Student name: Student NO.

: University of Alexandria Faculty of Medicine Master degree of Critical Care Medicine Physics and Clinical Measurement Time allowed ONE hour All Questions to be Attempted. 15/1/2009

Put (T or F) for each statement: 1- Laminar flow through a tube. a) Is proportional to the pressure gradient. b) Is proportional to the viscosity. c) Is inversely proportional to the density. d) Is proportional to the tube diameter to the power of four. e) May become turbulent if the velocity decreases. 2- The Severinghaus electrode a) Consists of CO2-sensitive glass. b) Is better with gases than blood. c) Is affected by nitrous oxide. d) Contains bicarbonate ions in the electrolyte solution. e) Measures pH. 3- Monitoring of evoked potentials a) The stimulus can be auditory. b) The stimulus can be visual. c) The stimulus can be somatosensory. d) Evoked potential signals have an amplitude of 10-300 V. e) The signal is only revealed after summation of multiple repetitions. 4- Concerning intra-arterial blood pressure measurement a) The transducer is a piezoresistive strain gauge type. b) The system is designed with a frequency response range of 40-200 Hz. c) Air bubbles in the tubing increase the damping. d) Arterial cannulae are designed to be compliant. e) False aneurysm is a late complication of arterial cannulation. 5-The following values are less in obstructive than in restrictive lung disease. a) Functional residual capacity (FRC). b) FEV1/FVC. c) Peak expiratory flow rate (PEFR). d) Carbon monoxide transfer factor (TLCO). e) Tidal volume (TV). 6- Measurement of cardiac output using a pulmonary artery catheter is affected by: a) The temperature of the patient. b) The temperature of the injectate. c) Position of the proximal port. d) Constrictive pericarditis. 1

e)

The skill of the operator.

7- With reference to colloids. a) 4.5% albumin solution has an oncotic pressure similar to blood. b) Hetastarch can prolong the prothrombin time. c) Polygeline can cause acute renal failure. d) Dextran 70 alters red cell deformability. e) Cryoprecipitate is rich in factor VIII. 8- The reading of the pulse oximeter can be unreliable in the following circumstances. a) Carboxyhaemoglobin. b) Fetal haemoglobin. c) Sickle cell disease. d) Polycythaemia. e) Anaemia. 9- The bispectral index (BIS) monitor. a) The probability of recall is very low if the BIS is kept < 60. b) BIS demonstrates a dose-response effect with isoflurane. c) BIS demonstrates a dose-response effect with midazolam. d) BIS demonstrates a dose-response effect with ketamine. e) Use generally results in more anaesthetic agents being used. 10- Intracranial pressure monitoring. a) The normal pressure in supine adults is 7-15 mmHg (1-2 kPa). b) The pressure trace resembles the arterial waveform. c) Extradural fibre optic probes have the lowest infection rates. d) The pressure falls with each ventilator-delivered breath. e) A waves are a reassuring sign. 11- Pulse oximeters. a) Can cause burns to the skin under the probe. b) May be inaccurate in the presence of vasoconstriction. c) Are inaccurate in the presence of pigmented skin. d) May be inaccurate in patients with tricuspid regurgitation. e) Have a slower response time than transcutaneous oxygen electrodes. 12- Automated occlusive cuff blood pressure monitors. a) Tend to under read at high blood pressures. b) Tend to be inaccurate at very low blood pressures. c) Calculate MAP as diastolic plus one-third of pulse pressure. d) Adult cuff width is 10cm. 13- Concerning temperature a) The triple point of water is 0C. b) At sea-level water boils at 373 on the Kelvin scale. c) Rectal temperature is usually greater than core temperature due to bacterial fermentation. d) If atmospheric pressure is reduced to 50 kPa (0.5 bar) water boils at 80C. e) The resistance of a thermistor decreases as the temperature increases. 14- The reading level of a central venous manometer. a) Is a guide to right ventricular preload. b) Rises during the inspiratory phase of artificial ventilation. 3

c) Gives the most accurate readings when the catheter tip lies within the right atrium. d) Should be measured against a previous base-line zero. e) Will demonstrate a, c and v oscillations of the central venous pulse if the catheter tip lies within the axillary vein.

