. Glutaraldhyde sterilization
C. Ethylene Oxide Gas Sterilization
D. 1:10 hypochlorite sterilization
Answer D
During GA for THA, periods of systole are noted during times of electrocautery use. At this time, the most appropriate therapy is to:
A. Administer atropine
B. Administer carotid massage
C. Placement of temporary transvenous pacemaker
D. Switch to bipolar electrocautery
Answer: D
At 20C, the pressure of Nitrous oxide E-cylinder should not exceed:
745 psi
One hour after induction of GA in a three year old for cleft palate repair, the capnogram below was obtained, this capnogram is consistent with:
A. Exhausted soda lime
B. Incompetent Expiratory Valve
C. Incompetent Inspiratory Valve
D. Inadequate MV
Answer: D
This capnogram shows
elevated end-tidal carbon
dioxide levels and the patient
overriding mechanical
ventilation.
The Oxygen Flush Valve delivers: ____ L/min
35 - 70 L/min
Comparing BP measurements made from the radial artery to measurements from the dorsals pedis artery measurements have:
A. an elevated SBP and lower pulse pressure
B. elevated SBP and Elevated PP
C. Depressed SBP and elevated PP
D. Depressed SBP and Depressed PP
B
Arterial blood pressure is
greatly affected by where the
pressure is measured. As a
pulse moves peripherally,
wave reflection distorts the
pressure waveform, leading to
an exaggeration of systolic
and pulse pressures.
A 34F is undergoing laparoscopic tubal ligation. Her vitals are:
BP 110/74
HR 70
RR 10
MAP is approximately:
Answer: 86 mmHg
In adults, the distance from the ventricular port to the tip of the pulmonary artery catheter is:
20 cm
In adults, the distance from the proximal port to the tip of the PAC is:
30 cm
Do oxygen and nitrogen absorb infrared light?
No
According to the American Society for Testing And Materials F1850-00 standard, an anesthesia machine must have:
An exhaled volume or Ventilatory CO2 monitor
The risk of occupational exposure to inhaled anesthetic agents is higher with:
An open scavenger
An active scavenger
A closed scavenger
Open
When reusing a circle system, readings from the Oxygen analyzer may overestimate the actual inspired oxygen concentration if the sensor is placed in the:
Fresh Gas line
