Physiologic and Monitoring Practice Test

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• Functional saturation is defined as HbO2 divided by the sum of HbO2 and Hb.
• Train-of-four (TOF) monitoring during anesthesia is used to...
• Ketamine tends to have what effect on the cardiovascular system during anesthesia?
• What is the Berlin definition range for mild ARDS in terms of the PaO2/FiO2 ratio?
• What happens to PtcO2 readings when perfusion is poor?
• What is the approximate normal value for VO2?
• On a ventilator expiratory flow-time trace, how is auto-PEEP detected?
• In adult ARDS management, which ventilation strategy is recommended?
• CaO2 includes the dissolved oxygen term in addition to oxygen bound to hemoglobin.
• What plateau pressure should be avoided to minimize lung injury during high-PEEP ventilation?
• Arterial oxygen content (CaO2) is measured in which units?
• A negative end-expiratory transpulmonary pressure indicates what?
• Which statement is true about the alveolar gas equation PAO2 and its clinical use?
• List a common intraoperative cause of hypotension and a basic management approach.
• Normal PaCO2–ETCO2 gradient range?
• Normal Ejection Fraction range is which of the following?
• Which of the following best differentiates high peak inspiratory pressure due to bronchospasm from mainstem intubation?
• What is the purpose of inflating the balloon via the inflation lumen in a pulmonary artery catheter?
• Which description best characterizes hypovolemic shock?
• Which statement best describes the interpretation when SvO2/ScvO2 is 50-70%?
• End-Expiratory transpulmonary pressure is calculated as which of the following?
• Which of the following is an advantage of Mainstream ETCO2 sampling?
• Two-wavelength oximetry measures functional saturation; co-oximetry measures fractional saturation including dysfunctional species. True or False?
• Which factor most directly determines arterial CO2 levels under resting conditions?
• In acid-base disorders, what best describes primary abnormalities and compensatory responses?
• Which statement best describes the hemodynamic effects of opioids in anesthesia?
• Transmittance oximetry measures light that:
• During chest compressions in CPR, how might arterial line readings be affected?
• A CVP reading that indicates low filling pressure is best represented by which value?
• Which modality is considered the gold standard for measuring fractional saturation of hemoglobin species?
• What are the ARDSNet recommended targets for tidal volume and plateau pressure?
• Which neuromonitoring modalities assess cerebral perfusion and intraoperative depth of anesthesia, and what do their results imply?
• Which condition is associated with long time constants due to increased resistance?
• Contractility is described as which of the following?
• Which parameter best reflects the balance of systemic oxygen delivery and tissue oxygen consumption at the bedside?
• Which formula represents transpulmonary pressure?
• What are common limitations of continuous cardiac output monitoring and how can accuracy be verified?
• Normal ETCO2 range?
• What is the normal SvO2 value range?
• Identify common ECG monitoring artifacts and how they can be differentiated from true arrhythmias.
• Normal stroke volume per beat is approximately which of the following?
• Explain DO2 and CaO2 formulas and why both cardiac output and oxygen content matter.
• Which diagnostic test is commonly used to diagnose pulmonary embolism?
• What is pulse pressure variation (PPV) and under what conditions is PPV a reliable predictor of fluid responsiveness?
• Lung compliance is defined as the change in volume per change in transpulmonary pressure. Which ratio expresses this definition?
• What is the normal oxygen extraction ratio in a healthy person?
• What is the clinical use of ScvO2 in guiding resuscitation, and a typical target range?
• Which statement about two-wavelength oximetry is true?
• What is typically the first-line vasopressor in septic shock after fluid resuscitation?
• Which condition makes PPV an unreliable predictor of fluid responsiveness?
• What is the best differentiator between invasive arterial BP monitoring and noninvasive cuff BP?
• Which characteristic best describes two-wavelength pulse oximeters compared to bench co-oximeters?
• Airway resistance is calculated as (PIP - Pplat) divided by which quantity?
• Initial management of hypovolemic shock typically includes which of the following?
• Preload is defined as which of the following?
• Normal PaCO2 range?
• A SvO2/ScvO2 of 25-30% indicates severe lactic acidosis.
• On arterial blood gas, how do you distinguish respiratory acidosis from metabolic acidosis, including compensation?
