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FRCA Physics > Gas, Breathing systems and Ventilators > Flashcards

Gas, Breathing systems and Ventilators Flashcards

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1
Q

With regard to the Bain System It requires a test of the bag integrity using the Pethick procedure

A

False

The Pethick procedure is used to test for Fracture of the inner fresh gas tube at the common gas outlet

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2
Q

With regard to the Bain System It is most efficient in controlled ventilation

A

True

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3
Q

With regard to the Bain System It risks failure of safe scavenging if the inner tube fractures at the common gas outlet

A

False
fracture of the inner fresh gas tube at the common gas outlet results in a massive increase in dead space within the system rather than scavenging failure.

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4
Q

With regard to the Bain System It is a coaxial variant of the Mapleson D system

A

True

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5
Q

With regard to the Bain System It can safely be extended to over 5 m in length with no loss in efficiency

A

True
The length of the system does not affect efficiency and this makes the Bain a useful alternative to the Circle when long systems are required for example in the MRI scanner.

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6
Q

The critical temperature of a gas can be correctly defined as ‘The temperature…

A

Above which it cannot be liquefied by pressure alone

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7
Q

With regard to Entonox:

It is a 50:50 mix by weight of oxygen and nitrous oxide

A

False

Entonox is oxygen and nitrous oxide 50:50 by volume.

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8
Q

With regard to Entonox:

It is supplied in cylinders at a pressure of 137 bar

A

True

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9
Q

With regard to Entonox:

It has a pseudo-critical temperature of 5.5 degrees Celsius

A

False

The two components separate below the pseudo-critical temperature of -5.5 Celsius.

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10
Q

With regard to Entonox:

Cylinders should be stored upright

A

False
horizontal storage increases the surface area for diffusion of oxygen back into the liquid nitrous oxide to reform the entonox mix more quickly but this is not a normal storage requirement per se.

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11
Q

With regard to Entonox:

It exists only in gaseous form in a cylinder

A

True

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12
Q

Essential elements of the oxygen VIE include:

A double-skinned steel pressure vessel

A

True

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13
Q

Essential elements of the oxygen VIE include:

A secondary outlet to remove additional vapour from the top of the tank in times of high demand

A

False
During high demand or cold temperatures, vapour pressure will fall within the VIE and so liquid must be removed from the bottom of the tank and vapourized to meet demand.

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14
Q

Essential elements of the oxygen VIE include:

A bourdon gauge to indicate remaining contents of the vessel

A

False
Because the tank contains predominantly liquid oxygen, contents are primarily measured by weighing scales which form the support base for the tank.

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15
Q

Essential elements of the oxygen VIE include:

A system of regulators to reduce supply pressure to 4.1 bar

A

True

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16
Q

Essential elements of the oxygen VIE include:

A safety valve to open at 15 bar

A

True

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17
Q

With regard to standard medical gas cylinders:

Undergo safety checks every three years

A

False

Cylinders are checked every five years

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18
Q

With regard to standard medical gas cylinders:

Have plastic neck rings to signify year of manufacture

A

False

Safety check dates rather than those of manufacture, are indicated by coloured plastic rings around the cylinder neck.

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19
Q

With regard to standard medical gas cylinders:

Are made of molybdenum steel

A

True

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20
Q

With regard to standard medical gas cylinders:

Can withstand pressures 65-70% above working pressure

A

True

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21
Q

With regard to standard medical gas cylinders:

Are safe in MRI scanners

A

False
Standard cylinders are ferromagnetic (molybdenum steel) and are extremely dangerous in MRI scanners – specialist composite or aluminium cylinders are required in this environment.

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22
Q

With regard to the Mapleson A System:

It is most efficient when used for controlled ventilation

A

False

The Mapleson A system is most efficient in spontaneous ventilation

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23
Q

With regard to the Mapleson A System:

It is available in parallel and coaxial configurations

A

True

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24
Q

With regard to the Mapleson A System:

It removes the weight of the APL valve from the patient’s face when used in the Magill configuration

A

False
The Lack modification of the original Magill removes the APL valve from the patient mask to the anaesthestic machine end of the system.

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25
Q

With regard to the Mapleson A System:

It requires a fresh gas flow 1.5-2 x minute volume when used for spontaneous ventilation

A

False

spontaneous ventilation requiring a fresh gas flow of approximately 70% minute ventilation.

