Welcome to your Critical Care Test 5 Which of the following is the most common cause of hypokalemia in ICU patients? Diuretics Renal failure Acidosis Hyperaldosteronism None In a patient with severe hyponatremia, what is the recommended initial approach to correct the sodium level? Rapid correction with hypertonic saline Gradual correction over 48 hours Fluid restriction only Administer isotonic saline None Which of the following electrolyte abnormalities is most commonly associated with prolonged QT intervals? Hyperkalemia Hypokalemia Hypercalcemia Hypomagnesemia None Which of the following is the classic triad of thrombotic microangiopathy (TMA)? Thrombocytopenia, hemolytic anemia, renal failure Thrombocytopenia, leukopenia, renal failure Hypertension, hyperkalemia, hemolytic anemia Anemia, leukopenia, seizures None Which of the following is the treatment of choice for thrombotic thrombocytopenic purpura (TTP)? Plasmapheresis Steroids Eculizumab Heparin None In which of the following conditions is plasmapheresis most commonly used? Guillain-Barré Syndrome Acute myocardial infarction Hyperkalemia Acute respiratory distress syndrome (ARDS) None Which of the following is the most common complication of plasmapheresis? Hypotension Hyperkalemia Hypercalcemia Thrombocytosi None Which of the following is a major advantage of CRRT over intermittent hemodialysis in critically ill patients? Faster fluid removal Easier to perform Less hemodynamic instability More efficient solute clearance None Which of the following is a contraindication to CRRT? Severe hypotension despite vasopressor therapy Acute liver failure with renal involvement Inability to access a large venous site Severe metabolic acidosis None What is the most common indication for venovenous ECMO (VV-ECMO) in the ICU? Acute respiratory failure Cardiogenic shock Sepsis Acute kidney injury None Which of the following is the main complication associated with ECMO therapy? Hypovolemia Bleeding Hyperkalemia None In the management of elevated intracranial pressure (ICP), which of the following interventions should be performed first? Hyperventilation Administration of mannitol Placement of an external ventricular drain Sedation and analgesia None Which of the following is the most appropriate first-line treatment for status epilepticus? Phenytoin Lorazepam Levetiracetam Phenobarbital None Which of the following is the most appropriate management for a patient with a massive pulmonary embolism and hemodynamic instability? Heparin alone Thrombolysis Norepinephrine infusion High-dose aspirin None Which of the following is a key parameter to monitor in patients on a nitroglycerin infusion for acute coronary syndrome (ACS)? Blood pressure Heart rate Oxygen saturation Serum potassium levels None A patient with severe hyperkalemia is being treated with calcium gluconate, sodium bicarbonate, and insulin. What is the primary mechanism of action of calcium gluconate in this setting? Increases potassium excretion in the urine Stabilizes the myocardial cell membrane Decreases potassium release from the cells Enhances potassium uptake into cells None Which of the following is a common cause of hypercalcemia in critically ill patients? Tumor lysis syndrome Hyperparathyroidism Diuretic use Acute kidney injury (AKI) None Which laboratory test is most useful for differentiating between TTP and HUS? ADAMTS13 activity levels Urine protein-to-creatinine ratio Antinuclear antibody (ANA) test Serum lactate dehydrogenase (LDH) levels None Which of the following is an early sign of thrombotic thrombocytopenic purpura (TTP)? Hemolysis with schistocytes Seizures Fever Hepatomegaly None What is the role of plasmapheresis in the management of myasthenia gravis crisis? To remove acetylcholine receptor antibodies To increase acetylcholine receptor availability To correct electrolyte imbalances To improve blood pressure and fluid balance None In which of the following conditions is plasmapheresis contraindicated? Acute thrombotic thrombocytopenic purpura (TTP) Guillain-Barré syndrome (GBS) Hypovolemic shock with no venous access Myasthenia gravis None Which of the following is the primary indication for CRRT in critically ill patients? Severe hyperkalemia refractory to medical treatment Acute kidney injury with hemodynamic instability Chronic kidney disease Acute respiratory failure None Which of the following is a potential complication of CRRT? Hyperkalemia Hypotension due to fluid shifts Hypertension due to fluid overload Pulmonary edema due to rapid fluid removal None