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KETTERING TESTS COMPREHENSIVE EXAM SCRIPT 2026 SOLVED QUESTIONS VERIFIED, Exams of Biomedicine

Princeton UniversityBiomedicine

KETTERING TESTS COMPREHENSIVE EXAM SCRIPT 2026 SOLVED QUESTIONS VERIFIED

Typology: Exams

2025/2026

Available from 01/07/2026

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KETTERING TESTS COMPREHENSIVE EXAM
SCRIPT 2026 SOLVED QUESTIONS VERIFIED
◉ What is a perfusion scan? Answer: - Albumin, tagged with iodine,
is injected to a peripheral vein and when it passes into the
pulmonary circulation, lodged in the capillaries
- A scanning device is passed over the chest and produces a pattern
of radiation that indicates the distribution and volume of perfusion
◉ What are PET scans commonly used for? Answer: - Used in
determining the presence of cancer, brain disorders and heart
disease
◉ What is a pulmonary angiography used for? Answer: - Solely used
to diagnose a *pulmonary embolism*
◉ What is an echocardiogram? Answer: - An ultrasound of the heart;
noninvasive method for monitoring cardiac performance
- Indications include: Abnormal heart sounds, cardiac anomalies in
the infant, myocardial disease, abnormal cardiac blood flow
◉ ICP monitoring Answer: - *Normal value: 5-10 mmHg*
(Recommend initiating treatment if ICP > 20 mmHG)
- Mannitol is used to remove fluid from the brain
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Download KETTERING TESTS COMPREHENSIVE EXAM SCRIPT 2026 SOLVED QUESTIONS VERIFIED and more Exams Biomedicine in PDF only on Docsity!

KETTERING TESTS COMPREHENSIVE EXAM

SCRIPT 2026 SOLVED QUESTIONS VERIFIED

◉ What is a perfusion scan? Answer: - Albumin, tagged with iodine, is injected to a peripheral vein and when it passes into the pulmonary circulation, lodged in the capillaries

  • A scanning device is passed over the chest and produces a pattern of radiation that indicates the distribution and volume of perfusion ◉ What are PET scans commonly used for? Answer: - Used in determining the presence of cancer, brain disorders and heart disease ◉ What is a pulmonary angiography used for? Answer: - Solely used to diagnose a pulmonary embolism ◉ What is an echocardiogram? Answer: - An ultrasound of the heart; noninvasive method for monitoring cardiac performance
  • Indications include: Abnormal heart sounds, cardiac anomalies in the infant, myocardial disease, abnormal cardiac blood flow ◉ ICP monitoring Answer: - Normal value: 5-10 mmHg (Recommend initiating treatment if ICP > 20 mmHG)
  • Mannitol is used to remove fluid from the brain

- HYPERVENTILATE PATIENT THAT HAS HIGH ICP

◉ What is Exhaled Nitric Oxide (FENO) testing? Answer: - Used to monitor patient's response to anti-inflammatory (corticosteroid) treatment.

  • A decrease in FENO suggest a decrease in airway inflammation ◉ What is Exhaled Carbon Monoxide (FECO) testing and ranges? Answer: - Used to monitor abstinence in cigarette smokers
  • Heavy smokers = >20
  • Moderate smokers = 11-20
  • Light smokers = 7- 10
  • Non smokers = <7 ◉ What makes up a CBC? Normal Values? Answer: - RBC (4- 6 million) (Low = blood loss or hemorrhage) (High = Chronic tissue hypoxemia ..i.e. COPD)
  • Hemoglobin (12-16) (Low = anemia) (High = polycythemia)
  • Hematocrit (Hct) (40-50%)
  • WBC (5-10 thousand) (Low = Viral infection) (High = Bacterial infection) ◉ What makes up Electrolytes? Normal Values? Answer: - K+ (3.5- 4.5) (High = kidney failure (Low = excessive excretion, vomiting)

◉ Sputum analysis of pink frothy sputum Answer: - PULMONARY EDEMA ◉ What is a gram stain? Answer: - Distinguishes between gram positive or gram negative

  • Viral infections do not stain ◉ What is an acid-fast stain? Answer: Identifies tuberculosis ◉ What is troponin? Values? Answer: - A protein found in myocardial cells (indicator of damage to heart muscle)
  • Normal = <0.1
  • Recommend "M.O.N.A" = Morphine, Oxygen, Nitroglycerin, Aspirin ◉ What is BNP? Values? Answer: - Secreted by the cardiac muscle when heart failure develops or worsens
  • Normal = <100
  • Elevated levels indicate CHF ◉ How many leads are displayed on an ECG monitor? Answer: - Generally displays a single lead (Lead 2 is most common)

◉ How do you estimate heart rate from an ECG strip? Answer: - If the two R waves are between 3-5 large boxes, then the rate is normal (60-100)

