Exam 1 Flashcards
What gas are you using if you have a white cylinder?
O2
What is th emax peak airway pressure you should generate during bag and mask ventilation ? (same appiies for LMA)
20cmH20
While in VCV, you change the RR from 10 to 20 bpm. Which parameter do you expect to increase the greatest?
Peak airway pressure (shorter time to deliver the same tidal volume)
If the RR is 8 bpm and the I:E ratio is 1:2, how long is inspiration?
2.5sec
When the machine is in standby, all of the following are available except:
A. O2 flush
B. Auxillary O2
C. Flowmeters
D. Suction
E. All items are available
C. Flowmeters (are not available)
If O2 supply pressure drops to 10psi, describe the order of the safety mechanisms?
1st: O2 fail-safe alarms
2nd: O2 fail-safe device activates
3rd: N2O flow stops
(Remember Alarms @ 30psi, N2O stops @ 20psi)
Changing only the I:E ratio form 1:4 to 1:1 would have the following effect on ventilation?
A. increase RR
B. increase possibility of Auto-PEEP
C. Increase Paw
D. Increase Respiratory flow rate
E. Increase Plateau Pressure seen w/ inspiratory pause
B. Increase possibility of Auto-PEEP
Which of the following statements are False regarding wall or column gas pipeline connections:
A. there are no std. connectors for wall or column outlets
B. Wall or column outlets use DISS finttings
C. Wall or column connectors for O2 will not under any circumstances connect to the column for air or N2O
D. DISS connections can be more leak prone than quick connect fittings
D.Diss connections can be more leak prone than quick connect fittings is FALSE
Which ventilation mode utilizes a decelerating flow pattern?
A. VCV
B. PCV
C. SIMV
D. IMV
E. SV
B. PCV
Which of the following is not an anesthesia machine function?
A. Receive gases from pipeline or cylinders
B. Measure a precise amount of gases and load them with anesthetic vapors
C. Provide gases to pt.
D. Ensure pt. is stable and alive
E. All of the above are machine functions
D. Ensure pt. is stable and alive
(machine provides the tools for monitoring; it’syour your job to ensure the stability of the pt. )
A morbidly obese pt. is undergoing a laparoscopic gastric proc. After insulflation of the abdomen with CO2, you note that the Paw is 45cmH2O on your Aisys machine. Each of the following adjustments would be expected to lower Peak pressure EXCEPT:
A. Changing I:E from 1:3 to 1:2
B. Decreasing RR
C. Reducing the tidal volume
D. Switching to PCV
E. Reducing fresh gas flow from 3L/min to 1L/min
E. Reducing fresh gas flow from 3L/min to 1L/min
(it will only on the EXCEL due to fresh gas coupling)
If the pipeline pressure is 46 psi and the cylinder si 47 psi, which gas supply will the machine use?
Cylinder
You are administering 1L/min O2 and 1L/min N2O using an older Datex-Ohmeda machine. There is a sudden loss of O2 pipeline pressure. Which activates the fail-safe system. You immediately switch to the onboard O2-cylinder without adjusting flowmeters. Describe the action fo the floats.
Both floats go to zero and then rise back to their previous values.
What happens to expiratory time when you increase RR?
A. Shortens
B. Lengthens
C. Nothing
D. it depends
A. Shortens
If you are told that an E-cylinder is empty, what is the pressure in the cylinder?
A. 14.7 psig
B. 14.7 psia
C. 0 psia
D. 2200 psig
B. 14.7 psia
(which is equal to 0 psig)
You are doing a lap. cholecystectomy on a 100 kg pt. Teh abdomen is insulflated. Ventilator setting are TV=1000ml, RR=10, I:E=1:2. Actual tidal volume delivered is 400 ml w/ peak airway pressure @ 42cmH20. What would be the best way to reduce Paw on a machine that does not have PCV and still maintain minute-Ventilation?
A. Decrease Vt
B. Increase I:E ratio from 1:2 to 1:4
C. Increase RR
D. Both A and C
E. All of the above
D. Both A and C
The complete FDA approved anesthesia machine checkout proc. should be performed when?
Before the 1st case of the day
What can you control in SIMV that you can’t control on PSV?
A. Tidal volume
B. RR
C. Plateau pressure
D. I:E ratio
E. They are the same
B. RR
and
D. I:E ratio
Why does an alarm sound when you switch the machine on and again when you switch the machine off?
Because the O2 fail-safe alarm is being activated
Why should you turn off the O2 cylinder after the machine check?
A. maintain initial volume
B. so alarm goes off when pipeline supply is low
C. it is the backup O2 supply
D. all of the above
All of the above
What machine component generates positive pressure?
