Identify the phase of sleep where dreams normally occur.
Identify the channel of a sleep study that is unique to obstructive sleep apnea.
Identify the components of a normal sleep cycle.
Identify the direction of eye movements during REM sleep.
List the components associated with sleep-disordered breathing.
Define:
apnea
hypopnea
sedation
List scoring criteria in polysomnography.
Identify the AHI range that defines severe sleep apnea.
Identify the rating scale that can be used to diagnose and rate the severity of sleep apnea.
List measurements that are a part of a polysomnogram.
Identify the goal of an intraaortic balloon pump (IABP) during
inflation
deflation
Identify the phase(s) of the cardiac cycle during which the Impella device is pumping.
List surgical indications for the IABP.
Identify the medical gas used to inflate the IABP.
Identify the power source for the Impella device.
Identify the normal location of the inserted tip of the Impella catheter.
Identify the blood vessel into which the Impella is inserted.
Identify the cardiac cycle during which the IABP is
inflated.
deflated.
List common complications of ECMO.
Describe the rationale for using the widest tubing possible for an ECMO circuit.
Identify the diagnosis for which VA ECMO is best suited.
Identify the location to which blood processed through VV ECMO is delivered.
Identify the type of ECMO used when cardiovascular support is required.
Trace the route of blood flow through the circulatory system.
Identify the gas exchange unit used in ECMO.
Identify the insertion site of the arterial catheter used for VA ECMO.
List indications and complications of bronchoscopy.
Identify the factor(s) that indicate(s) the need for bronchoscopy.
List absolute contraindications for bronchoscopy.
List equipment that should be in the procedure room during a bronchoscopy.
Identify parts of a bronchoscope seen in an image.
List the information elements to be part of an informed consent.
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Understanding Sleep Studies, Cardiac Devices, and Respiratory Support Techniques
Understanding Sleep Studies, Cardiac Devices, and Respiratory Support Techniques
Sleep Studies
- Phase of Dreams: REM (Rapid Eye Movement) sleep is the phase where dreams normally occur.
- Channel for Obstructive Sleep Apnea: Unique channel - Respiratory Effort.
Normal Sleep Cycle Components
- The components of a normal sleep cycle include NREM (Non-Rapid Eye Movement) and REM stages.
REM Sleep
- Eye Movements: Rapid side-to-side movements during REM sleep.
Sleep-Disordered Breathing
- Components: Apneas, Hypopneas, Snoring, Gasping.
Definitions
- Apnea: Complete cessation of airflow for at least 10 seconds.
- Hypopnea: Partial reduction in airflow with oxygen desaturation.
- Sedation: Inducing relaxation or sleepiness.
Polysomnography Scoring Criteria
- Criteria includes Apnea-Hypopnea Index (AHI), Oxygen Desaturation, Sleep Stages, Respiratory Effort.
Severe Sleep Apnea
- AHI Range: More than 30 events per hour defines severe sleep apnea.
- Rating Scale: Severity can be assessed using the Epworth Sleepiness Scale.
Polysomnogram Measurements
- Measurements: EEG (Electroencephalogram), EOG (Electrooculogram), ECG (Electrocardiogram), EMG (Electromyogram).
Cardiac Devices
- IABP: Inflation - Augments coronary perfusion during diastole. Deflation - Reduces afterload during systole.
- Impella: Pumps during systole to assist the heart.
IABP Surgical Indications
- Indications: Cardiogenic Shock, High-Risk PCI, Acute MI.
- Gas: Helium is used to inflate the IABP.
- Power Source: Impella device is powered by an external console.
Impella Insertion
- Tip Location: Normal location is within the left ventricle.
- Blood Vessel: Inserted into the femoral artery.
ECMO Complications
- Common complications include Bleeding, Infection, Thrombosis, Hemolysis.
VV ECMO
- Blood is delivered back into the right atrium after processing.
VA ECMO
- Best suited for conditions requiring both cardiac and respiratory support.
Circulatory System Blood Flow
- Route: Heart → Arteries → Capillaries → Veins → Heart.
ECMO Components
- Gas Exchange Unit: Oxygenator performs gas exchange in ECMO circuit.
VA ECMO Arterial Catheter
- Insertion Site: Commonly placed in the femoral artery.
Bronchoscopy
- Indications: Diagnostic evaluation, Therapeutic interventions, Foreign body removal.
Informed Consent
- Elements for Consent: Nature of Procedure, Risks, Benefits, Alternatives, Consequences of Refusal.
Sample Answer
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