FCCS Review 2024 - Answered
What is the most important sign in a critically ill pt? Why? - ️️ - Tachypnea
Indicates metabolic acidosis w/ respiratory alkalosis compensation
A pt misses dialysis for a few days and comes in with fluid overload. He's tachycardic
and tachypneic. On physical exa...
A pt misses dialysis for a few days and comes in with fluid overload. He's tachycardic
and tachypneic. On physical exam, you find JVD, pulsus paradoxus (20 mmHg drop
during inspiration), and HoTN (80/40) with distant, muffled heart sounds. Lungs are
clear to auscultation. What is the dx? - ✔️✔️- Cardiac tamponade; obstructive shock
If a pt has a thyromental distance of 2 cm, what can you expect about their airway? -
✔️✔️- Difficult airway w/ an anteriorly displaced larynx
A COPD pt comes in with difficulty breathing. He then becomes apneic and
unresponsive. How would you ventilate this pt? - ✔️✔️- BVM
A pt arrives after falling from a ladder and has a frontal laceration. On examination, you
find papilledema and labored breathing w/o being able to clear secretions. What is your
biggest concern when intubating this pt? - ✔️✔️- Cerebral edema/increasing ICP
Intubation tends to cause an increase in ICP. Administer lidocaine prior to intubation to
inhibit vagal stimulation.
An ESRD pt w/ hyperkalemia develops dyspnea and requires intubation. Which
paralytic agent/NMB should you avoid and why? - ✔️✔️- Succinylcholine
Worsens hyperkalemia
, A pt is admitted after an OD. He starts to have apneic episodes and his SpO2 is
dropping. You place him on a non-rebreather mask w/ 100% O2, yet his SpO2 remains
at 80%. Why is it not being corrected?
Then, if you try a BVM and it also fails, and video laryngoscopy is unavailable, what is
your next best choice for an airway? - ✔️✔️- The pt is having apneic episodes, which
means that administering high-flow O2 will be ineffective.
Choose an LMA if the BVM fails.
What intervention improves outcomes with ROSC after cardiac arrest? - ✔️✔️-
Targeted temperature management.
32-36 C
A shunt means there is perfusion without ventilation. What disease process is an
example of a shunt? - ✔️✔️- Pneumonia
Which type of respiratory failure occurs with CNS depression after an OD? - ✔️✔️-
Acute hypercapnic respiratory failure --> mixed
A 50 y/o pt is having a COPD exacerbation. You have tried steroids, bronchodilators,
etc. with no improvement. PCO2 is in the 90s, pH is 7.20. You decide to intubate. Vent
settings are: VT 375, RR 20, FiO2 .35, PEEP 5. CXR is normal. A few minutes later, his
BP drops to 70/40. Lungs are clear/equal. Vent shows peak airway pressure of 55
(high) and plateau pressure of 15. End expiratory hold gives auto-peep of 15.
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