ABSITE - CRITICAL CARE QUESTIONS
WITH CORRECT ANSWERS 2026
All are potential causes of cardiogenic shock except:
- Myocardial infarction.
- Pericardial tamponade.
- Tension pneumothorax.
- Cardiac arrhythmias.
- Excessive preload. - CORRECT ANSWER -Excessive preload.
(Excessive preload is typically not a cause of cardiogenic shock, but is a result of cardiogenic shock.
)
A 60-year-
old man has an arterial PO of 60 mm Hg when the calculated alveolar PO is 94 mm Hg. This differ
ence is most commonly due to - CORRECT ANSWER -a ventilation-perfusion mismatch
oxygen delivery and consumption - CORRECT ANSWER --
Under normal circumstances, approximately 20% to 30% of the oxygen delivered to the capillary b
ed is extracted by the tissues.
-
In conditions of decreased delivery of oxygen, tissues are capable of extracting up to 50% to 60%
of the oxygen content in the capillary blood.
- When cellular oxygen supply does not meet demand, anaerobic respiration results.
(The variables in the equation for the delivery of oxygen are cardiac output, hemoglobin level, oxyg
en saturation of hemoglobin, and the partial pressure of oxygen dissolved in blood. Increases in th
e first three variables all yield significant increases in the total amount of oxygen carried by blood.
The partial pressure of oxygen is multiplied by a factor of 0.003, however, and therefore has a min
iscule contribution to the total oxygen content.)
Dopamine at doses of 5 to 10 μg/kg/min - CORRECT ANSWER -has a largely inotropic action profile
(Dopamine has a dose-
dependent action profile. At 3 to 5 μg/kg/min, its actions are largely to increase renal blood flow.
At doses of 5 to 10 μg/kg/min, it largely acts to stimulate myocardial β receptors and has an inotr
,opic effect. At doses greater than 10 μg/kg/min, it stimulates α receptors and has a chronotropic e
ffect.)
As oxygen delivery increases on the flat horizontal portion of the oxygen consumption-
delivery curve - CORRECT ANSWER -Oxygen consumption remains the same
(On the flat horizontal portion of the oxygen consumption-
delivery curve, oxygen delivery meets cellular demand of oxygen; as oxygen delivery increases, oxyg
en consumption remains the same.)
Most disorganized ventricular arrhythmias (frequent PVCs, ventricular fibrillation) are caused by -
CORRECT ANSWER -Metabolic derangements.
(Most disorganized ventricular arrhythmias are caused by some sort of metabolic derangement suc
h as ischemia or magnesium or potassium deficiencies. These abnormalities are not well treated by
antiarrhythmic medications.)
Thez bestz managementz forz az patientz withz az posteriorz kneez dislocationz -z CORRECTz ANSWERz -
Arteriogram.
(Thez patientz mayz havez fairlyz normalz pulsesz andz stillz havez anz intimalz injuryz ofz thez poplitealz arteryz t
h
atz isz similarz toz thez intimalz disruptionz thatz canz bez seenz inz aorticz isthmusz injury.)
thez possiblez etiologiesz ofz multiorganz failurez -z CORRECTz ANSWERz --
Anticytokinez antibodiesz havez shownz therapeuticz promisez inz animalz studies.
- Evidencez hasz shownz thatz intestinalz mucosaz isz madez permeablez byz sepsis.
- Thez "two-
hit"z hypothesisz postulatesz thatz aſterz mountingz anz appropriatez responsez toz somez physiologicz insult,z t
hez patientz isz leſtz withz az primedz immunez systemz whichz manifestsz anz exaggeratedz immunez response
toz az secondz challenge.
-
Thez earlyz stagesz aſterz injuryz actuallyz appearz toz consistz ofz anz immediatez proinflammatoryz statez asz t
hez organismz triesz toz addressz thez physiologicz insult.z Whenz properlyz modulated,z thisz isz anz appropriat
ez function.z Whenz overexpressed,z thisz proinflammatoryz statez leadsz toz thez systemicz inflammatoryz res
ponsez syndrome.z Later,z anti-
inflammatoryz andz immunosuppressivez mechanismsz arez broughtz intoz playz toz bringz thez organismz bac
kz toz homeostasis.z Ifz overmanifested,z theyz canz leadz toz az relativez generalizedz immunosuppressionz an
dz latez incidentsz ofz sepsisz orz multiorganz failure.
