pshycology test
Directions: The following exam consists of various types of questions designed to test the critical reasoning skills of the examinee. Answers are found on the following page, with rationales. This is a Twenty question test, with an allotted time of 45 minutes to indulge one's academic and clinical prowess. Questions 1-4 are based on the following scenario: A 55 year old male, medium body build of 90 Kg presents complaining of acute shortness of breath. He has a history of CHF and acute respiratory failure, he is agitated and disoriented. He has been placed on a ventilator two times during the past year. His medications include HCTZ, captopril, digoxin, and lasix. Paramedics have placed him in 100% O2 via Non-rebreathing mask, established an IV and administered 40 mg of Lasix IV enroute. He is cold, pale, and diaphoretic, with a BP of 200/110, HR 120, RR 48, rales are audible througout. ABG's are drawn, and the results are: pH - 7.3, PCO2 55, HCO3 24, PaO2 60. 1. Why is this gentleman's PCO2 elevated? a. Not enough total ventilation (CNS/Respiratory muscle weakness) b. Too much total ventilation Dead Space (Rapid breathing)
b. With this MAP of 80, her cerebral perfusion pressure she should receive sublingual calcium channel blockers c. The sense of respiratory effort (increased with increased WOB) 5. During preop examination, you patient is SOB at rest with an abnormal ABG. You you grade this patient: 6. The proposed mechanisms of dyspnea/SOB share no common link they are: (1) increased WOB due to Increased Raw, "stiff lungs", (2) abnormal ABG's with ether an Increased PCO2 or decreased PO2, or (3) altered respiratory drive with normal respiratory system. Having shared the mechanisms 20. All of the following are considered essentials of preoperative cardiac evaluation EXCEPT:
Some common words found in the essay are:
Vasodilatory Vasoconstrictive, Stat MAP, Currently ECG, CXR ECG, Disease Disease, ICP CVP, FEV1/FVC MMFR, Exam Directions, GFR RBF, II V5, perfusion pressure, cerebral perfusion, cerebral perfusion pressure, smooth muscle, o2 consumption, leads ii, renal function, maintain normal co2, normal co2, proposed sources, possibilities airway, airway hyperresponsiveness, possibilities airway hyperresponsiveness, proposed sources breathlessness, amount maintain normal,
Approximate Word count = 3389
Approximate Pages = 14 (250 words per page double spaced)
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