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raffat naseem raffat naseem
wrote...
Posts: 540
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6 years ago
Which of the following patients are at greatest risk for developing auto-PEEP during mechanical ventilation?
 
  a. Those with acute lung injury
  b. Those with COPD
  c. Those with congestive heart failure
  d. Those with bilateral pneumonia



Q. 2  Which of the following is the normal alveolar-to-arterial difference for a 56-year-old female in the emergency department?
 
  a. 12 mm Hg
  b. 14 mm Hg
  c. 16 mm Hg
  d. 18 mm Hg



Q. 3  In intubated patients, what do sources of increased imposed work of breathing include? 1. Endotracheal tube 2. Ventilator circuit 3. Auto-PEEP
 
  a. 1 and 2 only
  b. 1 and 3 only
  c. 2 and 3 only
  d. 1, 2, and 3



Q. 4  Which of the following modes of ventilatory support would you recommend for a hypoxemic patient with congestive heart failure?
 
  a. Continuous positive airway pressure (CPAP)
  b. Intermittent mandatory ventilation (IMV)
  c. Inverse-ratio pressure-control ventilation (PCV)
  d. High-level pressure support ventilation (PSV)



Q. 5  Which of the following modes of ventilatory support would you recommend for a severely hy-poxemic patient with acute lung injury or acute respiratory distress syndrome (ARDS)?
 
  a. Continuous positive airway pressure
  b. High VT volume-cycled ventilation
  c. Pressure-controlled ventilation
  d. Bilevel pressure support by mask
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wrote...
6 years ago
(Answer to Q. 1)  ANS: B
These patients frequently have problems with elevated airway pressure or dynamic hyperinflation (auto-PEEP), which can cause barotrauma and increased dyssynchrony between the patient and the ventilator.

(Answer to Q. 2)  ANS: D
P(Aa)O2 = (age/4) + 4
P(Aa)O2 = (56/4) + 4
P(Aa)O2 = 18 mm Hg

(Answer to Q. 3)  ANS: D
In intubated patients, sources of imposed work of breathing include the endotracheal tube, ven-tilator circuit, and auto-PEEP due to dynamic hyperinflation with airflow obstruction, as is commonly seen in the patient with COPD.

(Answer to Q. 4)  ANS: A
In a systematic review of randomized trials, noninvasive positive-pressure ventilation was found to reduce intubation rates and mortality in patients with acute cardiogenic pulmonary edema. Overall, the level of evidence was noted to be similar for CPAP without significant advantages of bilevel positive-pressure ventilation over CPAP.

(Answer to Q. 5)  ANS: C
Volume-cycled ventilation in patients with ARDS frequently leads to high-peak airway and plateau pressures.
raffat n. Author
wrote...
6 years ago
I can't even begin to explain how much your help meant to me.
wrote...
6 years ago
Happy to hear that, good luck with the rest of them
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