Critical Care & Intensive Care Flashcards
7 cards from real BCA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Critical Care & Intensive Care flashcards as text
A burn patient is intubated for inhalation injury. Three months later, the patient requires elective surgery. Which anesthetic consideration is most critical?
Answer: Avoid succinylcholine due to upregulated acetylcholine receptors
Burn patients develop upregulation of extrajunctional acetylcholine receptors for weeks to months, making succinylcholine dangerous due to massive potassium release.
In a patient with refractory intracranial hypertension despite standard measures, which intervention has level II evidence for ICP reduction?
Answer: Decompressive craniectomy
Decompressive craniectomy is supported by evidence (DECRA, RESCUEicp trials) for refractory ICP reduction when medical management fails.
Which acid-base abnormality is expected in a patient with pyloric obstruction and persistent vomiting?
Answer: Metabolic alkalosis with low chloride
Loss of gastric HCl through vomiting causes hypochloremic metabolic alkalosis with compensatory renal bicarbonate retention.
A critically ill patient on vasopressors develops new ST elevation and troponin rise. Bedside echo shows new wall motion abnormality. Which intervention has the strongest evidence?
Answer: Emergent percutaneous coronary intervention
Primary PCI is the gold-standard reperfusion strategy for STEMI with cardiogenic shock, associated with superior outcomes over thrombolytics.
A patient on mechanical ventilation has auto-PEEP. Which ventilator adjustment will most effectively reduce auto-PEEP?
Answer: Decrease respiratory rate to lengthen expiratory time
Decreasing respiratory rate prolongs expiratory time, allowing more complete exhalation and reducing dynamic hyperinflation (auto-PEEP).
In severe traumatic brain injury, which intervention is recommended to reduce secondary injury?
Answer: Maintain SBP ≥100 mmHg and avoid hypoxia (SpO2 <90%)
Current TBI guidelines emphasize avoiding hypotension (SBP <90 mmHg) and hypoxia (SpO2 <90%) as they worsen secondary brain injury.
Which electrolyte abnormality is most associated with prolonged QT interval and risk of torsades de pointes in ICU patients?
Answer: Hypokalemia and hypomagnesemia
Hypokalemia and hypomagnesemia both prolong cardiac repolarization and are the most common electrolyte causes of QT prolongation and torsades in critically ill patients.