,z
compensatoryz mechanismsz inz shockz -z CORRECTz ANSWERz -
Antidiureticz hormonez causesz thez reabsorptionz ofz freez waterz byz thez kidneyz andz hasz vasoconstrictive
properties.
(Antidiureticz hormonez isz releasedz fromz thez posteriorz pituitaryz wherez itz stimulatesz freez waterz retenti
onz byz thez kidneyz andz actsz asz az powerfulz vasoconstrictor.)
Az 71-year-
oldz manz withz colonz cancerz isz inz thez intensivez carez unitz followingz az leſtz hemicolectomy.z Hisz bloodz
p
ressure
94%z on z is
z z272/38 mmz Hg,
z Lz ofzzoxygen z pulse
z by z rate
z nasal z isz 114/min,
z cannulae. z respiratory
z Az pulmonary z rate
z artery isz 23/min,
z zcatheter z andzzaoxygen
z shows z saturation
z central zi
z venousz pr
s e z ofz 8z cmz Hz O,z az pulmonaryz arteryz pressurez ofz 22/8z mmz Hg,z az pulmonaryz arteryz wedgez press
ssure
u
rez ofz 6z mmz Hg,z andz az cardiacz outputz ofz 3.4z L/min.z Thez nextz stepz inz managementz shouldz bez thez i
n
travenousz administrationz ofz -z CORRECTz ANSWERz -az fluidz bolus
pulmonaryz arteryz cathetersz -z CORRECTz ANSWERz -
Allowz accuratez approximationz ofz leſtz atrialz pressure.
Thez magnitudez ofz az leſt-to-
rightz shuntz inz thez presencez ofz anz ASDz isz determinedz byz -
CORRECTz ANSWERz -Differencez inz compliancez betweenz leſtz andz rightz ventricles.
(Thez bloodz willz tendz toz fillz thez morez compliantz ventriclez whichz willz usuallyz bez thez right,z untilz chron
i
cz pulmonaryz hypertensionz yieldsz rightz ventricularz hypertrophy.)
Comparedz toz conventionalz ventilationz (endotrachealz intubation),z noninvasivez ventilationz (mask,z conti
nuousz positivez airwayz pressure)z isz -z CORRECTz ANSWERz -
contraindicatedz inz hemodynamicallyz unstablez patients
Accordingz toz thez Americanz Collegez ofz Chestz Physicians/Societyz ofz Criticalz Carez Medicinez Consensus
Conference,z whichz ofz thez followingz arez notz partz ofz thez diagnosticz criteriaz forz sepsis?z -
CORRECTz ANSWERz -Hypotensionz definedz asz az systolicz bloodz pressurez lessz thanz 90z mmz Hg.
(Sepsisz isz definedz asz bacteriologicz evidencez ofz infectionz superimposedz onz az clinicalz picturez ofz SIRS.
Accordingz toz thez ACCP/SCCM,z byz definitionz thesez patientsz arez hemodynamicallyz stable.z Ifz theyz shou
ldz becomez hemodynamicallyz unstablez (definedz asz az systolicz bloodz pressurez <90z mmz Hg),z thez name
forz thez conditionz changesz toz "severez sepsis.")
SIRSz -z CORRECTz ANSWERz --z Temperaturez greaterz thanz 38°Cz orz lessz thanz 36°C.
,z
- Heartz ratez greaterz thanz 90z bpm.
- Respiratoryz ratez greaterz thanz 22z bpm
- Whitez bloodz cellz countz greaterz thanz 12,000z orz lessz thanz 4,000z andz greaterz thanz 10%z bands
.
abdominalz compartmentz syndromez -z CORRECTz ANSWERz -
Oncez diagnosed,z treatmentz consistsz ofz reopeningz thez abdomenz includingz doingz soz atz thez bedsidez if
necessary.