• In septic shock, what therapy is routinely required?
• Two-wavelength pulse oximetry uses which two light wavelengths?
• The proximal lumen port on a Swan-Ganz catheter has which of the following characteristics?
• In myocardial infarction with left-sided heart failure, which statement is true about hemodynamics?
• One key limitation of pulse oximetry is:
• The respiratory time constant is defined as which of the following?
• Which intervention reduces airway resistance to help eliminate auto-PEEP?
• ARDS is best described as which type of edema?
• Stroke Work is defined as which of the following?
• If O2ER is elevated in a critically ill patient, what is most likely true?
• Co-oximetry reports fractional saturation as HbO2 divided by the sum of which species?
• Ejection Fraction is defined as which of the following?
• Co-oximetry reports fractional saturation as the percentage of which species relative to total hemoglobin?
• Co-oximetry can differentiate which hemoglobin species that two-wavelength oximetry cannot?
• Approximate normal DO2 value?
• In the early management of septic shock after fluid resuscitation, what are standard hemodynamic goals and the role of vasopressor therapy?
• Under anesthesia, thermoregulation is impaired, typically causing hypothermia. Which statement accurately describes common temperature-monitoring sites?
• Which device is used to estimate pleural pressure in the mid-thorax as a surrogate measurement?
• Which condition is associated with decreased lung compliance?
• In septic shock, what is a typical initial hemodynamic change?
• In ARDS Crs typically falls to what range?
• The distal lumen port measures what value when the balloon is inflated?
• How is auto-PEEP quantified during an expiratory hold?
• CvO2 is most directly influenced by which factor?
• Which statement about CVP limitations is true?
• In ARDS, why is careful FiO2 titration important and how can oxygenation be improved without causing oxygen toxicity?
• Transpulmonary Pressure PL is defined as pressure gradient between which two spaces?
• What is plateau pressure and why is it clinically significant during mechanical ventilation?
• Widening the PaCO2–ETCO2 gradient is most commonly caused by which scenario?
• Which condition increases chest wall compliance?
• Which combination represents core physiologic monitoring components in the operating room?
• What factor can cause a falsely high O2 reading and falsely low CO2 reading due to poor application?
• Which statement best describes ARDS?
• How do you recognize a normal capnography trace and identify abnormal shapes such as curare cleft and 'shark fin'?
• Mean pulmonary artery pressure is calculated as which expression?
• Normal static Crs for a normal, passively ventilated adult is typically between which values?
• Normal Crs on a ventilator is ...
• Five time constants correspond to what percentage of lung volume change?
• Which statement correctly describes cold septic shock?
• Which intervention directly increases expiratory time to reduce auto-PEEP?
• Stroke volume variation (SVV) is most valid for predicting fluid responsiveness in which scenario?
• During ventilation, what is the target for end-inspiratory transpulmonary pressure to avoid overdistension?
• What is the absolute harmful threshold of end-inspiratory transpulmonary pressure associated with dangerous lung strain?
• Normal lung compliance is approximately how many milliliters per centimeter of water?
• Under normal conditions, end-tidal CO2 (EtCO2) approximates arterial CO2 (PaCO2) but is typically slightly lower.
• What is a pulmonary embolism?
• What happens when preload is excessive and surpasses the heart’s optimal stretch point?
• Why is the skin heated to 41-45 C (43-43.5 C for neonates) in transcutaneous monitoring?
• A SvO2/ScvO2 of 30-50% indicates the exhaustion of the body's extraction capabilities and the beginning of lactic acidosis.
• A Cardiac Index below 2.5 L/min/m² indicates:
• According to ARDS severity by the PaO2/FiO2 ratio, which category defines severe ARDS?
• After a positive inotropic treatment for myocardial infarction, what is the expected change in systemic vascular resistance (SVR)?
• Which statement about mean arterial pressure is true?
• Co-oximetry typically uses wavelengths across which range?
• Which statement best defines the A-a gradient and what an elevated A-a gradient implies?
• Which action most effectively corrects a damped arterial line trace?
• In the evaluation of suspected pulmonary embolism, what is the role of d-dimer?
• The normal CaO2 range for males is?
• Oxygen Extraction Ratio (O2ER) represents which of the following?
