Pulmonary Question 20

Answer and Explanation 22

22. B is the correct answer. The pulmonary artery is the last place the blood goes before it is reoxygenated and thus the most accurate place to obtain a mixed venous blood gas. The pulmonary vein and aorta have oxygenated blood already and the femoral vein will give a sample but it will tend to reflect the local metabolic activity but still can be helpful clinically.

Question 22

22. Which of the following areas is the most accurate place to obtain a mixed venous blood gas?

A. Pulmonary Vein

B. Pulmonary Artery

C. Femoral Vein

D. Aorta

Answer and Explanation 21

21. B is the correct answer. Elevated cortisol levels is not a risk factor for thromboembolism. Malignancy is a hypercoagulable state. Recent sugery in particular when general anesthesia is administered is a risk factor. It has been shown to slow the flow of venous blood through the femoral veins. Smoking on oral contraception is also a risk factor.

Question 21

21. Which of the following is not a risk factor for venous thromboembolism

A. Malignancy

B. High Cortisol Levels

C. Recent Surgery

D. Smoking on Oral Contraceptives

Answer and Explanation 20

20. A is the correct answer. This patient has RDS (Repsiratory Distress Syndrome). This patient needs immediate administration of Survanta. Surfactant replacement is essential to decrease mortality and morbidity. Administering oxygen would be appropriate for transicient tachypnea of the newborn (TTN). This is not likely in this age group. Also high FiO2 for a prolonged period of time can cause Reitinopathy of Prematurity (ROP). Getting a CBG alone is not agressive enoug in this situation. Nasal CPAP may be beneficial in an older term infant but this baby really needs surfactant.

Question 20

20. Your patient is a 29 week gestation male born to a group B negative mother that you are seeing in the delivery room. He has no fever but has signs of respiratory distress. His RR is 80 and Sats are 88%. Which of the following is the best management option?

A. Intubate the patient and administer Survanta

B. Administer oxygen at a 100% and if the patients Sats improve to 100% leave the patient on that so they can recover.

C. Get a capillary blood gas and observe the patient

D. Place the patient on nasal CPAP