FFICM FFICM Organ System Failure and Support 2 — Questions and Answers
Question 1: Which neurological monitoring technique measures the electrical activity of the brain and is used to detect non-convulsive status epilepticus in the ICU?
- Continuous EEG monitoring (Correct answer)
- Transcranial Doppler
- Intracranial pressure monitoring
- Cerebral oximetry (NIRS)
Correct answer: Continuous EEG monitoring
Continuous EEG monitoring is the standard tool for diagnosing non-convulsive seizures and non-convulsive status epilepticus in ICU patients with altered consciousness.
Question 2: What cerebral perfusion pressure (CPP) is targeted in severe traumatic brain injury management?
- 60–70 mmHg (Correct answer)
- 40–50 mmHg
- 80–90 mmHg
- >100 mmHg
Correct answer: 60–70 mmHg
Current TBI guidelines recommend a CPP target of 60–70 mmHg (CPP = MAP − ICP) to ensure adequate cerebral perfusion while avoiding secondary ischemic injury.
Question 3: In patients with raised intracranial pressure (ICP), what is the first-line osmotic therapy used to reduce cerebral edema?
- Mannitol 20% IV bolus (Correct answer)
- Furosemide IV infusion
- Hypertonic saline 3% oral
- Dexamethasone IV
Correct answer: Mannitol 20% IV bolus
Mannitol 20% given as an IV bolus creates an osmotic gradient that draws free water from the brain parenchyma into the vasculature, rapidly reducing ICP.
Question 4: Which condition is the most common cause of community-acquired bacterial meningitis requiring ICU admission in adults?
- Streptococcus pneumoniae (Correct answer)
- Neisseria meningitidis
- Listeria monocytogenes
- Haemophilus influenzae
Correct answer: Streptococcus pneumoniae
Streptococcus pneumoniae (pneumococcal meningitis) is the most common cause of bacterial meningitis in adults and carries the highest mortality among common pathogens.
Question 5: What is Cushing's triad, a sign of critically elevated intracranial pressure?
- Hypertension, bradycardia, and irregular respirations (Correct answer)
- Hypotension, tachycardia, and tachypnea
- Hypertension, tachycardia, and Cheyne-Stokes breathing
- Hypotension, bradycardia, and apnea
Correct answer: Hypertension, bradycardia, and irregular respirations
Cushing's triad — hypertension, bradycardia, and irregular respirations — represents the brain's last-ditch reflex to maintain cerebral perfusion pressure against severely elevated ICP.
Question 6: In severe acute pancreatitis, which scoring system uses CT findings to grade severity and necrosis?
- CT Severity Index (Balthazar score) (Correct answer)
- Ranson criteria
- APACHE II
- Glasgow score
Correct answer: CT Severity Index (Balthazar score)
The CT Severity Index (Balthazar score) combines the degree of pancreatic inflammation (A–E) with the percentage of gland necrosis to provide a radiological severity score.
FFICM FFICM Organ System Failure and Support 2
Which neurological monitoring technique measures the electrical activity of the brain and is used to detect non-convulsive status epilepticus in the ICU?