  • Heart rate = 300 / # of large boxes between R waves ◉ How does atrial flutter look on ECG? Answer: - Saw tooth
  • Correct with cardioversion ◉ What is the apgar scale? (the 1's) Answer: - Appearance (color) = Body pink extremities blue
  • Pulse = < 100/minute
  • Grimace (reflex) = Grimace
  • Activity = Some flexion of extremities
  • Respiratory effort = slow, irregular weak cry ◉ Infants Vital Signs Answer: - HR = 110- 160
  • RR = 30- 60
  • BP = 60/
  • Birth weight = >3000 g..... 1000 g for 28 weeks ◉ How do you determine if the newborn has a PDA with right to left shunt? Answer: If the pre-ductal (right radial artery) is 15 torr

- THIS IS A GOOD SIGN

◉ Pulse pressure equation Answer: - Pulse pressure =systolic pressure - diastolic pressure

  • Normal = 40 mm Hg ◉ Mean Arterial Pressure (MAP) equation Answer: MAP = (2 x diastolic pressure) + systolic / 3 ◉ Cardiac index equation Answer: CI = Qt/BSA
  • Normal = 2.5-4 ◉ What is pulmonary vascular resistance (PVR) Answer: - The pressure gradient across the pulmonary circulation divided by the cardiac output
  • PVR = MPAP-PCWP/CO
  • Normal = <2.5 ◉ How often should a NPA be changed? Answer: - Every 24 hours to prevent Epistaxis (nose bleeds) ◉ What is the Modified Jaw Thrust? Answer: - Implies NO head extension is performed (C-Spine injuries)

◉ What should always be used with a Flow-Inflating Bag? Answer: - A pressure manometer to monitor PIP and PEEP ◉ "V.A.N.E" pneumonic Answer: - Valium/Versed = Sedative

  • Atropine = Bradycardia
  • Narcan = Narcotic Overdose
  • Epinephrine = Asystole (These are all drugs that can be pushed through the ET tube) ◉ Alveolar Air Equation Answer: - PAO2= (PB - PH2O) x FiO2 - (PaCO2 x 1.25) ◉ A-a Gradient and values? Answer: - A-a gradient =PAO2 - PaO
  • 25-65 torr on 100% = Normal
  • 66-300 torr = V/Q mismatch (This is solved by going up on FiO to 60%.. anymore will cause NITROGEN WASHOUT and Atelectasis!
  • >300 = Shunting (GIVE PPV, and increase of FiO2 won't fix shunt) ◉ P/F ratio? values Answer: - PaO2/FiO
  • Normal = 380 torr or greater
  • <300 = Acute Lung Injury (ALI)

◉ How do you predict PaO2 from SaO2? Answer: - Minus 30 from your SaO2 and that is the approximate PaO2 value ◉ What is Oxygen Index? Values? Answer: - Measures the amount of ventilatory support required to provide the level of oxygenation

  • OI = *MAP X FiO2 / PaO2 *
  • Normal OI = <10
  • A higher OI means the patient is worsening
  • ECMO for newborns with OI >40 ◉ Deadspace to tidal volume ratio (VD/VT) Answer: - PaCO2- PECO2/PaCO2 x 100
  • Normal: 20-40% (up to 60% for vent patients ◉ Desired Vmin equation Answer: - Desired Vmin = Vmin (actual) x PaCO2 (actual) / PaCO2 (desired) ◉ ETT tube sizes for preterm,full term infants, adult male, adult female Answer: - preterms = 2.5-3 mm
  • fullterms = 3.0-3.5 mm
  • adult males = 8.0-8.5 mm
  • adult females = 7.0-7.5 mm

◉ Tube distance markings for oral and nasal intubation Answer: - Oral = 21-25 cm at lips

  • Nasal = 26-29 cm at nares ◉ If you try passing a suction catheter through ETT tube and can't pass, what do you do? Answer: - Remove tube, ventilate, and insert new tube ◉ How do you diagnose a tracheoesophageal fistula? Answer: - Barium swallow test ◉ Vacuum pressures for Adults, kids, and infants Answer: - Adults = 120 - 150
  • Kids = 100- 120
  • Infants = 80- 100 ◉ Catheter size formula? Answer: - Catheter size = ETT x 3 / 2 ◉ Patient positioning for ARDS, CHF, OBESE, and Unilateral lung disease Answer: - ARDS = Prone
  • CHF = Fowlers
  • Obese = Lateral fowlers
  • Unilateral lung disease = Good lung down

◉ What is the minimum flow for a simple mask? Answer: - At least 6 L/min to flush exhaled CO2 ◉ Duration of cylinder flow equation and factors? Answer: - Gauge pressure X tank factor/ liter flow