• Transpulmonary pressure is defined as Palv minus Ppl and determines what?
• Which of the following options best reflects the normal range for Stroke Index (SV index)?
• Oxygen Delivery (DO2) formula?
• Which statement best explains a high mixed venous oxygen saturation (SvO2) in a postoperative patient?
• Why are perioperative potassium disturbances dangerous?
• Cardiac Output (CO) is defined as:
• What are the units used for a respiratory time constant?
• Which statement correctly describes Phase I of the normal capnogram?
• Which is NOT typically associated with an elevated A-a gradient?
• Capnography provides the measurement and graphic display of CO2 at the airway.
• Static Crs calculation uses tidal volume divided by which pressure difference?
• VO2 is measured in which units?
• In ARDS management, why is transpulmonary pressure monitored?
• <25% results in cellular death.
• Which statement best describes the relationship between FiO2, PaO2, and SaO2?
• Why is pulse oximetry limited in carbon monoxide poisoning, and what test clarifies the diagnosis?
• Increased chest wall compliance can occur with which intervention?
• What is the recommended upper limit to keep end-inspiratory transpulmonary pressure to minimize alveolar overdistension?
• Which formula defines Pulmonary Vascular Resistance (PVR)?
• What urine output threshold is commonly used to gauge adequate renal perfusion in adults during anesthesia/critical care?
• Which statement about severe anemia and oxygen delivery is true?
• What is the role of PEEP in mechanical ventilation and its hemodynamic effects?
• What data points does a pulmonary artery catheter measure?
• Which parameter is most useful to differentiate a preload deficit from a pure afterload problem?
• Define oxygen extraction ratio (O2ER) and its interpretation in critical illness.
• What is the recommended tidal volume for lung-protective ventilation (per kg predicted body weight)?
• What is the relationship between Crs, CL, and CCW?
• Stroke volume is defined as:
• What is the commonly targeted mean arterial pressure (MAP) needed to ensure organ perfusion in most adults?
• Where is SvO2 measured?
• End-Inspiratory transpulmonary pressure is calculated as which of the following?
• In resuscitation, what is a typical ScvO2 target?
• What is the normal range for Cardiac Index (CI)?
• Pulmonary Capillary Wedge Pressure (PCWP) is measured from the distal port of a Swan-Ganz catheter during wedge inflation. What does PCWP primarily assess?
• What does a sudden loss of end-tidal CO2 (ETCO2) most likely indicate?
• What are the two primary ways to measure ETCO2?
• Esophageal pressure monitoring helps titrate PEEP by estimating transpulmonary pressure. What end-expiratory transpulmonary pressure is targeted to prevent alveolar collapse?
• What is the recommended interval to rotate the transcutaneous sensor to avoid tissue damage?
• Define anion gap and its practical use in evaluating metabolic acidosis.
• Which statement best describes what the thermistor does in this catheter system?
• Reflectance oximetry is heavily utilized for monitoring which venous oxygen saturations?
• What is the normal serum potassium range?
• Afterload is best described as which of the following?
• In two-wavelength oximetry, carbon monoxide bound to hemoglobin can cause which result?
• Which condition is associated with increased lung compliance?
• Which of the following is the normal range for PCWP?
• Which scenario most commonly explains a persistently low ETCO2 with high dead space?
• In a patient with high MAP and high SVR due to an afterload problem, what is the expected effect of a vasodilator?
• Transcutaneous monitoring estimates arterial gases by continuously measuring which two partial pressures at the skin?
• Pulse pressure is the difference between systolic and diastolic pressures; a widened pulse pressure indicates what?
• The measurement of oximetry relies on which fundamental law?
• Which statement about accuracy of transcutaneous measures is true?
• What is alarm fatigue and a practical strategy to mitigate it in a monitoring environment?
• If SvO2 is 30-50%, what does this indicate?
• How do DO2 and VO2 relate to tissue hypoxia, and what signs suggest a mismatch?
• Which statement about esophageal Doppler is true?
• Which statement is an advantage of Sidestream sampling?
• SvO2 is defined as what?
• Which statement about ScvO2 as a surrogate for SvO2 is true?
• In cases of airway collapse, what is the effect of extrinsic PEEP?
• Stroke Volume is calculated as which of the following?