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26
Q

With regard to the Mapleson A System:

It has an inner expiratory and outer inspiratory tube in the coaxial variants

A

True

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27
Q

With regard to soda lime:

It is primarily composed of calcium salts

A

True

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28
Q

With regard to soda lime:

It is the active component of a Cardiff Aldasorber

A

False

The Cardiff Aldasorber adsorbs anaesthetic volatile agents onto activated charcoal.

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29
Q

With regard to soda lime:

1kg will absorb 120 L of carbon dioxide

A

True

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30
Q

With regard to soda lime:

It will become white when exhausted

A

False

Commonly, dyes change granules from white to violet or pink to white when exhausted.

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31
Q

With regard to soda lime:

It is associated with carbon monoxide generation

A

True

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32
Q

With regard to the Circle system:

It warms and humidifies inspired gases by passing the fresh gas through soda lime

A

False

Conventionally, the fresh gas enters the circuit after the soda lime canister.

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33
Q

With regard to the Circle system:

It requires at least one unidirectional valve to prevent rebreathing

A

False

The Circle system requires at least two unidirectional valves to prevent rebreathing.

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34
Q

With regard to the Circle system:

It can be used in a fully closed configuration

A

True

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35
Q

With regard to the Circle system:

Due to the recycling of expired gases does not require a scavenging system

A

False
While soda lime extracts carbon dioxide, scavenging is still required to prevent pollution of the theatre environment with waste anaesthetic vapours.

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36
Q

With regard to the Circle system:

Inspired and expired oxygen analysers are required for fully closed operation

A

True

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37
Q

With regard to pressure control ventilation:

It is able to compensate for breathing system leakage

A

True

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38
Q

With regard to pressure control ventilation:

It is the preferred choice in severe asthma to reduce barotrauma

A

False
Pressure control ventilation has the principal disadvantages of failing to ventilate those with high airways resistance (acute severe asthma) or low compliance whilst producing very large tidal volumes (potential volutrauma)

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39
Q

With regard to pressure control ventilation:

It is a suitable choice in paediatric anaesthesia

A

True

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40
Q

With regard to pressure control ventilation:

It utilizes constant inspiratory flow

A

False

It uses a constant pressure producing decreasing flow as the lungs inflate.

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41
Q

With regard to pressure control ventilation:

It can maintain ventilation with changes in compliance

A

False

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42
Q

With regard to volume control ventilation

It utilizes a constant inspiratory flow

A

True

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43
Q

With regard to volume control ventilation

It is the preferred choice in paediatric anaesthesia

A

False
Because of the uncuffed endotracheal tubes used in paediatric practice, volume modes are less efficient at maintaining adequate ventilation owing to the airway leak.

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44
Q

With regard to volume control ventilation

It can be combined with positive end-expiratory pressure (PEEP)

A

True

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45
Q

With regard to volume control ventilation

It is the preferred choice in head injured patients

A

True
Volume control ventilation maintains much better minute ventilation control providing better PaCO2 control than pressure control modes.

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46
Q

With regard to volume control ventilation

It is a good mode for the final stages of weaning ventilation on the ICU

A

False
Pressure modes tend to be better tolerated by conscious patients and this makes volume control a less suitable mode for ventilation weaning.

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47
Q

Methods of optimising oxygenation include:

Increasing levels of PEEP

A

True

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48
Q

Methods of optimising oxygenation include:

Increasing fractional inspiratory oxygen

A

True

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49
Q

Methods of optimising oxygenation include:

Increasing mean airways pressure

A

True

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50
Q

Methods of optimising oxygenation include:

Decreasing levels of Expiratory Positive Airways Pressure (EPAP)

A

False
EPAP increases mean airways pressure in a similar manner to PEEP (Positive End Expiratory Pressure) and so decreasing it may worsen oxygenation.

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51
Q

Methods of optimising oxygenation include:

Moving from supine to semi-recumbent position

A

True
In the semi-recumbent position, functional residual capacity is increased and atelectasis reduced. For ventilated ICU patients this is also the optimal posture to minimize the risk of gastric regurgitation and pulmonary aspiration.