  • *tank factors: E cyclinder = 0.28 L/psi...H cyclinder = 3.14 L/psi ◉ Accurate blood gas machines should be measured in what range of deviations? Answer: - Plus or Minus 2 standard deviations ◉ PaO2 <80 on 21-60% FiO2? reason and treatment Answer: - Hypoxemia can be caused by:
  • (1) Poor ventilation (high PaCO2)
  • (2) V/Q mismatch
  • FIX BY:
  • (1) Increase ventilation
  • (2) Increase FiO2 up to 60% ◉ PaO2 <80 on >60% FiO2? reason and treatment Answer: - Hypoxemia caused by:
  • (1) Shunt, Refractory hypoxemia, Venous admixture
  • FIX BY:
  • (1) Start or increase CPAP or PEEP..(recruit) ◉ Typical Peak flow value for a (healthy adult) Answer: - 10 L/sec or 600 L/min ◉ What does plethysmography measure? Answer: - Functional residual capacity (FRC)
  • Accuracy is measured by plus or minus 5 of the volume ◉ How do you calibrate a plethysmography? Answer: - With a 3.0 L syringe ◉ MIP normal and critical range? Answer: - Normal = - 80 cm H2O
  • Critical range = <-20 (intubation time) ◉ MEP normal and critical range? Answer: - Normal = 160 cm H2O
  • Critical = <40 (poor ability to clear airway secretions) ◉ A decreased FVC is the best indicator of what disease? Answer: - RESTRICTIVE
  • VC normal = not restrictive
  • VC decreased = restrictive (<80% predicted)

◉ Mild, Moderate, Severe, and Very Severe FEV1 for COPD patients? Answer: - Mild = >80%

  • Moderate = 50-79%
  • Severe = 30-49%
  • Very severe = <30% ◉ 3 Tests to measure FRC? Answer: - Helium Dilution (Closed)
  • Nitrogen Wash Out (Open)
  • DLCO ◉ What kind of bronchoscopy do you recommend for patients with suspected neck fracture? Answer: - Flexible bronchoscopy ◉ Contraindications for bronchoscopy? Answer: - Bleeding disorders
  • Cardiac instability
  • Marked Hypercapnia
  • Status asthmaticus ◉ Required tools for bronchoscopy? Answer: - Oxygen, Suction, Specimen collection equipment, and Syringes with flush solution ◉ What type of drugs end with "-cain"? Answer: - Local anesthetics

◉ What type of drugs end with "-lam" or "-pam"? Answer: - Sedatives ◉ What would you wash the bronchoscopy scope with? Answer: - Immerse the scope in alkaline glutaraldehyde ◉ Initial settings for adult on ventilator? Answer: - Vt: 6-8 mL/kg

  • Pressure: < or = 35
  • RR: 10-20 breaths/min
  • FiO2: < or = 60% or same level prior to ventilation
  • PEEP: 4-6 or same level prior to ventilation ◉ Initial settings for infant on ventilator? Answer: - Vt: 4-6 mL/kg
  • PIP: 20- 30
  • FiO2: < or = 60% or same level prior to ventilation
  • PEEP: 4-5 or same level prior to ventilation ◉ Tidal volume equation Answer: - Vt = (Ve / RR) ◉ Minute ventilation equation Answer: - Ve = Vt x RR

◉ Proning should be considered for patients with ALI/ARDS when? Answer: - FiO2 is >60% and PEEP >12 and when recruitment maneuvers have failed ◉ Auto-PEEP can be corrected by? Answer: - Decreases inspiratory time

  • Increase Flow rate (this shortens i-time)
  • Increase expiratory time
  • always try to match auto-PEEP ◉ What kind of drugs end in "-nium"? Answer: - Paralytics ◉ Normal urine output per day? Answer: - 40 - 60 mL/hour (about 1 liter) ◉ Initial settings for BiPAP? Answer: - IPAP = 8-12 cm H2O
  • EPAP = 4-6 cm H2O
  • FOR TEST THE IPAP HAS TO BE AT LEAST DOUBLE THE EPAP!!!! VERY IMPORTANT! ◉ iNO starting dose? and titration? Answer: - Starting dose = 20- 40 ppm
  • Titration = 20 --> 10 --> 5 --> 0
  • This titration method *avoids rebound hypoxia ◉ Apnea Hypopnea Index (AHI) mild, moderate, and severe values? Answer: - Mild = 5- 15
  • Moderate = 16- 30
  • Severe = > ◉ Where should the thoracentesis needle be placed? Answer: - Inserted between the 7th or 8th intercostal space ◉ Chest tube placement to air and fluid from pleural space? Answer:
  • Air = 2nd intercostal space in midCLAVICULAR line
  • Fluid = 5th to 7th intercostal space mid midAXILLARY line ◉ A pneumothorax of what % requires a chest tube? Answer: - > or = 20% ◉ When should a water-seal bottle bubble? PPV? Spontaneously? Answer: - PPV = bubbles during inspiration
  • Spontaneously = Exhalation
  • CONTINUOUS BUBBLING SHOULD BE REPORTED AS AN AIR LEAK