FCCS Review exam with 100% correct answers/guaranteed success
7 views 0 purchase
Course
FCCS 2024
Institution
FCCS 2024
FCCS Review exam with 100% correct answers/guaranteed success
A young asthmatic pt is on the vent. His lungs are very tight. He is on the AC setting and there is a lot of auto-PEEP. You correct it by reducing the rate, giving him more time to exhale and making sure he has enough flow. FiO2 is at ....
FCCS
Review
exam
with
100%
correct
answers/guaranteed
success
What
is
the
most
important
sign
in
a
critically
ill
pt?
Why?
-
ANS
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?
-
ANS
Cardiac
tamponade;
obstructive
shock
If
a
pt
has
a
thyromental
distance
of
2
cm,
what
can
you
expect
about
their
airway?
-
ANS
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?
-
ANS
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?
-
ANS
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?
-
ANS
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?
-
ANS
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?
-
ANS
Targeted
temperature
management.
32-36
C
A
shunt
means
there
is
perfusion
without
ventilation.
What
disease
process
is
an
example
of
a
shunt?
-
ANS
Pneumonia
Which
type
of
respiratory
failure
occurs
with
CNS
depression
after
an
OD?
-
ANS
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?
-
ANS
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
becomes
hypotensive
at
70/40.
You
observe
tracheal
deviation
to
the
R.
Normal
breath
sounds
on
the
right,
diminished
on
the
left.
No
wheezing.
WBC
is
normal.
What
is
the
dx
and
treatment?
-
ANS
Tension
pneumothorax
Needle
decompression/chest
tube
A
pt
in
ARDS
s/p
pneumonia
is
on
100%
FiO2
with
PEEP
of
22.
PO2
is
88%.
Peak
airway
pressure
and
plateau
are
both
high.
VT
is
5
ml/kg.
How
can
you
decrease
the
airway
pressures?
-
ANS
Decrease
the
PEEP,
even
though
it
will
decrease
PaO2.
(Note:
you
can't
decrease
the
VT
because
it
is
already
on
the
low
end).
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller excellentrevision964. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $7.99. You're not tied to anything after your purchase.
