Intensive Care Medicine MCQs: Multiple Choice Questions with Explanatory Answers

350 Pages·2015·9.33 MB·English

by  Steve Benington

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Intensive Care Medicine
MCQs
Multiple Choice Questions with Explanatory Answers
Editor:
Steve Benington MBChB MRCP FRCA EDIC FFICM
Authors:
Shoneen Abbas MBChB MRCP FFICM
Ruth Herod MBChB FRCA FFICM
Daniel Horner BA MBBS MD MRCP(UK) FCEM FFICM
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Intensive Care Medicine MCQs — Multiple Choice Questions with Explanatory Answers
tfm Publishing Limited, Castle Hill Barns, Harley, Shrewsbury, SY5 6LX, UK
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Paperback ISBN: 978-1-910079-07-2
E-book editions: 2015
ePub ISBN: 978-1-910079-08-9
Mobi ISBN: 978-1-910079-09-6
Web pdf ISBN: 978-1-910079-10-2
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Questions with Explanatory Answers is copyright tfm Publishing Ltd. Apart
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Contents
Page
Preface iv
Acknowledgements vi
Abbreviations vii
Converting units of measurement xii
Topic index xiii
Paper 1: Questions 1
Paper 1: Answers 39
Paper 2: Questions 105
Paper 2: Answers 143
Paper 3: Questions 219
Paper 3: Answers 259
iii
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Preface
This book contains three 90-question multiple choice papers designed to
test the candidate’s knowledge of intensive care medicine (ICM) and their
ability to apply it. Each paper begins with 60 multiple true false (MTF)
questions consisting of a stem and five statements, each requiring a true
or false answer. These are followed by 30 single best answer (SBA)
questions where a clinical vignette is presented with five possible
solutions. The candidate should select the one that best addresses the
problem, mirroring clinical practice where a case usually has several
possible approaches.
Topics have been chosen to cover the breadth of knowledge required
of the modern intensivist, including resuscitation, diagnosis, disease
management, organ support, applied anatomy, end-of-life care and applied
basic sciences. There is a strong focus on the evidence base
underpinning the specialty, making this book particularly useful for
physicians and others approaching professional examinations in ICM and
related acute medical and surgical specialties. There is no ‘pass mark’,
although a score of less than four out of five in an MTF question or an
incorrect response to an SBA question should help the candidate identify
areas where they would benefit from further reading. Each question is
accompanied by a detailed and fully referenced answer; the majority of
references are freely accessible online or through institutional
subscriptions.
The authors are all senior trainees or consultants practising intensive
care medicine in the UK with firsthand experience of passing professional
examinations. In addition, they have extensive training and experience in
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Preface
acute medicine, anaesthesia and emergency medicine, respectively, and
have drawn on their experience to devise questions that reflect these
specialties and their interface with intensive care medicine. The authors
hope that this book will be a useful resource not only for those
approaching examinations but for anyone wishing to keep up-to-date in
this fast-changing specialty.
Steve Benington MBChB MRCP FRCA EDIC FFICM
Shoneen Abbas MBChB MRCP FFICM
Ruth Herod MBChB FRCA FFICM
Daniel Horner BA MBBS MD MRCP(UK) FCEM FFICM
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Acknowledgements
The Editor would like to thank Dr Ola Abbas and Dr Fiona Wallace for their
invaluable help proofreading the manuscript. Also, thanks to Dr John
Macdonald, Dr Hakeem Yousuff, Dr Richard Ramsaran and Dr Andrew
