Exam (elaborations)
Anesthesia Equipment and Physics Questions with detailed Answers at the End
Anesthesia Equipment and Physics Questions with detailed Answers at the End
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July 25, 2023
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Anesthesia
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Anesthesia
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(Questions1through90):Eachquestionorincompletestatementinthissectionis
followedbyanswersorbycompletionsofthestatement,respectively.SelecttheONE
BESTanswerorcompletionforeachitem.DirectionsAnesthesiaEquipmentandPhysics
QuestionswithdetailedAnswersatthe
End
1.A75-year-oldpatientintheintensivecareunit(ICU)isextubatedafter
recoveringfromacuterespiratorydistresssyndrome(ARDS).Hehasahistory
ofpreviousmyocardialinfarction,congestiveheartfailure,andpneumonia.He
hasanA-line,pulmonaryartery(PA)catheterandisreceivingoxygenbynasal
cannula.WhichofthefollowingtechniquesisLEASTaccurateforassessing
anintravascularfluidchallenge?
A.Centralvenouspressure(CVP)
B.PAocclusionpressure
C.Transesophagealechocardiography(TEE)
D.Measurementofpulsepressurevariation(PPV)
2.SelectthecorrectstatementregardingcolorDopplerimaging.
A.ItisaformofM-modeechocardiography
B.ThetechnologyisbasedoncontinuouswaveDoppler
C.Byconvention,motiontowardtheultrasoundprobeisredand
motionawayfromtheprobeisblue
D.Twoultrasoundcrystalsareused:onefortransmissionofthe
ultrasoundsignalandoneforreceptionofthereturningwave
3.Whenthepressuregaugeonasize“E”compressed-gascylindercontainingN2
Obeginstofallfromitspreviousconstantpressureof750psi,approximately
howmanylitersofgaswillremaininthecylinder?
A.200L
B.400L
C.600L
D.Cannotbecalculated
4.Whatpercentdesfluraneispresentinthevaporizingchamberofadesflurane
vaporizer(pressurizedto1500mmHgandheatedto23°C)?
A.Nearly100%
B.85%
C.65%
D.45% 5.Iftheinternaldiameterofanintravenouscatheterweredoubled,flowthrough
thecatheterwouldbe
A.Decreasedbyafactorof2
B.Decreasedbyafactorof4
C.Increasedbyafactorof8
D.Increasedbyafactorof16
6.Asize“E”compressed-gascylindercompletelyfilledwithN2Ocontainshow
manyliters?
A.1160L
B.1470L
C.1590L
D.1640L
7.Whichofthefollowingmethodscanbeusedtodetectallleaksinthelow-
pressurecircuitofallcontemporaryanesthesiamachines?
A.Negative-pressureleaktest
B.Commongasoutletocclusiontest
C.Traditionalpositive-pressureleaktest
D.Noneoftheabove
8.Whichofthefollowingvalvespreventstransfillingbetweencompressed-gas
cylinders?
A.Fail-safevalve
B.Checkvalve
C.Pressure-sensorshutoffvalve
D.Adjustablepressure-limitingvalve
9.Thedrivingforceoftheventilator(Datex-Ohmeda7000,7810,7100,and
7900)ontheanesthesiaworkstationisaccomplishedwith
A.Compressedoxygen
B.Compressedair
C.Electricityalone
D.Electricityandcompressedoxygen
10.Thepressuregaugeonasize“E”compressed-gascylindercontainingO2reads
1600psi.HowlongcouldO2bedeliveredfromthiscylinderatarateof2
L/min?
A.90minutes
B.140minutes
C.250minutes
D.320minutes
11.A25-year-oldhealthypatientisanesthetizedforafemoralherniarepair.
AnesthesiaismaintainedwithisofluraneandN2O50%inO2,andthe
patient’slungsaremechanicallyventilated.Suddenly,the“low-arterial
saturation”warningsignalonthepulseoximetergivesanalarm.Afterthe
patientisdisconnectedfromtheanesthesiamachine,heundergoesventilation withanAmbubagwith100%O2withoutdifficulty,andthearterialsaturation
quicklyimproves.Duringinspectionofyouranesthesiaequipment,younotice
thatthebobbinintheO2rotameterisnotrotating.Thismostlikelyindicates
A.FlowofO2throughtheO2rotameter
B.NoflowofO2throughtheO2rotameter
C.AleakintheO2rotameterbelowthebobbin
D.AleakintheO2rotameterabovethebobbin
12.TheO2pressure-sensorshutoffvalverequireswhatO2pressuretoremainopen
andallowN2OtoflowintotheN2Orotameter?