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52
Q

Methods of reducing PaCO2 include

Increase in respiratory rate

A

True
Optimal minute ventilation is required to ensure CO2 clearance and this is determined by adequate respiratory rate and tidal volume.

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53
Q

Methods of reducing PaCO2 include

Avoiding high peak airways pressure

A

False
High peak airways pressure should always be avoided but this will not improve CO2 clearance. Higher CO2 is often permitted in cases of lung injury (ALI/ARDS) to avoid the damaging effects of high peak pressure.

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54
Q

Methods of reducing PaCO2 include

Increasing minute ventilation

A

True

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55
Q

Methods of reducing PaCO2 include

Increasing fresh gas flow

A

True
Increasing fresh gas flow when using semi-closed systems (those classified by Mapleson) will reduce the chance of re-breathing alveolar gas.

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56
Q

Methods of reducing PaCO2 include

Decrease in the duration of inspiration to the duration of expiration (I:E ratio)

A

False
A decrease in the I:E ratio, usually achieved by reducing inspiratory time, will result in decreased respiratory rate (and minute ventilation) unless adjustments are made to maintain constant rate.

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57
Q

Concerning cryogenic liquid systems

recommended on-site storage capacity is 4 days

A

False

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58
Q

Concerning cryogenic liquid systems

One volume of liquid O2 gives 130x its volume of gas

A

False

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59
Q

Concerning cryogenic liquid systems

pressure inside vacuum insulated evaporator is 4 bar

A

False

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60
Q

Concerning cryogenic liquid systems

heating of gaseous oxygen is required at the outlet

A

False

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61
Q

Concerning cryogenic liquid systems

cylinder back-up is required

A

True

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62
Q

Concerning medical gas cylinders

Titanium is most often used for making cylinders

A

False

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63
Q

Concerning medical gas cylinders

in the UK O2 cylinders are colour coded as blue

A

False

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64
Q

Concerning medical gas cylinders

gauge pressure in a full molydenum steel O2 cylinder should read 137 bar

A

True

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65
Q

Concerning medical gas cylinders

Nitrous oxide cylinders contain liquid

A

True

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66
Q

Concerning medical gas cylinders

Size E oxygen cylinders contain 1800 L

A

False

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67
Q

Regarding Piped gas supply

pipes are made of aluminium alloy

A

False

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68
Q

Regarding Piped gas supply

pressure in medical air pipe is 7 bar

A

False

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69
Q

Regarding Piped gas supply

Schrader sockets and probes are used on the back of the anaesthetic machine to prevent inadvertant misconection

