The Magill (Mapleson A) breathing system:

Select true or false for each of the following statements.

True False

A. Is the most efficient Mapelson

system for spontaneously
breathing patients

B. Will work with minimal

re-breathing at a fresh gas flow of
70% of minute volume in
spontaneous ventilation

C. Makes scavenging of exhaled

gases easier

D. The co-axial version is the Lack

system

E. Is also efficient during controlled

ventilation

Breathing (reservoir) bags:

Select true or false for each of the following statements.

True False

A. Have a capacity roughly equating

the vital capacity of an 80 Kg adult

B. A standard 0.5L bag can be used

with a Jackson-Rees system

C. Prevent wastage of fresh gas flow

during expiratory pause

D. Provide a rough visual assessment

of volume of ventilation
E. Act as a reservoir because the
anaesthetic machine can not
provide the peak inspiratory flow
required in normal respiration

Regarding breathing systems used in anaesthesia:

Select true or false for each of the following statements.

True False

A. The Magill system is most efficient

for spontaneously breathing
patients even at a fresh gas flow
(FGF) of 70% of minute ventilation

B. D, E and F systems are all T pieces

C. The Bain system requires a FGF of

50-60 ml/kg during spontaneous
breathing

D. The rate of change of vapour

concentration in circle system
depends on circle system volume,
the FGF rate and net gas uptake

E. The Magill system is inefficient

during controlled ventilation
because much of the gases are
vented via pop-off valve

Concerning absorption of carbon dioxide in breathing systems:

Select true or false for each of the following statements.

True False

A. Soda lime granules are size 4-8

mesh

B. Baralyme contains calcium

hydroxide in addition to barium
hydroxide
C. Soda lime produces more
compound A during low fresh gas
flow

D. Dry soda lime absorbs more

carbon dioxide

E. Carbon dioxide first reacts with

sodium and potassium hydroxide
of soda lime

Regarding anaesthetic breathing systems:

Select true or false for each of the following statements.

True False

A. Re-breathing does not occur in

Mapleson D during controlled
ventilation

B. With a fresh gas flow (FGF) <1.5

L, volatile concentration in the
breathing system may be higher
than the dial setting of the
vaporiser at steady state

C. In the circle system with a FGF <1

L (N2O:O2=66:34), FIO2 in the
circle may increase over time

D. A FGF of 3 times the minute

volume may be needed to prevent
re-breathing in Bain's co-axial
system during spontaneous
ventilation

E. Dead space gas is preserved in

Magill system during spontaneous
ventilation

Regarding nitrous oxide:

Select true or false for each of the following statements.

True False
A. Has a MAC of 1.05

B. Can be safely administered via a

Quantiflex mixer

C. Has a pseudocritical temperature

of -5.5C

D. Is an inert gas

E. Is recognisable by French-blue
cylinders and a pin-index of 3 and
5

The Mapleson A breathing system:

Select true or false for each of the following statements.

True False

A. Is a non-rebreathing system

B. Must have the expiratory valve

close to the patient

C. Requires a fresh gas flow equal to

the dead space ventilation

D. Requires a higher fresh gas flow

than a Mapleson D system in
manual ventilation

E. Was modified by Magill from

Mapleson's original design

Activated charcoal, as used in the Cardiff Aldasorber:

Select true or false for each of the following statements.

True False
A. Does not absorb nitrous oxide

B. Is effective in absorbing isoflurane

C. Increases expiratory resistance

significantly

D. Can be reactivated by heating to

remove the absorbed agents

E. Changes from white to blue when

exhausted

A canister of soda-lime:

Select true or false for each of the following statements.

True False

A. Contains mostly calcium carbonate

B. Requires water for the absorption

process

C. Contains 50% by weight of sodium

hydroxide

D. Will absorb nitrous oxide

E. When packed will be 50% filled

with granules

When using a circle system (with a CO2 absorber) and a vaporiser outside the circle:

Select true or false for each of the following statements.

True False
A. A fresh gas flow of at least 2/3 of
the minute volume is required

B. The actual inspired vapour

concentration during maintenance
may be higher than the vaporiser
setting

C. The actual inspired oxygen

concentration may be lower than
that of the fresh gas at low fresh
gas flows

D. Sevoflurane is a suitable agent to

use

E. The system can only be used for

patients breathing spontaneously

The critical temperature of a gas can be correctly defined as ‘The temperature…’:

Select true or false for each of the following statements.

Multiple rows with several possible answers per question

R R
e e
Question True s False s
ul ul
t t

At which pressure equals critical

A.
pressure

B. At which freezing occurs

Above which it cannot be liquefied by

C.
pressure alone

At which Boyle’s law is perfectly

D.
obeyed

At which attraction between molecules

E.
is negligible
With regard to Entonox:

Select true or false for each of the following statements.

