Intensive Care Medicine Flashcards

A patient with ARDS has a PaO2/FiO2 ratio of 110 mmHg. According to the Berlin Definition, this classifies as:

Answer: Severe ARDS

Severe ARDS is defined by PaO2/FiO2 ≤100 mmHg; moderate is 101–200; 110 mmHg falls in the severe category.

Which vasopressor is recommended as first-line therapy for septic shock in current surviving sepsis guidelines?

Answer: Norepinephrine

Norepinephrine is the first-line vasopressor for septic shock due to its strong α-adrenergic effect and favorable cardiac output profile.

A ventilated ICU patient has a plateau pressure of 34 cmH2O and a PEEP of 8 cmH2O. The driving pressure is:

Answer: 26 cmH2O

Driving pressure = Plateau pressure − PEEP = 34 − 8 = 26 cmH2O.

In acute liver failure, which finding indicates the poorest prognosis according to King's College Criteria?

Answer: INR >6.5 in acetaminophen-induced ALF

An INR >6.5 (PT >100 s) in acetaminophen-induced ALF is an independent criterion for transplant listing under King's College Criteria.

Prone positioning in severe ARDS improves survival primarily by:

Answer: Reducing ventilator-induced lung injury through more homogeneous ventilation

Prone positioning redistributes ventilation, reducing dorsal atelectasis and making lung stress/strain more homogeneous, thereby limiting VILI.

Which scoring system is most validated for predicting ICU mortality and is widely used across European ICUs?

Answer: SAPS II

SAPS II (Simplified Acute Physiology Score II) is widely validated and used in European ICUs for mortality prediction.

A patient on continuous renal replacement therapy (CRRT) becomes hypotensive. The most likely cause related to the CRRT circuit is:

Answer: Excessive ultrafiltration rate

Excessive net ultrafiltration removes intravascular volume faster than it can be replaced, causing hypovolemia and hypotension.