Diagram challenge

Question 1

Lung volumes

Answer 1

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Question 2

West zones

Answer 2

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Question 3

Oxygen cascade

Answer 3

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Question 4

Oxyhaemoglobin dissociation curve

Answer 4

Myoglobin dissociation curve = hyperbolic

Question 5

Iso-shunt graph

Answer 5

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Question 6

Fowler method for dead space

Answer 6

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Question 7

Valsalva manouvre

Answer 7

Autonomic dysfunction

CCF

Question 8

Action potentials: cardiac myocyte, pacemaker cell, nerve cell

Answer 8

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Question 9

Compliance curves

Answer 9

Normal
Liquid ventilation
ARDS

Inspiration is the inferior limb, expiration the superior.

Question 10

Cardiac cycle

Answer 10

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Question 11

Starling’s law

Answer 11

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Question 12

Starling forces

Answer 12

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Question 13

Total body water distribution

Answer 13

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Question 14

Cerebral blood flow (MAP, gases and Monro-Kellie hypothesis)

Answer 14

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Question 15

Capnograph traces

Answer 15

Lower airway obstruction
Ventilator dyssynchrony/relaxant wearing off
Cardiac oscillations 
Oesophageal intubation
Loss of cardiac output 
ROSC
Disconnection 
Rebreathing 
Hyperventilation
Hypoventilation 
Leak

Question 16

TEG

Answer 16

DIC stage 1
DIC stage 2 / anticoagulants / haemophilia
Antiplatelets / thrombocytopaenia Fibrinolysis / tPA

Question 17

Coronary circulation

Answer 17

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Question 18

Cardiac conduction system

Answer 18

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Question 19

Bioavailability graph

Answer 19

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Question 20

First and zero order kinetics

Answer 20

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Question 21

V/Q

Answer 21

Changes under GA and with position

Question 22

Ventilatory response to PaCO2 and PaO2

Answer 22

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Question 23

PVR

Answer 23

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Question 24

CVP waveform

Answer 24

a = atrial contraction
c = closure of tricuspid valve, ventricular contraction 
x = atrial relaxation 
v = atrial filling 
y = opening of tricuspid valve, ventricular filling 

Systole is between start of c wave and end of v wave.

AF: loss of a waves
TR: loss of x descent, giant v waves
CHB: cannon a waves

CVP reflects the pressure in the great veins of the thorax, and hence the RA. It approximates RV preload. Highest at end expiration in SV and end inspiration in IPPV.

Question 25

Arterial waveform

Answer 25

Upstroke: contractility (slurred upstroke in AS) Dicrotic notch: AV closure; low in low preload AUC up to dicrotic notch): SV Downstroke: SVR Swing: >10mmHg suggests underfilled Pulse pressure: wide in AR, narrow in AS/tamponade/cardiogenic shock/massive PE/tension PTX)

Question 26

ICP waveform

Answer 26

Percussion Tidal Dichrotic

Question 27

Damping and resonance

Answer 27

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Question 28

Wheatstone bridge

Answer 28

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Question 29

Pulmonary artery catheter

Answer 29

RA - inflate balloon once waveform seen RV PA PCWP 6-12mmHg (measured at end expiration) at 45-55cm Investigation of shock aetiology, cardiac shunts, CO measurement, PHTN, route for cardiac pacing. Info: SvO2, CO, core temp, PCWP = LVEDP estimate, RA/RV/PAP, CVP, SVR (derived). Normal SvO2 70-75%; lower in low CO, increased O2 consumption, reduced O2 content.

Question 30

Context sensitive half time

Answer 30

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Question 31

Defibrillator circuit

Answer 31

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Question 32

Ventilator mode graphs

Answer 32

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Question 33

Cardiac axis

Answer 33

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Question 34

Flow volume loops

Answer 34

Restrictive Obstructive Fixed extrathoracic obstruction NB flow volume loops are better than spirometry as effort/technique independent.

Question 35

Oesophageal Doppler trace

Answer 35

Flow time corrected = preload (normal = 330-360ms) Peak velocity = contractility AUC = stroke distance (can calculate SV)

Question 36

Starvation

Answer 36

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Question 37

Calibration/drift/hysteresis

Answer 37

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Question 38

Autonomic nervous system

Answer 38

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Question 39

Calcium homeostasis

Answer 39

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Question 40

Thyroid hormone synthesis

Answer 40

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Question 41

COX pathway

Answer 41

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Question 42

RAAS

Answer 42

Angiotensin II has 5 actions: vasoconstriction, thirst, and release of ADH, ACTH and aldosterone

Question 43

Catecholamine synthesis pathway

Answer 43

PLL DNA

Question 44

Spirogram (volume/time graph)

Answer 44

Normal, obstructive and restrictive

Question 45

Antibiotic classes

Answer 45

``` Inhibit cell wall synthesis - beta lactams - glycopeptides Protein - 30s: aminoglycosides - 50s: macrolides DNA - Fluroquinolones ``` Clavulinic acid and tazobactam = beta lactamase inhibitors

Question 46

Control of respiration

Answer 46

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Question 47

Aerobic and anaerobic metabolism

Answer 47

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Question 48

Vomiting inputs, receptors and drugs

Answer 48

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Question 49

Vaughan Williams classification

Answer 49

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Question 50

Fetal circulation

Answer 50

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Question 51

Intra-aortic balloon pump arterial trace

Answer 51

Early deflation Late deflation Early inflation Late inflation https://lifeinthefastlane.com/cardiovascular-curveball-007/ Up mid T to peak R Up dichrotic notch to just before upstroke