Which of the following is the most appropriate initial management for a patient on ECMO who develops heparin-induced thrombocytopenia (HIT)? Switch to warfarin Start a direct thrombin inhibitor (e.g., argatroban) Discontinue ECMO therapy Increase the heparin dose None Which of the following ECMO configurations is most appropriate for a patient with severe refractory cardiac failure? Veno-venous (VV) ECMO Veno-arterial (VA) ECMO Arteriovenous (AV) ECMO Arterio-venous (AV) bypass None In the management of traumatic brain injury (TBI), which of the following is the most critical goal of care? Rapid normalization of intracranial pressure (ICP) Prevention of seizures Correction of electrolyte imbalances Maintenance of adequate cerebral perfusion pressure (CPP) None Which of the following is the most appropriate next step in the management of a comatose patient with suspected non-convulsive status epilepticus (NCSE)? Start lorazepam infusion Perform an EEG to confirm the diagnosis Administer phenobarbital Increase the dose of antiepileptic drugs (AEDs) None Which of the following is the most appropriate treatment for a patient with STEMI and persistent hypotension despite adequate fluid resuscitation? Nitrates Intra-aortic balloon pump (IABP) Beta-blockers Angiotensin-converting enzyme (ACE) inhibitors None A patient with acute decompensated heart failure develops a new murmur. Which of the following is the most likely cause of this murmur? Aortic stenosis Mitral regurgitation due to papillary muscle dysfunction Tricuspid regurgitation due to volume overload Atrial septal defect None A patient with diabetic ketoacidosis (DKA) presents with severe dehydration. What is the most important consideration when initiating fluid replacement in DKA? Rapid administration of isotonic saline Correction of sodium deficit before glucose normalization Using hypotonic saline to correct hyperosmolarity Gradual rehydration to avoid cerebral edema None Which of the following is the most likely cause of hypernatremia in a critically ill patient receiving intravenous fluids? Hyperaldosteronism Diuretic use Excessive administration of sodium bicarbonate Severe renal failure None Which of the following is the most common cause of hemolytic uremic syndrome (HUS) in children? Streptococcus pneumoniae infection Escherichia coli O157:H7 infection HIV infection Drug-induced hemolysis None What is the primary treatment for hemolytic uremic syndrome (HUS)? Plasmapheresis Antibiotic therapy Dialysis Corticosteroids None Which of the following is a major risk of performing plasmapheresis in critically ill patients? Severe hyperkalemia Infection due to central venous catheter Electrolyte disturbances, particularly hypocalcemia Acute renal failure None Which of the following autoimmune diseases can benefit from plasmapheresis therapy? Rheumatoid arthritis Systemic lupus erythematosus Myasthenia gravis Osteoarthritis None What is the primary advantage of continuous venovenous hemofiltration (CVVH) over other CRRT modalities? Higher efficiency in removing waste products Reduced risk of bleeding More consistent fluid balance and hemodynamic stability Faster fluid removal None Which of the following is the most common complication of CRRT? Electrolyte disturbances Infection Thrombosis of the dialysis circuit Hypertension None What is a key difference between venovenous (VV) ECMO and veno-arterial (VA) ECMO? VA ECMO supports both the heart and lungs, while VV ECMO supports only the lungs VV ECMO is used for cardiac failure, while VA ECMO is used for respiratory failure VA ECMO requires a single cannula, while VV ECMO requires two separate cannulas VV ECMO has a higher risk of clot formation than VA ECMO None What is the most common complication of ECMO related to anticoagulation? Hemolysis Thrombosis of the ECMO circuit Bleeding Infection None In patients with subarachnoid hemorrhage (SAH), what is the most common cause of delayed cerebral ischemia (DCI)? Acute hydrocephalus Cerebral vasospasm Seizures Acute brain swelling None What is the first-line treatment for intracranial hypertension in a patient with traumatic brain injury? Hyperventilation Osmotic therapy with mannitol Corticosteroids Anticonvulsants None Which of the following is the most appropriate pharmacological therapy for a patient with acute coronary syndrome (ACS) and no contraindications to anticoagulation? Heparin Enoxaparin Warfarin Clopidogrel None A patient with severe congestive heart failure (CHF) develops hypotension despite adequate fluid resuscitation. What is