Choose the best single answer: 15- Patient with serum glucose level 270 mg/dL. What is the value when the unit is mmol/L (MW of glucose is 180) a) 5 mmol/L b) 7.5 mmol/L c) 10 mmol/L d) 15 mmol/L e) 20 mmol/L 17- Moles: all true Except a) Is the SI for expressing the concentration of a solution. b) Is the gram molecular weight of a substance c) Moles of all substance contains different number of molecules according to its volancy d) One molar solution excert pressure of 22.4 atmosphere e) To convert from the conc of mmol/L to mEq/L you must divided by the valency 19- Remarks on the Kelvin scale all are true Except a) It is derived from Charles's law of gases. b) It has no minus sign because it has a true zero c) The zero degree celsivs (0C) equal 273 K d) It is not the SI unit of temperature. e) Its degrees are the same size as the Celsius scale. 21- Specific heat a) It is the quantity of heat required to produce a change of state of a given substance. b) It is the quantity of heat required to convert 1g of liquid into vapour without change of temperature (T) c) It is the mean increase in the unit volume of a body for 1C rise in temperature (T) d) It is the quantity of heat required to raise (T) of 1 g of substance by 1C. e) It is an expression of the thermal state of a body reflecting the kinetic energy of its molecules. 23-All of the following are latent heat Except: a) Latent heat of melting. b) Latent heat of crystallization c) Latent heat of vaporization d) Latent heat of conduction e) Latent heat of condensation 16-An increase in the solute concentration (number of particles) will produce: all, Except a) Depression of the freezing point. b) Elevation of the boiling point c) Depression of the vapour pressure d) Elevation of the oncotic pressure e) Elevation of the osmotic pressure 18- Osmolality a) Number of osmols per liter of solution b) Number of osmols per kg of solvent c) Number of m mole per liter of solution d) It is not affected by the volume of solute in solution e) It is not affected by temperature of the solution

20-Hagen-poiseuille formula: a) It is true for laminar and turbulent flow. b) It is applied for gas only c) It describe the interrelation-ships between flow, pressure and resistance. d) It describe the interrelationship between flow, viscosity, and pressure e) It describe the interrelationship between flow, density and pressure. 22- When a fluid passes through a constriction, its velocity increases and its pressure drop this called: a) Bernoulli effect b) Venturi effect c) Coanda effect d) Newton's law (first law) e) Meyer-Overton theory

24-Factors affecting turbulent flow can be indicated by all Except: a) Flow b) Viscosity c) Radius of tube d) Length of tube e) Pressure

25-Oximetric pulmonary artery catheter depend on: a) Light absorption b) Light reflection c) Light refraction d) Raman scatter e) Photoluminescence Quenching 27- Pulse oximeter depend on: a) Light absorption b) Light reflection c) Light refraction d) Raman scattering e) Photoluminescence 29-The line isolation monitor a) Measures leakage current flowing from the patient to ground b) Measures leakage current flowing from the electrical equipment to the patient c) Sounds an alarm if the leakage current exceeds 50 mA d) Measures the impedance between the AC wiring and ground e) Cuts off power to the circuit if a faulty piece of equipment is connected

26- A blood pressure of 120/80 mmHg (gauge pressure) has an absolute pressure equal: a) 220/180 mmHg b) 270/230 mmHg c) 520/480 mmHg d) 720/680 mmHg e) 880/840 mmHg 28-Current flowing in a loop of wire moving within a magnetic field is an example of a) Inductance b) Capacitance c) Reactance d) Resistance e) Oscillation 30-Electrocautery machines do not cause ventricular fibrillation because the current they deliver differs from the electric current supplied by wall electrical outlets primarily by being a)Direct current instead of alternating current b) Lower in voltage c) Lower in frequency d) Higher in frequency e) Lower in amperage

Answer the following questions: 1-What information obtained from capnography (6 item). 2-List the possible method for measuring C.O.P. 3-As regard invasive blood pressure define: a) Resonance b) Damping c) Signal to noise ratio 4-Hazard of humidification device. 6

 5-As regard temperature define: a) Definition b) S.I unit c) Triple point of water
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