Critical Care

Pulmonology

100

What has the best evidence for minimizing post-op pulmonary complications

Incentive Spirometry

200

What is the appropriate ventilator tidal volume setting for ARDS patients?

6ml/kg, lung protective strategy

300

Two methods to determine severity of PNA

PSI or CURB-65

400

What is the appropriate duration of antibiotics for health care related or ventilator associated PNA

7 days; increase of recurrence in VAP but not mortality (new guidelines)

500

What are the diagnostic criteria for ARDS (Berlin definition)?

within 1 week of insult/cause decreased oxygenation (PaO2/FiO2 < 200-300) bilateral lung infiltrates PCWP <18 or no evidence of CHF

Cardiology

100

What are the top 5 signs and symptoms of Acute Coronary Syndrome

chest pain, sweating, shortness of breath, syncope, arm pain

200

What is the initial therapy for someone with presumed ACS?

MONA (morphine, Nitrates, Oxygen, and ASA)

300

For patients in acute decompensated heart failure on diuretics at home, what dose should we start of diuretics while in hospital (Assuming they can tolerate diuretics)?

1-2 times oral daily dosage

400

Indication, dosage, and half life of Adenosine

Supraventricular tachycardia; Dose: 6 mg and 6 second half life

500

Patients presenting with Aortic Dissection should have what blood pressure target

SBP less than 110 mmHg

Neurology

100

What is the principle of the Monroe Kelly Hypothesis/Doctrine?

80% brain, 10% CSF, 10% blood SPACE AND VOLUME

200

What are the 3 components for calculating the Glasgow Coma Scale?

Best eye opening, verbal, and motor response

300

What monitoring parameter is utilized for maximizing good outcomes in a patient with TBI?

Intracranial pressure (ICP)/Cerebral perfusion pressure (CPP)

400

Blood pressure goal for patients with ischemic stroke before initiation of tPA?

Less than 185/110 mmHg

500

Medication, dose, and duration utilized to prevent delayed cerebral ischemia after aneurysm?

Nimodipine 60 mg every 4 hours for 21 consecutive days

Shock

100

Low CO, high wedge, high SVR

Cardiogenic shock

200

Low CO, low wedge, high SVR

Hypovolemic shock

300

What are the 4 targets of initial resuscitation in early goal-directed therapy?

a. CVP 8 -12 mmHg (non-ventilated) b. MAP ≥ 65 mmHg c. UOP ≥ 0.5 mL/kg/hour d. SCVO2 of 70% or SCO2 of 65%

400

Dose and type of steroid that is recommended in the guidelines for patients failing vasopressor therapy with sepsis

Hydrocortisone 200 mg/day via continuous infusion

500

Low or normal PCWP, high CO, low SVR

Distributive shock

Emergency Med/Trauma

100

What is the dose of FEIBA for reversal of warfarin?

INR <5: 500 units INR >=5: 1000 units

200

What medication (and dose) can be utilized for reversal of antiplatelet bleeds?

DDAVP 0.3 mcg/kg IV

300

What thrombolytic can be utilized to treat massive pulmonary embolism? (don’t forget the dose!)

Alteplase 100 mg over 2 hours; administer 10 mg bolus followed by 90 mg over 2 hours

400

What can be used to decrease risk of death in trauma patients with significant hemorrhage? (medication, dose, and timing)

TXA 1 g over 10 minutes, then 1 g over 8 hours; for patients within 3 hours of injury

500

What guides fluid resuscitation in burn patients?

Parkland equation 4 mL/kg/% burned; administer 50% in first 8 hours and 50% in next 16 hours