(Thez presencez ofz anz abdominalz compartmentz syndromez requiresz decompressionz ofz thez abdomen.z If
thez patientz isz tooz unstablez toz bez transportedz toz thez operatingz room,z thez abdomenz shouldz bez pro
mptlyz reopenedz atz thez bedside.)
carotidz bruitz -z CORRECTz ANSWERz -az markerz forz generalizedz atherosclerosis
(Inz fact,z studiesz havez shownz thatz az carotidz bruitz isz az riskz factorz forz coronaryz arteryz diseasez andz fu
t
urez myocardialz infarction.)
alveolarz ventilationz -z CORRECTz ANSWERz -
Thez alveolarz gasz equationz characterizesz thez potentialz forz oxygenz uptakez andz carbonz dioxidez removal
.
(Tachypneaz atz az givenz minutez ventilationz increasesz anatomicz dead-
spacez ventilation,z notz alveolarz ventilation.z Minutez ventilationz isz thez volumez ofz gasz thatz isz inspiredz a
ndz expiredz atz thez nasopharynxz andz isz differentz thanz thatz occurringz atz thez alveolusz byz thez anatomic
dead-
spacez volume.z Althoughz arterialz Pcoz isz proportionalz toz alveolarz ventilation,z arterialz Poz isz notz asz itz
m
ayz bez affectedz byz physiologicz shunting,z diffusionz block,z andz soz on.z Thez RQz isz constantz underz norma
lz physiologicalz conditionsz atz ±z 0.8;z however,z itz mayz changez substantiallyz underz conditionsz suchz asz a
naerobicz metabolism,z overfeeding,z andz soz on.z Becausez thez alveolarz gasz equationz characterizesz the
partialz pressuresz ofz individualz gasesz withinz thez alveolus,z whichz inz turnz determinez thez individualz gra
dientsz forz diffusion,z thez equationz doesz characterizez thez potentialz forz oxygen/carbonz dioxidez exchang
e.z )
thez followingz mayz constitutez thez physiologicalz deadz spacez ofz thez respiratoryz systemz -
CORRECTz ANSWERz --z Emphysematousz lung.
- Lungz involvedz withz az pulmonaryz embolus.
- Proximalz twoz thirdsz subsegmentalz bronchi.
- Zonez onez alveoli.
WITH CORRECT ANSWERS 2026
All are potential causes of cardiogenic shock except:
- Myocardial infarction.
- Pericardial tamponade.
- Tension pneumothorax.
- Cardiac arrhythmias.
- Excessive preload. - CORRECT ANSWER -Excessive preload.
(Excessive preload is typically not a cause of cardiogenic shock, but is a result of cardiogenic shock.
)
A 60-year-
old man has an arterial PO of 60 mm Hg when the calculated alveolar PO is 94 mm Hg. This differ
ence is most commonly due to - CORRECT ANSWER -a ventilation-perfusion mismatch
oxygen delivery and consumption - CORRECT ANSWER --
Under normal circumstances, approximately 20% to 30% of the oxygen delivered to the capillary b
ed is extracted by the tissues.
-
In conditions of decreased delivery of oxygen, tissues are capable of extracting up to 50% to 60%
of the oxygen content in the capillary blood.
- When cellular oxygen supply does not meet demand, anaerobic respiration results.
(The variables in the equation for the delivery of oxygen are cardiac output, hemoglobin level, oxyg
en saturation of hemoglobin, and the partial pressure of oxygen dissolved in blood. Increases in th
e first three variables all yield significant increases in the total amount of oxygen carried by blood.
The partial pressure of oxygen is multiplied by a factor of 0.003, however, and therefore has a min
iscule contribution to the total oxygen content.)
Dopamine at doses of 5 to 10 μg/kg/min - CORRECT ANSWER -has a largely inotropic action profile
(Dopamine has a dose-
dependent action profile. At 3 to 5 μg/kg/min, its actions are largely to increase renal blood flow.
At doses of 5 to 10 μg/kg/min, it largely acts to stimulate myocardial β receptors and has an inotr
,opic effect. At doses greater than 10 μg/kg/min, it stimulates α receptors and has a chronotropic e
ffect.)
As oxygen delivery increases on the flat horizontal portion of the oxygen consumption-
delivery curve - CORRECT ANSWER -Oxygen consumption remains the same
(On the flat horizontal portion of the oxygen consumption-
delivery curve, oxygen delivery meets cellular demand of oxygen; as oxygen delivery increases, oxyg
en consumption remains the same.)
