MAC Fluid Management & Blood Products

Question 1

Which crystalloid solution is most appropriate for resuscitation in a patient at risk for hyperchloremic metabolic acidosis?

Accepted Answer

Lactated Ringer's solution

Answer

Normal saline (0.9% NaCl)

Answer

3% hypertonic saline

Answer

5% dextrose in water

Question 2

According to current evidence-based guidelines, what is the hemoglobin transfusion threshold for a hemodynamically stable, non-cardiac ICU patient without active ischemia?

Accepted Answer

Hgb < 7 g/dL

Answer

Hgb < 10 g/dL

Answer

Hgb < 9 g/dL

Answer

Hgb < 8 g/dL

Question 3

Which dynamic parameter BEST predicts fluid responsiveness in a mechanically ventilated patient with regular cardiac rhythm?

Accepted Answer

Pulse pressure variation (PPV)

Answer

Central venous pressure (CVP)

Answer

Static pulmonary artery occlusion pressure

Answer

Urine output over 30 minutes

Question 4

In a massive transfusion protocol (MTP) for hemorrhagic shock, what is the currently recommended ratio of packed red blood cells (pRBCs) to fresh frozen plasma (FFP) to platelets?

Accepted Answer

1:1:1

Answer

4:1:1

Answer

3:2:1

Answer

6:4:1

Question 5

A patient develops acute hypoxemic respiratory failure with bilateral pulmonary infiltrates and PaO2/FiO2 ratio < 300 within 6 hours of transfusion, with no evidence of volume overload. This presentation is most consistent with:

Accepted Answer

Transfusion-related acute lung injury (TRALI)

Answer

Acute hemolytic transfusion reaction

Answer

Febrile non-hemolytic transfusion reaction

Answer

Transfusion-associated circulatory overload (TACO)

Question 6

Which colloid solution has been shown in multiple randomized controlled trials to significantly increase the risk of acute kidney injury and renal replacement therapy in critically ill patients?

Accepted Answer

Hydroxyethyl starch (HES)

Answer

5% albumin

Answer

Dextran 40

Answer

Gelatin-based colloids

Question 7

Cryoprecipitate is the most concentrated source of which clotting factors and proteins?

Accepted Answer

Fibrinogen, Factor VIII, von Willebrand factor, and Factor XIII

Answer

Factors II, VII, IX, and X

Answer

Factor VII and protein C

Answer

Antithrombin III and protein S