FACEM FACEM Critical Care and Resuscitation 1 — Questions and Answers
Question 1: Which vasopressor is recommended as first-line therapy for septic shock refractory to fluid resuscitation?
- Epinephrine
- Norepinephrine (Correct answer)
- Dopamine
- Vasopressin
Correct answer: Norepinephrine
Norepinephrine is the first-line vasopressor for septic shock due to its potent alpha-adrenergic vasoconstriction with minimal tachycardia compared to alternatives.
Question 2: In the management of anaphylaxis, which is the most important first-line drug and route of administration?
- IV hydrocortisone 200 mg
- IM epinephrine 0.5 mg (1:1000) (Correct answer)
- IV antihistamine
- Nebulized salbutamol
Correct answer: IM epinephrine 0.5 mg (1:1000)
Intramuscular epinephrine (adrenaline) 0.5 mg of 1:1000 solution into the anterolateral thigh is the cornerstone of anaphylaxis treatment, reversing bronchospasm and vasodilation.
Question 3: What is the recommended compression-to-ventilation ratio in adult CPR for a single rescuer?
- 15:2
- 30:2 (Correct answer)
- 15:1
- 20:2
Correct answer: 30:2
The 2020 AHA guidelines recommend a 30:2 compression-to-ventilation ratio for adult CPR with a single rescuer, prioritizing chest compressions.
Question 4: Which acid-base disturbance is most commonly seen in early septic shock?
- Metabolic alkalosis
- Respiratory alkalosis
- High anion gap metabolic acidosis (Correct answer)
- Hyperchloremic metabolic acidosis
Correct answer: High anion gap metabolic acidosis
High anion gap metabolic acidosis from lactic acidosis is the most common acid-base abnormality in early septic shock due to tissue hypoperfusion and anaerobic metabolism.
Question 5: What is the target mean arterial pressure (MAP) recommended in the Surviving Sepsis Campaign for septic shock?
- 55 mmHg
- 65 mmHg (Correct answer)
- 75 mmHg
- 85 mmHg
Correct answer: 65 mmHg
The Surviving Sepsis Campaign recommends a target MAP of ≥65 mmHg as the initial resuscitation goal in adults with septic shock.
Question 6: In post-cardiac arrest care, what is the target temperature range for targeted temperature management (TTM)?
- 32–34°C
- 33–36°C (Correct answer)
- 36–38°C
- 30–32°C
Correct answer: 33–36°C
Current evidence supports TTM targeting 33–36°C for comatose survivors of cardiac arrest to reduce neurological injury, with active prevention of fever to at least 72 hours.
FACEM FACEM Critical Care and Resuscitation 1
Which vasopressor is recommended as first-line therapy for septic shock refractory to fluid resuscitation?