A

False

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70
Q

Regarding Piped gas supply

Schrader probes are of different size for different gases

A

False

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71
Q

Regarding Piped gas supply

pressure in O2 pipe is the same as in nitrous oxide pipe

A

True

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72
Q

The emergency O2 flush

bypasses the flowmeter block

A

True

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73
Q

The emergency O2 flush

should provide a flow of at least 20 L/min

A

False

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74
Q

The emergency O2 flush

it should be possible to lock it in position

A

False

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75
Q

The emergency O2 flush

incorporates a pressure limiting valve to prevent barotrauma

A

False

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76
Q

The emergency O2 flush

use may lead to awareness

A

True

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77
Q

Regarding suction

can be generated using the venturi system

A

True

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78
Q

Regarding suction

should be able to generate unrestricted flow >40 L/min

A

False

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79
Q

Regarding suction

should be able to generate negative pressure of >500 mmHg in 10 sec

A

True

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80
Q

Regarding suction

tubing should be of a low resistance but high compliance

A

False

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81
Q

Regarding suction

float controls are essential parts to protect the patient

A

False

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82
Q

Flowmeters on the anaesthetic machine

are constant pressure, variable orifice devices

A

True

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83
Q

Flowmeters on the anaesthetic machine

readings are taken from the bottom of the bobbin

A

False

84
Q

Flowmeters on the anaesthetic machine

bobbins are universal for all medical gases

A

False

85
Q

Flowmeters on the anaesthetic machine

the tube us a cylindrical shape

A

False

86
Q

Flowmeters on the anaesthetic machine

the flow control knobs are colour coded

A

True

87
Q

Regarding plenum vaporisers

temperature compensation is not required

A

False

88
Q

Regarding plenum vaporisers

the output is independant of the gas flow

A

False

89
Q

Regarding plenum vaporisers

TEC 6 vaporser is heated to 23.5C

A

False

90
Q

Regarding plenum vaporisers

splitting ratio ensures better vaporisation

A

False

91
Q

Regarding plenum vaporisers

latent heat of vaporisation reduces agent concentration

A

True

92
Q

Concerning soda lime

heat is produced in the process of its action

A

True

93
Q

Concerning soda lime

the largest component is sodium hydroxide

A

False

94
Q

Concerning soda lime

usually presented as powder

A

False

95
Q

Concerning soda lime

may react with sevoflurane to produce carbon monoxide

A

False

96
Q

Concerning soda lime

1kg will absorb about 100L of CO2

A

False

97
Q

Regarding scavenging

Maximum recommended concentrations for nitrous oxide in theatre are 100 ppm

A

True

98
Q

Regarding scavenging

it is attached to breathing systems with 22mm connection

A

False

99
Q

Regarding scavenging

pressure relief valves are incorporated in passive systems to maintain pressure within the -50 to 1000 Pa range

A

True

100
Q

Regarding scavenging

Active scavenging systems incorporate a reservoir that is open to the atmosphere

A

True

101
Q

Regarding scavenging

Active systems and suction use the same vacuum supply

A

True

102
Q

Regarding breathing systems

There is no mapleson classification for the circle system

A

True

103
Q

Regarding breathing systems

The circle system has the lowest minimum fresh gas flow requirement of all commonly used systems

A

True

104
Q

Regarding breathing systems
During spontaneous ventiation, mapleson D and E systems have the same minimum fresh gas flow requirement to prevent rebreathing

A

True

105
Q

Regarding breathing systems

Mapleson E system can only be used with spontaneously breathing patients

A

False

106
Q

Regarding breathing systems

Mapleson A systems function as a T-piece if the bag is removed

A

False

107
Q

Concerning Nitrous Oxide cylinders

The amount of N2O can be calculated using charles’s law

A

False

108
Q

Concerning Nitrous Oxide cylinders

The amount of N2O can be calculated using boyles law

A

False

109
Q

Concerning Nitrous Oxide cylinders

the filling ration in the UK is 0.85

A

False

110
Q

Concerning Nitrous Oxide cylinders

the knowledge of molecular weight of N2O is required to calculate the remaining amount

A

True

111
Q

Concerning Nitrous Oxide cylinders

The size is determined by the cylinder weight when empty

A

False

112
Q

The Desflurane Tec 6 vaporiser

the vaporisation chamber is heated to a temp of 23.5C

A

False

113
Q

The Desflurane Tec 6 vaporiser

the vaporisation chamber is pressurised to approx 200 kPa

A

True

114
Q

The Desflurane Tec 6 vaporiser

is an example of variable bypass vaporiser

A

False

115
Q

The Desflurane Tec 6 vaporiser

fresh gas flow never goes through the vaporising chamber

A

True

116
Q

The Desflurane Tec 6 vaporiser

incorporates a differential pressure transducer

A

True

117
Q

Regarding breathing system components

The standard adult reservoir bag size is 1 L

A

False

118
Q

Regarding breathing system components

Reservoir bags limit the pressure within the breathing system to 40 cm H2O

A

True

119
Q

Regarding breathing system components

when fully open, the APL valve requires a presure of 2-5 cm H2O to allow exhalation of gases

A

False

120
Q

Regarding breathing system components

the pressure across an APL valve is limited to a maximum of 50 cm H2O

A

False

121
Q

Regarding breathing system components

All connections except those for scavenging are 15 or 22mm

A

True

122
Q

The following are safety features of a modern anaesthetic workstation
emergency O2 flush

A

True

123
Q

The following are safety features of a modern anaesthetic workstation
NIST connections

A

True

124
Q

The following are safety features of a modern anaesthetic workstation
colour coded pressure gauges

A

True

125
Q

The following are safety features of a modern anaesthetic workstation
Ohmeda Link 25 system

A

True

126
Q

The following are safety features of a modern anaesthetic workstation
colour oded cylinder bodies

