1.A morbidly obese 44-year-old male patient requires urgent intubation for respiratory distress and pneumonia. His history is significant for diastolic dysfunction, obstructive sleep apnea, obesity hypoventilation syndrome, and right phrenic nerve palsy. He is anxious and currently breathing 26 times per minute with an oxygen saturation of 90% on a 60% venti-mask. Which of the following will provide you the most effective pre-oxygenation?

Non-rebreathing mask at 15LPM

Non-rebreathing mask at 15LPM plus a nasal cannula at 15LPM

Assisted respirations with a Bag-Valve Mask

Noninvasive positive pressure ventilation

2.Which of the following is NOT a predictor of difficult mask ventilation?

Age

Buck teeth

Obesity

Snoring

Pulmonary edema

3.In which of the following patients is succinylcholine contraindicated?

A 65-year-old male in cardiac arrest with unrecordable oxygen saturation that is unable to be intubated on the first attempt.

A 34-year-old obese patient with respiratory failure and delirium with anticipated difficult airway but no anticipated difficulty with mask ventilation.

A 68-year-old male with 45% body surface area burns 1 day prior to admission.

A 47-year-old with muscular dystrophy admitted for hypoxemic respiratory failure secondary to aspiration pneumonia.

4.A 56-year-old man with COPD and severe alcohol intoxication has been intubated using rapid sequence intubation. Following intubation tube placement was confirmed with end-tidal CO2 detection. About 10 minutes after intubation, the nurse informs you that the patient's blood pressure has fallen to 75/40. The heart rate is 38 and peak inspiratory pressure (PIP) is 6 cm H2O. Breath sounds are markedly diminished bilaterally. Oxygen saturation is 55%. The most appropriate next step is:

Chest X-ray

Immediate bilateral chest aspiration or tube thoracostomy

Extubation and reintubation

IV fluid bolus, atropine 2 mg IV

Stat ECG, Trendelenberg position, increase expiratory time.

5.A 43-year-old woman, recently started on enalapril, presents with angioedema. She has been admitted for observation. Her symptoms began about an hour ago and have progressed rapidly. Her tongue is protruding from her mouth, and her Mallampati score is class 4. Her blood pressure is 156/94 and pulse oximetry is 100% on non-rebreather mask. Her anterior neck shows normal airway landmarks. WHICH of the following is true when considering the best strategy for initial management.

If a videolaryngoscope is used, the C-MAC will be a better choice than the GlideScope, because it will bypass the tongue more successfully

Administration of IV steroids and antihistamines will improve the edema and reduce the need for intubation

Topical anesthesia with sedation only to maintain spontaneous respiration and facility fiberoptic intubation is preferred

Immediate RSI is indicated, as per the "forced to act" scenario in the DA algorithm

Intubation should not be undertaken without first having ENT and anesthesia come in from home (approximately 30 minutes ETA) and transferring the patient to the OR for possible tracheostomy