Critical Care

Question 1

The SAPS score system is not disease-specific but rather incorporates three underlying-disease variables:

Answer 1

AIDS, metastatic cancer, and hematologic malignancy.

Question 2

Signs of shock with low cardiac output

Answer 2

Narrow pulse pressure
Cool extremities
Delayed capillary refill

Question 3

Signs of shock with high cardiac output

Answer 3

Widened pulse pressure (usually reduced diastolic pressure)
Warm extremities with bounding pulses
Rapid capillary refill

Question 4

Most common cause of hypotension in patients with high cardiac output

Answer 4

Sepsis

causing decreased systemic vascular resistance

Question 5

Respiratory failure with alveolar flooding and intrapulmonary SHUNTING

Answer 5

Type 1 RF. ACUTE HYPOXEMIC RESPIRATORY FAILURE

Question 6

Management of Respiratory failure with alveolar flooding and intrapulmonary SHUNTING

Answer 6

Low tidal volume ventilation plus fluid conservative management strategy

Question 7

Mechanism of type 2 respiratory failure

Answer 7

Alveolar hypoventilation with inability to eliminate carbon dioxide effectively

Aka hypercarbic respiratory failure

Question 8

Type of respiratory failure sec to LUNG ATELECTASIS of perioperative respiratory failure

Answer 8

Type III

Question 9

Type of respiratory failure sec to hypoperfusion of respiratory muscles in patients sec to SHOCK

Answer 9

Type 4

Question 10

Screening criteria for respiratory function in the ICU for spontaneous breathing trials

Answer 10

1. Oxygenation is stable (PAO2/fio2>200 and peep=5 cmh2O)
2. Intact cough and airway reflexes
3. No vasopressor agents
4. No sedatives

Question 11

Criteria for failure to do spontaneous breathing trial

Answer 11

RR>35 for 5 mins
Sao2<90%
hr>140bpm or a 20% increase or decrease from baseline 
SBP <90 or >180mmhg
Increased Anxiety or diaphoresis

Question 12

Extubation is considered is none of the failure criteria is present plus

Answer 12

RR TO TV ratio is <105

Question 13

No benefit of blood transfusion if the trigger hgb <10g/dL compared to a trigger hgb of

Answer 13

7g/dL

Question 14

Most common underlying pathology of acute renal failure in icu due to hypoperfusion and nephrotoxic drugs

Answer 14

ACUTE TUBULAR NECROSIS ATN

Question 15

This condition is common after cardiac arrest and often results in severe and permanent brain injury in survivors

Answer 15

anoxic cerebral injury

Question 16

Certainly patients suffering cardiac arrest shouldhave a temperature targeted to no higher than

Answer 16

36°C.

Question 17

Most effective treatment of status epilepticus

Answer 17

LORAZEPAM

+phenytoin or fosphenytoin due to short half life of lorazepam

Question 18

irreversible cessation of all functions of the entire brain, including the brainstem,even if circulatory and respiratory functions remain intact on artificial life support.

Answer 18

Brain death

Question 19

Diagnosis of brain death

Answer 19

diagnosis requires demonstration of the absence of cerebral function (no response to any external stimulus) and brainstem functions (e.g., unreactive pupils, lack of ocular movement in response to head turning or ice-water irrigation of ear canals, positive apnea test [no drive to breathe]).