APL valve
What is meant by a “stacked breath”?
A. Rapid positive pressure breaths from ventilation with no pt. effort
B. Positive pressure breaths that progressively increase in volume.
C. Synchronize breath to pt. inspiratory effort
D. Timing of ventilation breath to conincide w/ pt. inspiratory effort.
E. Unsynchronized ventilator breath delivered immediately after full pt. inspiration
E
If you are in PSV mode and your pt. is takind a supported TV of 1000 ml/breath with a pressure support level of 15cmH2O and you want a TV level close to 500 ml/breath, what should you adjust on the machine?
A. Decrease the RR
B. Decr. Pressure Support Level
C. Decr. TV
D. Incr. the peak flow
E. Incr the APL valve to 10 cmH2O resistance
B. Decr. Pressure Support Level
What is the primary gas that pushes the bellows up during mechanical ventilation?
A. exhaled gas
B. fresh gas
C. drive gas
D. park gas
A. exhaled gas
The device on machine that most reliably detects delivery of hypoxic gas mixture is the
A. Fail-safe device
B. O2 analyzer
C. Second-stage O2 pressure regulator
D. Proportioning system
E. PISS
B. O2 analyzer
(note: Proportioning system prevents but can’t detect hypoxic mixture)
Changing only I:E ratio form 1:1 to 1:4 will affect ventilation by
A. Incr. Inspiratory pause
B. Incr. plateau pressure
C. Incr. TV
D. Incr. Inspiratory flow rate
E. Incr. RR
D. Increase Inspiratory flow rate
Medical gas purity is enforced by :
FDA
OSHA
DOT
NIOSH
FDA
Depressing the O2 flush button while the mahine is turned off results in an oxygen flow rate of ______ to the common gas outlet
A. 25 - 55 L/min
B. 50 - 100 L/min
C. 35 - 75 L/min
D. 100 - 200 L/min
C. 35-75 L/min
Which of the following is the best ventilation mode in order to control pressure being exerted on the alveoli, but at the same time maximize the amount of TV being delivered in a pt. w/ poorly compliant lungs?
PCV
Which of the following is NOT part of the low-pressure (~18psia) system of the anesthesia machine?
A. vaporize
B. Common-gas outlet
C. Floats
D. Flowmeter
E. O2 low-pressure alarm
E. O2 low-pressure alarm (intermediate ~30 psia)
note: low-pressure starts @ the flowmeters. Downstream of that are the vaporizer and common gas outlet
Which of the following is true regarding the Drager and newer generation Datex-Ohmeda anesthesia machines:
A. Low oxygen pressure will shut off the N2O flow
B. Low oxygen reduces the N2O in proportion to O2
B.
What information is obtained when performing an inspiratory pause maneuver during VCV ventilation?
Pressure exerted on the alveoli
Which of the following cylinder has the largest volume?
B
D
E
G
H
H
What do you expect to happen when you change form PCV with an inspiratory pressure of 20 to VCV w/ a plateau pressur of 20 given the pulmonary and throracic compliance remain constant?
A. Decrease in PIP
B. Decrease in TV
C. Increase PEEP
D. Increase in flow trigger
E. No diff in any parameter
B. Decrease in TV (less area under the curve)
How does a drop in minute-ventilation affect EtCO2?
EtCO2 increases
Link 25-mechanism utilizes what components:
A. Mechanical
B. Pneumatic (secondary pressure regulators)
C. Both
D. Neither
C. Both
Which is not part fo the intermediate pressure system of the anesthesia machine?
A. Vaporizer
B. O2-fail safe
C. O2 low pressure alarm
D. N2O second stage regulator
A. Vaporzier
Which of the following is not a mandatory safety feat. of current anesthesia delivery system?
A. O2 fail safe device
B. Pulse Oximetry
C. O2 flowmeters @ extreme rt. of flowmeter cluster
D. Vaporizer interlock
E. ALL
E. All
All of the following are a benefit of PEEP application EXCEPT?
A. Incr. FRC
B. Incr. intrathoracic pressure
C. Recruits collapsed alveoli
D. Redistribute lung fluid
E. Splints and distends alveoli
B.
What is a mesure of mean pressure being exerted on the alveolar wall during a mechanical breath?
Plateau pressure
Given a large university medical ctr. of 700 beds, which of the following piped gased are most likely provided to the pipeline by banks of cylinders
A. O2
B. Air
C. N2O
D. All of the above
C. N2O
Note: O2 - liquid tanks and Air - purified from the unlimited air
An E cylinder of O2 w/ 2000 psig will last approx. how long at 5L/min?
2 hrs
