AKT-1
Comprehensive
Questions with
Verified Answers
Graded A+
1. Complication of Cricoid Pressure Answer: i.e.
Sellick manoeuvre Complications Answer:
1) N/V
2) Esophageal rupture
3) Diflcult tracheal and mask intubation
4) minimal hemodynamic changes
5) complete AW obs
6) fracture of cricoid cartillage
2. Contraindications of LMA Answer: 1) small oral opening
2) "full stomach" (i.e. not npo, morbidly obese, trauma, GERD, intestinal obs)
3) dec lung compliance
4) not profoundly anesthetized
5) oropharyngeal growth/trauma
3. Extubation Criteria Answer: 1) Oxygenation Answer: SaO2 > 92%, PaO2 > 60 mm H
2) Ventillation Answer: Vt> 5ml/kg, RR >7, ETCo2 < 50, PaCO2 <60
3) Hemodynamically stable
4) Full reversal of NMB - sustained tetany, TOF ratio > 0.9. Sustained 5-sec head lift or hand grasp
5) Neuro - follows verbal commands, intact cough/gag
6) Acid/Base - pH > 7.25
7) Normal metabolic - electrolytes, volume status
,8) Normothermic
9) Other - aspiration risk, airway edema, Awake versus Deep
(recall stage 1 - analgesia
stage 2 - excitement
stage 3 - surgical anesthesia
stage 4 - medullary paralysis)
4. Confirming endotracheal intubation Answer: continuous waveform capnography
along with clinical as- sessment is the most reliable method of confirming and monitoring correct
placement of an ET tube
5. Rapid sequence induction Answer: http Answer: //image.slidesharecdn.com/13-
enpediatricresuscita-
tion-120507075455-phpapp02/95/emergency-lectures-pediatric-resuscitation-49-728.jpg?
cb=1336377382
Indications Answer:
,-ileus/obs
-delayed gastric emptying (pain, trauma, opioids, ETOH, vagotomy)
-incompetent LES, hiatus hernia, GERD
-altered LOC
-neurological/NM dz
-pregnancy
-diflcult AW
Contraindications Answer:
-total AW obs
-loss of facial/oropharyngeal landmarks
-anticipated diflcult intubation (lemon, 332)
6. Head position for tracheal intubation Answer: head should be 10 cm above
table with extension of the atlanto-occipital joint to be in the sniflng position
7. Difficult Airway Mangement Answer: http Answer:
//www.ebmedicine.net/media_library/aboutUs/Clinical%20Path- way%20Management%20Of
%20The%20Diflcult%20Airway.JPG
8. Position of Endotracheal tube Answer: tip should be approximately 5 cm above th
carina
9. CPR, Interruption of cardiac compressions Answer: Primarily - Pauses for
establishing ETT (ventilla- tion)
Secondary - rhythm checks, shocks
10. Therapeutic hypothermia and cardiac arrest Answer: only useful for
VT/VF
11. Cardiac arrest, blood gas changes Answer: Metabolic
Acidemia - Lactic Acidosis Respiratory Acidemia/Alkalosis - depending on
ventilation
Low HCO3-
Low PaO2
Neg BE (quantify degree of
MA) Hyperkalemia (from
acidosis) Hyperglcemia
, (stress response)
12. Postobstructive pulmonary edema Answer: Obstruction then patient takes a
large breath (e.g. closed APL, patient bitting on the ETT)
Comprehensive
Questions with
Verified Answers
Graded A+
1. Complication of Cricoid Pressure Answer: i.e.
Sellick manoeuvre Complications Answer:
1) N/V
2) Esophageal rupture
3) Diflcult tracheal and mask intubation
4) minimal hemodynamic changes
5) complete AW obs
6) fracture of cricoid cartillage
2. Contraindications of LMA Answer: 1) small oral opening
2) "full stomach" (i.e. not npo, morbidly obese, trauma, GERD, intestinal obs)
3) dec lung compliance
4) not profoundly anesthetized
5) oropharyngeal growth/trauma
3. Extubation Criteria Answer: 1) Oxygenation Answer: SaO2 > 92%, PaO2 > 60 mm H
2) Ventillation Answer: Vt> 5ml/kg, RR >7, ETCo2 < 50, PaCO2 <60
3) Hemodynamically stable
4) Full reversal of NMB - sustained tetany, TOF ratio > 0.9. Sustained 5-sec head lift or hand grasp
5) Neuro - follows verbal commands, intact cough/gag
6) Acid/Base - pH > 7.25
7) Normal metabolic - electrolytes, volume status
,8) Normothermic
9) Other - aspiration risk, airway edema, Awake versus Deep
(recall stage 1 - analgesia
stage 2 - excitement
stage 3 - surgical anesthesia
stage 4 - medullary paralysis)
4. Confirming endotracheal intubation Answer: continuous waveform capnography
along with clinical as- sessment is the most reliable method of confirming and monitoring correct
placement of an ET tube
5. Rapid sequence induction Answer: http Answer: //image.slidesharecdn.com/13-
enpediatricresuscita-
tion-120507075455-phpapp02/95/emergency-lectures-pediatric-resuscitation-49-728.jpg?
cb=1336377382
Indications Answer:
,-ileus/obs
-delayed gastric emptying (pain, trauma, opioids, ETOH, vagotomy)
-incompetent LES, hiatus hernia, GERD
-altered LOC
-neurological/NM dz
-pregnancy
-diflcult AW
Contraindications Answer:
-total AW obs
-loss of facial/oropharyngeal landmarks
-anticipated diflcult intubation (lemon, 332)
6. Head position for tracheal intubation Answer: head should be 10 cm above
table with extension of the atlanto-occipital joint to be in the sniflng position
7. Difficult Airway Mangement Answer: http Answer:
//www.ebmedicine.net/media_library/aboutUs/Clinical%20Path- way%20Management%20Of
%20The%20Diflcult%20Airway.JPG
8. Position of Endotracheal tube Answer: tip should be approximately 5 cm above th
carina
9. CPR, Interruption of cardiac compressions Answer: Primarily - Pauses for
establishing ETT (ventilla- tion)
Secondary - rhythm checks, shocks
10. Therapeutic hypothermia and cardiac arrest Answer: only useful for
VT/VF
11. Cardiac arrest, blood gas changes Answer: Metabolic
Acidemia - Lactic Acidosis Respiratory Acidemia/Alkalosis - depending on
ventilation
Low HCO3-
Low PaO2
Neg BE (quantify degree of
MA) Hyperkalemia (from
acidosis) Hyperglcemia
, (stress response)
12. Postobstructive pulmonary edema Answer: Obstruction then patient takes a
large breath (e.g. closed APL, patient bitting on the ETT)