Most disorganized ventricular arrhythmias (frequent PVCs, ventricular fibrillation) are caused by -
CORRECT ANSWER -Metabolic derangements.
(Most disorganized ventricular arrhythmias are caused by some sort of metabolic derangement suc
h as ischemia or magnesium or potassium deficiencies. These abnormalities are not well treated by
antiarrhythmic medications.)
Thez bestz managementz forz az patientz withz az posteriorz kneez dislocationz -z CORRECTz ANSWERz -
Arteriogram.
(Thez patientz mayz havez fairlyz normalz pulsesz andz stillz havez anz intimalz injuryz ofz thez poplitealz arteryz t
h
atz isz similarz toz thez intimalz disruptionz thatz canz bez seenz inz aorticz isthmusz injury.)
thez possiblez etiologiesz ofz multiorganz failurez -z CORRECTz ANSWERz --
Anticytokinez antibodiesz havez shownz therapeuticz promisez inz animalz studies.
- Evidencez hasz shownz thatz intestinalz mucosaz isz madez permeablez byz sepsis.
- Thez "two-
hit"z hypothesisz postulatesz thatz aſterz mountingz anz appropriatez responsez toz somez physiologicz insult,z t
hez patientz isz leſtz withz az primedz immunez systemz whichz manifestsz anz exaggeratedz immunez response
toz az secondz challenge.
-
Thez earlyz stagesz aſterz injuryz actuallyz appearz toz consistz ofz anz immediatez proinflammatoryz statez asz t
hez organismz triesz toz addressz thez physiologicz insult.z Whenz properlyz modulated,z thisz isz anz appropriat
ez function.z Whenz overexpressed,z thisz proinflammatoryz statez leadsz toz thez systemicz inflammatoryz res
ponsez syndrome.z Later,z anti-
inflammatoryz andz immunosuppressivez mechanismsz arez broughtz intoz playz toz bringz thez organismz bac
kz toz homeostasis.z Ifz overmanifested,z theyz canz leadz toz az relativez generalizedz immunosuppressionz an
dz latez incidentsz ofz sepsisz orz multiorganz failure.
,z
compensatoryz mechanismsz inz shockz -z CORRECTz ANSWERz -
Antidiureticz hormonez causesz thez reabsorptionz ofz freez waterz byz thez kidneyz andz hasz vasoconstrictive
properties.
(Antidiureticz hormonez isz releasedz fromz thez posteriorz pituitaryz wherez itz stimulatesz freez waterz retenti
onz byz thez kidneyz andz actsz asz az powerfulz vasoconstrictor.)
Az 71-year-
oldz manz withz colonz cancerz isz inz thez intensivez carez unitz followingz az leſtz hemicolectomy.z Hisz bloodz
p
ressure
94%z on z is
z z272/38 mmz Hg,
z Lz ofzzoxygen z pulse
z by z rate
z nasal z isz 114/min,
z cannulae. z respiratory
z Az pulmonary z rate
z artery isz 23/min,
z zcatheter z andzzaoxygen
z shows z saturation
z central zi
z venousz pr
s e z ofz 8z cmz Hz O,z az pulmonaryz arteryz pressurez ofz 22/8z mmz Hg,z az pulmonaryz arteryz wedgez press
ssure
u
rez ofz 6z mmz Hg,z andz az cardiacz outputz ofz 3.4z L/min.z Thez nextz stepz inz managementz shouldz bez thez i
n
travenousz administrationz ofz -z CORRECTz ANSWERz -az fluidz bolus
pulmonaryz arteryz cathetersz -z CORRECTz ANSWERz -
Allowz accuratez approximationz ofz leſtz atrialz pressure.
Thez magnitudez ofz az leſt-to-
rightz shuntz inz thez presencez ofz anz ASDz isz determinedz byz -
CORRECTz ANSWERz -Differencez inz compliancez betweenz leſtz andz rightz ventricles.
(Thez bloodz willz tendz toz fillz thez morez compliantz ventriclez whichz willz usuallyz bez thez right,z untilz chron
i
cz pulmonaryz hypertensionz yieldsz rightz ventricularz hypertrophy.)
