Sample Questions and Answers
In APRV, what is the main function of TLow?
A) Maintain high alveolar pressure
B) Allow brief expiration for CO2 clearance
C) Prolong inspiratory time
D) Set a fixed tidal volume
Answer: B
What is a key limitation of ECCO2R?
A) Cannot provide oxygenation support
B) Causes severe hypercapnia
C) Requires large cannulas
D) Increases blood flow resistance
Answer: A
Which of the following increases CO2 clearance in High-Frequency Jet Ventilation (HFJV)?
A) Increasing amplitude
B) Increasing frequency
C) Reducing mean airway pressure
D) Increasing inspiratory time
Answer: A
What complication is most common in ECMO therapy?
A) Coagulopathy and bleeding
B) Pulmonary embolism
C) Myocardial infarction
D) Hyperventilation
Answer: A
A patient on veno-venous ECMO develops hypoxia despite 100% oxygen delivery. What is the most likely cause?
A) Oxygenator failure
B) Increased cardiac output
C) Hypercapnia
D) Excessive tidal volume
Answer: A
What is a major advantage of Proportional Assist Ventilation (PAV)?
A) Dynamically adjusts to patient demand
B) Provides complete control of ventilation
C) Prevents all patient effort
D) Eliminates the need for sedation
Answer: A
Which ECMO mode is indicated for refractory cardiogenic shock?
A) Veno-venous ECMO
B) Veno-arterial ECMO
C) Extracorporeal CO2 removal
D) Invasive mechanical ventilation
Answer: B
In HFOV, reducing frequency has what effect on CO2 clearance?
A) Increases CO2 elimination
B) Decreases CO2 elimination
C) Increases oxygenation
D) Increases airway resistance
Answer: A
Which advanced ventilatory mode is most suitable for a patient with spontaneous breathing effort and ARDS?
A) NAVA
B) Volume-Controlled Ventilation (VCV)
C) APRV
D) High-Frequency Oscillatory Ventilation (HFOV)
Answer: C
In Adaptive Support Ventilation (ASV), which parameter is primarily used to determine ventilatory settings?
A) Ideal body weight and lung mechanics
B) Fixed tidal volume
C) Peak inspiratory flow
D) Arterial blood gas results
Answer: A
Which of the following is a key feature of Proportional Assist Ventilation (PAV)?
A) Fixed inspiratory pressure
B) Dynamic adjustment based on patient effort
C) Mandatory controlled breaths
D) Requires neuromuscular blockade
Answer: B
What is the primary benefit of Airway Pressure Release Ventilation (APRV)?
A) Allows spontaneous breathing while maintaining alveolar recruitment
B) Requires no patient effort
C) Uses very low airway pressures
D) Eliminates the need for FiO₂ adjustments
Answer: A
What is the major function of ECMO in severe ARDS?
A) Fully replace mechanical ventilation
B) Improve oxygenation while allowing lung-protective ventilation
C) Provide cardiac support only
D) Eliminate the need for sedation
Answer: B
In High-Frequency Oscillatory Ventilation (HFOV), which setting has the most direct effect on CO₂ clearance?
A) Oscillation amplitude
B) Mean airway pressure
C) Inspiratory time
D) Frequency
Answer: A
What is a primary indication for veno-arterial ECMO (VA-ECMO)?
A) Isolated hypoxemic respiratory failure
B) Cardiogenic shock with severe respiratory distress
C) Severe metabolic acidosis
D) COPD exacerbation
Answer: B
Which of the following ECMO complications is most common?
A) Hemorrhage
B) Hypercapnia
C) Myocardial infarction
D) Hypertension
Answer: A
In NAVA, what physiological signal is used to trigger ventilation?
A) Airway pressure
B) Electrical activity of the diaphragm (Edi)
C) Tidal volume
D) End-tidal CO₂
Answer: B
A patient on VV-ECMO develops worsening hypoxemia despite adequate circuit function. What is the most likely cause?