A

False

127
Q

Regarding the oxygen supply failure alarm

activation is dependant solely on oxygen supply pressure

A

True

128
Q

Regarding the oxygen supply failure alarm

it eliminates the possibility of anoxic gas mixtures

A

False

129
Q

Regarding the oxygen supply failure alarm

it is coupled to a valve that interrupts the flow of anaesthetic gases

A

True

130
Q

Regarding the oxygen supply failure alarm

it requires oxygen in the back-up cylinder as a power source

A

false

131
Q

Regarding the oxygen supply failure alarm

requires an electrical power source for its audible component

A

False

132
Q

Concerning Vacuum insulated evapouriser

it contains only liquid oxygen

A

False

133
Q

Concerning Vacuum insulated evapouriser

the temp inside is -119C

A

False

134
Q

Concerning Vacuum insulated evapouriser

the blow-off valve opens at 1000 kPa

A

False

135
Q

Concerning Vacuum insulated evapouriser

the pressure inside is less than 100kPa

A

False

136
Q

Concerning Vacuum insulated evapouriser

amount of oxygen inside isdetermined by the pressure gauge

A

False

137
Q

Concerning Mapleson D (Bain Circuit)

fresh gas flow is delivered via inner tube

A

True

138
Q

Concerning Mapleson D (Bain Circuit)

is a type of T-piece system

A

True

139
Q

Concerning Mapleson D (Bain Circuit) is more efficient for controlled ventilation than spontaneous

A

True

140
Q

Concerning Mapleson D (Bain Circuit)

could be used with low-flow anaesthesia

A

False

141
Q

Concerning Mapleson D (Bain Circuit)

better for controlled ventilation due to high resistance to breathing

A

False

142
Q

in a circle system

a unidirectional valve must be located between the patient and reservoir bag only on the expiratory limb

A

Flase

143
Q

in a circle system

fresh gas flow cannot enter between patient and expiratory valve

A

True

144
Q

in a circle system

APL valve can be located between patient and inspiratory valve

A

False

145
Q

in a circle system

soda lime is always essential for use

A

False

146
Q

in a circle system

scavenging is easier compared to jackson rees circuit

A

True

147
Q

The variable bypass vaporisers currently available

are based on the principle of dilution of the vapour produced in the vaporising chamber by a bypass gas stream

A

True

148
Q

The variable bypass vaporisers currently available

deviate the major part of the gas flow through a channel which bypasses the vaporising chamber

A

True

149
Q

The variable bypass vaporisers currently available

completely saturate the carrier gas passing through the vaporising chamber with anaesthetic vapour

A

True

150
Q

The variable bypass vaporisers currently available

have comparatively high resistance to flow

A

True

151
Q

The variable bypass vaporisers currently available

have a temperature sensitive valve that reduces flow through the vaporiser when cooled

A

False

152
Q

Regarding anaesthetic machines

it is recommended that vaporisers be removed from the machine prior to filling them

A

False

153
Q

Regarding anaesthetic machines

tilting vaporisers can esult in a delivery of a dangerously high concentration of vapour

A

True

154
Q

Regarding anaesthetic machines

The oxygen failure alarm should be checked weekly by disconnection of the O2 hose

A

True

155
Q

Regarding anaesthetic machines

the anti-hypoxia device should ensure that when nitrous oxide is used at least 25% O2 also flows

A

True

156
Q

Regarding anaesthetic machines

the AAGBI anaesthetic machine checklist includes cheking the scavenging system

A

True

157
Q 
The Magill (Mapleson A) breathing system:
Is the most efficient Mapelson system for spontaneously breathing patients
A

True. This system is characteristically efficient for spontaneous ventilation but not controlled ventilation.

158
Q 
The Magill (Mapleson A) breathing system:
Will work with minimal re-breathing at a fresh gas flow of 70% of minute volume in spontaneous ventilation
A

True

159
Q 
The Magill (Mapleson A) breathing system:
Makes scavenging of exhaled gases easier
A

False. Scavenging requires an appropriate system to be connected to the APL valve but this is not particularly more or less easy to achieve for the Mapleson A than other systems.

160
Q 
The Magill (Mapleson A) breathing system:
The co-axial version is the Lack system
A

True

161
Q 
The Magill (Mapleson A) breathing system:
Is also efficient during controlled ventilation
A

True

162
Q

Breathing (reservoir) bags:

Have a capacity roughly equating the vital capacity of an 80 Kg adult

A

False. The reservoir bag for adult use has a volume of approximately 2L.

