FCCS Practice test Questions and Answers 2024

FCCS Practice test Questions and Answers 2024 Most important indicator that a patient has a severe illness? - Tachypnea 3 respiratory types, and their criteria - Hypoxemic (PaO2 50-60) Hypercapnic (PaCO2 50, pH 7.36) Mixed Delta gap (formula, when and why it's used) - Difference in AG from normal - Difference in HCO3 from normal In AG metabolic acidosis it's used. It tells you if there's underlying metabolic alkalosis or respiratory acidosis with bicarb compensation IN ADDITION to the AG metabolic acidosis. Both of those would result in a high bicarb to begin with, and a smaller change in bicarb from normal. Winter's formula (equation, what it measures) - 1.5[HCO3] + 8 +/- 2 If compensation is adequate in acid/base issues How AG changes with albumin changes - Decreases 2.5-3 for every 1 decrease in albumin Hemodynamic changes after intubation - Hypo/hypertension Arrhythmia Tachycardia Pressure support equation for BiPAP - IPAP - EPAP 3 types of vent cycles - Volume (preset tidal volume, relieves WOB the most) Time (constant pressure of time) Flow (constant pressure until inspiratory flow is below 25% of peak) Goal tidal volume - 10 cc/kg Goal FiO2 on vent - Start at 1.0, then decrease as SpO2 tolerates (goal of 92-94 saturation) Ppeak - Peak inspiratory pressure Pplat (try to keep it below ?) - Inspiratory plateau pressure (shows alveolar distention) 30 AutoPEEP (what it is, what it causes, how to fix it) - Breath stacking Decreases preload to the heart with positive pressure on the lungs -- hypotension Decrease RR, decrease inspiration time (goal is to have more time for the lungs to exhale) Danger of increased PEEP - Increases autoPEEP, increases Pplat PaO2 we're usually happy with - 60 When to consider NPPV vs invasive - When it's a quickly solved problem in 1-2 days (e.g. COPD exacerbation) When the patient can be compliant with working with NPPV When to consider switching from NPPV to invasive ventilation support - If things aren't really improving in a matter of hours If your therapeutic goals haven't been met in 4-6 hours Manual decompression (when you use it) - If patient is air trapping like crazy on the vent, and you disconnect it and push up on the patients diaphragm to get everything out What a high A-a gradient means - V/Q mismatch Volume assist-control breath (Volume cycled) - Vent delivers preset tidal volume Pressure assist-control breath (time cycled) - Vent delivers a constant pressure over a preset time