FRCS Critical Care and Emergency

Question 1

A patient with severe sepsis has a serum lactate of 6.2 mmol/L. According to the Surviving Sepsis Campaign (SSC) guidelines, what is the target for lactate clearance within the first 6 hours?

Accepted Answer

Decrease by at least 20% within 6 hours

Answer

Normalise to below 1 mmol/L within 6 hours

Answer

Decrease by 50% within 2 hours

Answer

No specific lactate target is recommended

Question 2

In the primary survey of a trauma patient (ATLS), after addressing airway with cervical spine control, what is the next priority?

Accepted Answer

Breathing and ventilation

Answer

Circulation with haemorrhage control

Answer

Disability (neurological assessment)

Answer

Exposure with environmental control

Question 3

A patient in the ICU develops acute respiratory distress syndrome (ARDS). According to the Berlin definition, what PaO2/FiO2 ratio defines moderate ARDS?

Accepted Answer

100-200 mmHg

Answer

200-300 mmHg

Answer

Less than 100 mmHg

Answer

300-400 mmHg

Question 4

A 70 kg patient with 40% total body surface area full-thickness burns presents 1 hour post-injury. Using the Parkland formula, what volume of Hartmann's solution should be administered in the first 8 hours from the time of burn?

Accepted Answer

5600 ml

Answer

11200 ml

Answer

2800 ml

Answer

8400 ml

Question 5

Which scoring system is used in UK emergency departments to assess the severity of community-acquired pneumonia and guide admission decisions?

Accepted Answer

CURB-65

Answer

APACHE II

Answer

SOFA

Answer

Glasgow-Blatchford

Question 6

A post-operative patient develops a pulmonary embolism with haemodynamic instability (systolic BP 70 mmHg). What is the definitive pharmacological treatment?

Accepted Answer

Systemic thrombolysis with alteplase

Answer

Therapeutic dose LMWH

Answer

Intravenous unfractionated heparin bolus

Answer

Oral rivaroxaban