163
Q

Breathing (reservoir) bags:

A standard 0.5L bag can be used with a Jackson-Rees system

A

False. The Jackson-Rees modification to the Mapelson E (making it a Mapelson F) includes a specialised reservoir bag with an opening at the end to allow a controlled leak and variable PEEP.

164
Q

Breathing (reservoir) bags:

Prevent wastage of fresh gas flow during expiratory pause

A

True

165
Q

Breathing (reservoir) bags:

Provide a rough visual assessment of volume of ventilation

A

True

166
Q

Breathing (reservoir) bags:
Act as a reservoir because the anaesthetic machine can not provide the peak inspiratory flow required in normal respiration

A

True

167
Q

Regarding breathing systems used in anaesthesia:
The Magill system is most efficient for spontaneously breathing patients even at a fresh gas flow (FGF) of 70% of minute ventilation

A

True

168
Q

Regarding breathing systems used in anaesthesia:

D, E and F systems are all T pieces

A

True

169
Q

Regarding breathing systems used in anaesthesia:

The Bain system requires a FGF of 50-60 ml/kg during spontaneous breathing

A

False. The Bain system (a Mapelson D variant) requires a FGF 2-3x minute ventilation to prevent rebreathing.

170
Q

Regarding breathing systems used in anaesthesia:
The rate of change of vapour concentration in circle system depends on circle system volume, the FGF rate and net gas uptake

A

True

171
Q

Regarding breathing systems used in anaesthesia:

The Magill system is inefficient during controlled ventilation because much of the gases are vented via pop-off valve

A

True

172
Q

Concerning absorption of carbon dioxide in breathing systems:
Soda lime granules are size 4-8 mesh

A

True

173
Q

Concerning absorption of carbon dioxide in breathing systems:
Baralyme contains calcium hydroxide in addition to barium hydroxide

A

True

174
Q

Concerning absorption of carbon dioxide in breathing systems:
Soda lime produces more compound A during low fresh gas flow

A

True

175
Q

Concerning absorption of carbon dioxide in breathing systems:
Dry soda lime absorbs more carbon dioxide

A

False. Water is generated by the overall reaction of CO2 with soda lime but it’s presence or absence does not influence performance of the compound.

176
Q

Concerning absorption of carbon dioxide in breathing systems:
Carbon dioxide first reacts with sodium and potassium hydroxide of soda lime

A

True

177
Q

Regarding anaesthetic breathing systems:

Re-breathing does not occur in Mapleson D during controlled ventilation

A

False. Re-breathing can be prevented from occurring in controlled ventilation with the Mapelson D but this is dependent on adequate fresh gas flow.

178
Q

Regarding anaesthetic breathing systems:
With a fresh gas flow (FGF) <1.5 L, volatile concentration in the breathing system may be higher than the dial setting of the vaporiser at steady state

A

False. The delivered volatile concentration is, in practice, rarely the same as the dial setting but it cannot exceed it except in the few moments after the vapouriser is dramatically turned down or switched off and the system is re-equilibrating.

179
Q

Regarding anaesthetic breathing systems:

In the circle system with a FGF <1 L (N2O:O2=66:34), FIO2 in the circle may increase over time

A

False. In low flow operation of the circle, particularly where the oxygen volume supplied falls towards or below metabolic requirements, the FiO2 will steadily fall and the circle will empty; N2O rapidly equilibrates and so uptake of N2O will not exceed that of oxygen so increase in oxygen concentration does not result.

180
Q

Regarding anaesthetic breathing systems:
A FGF of 3 times the minute volume may be needed to prevent re-breathing in Bain’s co-axial system during spontaneous ventilation

A

True

181
Q

Regarding anaesthetic breathing systems:

Dead space gas is preserved in Magill system during spontaneous ventilation

A

True

182
Q

Regarding nitrous oxide:

Has a MAC of 1.05

A

False. Nitrous oxide has a MAC of 105% and so is not an anaesthetic suitable for use at STP as pure nitrous oxide would neither have a MAC of 1.0 nor deliver any oxygen to the patient.

183
Q

Regarding nitrous oxide:

Can be safely administered via a Quantiflex mixer

A

True. It can be safely delivered via a Quantiflex mixer which allows a full range oxygen/nitrous oxide mixtures to be administered from 21-100% oxygen so avoiding accidental hypoxic mixtures.

