General ICU UPDATED ACTUAL Exam Questions and CORRECT
Answers
Key sign of resp failure - Tachypnea
Loss of cough Gaga
Ams
3 types of respiratory failure - Hypoxemic- ARDS pneumonia CHF interstitial lung disease
Room air PaO2 <=60, Abnormal PaO2/FiO2 Ratio
CXR- infiltrates
Hypercapnic- TBI, sedative drugs, neuro mask disease- MG GB, sleep apnea, metabolic disease
PaCO2 >=50 with ph <7.6
CXR- clear lung fields with hyperinflation
Mixed- COPD and CHF
VQ mixmatch - ventilation of alveoli is less than perfusion of capillary bed --> decreased O2
perfusion
COPD, Pulmonary Embolism, atelectasis
normal- ventilation and perfusion are matched
shunt- O2 ventilation to alveoli is blocked whereas perfusion continues, CHF atelectasis
dead space- O2 ventilation to alveoli continues whereas capillary bed cannot exchange gases,
Pulm emboli and high airway pressures
, Hypercapnia - Increased dead space
- hypovolemia, low CO, high airway pressure, hypovolemia
Pharm Resp Adjuncts for resp failure - Inhaled B2 agonist- metered dose inhaler, nebulzer
Inhaled ipratropium- metered dose inhaler neb
corticosteroids
abx
I: E time - Increase TV = increase I time
Insp flow late - increase rate = decrease in I time
auto peep - exp pause.. should be same as peep
breath stacking
flow graph breath stacking
Examples: increase airway resistance- asthma COPD
conseq: intrathor pressure increases -> decrease venous return --> hypotension impaired -->
worsening O2
To fix: increase exp time --> reduce RR, decrease TV, increase gas flow
CxR - Lesion in bronchus intermediate shift towards white out
Left lung collapse- mediastinal heart shift, partial white out, bronchus cut off- tumor or mucous
Doug
deep sulcus sign - pneumothorax
DIC - bleeding/thrombus
cryo, platelets and FFP
Answers
Key sign of resp failure - Tachypnea
Loss of cough Gaga
Ams
3 types of respiratory failure - Hypoxemic- ARDS pneumonia CHF interstitial lung disease
Room air PaO2 <=60, Abnormal PaO2/FiO2 Ratio
CXR- infiltrates
Hypercapnic- TBI, sedative drugs, neuro mask disease- MG GB, sleep apnea, metabolic disease
PaCO2 >=50 with ph <7.6
CXR- clear lung fields with hyperinflation
Mixed- COPD and CHF
VQ mixmatch - ventilation of alveoli is less than perfusion of capillary bed --> decreased O2
perfusion
COPD, Pulmonary Embolism, atelectasis
normal- ventilation and perfusion are matched
shunt- O2 ventilation to alveoli is blocked whereas perfusion continues, CHF atelectasis
dead space- O2 ventilation to alveoli continues whereas capillary bed cannot exchange gases,
Pulm emboli and high airway pressures
, Hypercapnia - Increased dead space
- hypovolemia, low CO, high airway pressure, hypovolemia
Pharm Resp Adjuncts for resp failure - Inhaled B2 agonist- metered dose inhaler, nebulzer
Inhaled ipratropium- metered dose inhaler neb
corticosteroids
abx
I: E time - Increase TV = increase I time
Insp flow late - increase rate = decrease in I time
auto peep - exp pause.. should be same as peep
breath stacking
flow graph breath stacking
Examples: increase airway resistance- asthma COPD
conseq: intrathor pressure increases -> decrease venous return --> hypotension impaired -->
worsening O2
To fix: increase exp time --> reduce RR, decrease TV, increase gas flow
CxR - Lesion in bronchus intermediate shift towards white out
Left lung collapse- mediastinal heart shift, partial white out, bronchus cut off- tumor or mucous
Doug
deep sulcus sign - pneumothorax
DIC - bleeding/thrombus
cryo, platelets and FFP