CEN Respiratory Emergencies 2

Question 1

A patient is intubated and the ventilator alarms for high peak airway pressure. Breath sounds are absent on the left. What is the most likely cause?

Accepted Answer

Right mainstem intubation

Answer

Pulmonary edema

Answer

Mucus plug in the right bronchus

Answer

Ventilator malfunction

Question 2

Which clinical criterion is NOT part of the Berlin Definition of ARDS?

Accepted Answer

A high BNP level confirming cardiac cause

Answer

Bilateral opacities on imaging

Answer

PaO2/FiO2 ratio below 300 mmHg

Answer

Respiratory failure not fully explained by cardiac failure

Question 3

A 65-year-old patient post-knee replacement develops sudden dyspnea, tachycardia, and hypoxia. ECG shows sinus tachycardia with an S1Q3T3 pattern. What is the most appropriate initial diagnostic test?

Accepted Answer

CT pulmonary angiography (CTPA)

Answer

Chest X-ray

Answer

D-dimer assay

Answer

V/Q scan

Question 4

What is the appropriate size (French) for a chest tube inserted for a hemothorax?

Accepted Answer

28–32 Fr or larger tube

Answer

12–14 Fr pigtail catheter

Answer

20–22 Fr small-bore tube

Answer

Needle thoracostomy only

Question 5

Which ventilator strategy is recommended to reduce lung injury in ARDS patients?

Accepted Answer

Tidal volume of 6 mL/kg ideal body weight with permissive hypercapnia

Answer

Tidal volume of 10–12 mL/kg ideal body weight

Answer

High PEEP with tidal volume 8 mL/kg

Answer

Low PEEP to minimize barotrauma

Question 6

A patient with epiglottitis is in the ER. She is drooling, sitting upright, and has inspiratory stridor. What is the most important initial action?

Accepted Answer

Keep the patient calm and upright; prepare for definitive airway in the OR

Answer

Attempt immediate oral intubation in the ER

Answer

Administer racemic epinephrine via nebulizer

Answer

Perform lateral neck X-ray immediately