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FCCS REVIEW QUESTIONS WITH ACCURATE ANSWERS
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FCCS REVIEW QUESTIONS WITH ACCURATE ANSWERS
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FCCS REVIEW QUESTIONS WITH ACCURATE ANSWERSWhat is the most important sign in a critically ill pt? Why?
Accurate Answer - 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 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?
Accurate Answer - Cardiac tamponade; obstructive shock
If a pt has a thyromental distance of 2 cm, what can you expect about their
airway?
Accurate Answer - 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?
Accurate Answer - 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?
Accurate Answer - 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?
Accurate Answer - 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?
Accurate Answer - 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?
Accurate Answer - Targeted temperature management.
32-36 C
A shunt means there is perfusion without ventilation. What disease process is
an example of a shunt?
Accurate Answer - Pneumonia
Which type of respiratory failure occurs with CNS depression after an OD?
Accurate Answer - 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.
What is the cause of this pt's HoTN and why?
Accurate Answer - Auto-peep is the cause.
COPD pts have difficulty exhaling --> pressure buildup in alveoli.
We use PEEP for the pressure and to improve oxygenation. Auto-peep comes
from breath-stacking --> intrinsic peep. Alveoli enlarge --> high peak airway
pressure. All leads to low venous return --> low CO --> HoTN
A COPD pt is admitted to the ICU for exacerbation. Pt is on a vent. Pt is tx w/
bronchodilators, steroids, and Abx. ABG was normal 1 hr ago, but now the
peak airway pressure is up to 55 and plateau pressure is also high at 50. Pt
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