Comparedz toz conventionalz ventilationz (endotrachealz intubation),z noninvasivez ventilationz (mask,z conti
nuousz positivez airwayz pressure)z isz -z CORRECTz ANSWERz -
contraindicatedz inz hemodynamicallyz unstablez patients
Accordingz toz thez Americanz Collegez ofz Chestz Physicians/Societyz ofz Criticalz Carez Medicinez Consensus
Conference,z whichz ofz thez followingz arez notz partz ofz thez diagnosticz criteriaz forz sepsis?z -
CORRECTz ANSWERz -Hypotensionz definedz asz az systolicz bloodz pressurez lessz thanz 90z mmz Hg.
(Sepsisz isz definedz asz bacteriologicz evidencez ofz infectionz superimposedz onz az clinicalz picturez ofz SIRS.
Accordingz toz thez ACCP/SCCM,z byz definitionz thesez patientsz arez hemodynamicallyz stable.z Ifz theyz shou
ldz becomez hemodynamicallyz unstablez (definedz asz az systolicz bloodz pressurez <90z mmz Hg),z thez name
forz thez conditionz changesz toz "severez sepsis.")
SIRSz -z CORRECTz ANSWERz --z Temperaturez greaterz thanz 38°Cz orz lessz thanz 36°C.
,z
- Heartz ratez greaterz thanz 90z bpm.
- Respiratoryz ratez greaterz thanz 22z bpm
- Whitez bloodz cellz countz greaterz thanz 12,000z orz lessz thanz 4,000z andz greaterz thanz 10%z bands
.
abdominalz compartmentz syndromez -z CORRECTz ANSWERz -
Oncez diagnosed,z treatmentz consistsz ofz reopeningz thez abdomenz includingz doingz soz atz thez bedsidez if
necessary.
(Thez presencez ofz anz abdominalz compartmentz syndromez requiresz decompressionz ofz thez abdomen.z If
thez patientz isz tooz unstablez toz bez transportedz toz thez operatingz room,z thez abdomenz shouldz bez pro
mptlyz reopenedz atz thez bedside.)
carotidz bruitz -z CORRECTz ANSWERz -az markerz forz generalizedz atherosclerosis
(Inz fact,z studiesz havez shownz thatz az carotidz bruitz isz az riskz factorz forz coronaryz arteryz diseasez andz fu
t
urez myocardialz infarction.)
alveolarz ventilationz -z CORRECTz ANSWERz -
Thez alveolarz gasz equationz characterizesz thez potentialz forz oxygenz uptakez andz carbonz dioxidez removal
.
(Tachypneaz atz az givenz minutez ventilationz increasesz anatomicz dead-
spacez ventilation,z notz alveolarz ventilation.z Minutez ventilationz isz thez volumez ofz gasz thatz isz inspiredz a
ndz expiredz atz thez nasopharynxz andz isz differentz thanz thatz occurringz atz thez alveolusz byz thez anatomic
dead-
spacez volume.z Althoughz arterialz Pcoz isz proportionalz toz alveolarz ventilation,z arterialz Poz isz notz asz itz
m
ayz bez affectedz byz physiologicz shunting,z diffusionz block,z andz soz on.z Thez RQz isz constantz underz norma
lz physiologicalz conditionsz atz ±z 0.8;z however,z itz mayz changez substantiallyz underz conditionsz suchz asz a
naerobicz metabolism,z overfeeding,z andz soz on.z Becausez thez alveolarz gasz equationz characterizesz the
partialz pressuresz ofz individualz gasesz withinz thez alveolus,z whichz inz turnz determinez thez individualz gra
dientsz forz diffusion,z thez equationz doesz characterizez thez potentialz forz oxygen/carbonz dioxidez exchang
e.z )
thez followingz mayz constitutez thez physiologicalz deadz spacez ofz thez respiratoryz systemz -
CORRECTz ANSWERz --z Emphysematousz lung.
- Lungz involvedz withz az pulmonaryz embolus.
- Proximalz twoz thirdsz subsegmentalz bronchi.
- Zonez onez alveoli.