A) Oxygenator thrombosis
B) Increased pulmonary shunting
C) Low hemoglobin levels
D) High ECMO blood flow
Answer: B
In HFOV, how does increasing oscillation frequency affect ventilation?
A) Decreases CO₂ clearance
B) Increases CO₂ clearance
C) Increases mean airway pressure
D) Enhances lung recruitment
Answer: A
What is the primary limitation of Extracorporeal CO₂ Removal (ECCO₂R)?
A) Limited oxygenation support
B) Requires large cannulas
C) Increases cardiac output
D) Causes severe acidosis
Answer: A
What is a major risk of Proportional Assist Ventilation (PAV)?
A) Does not support apneic patients
B) Requires fixed pressure levels
C) Prevents patient-ventilator interaction
D) Reduces compliance adaptation
Answer: A
Which ventilatory mode is most suitable for a patient with ARDS and spontaneous breathing effort?
A) Volume-Controlled Ventilation (VCV)
B) APRV
C) High-Frequency Ventilation (HFV)
D) SIMV
Answer: B
What is a key feature of Adaptive Support Ventilation (ASV)?
A) Delivers fixed pressure regardless of lung mechanics
B) Adjusts ventilatory parameters automatically based on patient condition
C) Requires deep sedation for effectiveness
D) Uses a mandatory respiratory rate
Answer: B
In ECMO, what is the function of the bladder reservoir?
A) Acts as a pressure buffer in the circuit
B) Enhances CO₂ removal
C) Regulates blood temperature
D) Increases oxygenation efficiency
Answer: A
Which setting in APRV has the greatest effect on CO₂ clearance?
A) TLow
B) THigh
C) PEEP
D) FiO₂
Answer: A
Which parameter in HFOV directly influences alveolar recruitment?
A) Amplitude
B) Mean airway pressure
C) Frequency
D) Inspiratory time
Answer: B
In VA-ECMO, which of the following may cause differential hypoxia (Harlequin syndrome)?
A) High cardiac output
B) Poor left ventricular ejection
C) Decreased ECMO flow
D) Increased lung compliance
Answer: B
What is the main goal of Neurally Adjusted Ventilatory Assist (NAVA)?
A) Provide fully controlled mechanical ventilation
B) Improve patient-ventilator synchrony by using diaphragm signals
C) Eliminate the need for ventilatory support
D) Fix tidal volume settings
Answer: B
What is a key indication for ECCO₂R therapy?
A) Severe ARDS with refractory hypoxemia
B) Hypercapnic respiratory failure with low ventilatory requirements
C) Myocardial infarction with cardiogenic shock
D) High-altitude pulmonary edema
Answer: B
A patient on VA-ECMO develops worsening pulmonary edema. What is the most likely cause?
A) Increased left atrial pressure
B) Low ECMO blood flow
C) Excessive CO₂ removal
D) High hematocrit
Answer: A
What is the major advantage of HFOV in ARDS?
A) Maintains lung recruitment with low tidal volumes
B) Provides full cardiovascular support
C) Eliminates CO₂ retention
D) Reduces ventilatory drive
Answer: A
What is a major contraindication for VA-ECMO?
A) Severe left ventricular failure
B) Unrecoverable multi-organ failure
C) Refractory hypoxemia
D) Acute pulmonary embolism
Answer: B
Which of the following increases CO₂ removal in ECCO₂R?
A) Increased blood flow through the oxygenator
B) Decreasing sweep gas flow
C) Lowering hemoglobin levels
D) Increasing PEEP
Answer: A
In HFOV, reducing frequency results in:
A) Increased CO₂ elimination
B) Decreased lung recruitment
C) Higher mean airway pressure
D) Increased dead space ventilation
Answer: A
What is the primary function of the ECMO pump?
A) Oxygenate blood
B) Circulate blood through the extracorporeal circuit
C) Remove excess CO₂
D) Maintain normal blood pressure
Answer: B
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