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Beademing - 2

EDIC-1 voorbereidingsdag

1) During controlled ventilationa) Airway pressure generated depends on compliance and resistance

of the respiratory system and circuitb) The inspiratory pressure waveform is constant during volume

ventilationc) In time triggering, breaths are delivered according to a pre-set

frequencyd) Triggering is when the ventilator incorrectly cycles to inspiratione) Cycling is used to dictate when the inspiratory phase is complete

1) During controlled ventilationa) Airway pressure generated depends on compliance and resistance

of the respiratory system and circuitb) The inspiratory pressure waveform is constant during volume

ventilationc) In time triggering, breaths are delivered according to a pre-set

frequencyd) Triggering is when the ventilator incorrectly cycles to inspiratione) Cycling is used to dictate when the inspiratory phase is complete

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1) During controlled ventilationa) Airway pressure generated during controlled ventilation depends

on the compliance and resistance of the respiratory system andcircuit

b) Inspiratory flow is constant (square wave) durrng volume controlled ventilation

c) In time triggering, breaths are delivered according to a pre-set frequency

d) Triggering is when the ventilator detects a drop in airway pressureor flow that occurs when a patient makes a spontaneous breath, instigating the ventilatoir to deliver a positive pressure inspiratorybreath

e) Volume, time and flow can be used to cycle a ventilator

2) Regarding the physiology of the lungsduring mechanical ventilation

a) Normal static lung compliance is 50-100ml/cmH20b) Plateau pressure = P compliance – Presistancec) Volume-controlled ventilation produces a square inspiratory flow

patternd) CO2 elimination is proportional to minute volume e) Ventilation is greater at the lung basis in healthy spontaneausly

breathing individuals

2) Regarding the physiology of the lungsduring mechanical ventilation

a) Normal static lung compliance is 50-100ml/cmH20b) Plateau pressure = P compliance – Presistancec) Volume-controlled ventilation produces a square inspiratory flow

patternd) CO2 elimination is proportional to minute volume e) Ventilation is greater at the lung basis in healthy spontaneausly

breathing individuals

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2) Regarding the physiology of the lungsduring mechanical ventilationb) Plateau pressure is a measure of compliance with resistive element negated by an inspiratory hold manoeuvre. Plateau pressure is therefore: P peak – Presistanced) CO2 eleminiation is proportional to alveolar minute volume, but total minute volume includes anatomical dead space > a low rate, deep breath strategy will eliminate more CO2 than a high rate withlower tidal volumes e) Alveoli are less distended in the lung bases and therefore a steeperpart of the compliance curve

3) The mandatory breaths in “Pressure Control –Synchronised Intermittent MandatoryVentilation’(P-SIMV) may be described as• A) Limit – Volume, Cycling – Pressure

• B) Limit – Pressure, Cycling – Time

• C) Limit – Pressure, Cycling – Flow

• D) Limit – Flow, Cycling – Time

3) The mandatory breaths in “Pressure Control –Synchronised Intermittent MandatoryVentilation’(P-SIMV) may be described as• A) Limit – Volume, Cycling – Pressure

• B) Limit – Pressure, Cycling – Time

• C) Limit – Pressure, Cycling – Flow

• D) Limit – Flow, Cycling – TimeF

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4) Mechanical ventilation leads to thefollowing cardiovascular changes

• A) A rise in right atrial pressure.

• B) Increase in systemic venous pressure in vena cava inferior.

• C) A decrease in pulmonary vascular resistance.

• D) Fall in right ventricular stroke volume.

4) Mechanical ventilation leads to thefollowing cardiovascular changes

• A) A rise in right atrial pressure.

• B) Increase in systemic venous pressure in vena cava inferior.

• C) A decrease in pulmonary vascular resistance.

• D) Fall in right ventricular stroke volume.

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5) Lung ultrasound is a useful bedside examination in the diagnosis of:

• A) Pleural effusion

• B) Pneumothorax

• C) Lobar pneumonia

• D) Atelectasis

5) Lung ultrasound is a useful bedside examination in the diagnosis of:

• A) Pleural effusion

• B) Pneumothorax

• C) Lobar pneumonia

• D) Atelectasis

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• A) Decrease FiO2 to 0,3 (30%)

• B) Increase PEEP tot 15 cm H2O

• C) Decrease respiratory rate to 12 breaths per minute

• D) Increase tidal volume to 600 ml

• E) Nothing

• A) Decrease FiO2 to 0,3 (30%)

• B) Increase PEEP tot 15 cm H2O

• C) Decrease respiratory rate to 12 breaths per minute

• D) Increase tidal volume to 600 ml

• E) Nothing

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7) Which of the following are effects of PEEP

• A) Decrease in left ventricular transmural pressure

• B) Increase in left ventricular transmural pressure

• C) Decrease in left ventricular afterload

• D) Decrease in right ventricle afterload

7) Which of the following are effects of PEEP

• A) Decrease in left ventricular transmural pressure

• B) Increase in left ventricular transmural pressure

• C) Decrease in left ventricular afterload

• D) Decrease in right ventricle afterload

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• A) The plateau pressure varies positively with the compliance of therespiratory system

• B) Pneumothorax is a likely diagnosis in this scenario

• C) The increase in peak pressure could be explained by a kink in theventilator tubing

• D) Prolonging the expiratory time and slowing the rate is likely tosolve the problem

• A) The plateau pressure varies positively with the compliance of therespiratory system

• B) Pneumothorax is a likely diagnosis in this scenario

• C) The increase in peak pressure could be explained by a kink in theventilator tubing

• D) Prolonging the expiratory time and slowing the rate is likely tosolve the problem

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9) Regarding Lung Compliance

• A) Compliance is defined as the lung volume change per unit pressure change

• B) Increased compliance is associated with asthma

• C) A pressure volume curve of lung inflation and deflation shows hysteresis which is thought to respresent surface tension of the lungs

• D) Lung apices are more compliant than mid-zones and bases

9) Regarding Lung Compliance

• A) Compliance is defined as the lung volume change per unit pressure change

• B) Increased compliance is associated with asthma

• C) A pressure volume curve of lung inflation and deflation shows hysteresis which is thought to respresent surface tension of the lungs

• D) Lung apices are more compliant than mid-zones and bases

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https://derangedphysiology.com/main/cicm-primary-exam/required-reading/respiratory-system/Chapter%20031/static-dynamic-and-specific-compliance

10) A normal chest X-ray rules out the following diagnoses:

• A. Bronchitis

• B. Right side lower lobe atelectasis

• C. Pulmonary embolism

• D. Early stage of pneumonia

10) A normal chest X-ray rules out the following diagnoses:

• A. Bronchitis

• B. Right side lower lobe atelectasis

• C. Pulmonary embolism

• D. Early stage of pneumonia

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