Critical Care & Intensive Care Flashcards

A mechanically ventilated patient develops sudden hypotension, tachycardia, and decreased breath sounds on the left. Which diagnosis should be addressed first?

Answer: Tension pneumothorax

Tension pneumothorax causes obstructive shock and requires immediate needle decompression before confirmation by imaging.

What is the target MAP recommended by the Surviving Sepsis Campaign for septic shock resuscitation?

Answer: ≥65 mmHg

The Surviving Sepsis Campaign recommends a MAP ≥65 mmHg as the initial resuscitation target in septic shock.

Which ventilator parameter is most directly associated with ventilator-induced lung injury (VILI)?

Answer: Tidal volume (driving pressure)

Excessive tidal volumes and driving pressures cause volutrauma and barotrauma, the primary mechanisms of VILI.

A patient in the ICU develops oliguria, rising creatinine, and FENa <1%. Which condition is most consistent?

Answer: Prerenal azotemia

FENa <1% indicates avid sodium retention by intact tubules, consistent with prerenal azotemia from reduced renal perfusion.

Which neuromuscular blocking agent is preferred for rapid sequence intubation in a patient with hyperkalemia?

Answer: Rocuronium

Succinylcholine is contraindicated in hyperkalemia due to risk of fatal hyperkalemic cardiac arrest; rocuronium (with sugammadex reversal available) is preferred.

In the management of ARDS, the ARDSNet trial demonstrated mortality benefit with which ventilation strategy?

Answer: Tidal volumes of 6 mL/kg IBW

The landmark ARDSNet trial showed reduced mortality with low tidal volume ventilation (6 mL/kg IBW) compared to 12 mL/kg.

Which vasopressor is recommended as first-line therapy for septic shock according to current guidelines?

Answer: Norepinephrine

Norepinephrine is the first-line vasopressor in septic shock due to its predominant alpha-1 effect and favorable safety profile.