Stanford CA-1 Prep (Basic Monitoring)

Question 1

Oxygen probes emit light at ______ nanometers to detect unoxygenated blood.

Answer 1

660 (red, for Hgb)

Question 2

Oxygen probes emit light at 940 nanometer for ___________ blood.

Answer 2

oxygenated (infrared)

Question 3

In the presence of methemoglobinemia, when true SpO₂ is > 85% you will get a falsely _____ reading.

Answer 3

Low

Question 4

In the presence of methemoglobinemia, when true SpO₂ is < 85% you will get a falsely _____ reading.

Answer 4

High

Question 5

What is the typical treatment for methemoglobinemia?
What if the patient has a G6PD deficiency?

Answer 5

• Typical: Methylene Blue
• G6PD Deficiency? → Vitamin C

Question 6

What are common causes of elevated carboyxhemoglobin levels?

Answer 6

• Smoke inhalation
• VAA degradation
• Dessicated soda lime

Question 7

What is the treatment for excessive carboxyhemoglobin?

Answer 7

• 100% FiO₂
• Hyberbaric O₂

Question 8

The cardinal sign of cyanide toxicity is….

Answer 8

Clinical cyanosis despite high SpO₂.

Question 9

What are two common causes of cyanide toxicity?

Answer 9

• Nitroprusside
• Smoke Inhalation

Question 10

What is the treatment for cyanide toxicity?

Answer 10

Hydroxycobalamin

Question 11

Which leads in a 5 lead EKG system are 98% sensitive for the detection of ischemic events?

Answer 11

II, V4, V5

Question 12

Which lead(s) is/are most sensitive to atrial dysrhythmias?

Answer 12

1. Lead II
2. V1

Question 13

How is MAP calculated?

Answer 13

(SBP + 2*DBP) ÷ 3

Question 14

Where would one want to level the transducer for a neurosurgical case?

Answer 14

At the tragus of the ear to assess cerebral perfusion

Question 15

Whats the mnemonic for assessing the difference in blood pressure between two different sites?

Answer 15

pH 7.410

pressure of 7.4 mmHg occurs with ever height change of 10 cm

Question 16

In the beach chair position the BP cuff in the leg reads 120/80 but you note that the brain is 60 cm higher than the cuff. What would you anticipate the pressure in the brain to be?

Answer 16

~ 75/35

Question 17

What would occur with your arterial waveform as you move away from the proximal aorta?

Answer 17

Systolic amplification

Question 18

What are the phases in a capnographic waveform?

Answer 18

1. V_D gas exhaled
2. V_D and alveolar gas transition
3. Alveolar plateua
4. Inspiration

Question 19

Pulse Pressure will increase with _________ stroke volume and ________ vessel compliance.

Answer 19

increased ; decreased

Question 20

When would PPV be at its apex? How about its lowest?

Answer 20

Question 21

What aspect of the capnography waveform denotes the change from airway gas to alveolar gas?

Answer 21

the α angle

Question 22

Significant hypotension can be associated with a ______ in EtCO₂ .

Answer 22

drop

Question 23

What type of capnography waveform would be anticipated in a patient undergoing bronchospasm?

Answer 23

Question 24

What are the three overarching causes for a drop in EtCO₂?

Answer 24

1. ↓ CO₂ elimination
2. ↓ CO₂ production
3. Circuit problems

Question 25

What are the four most common causes related to decreased CO₂ elimination?

Answer 25

- CV collapse (↓CI) - Venous air embolism - Large PE - Kinked, dislodge, or esophageal ETT

Question 26

What are the three greatest reasons for decreased CO₂ production?

Answer 26

↓ CO₂ production = ↓ metabolism - Hypothermia - Hypothyroidism - Neuromuscular blockade

Question 27

During a diagnostic laparascopy, an intubated and anesthetized patient is placed in trendelenburg. Over the next 20 minutes SpO₂ decreases from 100% to 95%, and EtCO₂ increases from 35 to 40 with no concurrent ventilator setting changes. The most likely reason is: A. Decreased diaphragmatic excursion B. Compression of the Vena Cava C. Carbon Dioxide Embolism D. Pneumothorax

Answer 27

A. Decreased Diaphragmatic Excursion

Question 28

What type of capnogram is depicted below?

Answer 28

Normal capnogram

Question 29

What would you anticipate is the issue based on the capnography below?

Answer 29

Bronchospasm/asthma - Obstruction - Kinked ETT or expiratory circuit

Question 30

What would you anticipate is the issue based on the capnography below?

Answer 30

**Hypoventilation** likely (increasing CO₂) - ↓ RR or V_T - ↑ metabolism - Hyperthermia

Question 31

What would you anticipate is the issue based on the capnography below?

Answer 31

**Hyperventilation** likely (decreasing CO₂) - ↑ resp rate - ↑ V_T - Metabolic acidosis - ↓ body temp

Question 32

What would you anticipate is the issue based on the capnography below?

Answer 32

**Rebreathing CO₂**

Question 33

What would you anticipate is the issue based on the capnography below?

Answer 33

**Curare Cleft** Indication of neuromuscular blockade wearing off (2-3 minutes until patient movement typically).