Martin for their comments while testing the questions.
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Abbreviations
The following are the most commonly used abbreviations throughout the book:
AAGBI Association of Anaesthetists of Great Britain and Ireland
ABG Arterial blood gas
ACS Abdominal compartment syndrome
ACTH Adrenocorticotropic hormone
AF Atrial fibrillation
AFE Amniotic fluid embolism
AFLP Acute fatty liver of pregnancy
AIS Abbreviated Injury Scale
AKI Acute kidney injury
ALF Acute liver failure
ALI Acute lung injury
ALS Advanced Life Support
AP Acute pancreatitis
APACHE Acute Physiology and Chronic Health Evaluation
APLS Advanced Paediatric Life Support
APRV Airway pressure release ventilation
aPTT Activated partial thromboplastin time
ARDS Acute respiratory distress syndrome
ARR Absolute risk reduction
ASIA American Spinal Injury Association
AT Anaerobic threshold
ATLS Advanced Trauma Life Support
ATN Acute tubular necrosis
BE Base excess
BMI Body mass index
BNP B-natriuretic peptide
BP Blood pressure
BTS British Thoracic Society
CAM-ICU Confusion Assessment Method for the Intensive Care Unit
cAMP Cyclic adenosine monophosphate
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Intensive Care Medicine MCQs — Multiple Choice Questions with Explanatory Answers
CAP Community-acquired pneumonia
CDI Clostridium difficileinfection
cGMP Cyclic guanosine monophosphate
CIN Contrast-induced nephropathy
CK Creatine kinase
CKD Chronic kidney disease
Cl- Chloride
CMAP Compound muscle action potential
CMV Cytomegalovirus
COPD Chronic obstructive pulmonary disease
CPAP Continuous positive airway pressure
CPET Cardiopulmonary exercise testing
CPIS Clinical Pulmonary Infection Score
CPK Creatinine phosphokinase
CPP Cerebral perfusion pressure
CPR Cardiopulmonary resuscitation
CRP C-reactive protein
CRRT Continuous renal replacement therapy
CSF Cerebrospinal fluid
CT Computed tomography
CTPA Computed tomography pulmonary angiogram
CVC Central venous catheter
CVP Central venous pressure
CXR Chest X-ray
DBD Donation after brainstem death
DCD Donation after cardiac death
DDAVP Desmopressin
DI Diabetes insipidus
DIC Disseminated intravascular coagulation
DKA Diabetic ketoacidosis
DVT Deep vein thrombosis
ECG Electrocardiogram
ECMO Extracorporeal membrane oxygenation
EEG Electroencephalography
EMG Electromyography
ESR Erythrocyte sedimentation rate
ETCO End-tidal carbon dioxide
2
EVD External ventricular drain
FFP Fresh frozen plasma
FRC Functional residual capacity
viii HR Heart rate
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Abbreviations
GBS Guillain-Barré syndrome
GCS Glasgow Coma Scale
GFR Glomerular filtration rate
GMC General Medical Council
GTN Glyceryl trinitrate
HAS Human albumin solution
HCM Hypertrophic cardiomyopathy
HFOV High-frequency oscillatory ventilation
HME Heat and moisture exchangers
HRS Hepatorenal syndrome
IABP Intra-aortic balloon pump
IAH Intra-abdominal hypertension
IAP Intra-abdominal pressure
ICP Intracranial pressure
ICU Intensive care unit
ICUAW Intensive care unit-acquired weakness
ILCOR International Liaison Committee on Resuscitation
INR International Normalised Ratio
ISS Injury Severity Score
K+ Potassium
KDIGO The Kidney Disease: Improving Global Outcomes
LDH Lactate dehydrogenase
LMA Laryngeal mask airway
LMWH Low-molecular-weight heparin
LP Lumbar puncture
LQTS Long QT syndrome
LVOT Left ventricular outflow tract
MAP Mean arterial pressure
MDR Multidrug resistance
MELD Modified End-stage Liver Disease
MEN Multiple endocrine neoplasia
MEOWS Modified Early Obstetric Warning Score
MET Metabolic equivalent
MG Myasthenia gravis
Mg2+ Magnesium
MH Malignant hyperthermia
MHRA Medicines and Healthcare Products Regulatory Agency
MI Myocardial infarction
MODS Multiple Organ Dysfunction Score
MPAP Mean pulmonary artery pressure
MPM Mortality Prediction Model ix