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Exam (elaborations)

FCCS Review 2024 - Answered

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FCCS Review 2024 - Answered What is the most important sign in a critically ill pt? Why? - ️️ - 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 exa...

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  • May 25, 2024
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  • 2023/2024
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MERCYTRISHIA
FCCS Review 2024 - Answered

What is the most important sign in a critically ill pt? Why? - ✔️✔️- 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? - ✔️✔️- Cardiac tamponade; obstructive shock

If a pt has a thyromental distance of 2 cm, what can you expect about their airway? -

✔️✔️- 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? - ✔️✔️- 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? - ✔️✔️- 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? - ✔️✔️- 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? - ✔️✔️- 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? - ✔️✔️-

Targeted temperature management.



32-36 C

A shunt means there is perfusion without ventilation. What disease process is an

example of a shunt? - ✔️✔️- Pneumonia

Which type of respiratory failure occurs with CNS depression after an OD? - ✔️✔️-

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.

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