A.10psi
B.30psi
C.50psi
D.100psi
13.A78-year-oldpatientisanesthetizedforresectionofalivertumor.After
inductionandtrachealintubation,a20-gaugearteriallineisplacedand
connectedtoatransducerthatislocated20cmbelowtheleveloftheheart.
Thesystemiszeroedatthestopcocklocatedatthewristwhilethepatient’s
armisstretchedoutonanarmboard.Howwillthearteriallinepressure
comparewiththetruebloodpressure(BP)?
A.Itwillbe20mmHghigher
B.Itwillbe15mmHghigher
C.Itwillbethesame
D.Itwillbe15mmHglower
14.Thesecond-stageO2pressureregulatordeliversaconstantO2pressuretothe
rotametersof
A.4psi
B.8psi
C.16psi
D.32psi
15.Youarecalledtoassistacolleaguewhonotesalargegasleakintheanesthesia
circuit.Veryhighoxygenflows(15L/minute)arebeingused,buttheventilator
bellowsdonotfillduringtheventilatorcycle.Youthenattempttomanually
ventilatethepatient,butthereservoirbagdoesnotfill.Youthendisconnect
thepatientfromtheanesthesiamachineandattempttoventilatethepatient
withananesthesiabag(connectedtoseparateoxygensource),buthighoxygen
flowsarestillrequiredtoachieveevenalowpositivepressureforventilation.
Themostappropriatestepwouldbe
A.Deflatecuffandreinflateuntilthereisagoodseal
B.Pulloutnasogastrictube
C.Reintubatethepatient D.Reconnecttheendotrachealtubetotheanesthesiamachinecircuit
with15L/minuteflowO2plus15L/flowair
16.Asevofluranevaporizerwilldeliveranaccurateconcentrationofanunknown
volatileanestheticifthelattershareswhichpropertywithsevoflurane?
A.Molecularweight
B.Oil/gaspartitioncoefficient
C.Vaporpressure
D.Blood/gaspartitioncoefficient
17.A58-year-oldpatienthassevereshortnessofbreathand“wheezing.”On
examination,thepatientisfoundtohaveinspiratoryandexpiratorystridor.
Furtherevaluationrevealsmarkedextrinsiccompressionofthemidtracheaby
atumor.Thetypeofairflowatthepointofobstructionwithinthetracheais
A.Laminarflow
B.Turbulentflow
C.Undulantflow
D.Stenoticflow
18.ConcerningthepatientinQuestion17,administrationof70%heliuminO2
insteadof100%O2willdecreasetheresistancetoairflowthroughthestenotic
regionwithinthetracheabecause
A.Heliumdecreasestheviscosityofthegasmixture
B.Heliumdecreasesthefrictioncoefficientofthegasmixture
C.Heliumdecreasesthedensityofthegasmixture
D.HeliumincreasestheReynoldsnumberofthegasmixture
19.A56-year-oldpatientisbroughttotheoperatingroom(OR)forelective
replacementofastenoticaorticvalve.Anawake20-gaugearterialcatheteris
placedintotherightradialarteryandisthenconnectedtoatransducerlocated
atthesamelevelasthepatient’sleftventricle.Theentiresystemiszeroedat
thetransducer.Severalsecondslater,thepatientraisesbotharmsintotheair
untilhisrightwristis20cmabovehisheart.AsheisdoingthistheBPonthe
monitorreads120/80mmHg.Whatwouldthispatient’strueBPbeatthis
time?
A.140/100mmHg
B.135/95mmHg
C.120/80mmHg
D.105/65mmHg
20.Anadmixtureofroomairinthewastegasdisposalsystemduringan
appendectomyinaparalyzed,mechanicallyventilatedpatientundergeneral
volatileanesthesiacanbestbeexplainedbywhichmechanismofentry?
A.Positive-pressurereliefvalve
B.Negative-pressurereliefvalve
C.Sodalimecanister
D.Ventilatorbellows