SCCM Textbook

Question 1

Myesthenia gravis 20/30/40 rule

Answer 1

Vital capacity < 20 mL/kg, maximal inspiratory pressure < 30 cm H2O, maximal expiratory pressure < 40 cm H2O.

Question 2

Nocardiosis CXR findings

Answer 2

Cavitation

Question 3

Trigger, target, cycle for PSV

Answer 3

Patient, pressure, flow

Question 4

Morbid obesity effect on Pplat

Answer 4

Overestimates (due to high pleural pressures caused by low chest wall compliance). Thus higher pressures could be used in obese patients.

Question 5

Heliox percent O2, indications, and contraindications

Answer 5

30% O2 (70% helium); indicated to improve flow in obstruction (reduce CO2) (asthma, COPD) until bronchodilators and steroids can take effect; hypoxia with patient requiring higher than 30% FiO2.

Question 6

Ketamine effects on airways

Answer 6

Bronchodilates

Question 7

Sensitivity and specificity of lung sliding for PTX

Answer 7

95%, 91% (more sensitive than specific)

Question 8

Maximum flow of the distal brown port on a TLC, compared to 20 gauge peripheral

Answer 8

52 mL/min compared to 60 mL/min

Question 9

Dynamic compliance equation

Answer 9

Tidal volume/ (peak pressure - PEEP)

Question 10

Static compliance equation

Answer 10

Tidal volume / (Pplat - PEEP)

Question 11

Increases in PIP without change in Pplat indicate what?

Answer 11

Airway obstruction (PTX, mainstem intubation, and air trapping all would have increased Pplat)

Question 12

True indication for lytics in PE

Answer 12

Massive PE with hemodynamic instablity

Question 13

Risk of Linezolid with SSRIs

Answer 13

Serotonin syndrome

Question 14

Daptomycin cannot be used to treat this due to binding to surfactant

Answer 14

Pneumonia

Question 15

Typical goal Vanc trough

Answer 15

10-15 µg/mL

Question 16

Ampicillin coverage in meningitis is used to cover this organism

Answer 16

Listeria (pregnancy) (soft cheese)

Question 17

Leptospirosis treatment

Answer 17

doxycycline

Question 18

Must monitor this lab when prescribing daptomycin

Answer 18

CK levels

Question 19

Lemierre syndrome

Answer 19

Septic thrombophlebitis of IJV, usually caused by fusobacterium, diagnosed with neck CT and thrombus in IJV

Question 20

Regimen for infected prosthesis

Answer 20

VAnc, Gent, Rifampin

Question 21

Signs of severe C. diff colitis

Answer 21

ICU admission, hypotension, fever > 38.5, ileus, MS changes, WBC > 35, lactate < 2.2, end organ failure.

Question 22

Indications for eval for transplant in acetaminophen overdose

Answer 22

Ingestion > 30g, acetaminophen level > 500

Question 23

Diagnosis of SBP

Answer 23

> 250 PMN/ mL ascitic fluid (corrected by decreasing 1 PMN for every 250 RBCs/mL)

Question 24

Contraindications to rtPA

Answer 24

INR > 1.7, SBP > 185

Question 25

GBS CSF

Answer 25

high protein, low cell count

Question 26

Indications for ICP monitoring in GCS 3-8 with normal head CT

Answer 26

AGe > 40; SBP < 90; posturing.

Question 27

Winters formula

Answer 27

PaCO2 = (1.5 x HCO3) + 8

Question 28

delta pH

Answer 28

0.008 (New PCO2 - baseline)