• Compare thermodilution cardiac output via a pulmonary artery catheter with esophageal Doppler in terms of invasiveness and accuracy.
• Which port on the pulmonary artery catheter is used to obtain true mixed venous blood samples for SvO2?
• What is the respiratory quotient, and how does substrate utilization affect it?
• Which is a risk of high PEEP?
• Which expression is the Bohr equation for physiologic dead space?
• Central venous pressure (CVP) and its limitations: which statement is true?
• What is the formula for static respiratory system compliance Crs?
• What is a typical hemodynamic goal in septic shock?
• In cardiac tamponade, which hemodynamic pattern is typically observed?
• Where does the distal port of a pulmonary artery catheter rest?
• For a valid expiratory hold measurement of auto-PEEP, which condition must be true?
• What is a key risk associated with pulmonary artery catheterization?
• Normal Chest Wall Compliance (Ccw) value?
• Which statement correctly defines the normal range for Stroke Index (SV index) in clinical practice?
• Exceeding safe end-inspiratory transpulmonary pressure is independently correlated with which risks?
• How do lactate levels guide assessment of tissue perfusion, and what does failure to clear lactate imply?
• At what true PaO2 value does the device begin to underestimate PaO2 due to hyperoxemia?
• After administering fluids for a hypovolemic patient, which change would be expected?
• What is the purpose of Electrical Impedance Tomography (EIT) in ARDS management?
• Which intervention produces an upward shift of the Frank-Starling curve?
• The Frank-Starling mechanism describes the relationship between preload and cardiac output by stating that:
• Which change would shift the Frank-Starling curve downward?
• Oxygen Consumption (VO2) is defined by which equation?
• What does BIS monitoring measure and what BIS range generally corresponds to adequate anesthesia depth?
• Interpret capnography waveform changes during tube dislodgement, bronchospasm, and pulmonary embolism.
• Which electrode in a transcutaneous sensor measures PtcO2?
• In acute pulmonary embolism, which ventilation-perfusion change is most likely?
• If SvO2 is 50-70%, what does this indicate?
• In metabolic acidosis, what compensation would you expect in the respiratory system?
• The relationship 1/Crs = 1/CL + 1/Ccw represents which of the following?
• The mixed venous oxygen content (CvO2) is calculated using which formula?
• What does SvO2 indicate in hemodynamic monitoring?
• Methemoglobin presence causes pulse oximetry to read approximately what saturation when true saturation is below 85%?
• Which statement correctly describes the hemodynamic effects of common anesthetic agents?
• According to Frank-Starling curves, which ventricle yields higher cardiac output at the same filling pressure?
• Chest Wall Compliance (Ccw) is estimated by which formula?
• Arterial oxygen content (CaO2) accounts for oxygen bound to hemoglobin and what else?
• Which limitation would cause PCWP to no longer accurately reflect LVEDP?
• What is the primary effect of a positive inotropic drug on cardiac performance when preload is normal?
• Auto-PEEP is best described as?
• Which tools and monitoring methods are used to confirm correct endotracheal tube placement?
• In volume-controlled ventilation, which statement is true?
• Which monitoring modality provides real-time assessment of ventilation by measuring end-tidal CO2?
• Which statement best describes right and left heart compliance and its effect on cardiac output when filling pressures are equal?
• Pulmonary Capillary Wedge Pressure (PCWP) reflects which cardiac pressure?
• CRS depends on which structures?
• What is venous oxygen saturation (SvO2) and what does a low versus high SvO2 indicate?
• Which factors are included in calculating PAO2 using the alveolar gas equation?
• Which formula correctly defines arterial oxygen content (CaO2)?
• Which statement best describes the hemodynamics of hypovolemic shock?
• Which formula defines Systemic Vascular Resistance (SVR)?
• Which equation correctly relates DO2, VO2, and DvO2?
• What practical endpoints indicate adequate end-organ perfusion in shock management?
• How is alveolar ventilation calculated, and why is it clinically important for CO2 homeostasis?
• Increased intrathoracic pressure (such as from PEEP) typically causes PCWP readings to do which of the following?
• Which scenario would most likely decrease SvO2?
• What is a major hemodynamic consequence of excessive PEEP?
• Transpulmonary pressure represents what clinically?