184
Q

Regarding nitrous oxide:

Has a pseudocritical temperature of -5.5C

A

False. A pseudocritical temperature is a property of gas mixtures such as entonox.

185
Q

Regarding nitrous oxide:

Is an inert gas

A

False. Nitrous oxide is not an inert gas and in fact with sufficient heat, dissociates to become an avid oxidant.

186
Q

Regarding nitrous oxide:

Is recognisable by French-blue cylinders and a pin-index of 3 and 5

A

True

187
Q

The Mapleson A breathing system:

Is a non-rebreathing system

A

False. Re-breathing can occur with any Mapelson system if used incorrectly.

188
Q

The Mapleson A breathing system:

Must have the expiratory valve close to the patient

A

False. The position of the APL relative to the patient is not the critical factor and the Lack system is a Mapelson A where the APL is removed from the patient end of the system.

189
Q

The Mapleson A breathing system:

Requires a fresh gas flow equal to the dead space ventilation

A

False. Fresh gas flow requirements are determined by the ventilation mode - 70% of MV in spontaneous ventilation, 200-300 ml/kg in controlled ventilation.

190
Q

The Mapleson A breathing system:

Requires a higher fresh gas flow than a Mapleson D system in manual ventilation

A

True

191
Q

The Mapleson A breathing system:

Was modified by Magill from Mapleson’s original design

A

False. William Mapelson classified the semi-open breathing systems by functional characteristics, he did not design them.

192
Q

Activated charcoal, as used in the Cardiff Aldasorber:

Does not absorb nitrous oxide

A

True

193
Q

Activated charcoal, as used in the Cardiff Aldasorber:

Is effective in absorbing isoflurane

A

True

194
Q

Activated charcoal, as used in the Cardiff Aldasorber:

Increases expiratory resistance significantly

A

False. The Cardiff Aldasorber is a low resistance device.

195
Q

Activated charcoal, as used in the Cardiff Aldasorber:

Can be reactivated by heating to remove the absorbed agents

A

True

196
Q

Activated charcoal, as used in the Cardiff Aldasorber:

Changes from white to blue when exhausted

A

False. There is no indicator dye; the only change the device undergoes during use is a small and gradual increase in mass as volatile substances are adsorbed onto the granules.

197
Q

A canister of soda-lime:

Contains mostly calcium carbonate

A

False. The principal ingredient in soda-lime is calcium hydroxide with others including sodium hydroxide (3%) and water (20%).

198
Q

A canister of soda-lime:

Requires water for the absorption process

A

True

199
Q

A canister of soda-lime:

Contains 50% by weight of sodium hydroxide

A

False

200
Q

A canister of soda-lime:

Will absorb nitrous oxide

A

False. Nitrous oxide is not absorbed.

201
Q

A canister of soda-lime:

When packed will be 50% filled with granules

A

True

202
Q

When using a circle system (with a CO2 absorber) and a vaporiser outside the circle:
A fresh gas flow of at least 2/3 of the minute volume is required

A

False. Due to the ability to largely recycle gases and a lack of leaks, modern circle systems can sustain very low flows; in a fully closed configuration, total gas flow can be reduced to 100% oxygen at a rate equivalent to the metabolic requirements of the patient (200-300ml/min).

203
Q

When using a circle system (with a CO2 absorber) and a vaporiser outside the circle:
The actual inspired vapour concentration during maintenance may be higher than the vaporiser setting

A

False. During maintenance (i.e. at steady-state), the inspired volatile agent will eventually reach but never surpass the set concentration on the vapouriser.

204
Q

When using a circle system (with a CO2 absorber) and a vaporiser outside the circle:
The actual inspired oxygen concentration may be lower than that of the fresh gas at low fresh gas flows

A

True

205
Q

When using a circle system (with a CO2 absorber) and a vaporiser outside the circle:
Sevoflurane is a suitable agent to use

A

True

206
Q

When using a circle system (with a CO2 absorber) and a vaporiser outside the circle:
The system can only be used for patients breathing spontaneously

A

False. The circle can be used equally well in spontaneous or controlled ventilation.

FRCA Physics (7 decks)

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