the most likely cause of hypotension in this patient? Hyperkalemia Acute coronary syndrome Decreased cardiac output due to impaired ventricular function Pulmonary embolism None Which of the following is the primary treatment for intracerebral hemorrhage (ICH)? Surgical evacuation Antihypertensive therapy Corticosteroids Anticonvulsant therapy None What is the most important management strategy in preventing secondary brain injury in patients with traumatic brain injury? Aggressive glucose control Prevention of hypoxia and hypotension Early use of antibiotics Induced hypothermia None A patient is diagnosed with hypercalcemia due to malignancy. Which of the following is the first-line treatment to lower calcium levels in this patient? Furosemide Furosemide Calcium gluconate Sodium bicarbonate None A critically ill patient develops severe hyponatremia. Which of the following is the most appropriate initial step in management? Rapid administration of hypertonic saline Administration of isotonic saline Diuretic therapy Restrict fluid intake only None A patient with a history of renal transplant presents with acute kidney injury, thrombocytopenia, and microangiopathic hemolytic anemia. What is the most likely diagnosis? Hemolytic uremic syndrome (HUS) Thrombotic thrombocytopenic purpura (TTP) Disseminated intravascular coagulation (DIC) Antiphospholipid syndrome None Which of the following is the most appropriate management for a patient with thrombotic thrombocytopenic purpura (TTP)? Intravenous immunoglobulin (IVIG) Plasma exchange (plasmapheresis) Steroids Blood transfusion None What is the primary mechanism by which plasmapheresis improves outcomes in patients with autoimmune hemolytic anemia (AIHA)? Removal of circulating immune complexes Restoration of platelet function Restoration of platelet function Decreased production of red blood cells in the bone marrow None Which of the following is an advantage of using continuous renal replacement therapy (CRRT) over intermittent hemodialysis in critically ill patients? Faster fluid removal Greater flexibility in anticoagulation Less hemodynamic instability during therapy Better clearance of urea None Which of the following patients would most likely benefit from veno-venous (VV) ECMO? A patient with severe cardiogenic shock following a myocardial infarction A patient with acute respiratory distress syndrome (ARDS) A patient with profound hypotension and cardiac arrest A patient with severe arrhythmia causing hemodynamic instability None Which of the following is a potential complication of ECMO therapy? Pneumothorax Pulmonary embolism Heparin-induced thrombocytopenia Hypertension None In the management of acute ischemic stroke, which of the following is the most important determinant of whether a patient is a candidate for thrombolysis? Time of symptom onset Blood glucose levels Blood pressure control Age of the patient None Which of the following is the most appropriate initial treatment for a patient with a suspected brain herniation syndrome due to increased intracranial pressure (ICP)? Mannitol administration Endotracheal intubation and hyperventilation Administration of corticosteroids Surgical decompression None A patient with acute heart failure presents with hypotension, a low cardiac output, and pulmonary edema. Which of the following interventions is most appropriate for this patient? Increase preload with intravenous fluids Administer nitroglycerin for afterload reduction Use high-dose diuretics to decrease preload Intubate and provide mechanical ventilation None Which of the following arrhythmias is most commonly seen in patients with acute myocardial infarction (MI)? Ventricular fibrillation Atrial fibrillation Sinus bradycardia Supraventricular tachycardia None A patient with a severe head injury develops a sudden decrease in Glasgow Coma Scale (GCS) score. What is the most appropriate next step? Administer hypertonic saline Reassess for new neurological deficits Perform a CT scan of the brain Initiate hyperventilation None Which of the following factors is most commonly associated with poor outcomes in patients with subarachnoid hemorrhage (SAH)? Age over 50 years Aneurysm size larger than 5 mm Initial Glasgow Coma Scale (GCS) score less than 9 Female sex None In the management of acute myocardial infarction (MI), what is the primary benefit of using thrombolytics (e.g., tissue plasminogen activator)? Reduces myocardial oxygen demand Restores coronary blood flow Prevents arrhythmias Reduces the risk of heart failure None Time's up
