Intensive Care Medicine MCQs

Multiple Choice Questions with Explanatory Answers

Abbas, Shoneen, Herod, Ruth, Horner, Daniel, Benington, Steve

• Publisher: tfm Publishing Ltd
• Year: 2015
• ISBN:
  9781910079089
• Topic: Médecine
• Subtopic: Médecine d'urgence et soins intensifs

Intensive care medicine is a dynamic and evolving specialty, requiring its practitioners to be part physician, physiologist and anaesthetist. This requires a firm foundation of knowledge and an ability to apply this to the clinical situation. This book contains 270 multiple-choice questions allowing self-assessment of the breadth of knowledge required of the modern intensivist. The book is divided into three papers each consisting of 60 multiple true false (MTF) and 30 single best answer (SBA) questions covering areas including resuscitation, diagnosis, disease management, organ support, and ethical and legal aspects of practice. The MTF questions test factual knowledge and understanding of the evidence base underpinning intensive care medicine, while the SBA questions test the ability of the candidate to prioritise, compete options and make the best decision for the patient. Each question is peer reviewed and accompanied by concise and detailed explanatory notes with references to guide further reading. All the authors are practising intensive care physicians with firsthand experience of professional examinations in the specialty. This book will appeal to intensive care physicians approaching professional examinations worldwide, including the European Diploma, American Board and Faculty of Intensive Care Medicine examinations. In addition, it will appeal to intensive care nurses and allied healthcare professionals wishing to update their knowledge as part of continuing professional development, and to physicians sitting professional examinations in related specialties requiring knowledge of intensive care medicine such as general medicine, general surgery and anaesthesia. This new book will complement the existing international best-selling title 'Multiple Choice Questions in Intensive Care Medicine' (ISBN 978 1 903378 64 9), also written by Dr Steve Benington.

Paper 1 Questions

Multiple True False (MTF) questions — select true or false for each of the five stems.

1	Guillain-Barré syndrome (GBS):
a.	Affects more females than males.
b.	Is a disease of the middle-aged.
c.	When secondary to a respiratory illness, the majority of cases present within a month.
d.	The presence of cranial nerve signs effectively rules out the diagnosis.
e.	The most common associated pathogen is Clostridium perfringens.

2	In the trauma patient with massive haemorrhage, the following statements are correct:
a.	An initial target systolic blood pressure of 80-90mmHg is recommended for the patient without brain injury.
b.	Desmopressin at a dose of 0.3μg/kg is recommended in the bleeding patient taking platelet-inhibiting drugs.
c.	Recombinant factor VIIa (rFVIIa) can be considered as a rescue measure provided the platelet count is greater than 30 × 10^9/L.
d.	Pre-injury warfarin use doubles the odds of death for trauma patients with blunt head injury.
e.	Antifibrinolytic drugs recommended for use in the bleeding major trauma patient include tranexamic acid, aprotinin and aminocaproic acid.

3	The following drugs undergo non-organ metabolism:
a.	Esmolol.
b.	Atracurium.
c.	Inhaled nitric oxide.
d.	Propofol.
e.	Adrenaline.

4	Which of the following features of an asthma attack are classified as ‘life-threatening’ in the 2011 BTS asthma guideline?
a.	Inability to complete sentences in one breath.
b.	PaO2 of >8kPa.
c.	Silent chest.
d.	PaCO2 >6kPa.
e.	Peak expiratory flow rate (PEFR) <50% of predicted.

5	With regard to bleeding and coagulopathy in the critically ill patient:
a.	If a platelet transfusion is indicated, 1 unit will raise the count by approximately 20 × 10^9/L.
b.	The principal constituents of cryoprecipitate include Factors VIII, XIII, vWF, fibronectin and fibrinogen.
c.	A suggested dose of fresh frozen plasma in the bleeding trauma patient with coagulopathy is 30ml/kg.
d.	Desmopressin at a dose of 0.3μg/kg is a useful treatment in patients with coagulopathy related to uraemia, cirrhosis and aspirin use.
e.	At temperatures of 33-35°C, altered enzyme kinetics equate to a 33% reduction in normal clotting factors.

6	Regarding drug-receptor interactions:
a.	An antagonist has receptor affinity an...