Multiple rows with several possible answers per question

R R
e e
Question True s False s
ul ul
t t

It is a 50:50 mix by weight of oxygen

A.
and nitrous oxide

It is supplied in cylinders at a
B.
pressure of 137 bar

It has a pseudo-critical temperature of

C.
5.5 degrees Celsius

D. Cylinders should be stored upright

It exists only in gaseous form in a

E.
cylinder

Essential elements of the oxygen VIE include:

Select true or false for each of the following statements.

Multiple rows with several possible answers per question

R R
e e
Question True s False s
ul ul
t t

A double-skinned steel pressure

A.
vessel

A secondary outlet to remove

B. additional vapour from the top of the
tank in times of high demand
 A bourdon gauge to indicate
C.
remaining contents of the vessel

A system of regulators to reduce

D.
supply pressure to 4.1 bar

E. A safety valve to open at 15 bar

With regard to standard medical gas cylinders:

Select true or false for each of the following statements.

Multiple rows with several possible answers per question

R R
e e
Question True s False s
ul ul
t t

Undergo safety checks every three

A.
years

Have plastic neck rings to signify year

B.
of manufacture

C. Are made of molybdenum steel

Can withstand pressures 65-70%

D.
above working pressure

E. Are safe in MRI scanners

With regard to the Bain system:

Select true or false for each of the following statements.

Multiple rows with several possible answers per question

R R
Question True e False e
s s
 ul ul
t t

It requires a test of the bag integrity

A.
using the Pethick procedure

It is most efficient in controlled

B.
ventilation

It risks failure of safe scavenging if

C. the inner tube fractures at the
common gas outlet

It is a coaxial variant of the Mapleson

D.
D system

It can safely be extended to over 5 m

E.
in length with no loss in efficiency

With regard to the Mapleson A System:

Select true or false for each of the following statements.

Multiple rows with several possible answers per question

R R
e e
Question True s False s
ul ul
t t

It is most efficient when used for

A.
controlled ventilation
It is available in parallel and coaxial
B.
configurations

It removes the weight of the APL

C. valve from the patient’s face when
used in the Magill configuration

It requires a fresh gas flow 1.5-2 x

D. minute volume when used for
spontaneous ventilation

It has an inner expiratory and outer

E.
inspiratory tube in the coaxial variants
With regard to soda lime:

Select true or false for each of the following statements.

Multiple rows with several possible answers per question

R R
e e
Question True s False s
ul ul
t t

It is primarily composed of calcium

A.
salts

It is the active component of a Cardiff

B.
Aldasorber

1kg will absorb 120 L of carbon

C.
dioxide

D. It will become white when exhausted

It is associated with carbon monoxide

E.
generation

With regard to the Circle system:

Select true or false for each of the following statements.

Multiple rows with several possible answers per question

R R
e e
Question True s False s
ul ul
t t

It warms and humidifies inspired

A. gases by passing the fresh gas
through soda lime

It requires at least one unidirectional

B.
valve to prevent rebreathing
 It can be used in a fully closed
C.
configuration

Due to the recycling of expired gases

D.
does not require a scavenging system

Inspired and expired oxygen analysers

E.
are required for fully closed operation

With regard to pressure control ventilation:

Select true or false for each of the following statements.

Multiple rows with several possible answers per question

R R
e e
Question True s False s
ul ul
t t

It is able to compensate for breathing

A.
system leakage

It is the preferred choice in severe

B.
asthma to reduce barotrauma

It is a suitable choice in paediatric

C.
anaesthesia

D. It utilizes constant inspiratory flow

It can maintain ventilation with

E.
changes in compliance

With regard to volume control ventilation:

Select true or false for each of the following statements.

Multiple rows with several possible answers per question

R R
Question True False
e e
 s s
ul ul
t t

A. It utilizes a constant inspiratory flow

It is the preferred choice in paediatric

B.
anaesthesia

It can be combined with positive

C.
end-expiratory pressure (PEEP)

It is the preferred choice in head

D.
injured patients

It is a good mode for the final stages

E.
of weaning ventilation on the ICU

Methods of optimising oxygenation include:

Select true or false for each of the following statements.

Multiple rows with several possible answers per question

R R
e e
Question True s False s
ul ul
t t

A. Increasing levels of PEEP

Increasing fractional inspiratory

B.
oxygen

C. Increasing mean airways pressure

Decreasing levels of Expiratory

D.
Positive Airways Pressure (EPAP)

Moving from supine to

E.
semi-recumbent position
Methods of reducing PaCO2 include:

Select true or false for each of the following statements.

Multiple rows with several possible answers per question

R R
e e
Question True s False s
ul ul
t t

A. Increase in respiratory rate

B. Avoiding high peak airways pressure

C. Increasing minute ventilation

D. Increasing fresh gas flow

Decrease in the duration of inspiration

E. to the duration of expiration (I:E
ratio)