EDAIC Intensive Care Medicine 4

Question 1

Neuromuscular blockade in ARDS is recommended within the first 48 hours when:

Accepted Answer

P/F ratio <200 mmHg with FiO2 >0.6

Answer

ACURASYS trial criteria and current practice recommend NMB for moderate-severe ARDS (P/F <150) but it is used selectively; the 2019 ROSE trial showed no benefit in all ARDS, so indications are debated at P/F <150–200.

Question 2

A patient develops fever, rigors, and hypotension 30 minutes after starting a blood transfusion. The immediate action is:

Accepted Answer

Stop the transfusion and send blood samples for cross-match and cultures

Answer

Acute hemolytic transfusion reaction must be excluded immediately by stopping the transfusion, returning the blood product, and sending samples.

Question 3

Which pulmonary artery catheter-derived parameter best reflects left ventricular preload?

Accepted Answer

Pulmonary artery occlusion pressure (PAOP)

Answer

PAOP (wedge pressure) reflects left atrial pressure and thus left ventricular end-diastolic pressure when measured correctly.

Question 4

In hypertensive emergency with acute aortic dissection, the preferred agent to reduce blood pressure is:

Accepted Answer

IV labetalol or esmolol (β-blocker first)

Answer

β-blockade must precede any vasodilator in aortic dissection to prevent reflex tachycardia, which increases aortic shear stress.

Question 5

Stress ulcer prophylaxis in ICU patients is most clearly indicated in patients who have:

Accepted Answer

Mechanical ventilation >48 hours or coagulopathy

Answer

Mechanical ventilation >48 hours and coagulopathy are the two strongest independent risk factors identifying patients who benefit from stress ulcer prophylaxis.

EDAIC - European Diploma in Anesthesiology and Intensive Care Practice Test

EDAIC - European Diploma in Anesthesiology and Intensive Care Practice Test

EDAIC Intensive Care Medicine 4