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.)
Thex bestx managementx forx ax patientx withx ax posteriorx kneex dislocationx -
x CORRECTx ANSWERx -
Arteriogram.
(Thex patientx mayx havex fairlyx normalx pulsesx andx stillx havex anx intimalx injuryx ofx thex poplitealx arteryx
th
atx isx similarx tox thex intimalx disruptionx thatx canx bex seenx inx aorticx isthmusx injury.)
thex possiblex etiologiesx ofx multiorganx failurex -x CORRECTx ANSWERx --
Anticytokinex antibodiesx havex shownx therapeuticx promisex inx animalx studies.
- Evidencex hasx shownx thatx intestinalx mucosax isx madex permeablex byx sepsis
.
-
hit"The x "two-
x hypothesis x postulatesx thatx aſterx mountingx anx appropriatex responsex tox somex physiologicx insult,
xt
hex patientx isx leſtx withx ax primedx immunex systemx whichx manifestsx anx exaggeratedx immunex respons
e
-tox ax secondx challenge.
Thex earlyx stagesx aſterx injuryx actuallyx appearx tox consistx ofx anx immediatex proinflammatoryx statex as
xt
hex organismx triesx tox addressx thex physiologicx insult.x Whenx properlyx modulated,x thisx isx anx appropria
t
ex function.x Whenx overexpressed,x thisx proinflammatoryx statex leadsx tox thex systemicx inflammatoryx res
ponsex syndrome.x Later,x anti-
inflammatoryx andx immunosuppressivex mechanismsx arex broughtx intox playx tox bringx thex organismx ba
c
kx tox homeostasis.x Ifx overmanifested,x theyx canx leadx tox ax relativex generalizedx immunosuppressionx a
n
dx latex incidentsx ofx sepsisx orx multiorganx failure.
,x
compensatoryx mechanismsx inx shockx -x CORRECTx ANSWERx -
Antidiureticx hormonex causesx thex reabsorptionx ofx freex waterx byx thex kidneyx andx hasx vasoconstrictiv
e
properties.
(Antidiureticx hormonex isx releasedx fromx thex posteriorx pituitaryx wherex itx stimulatesx freex waterx reten
ti
onx byx thex kidneyx andx actsx asx ax powerfulx vasoconstrictor.)
Ax 71-year-
oldx manx withx colonx cancerx isx inx thex intensivex carex unitx followingx ax leſtx hemicolectomy.x Hisx blood
xp
ressure
94%x on x is
x x272/38 mmx Hg,
x Lx ofx oxygen x pulse
x by x rate
x nasal x isx 114/min,
x cannulae. x respiratory
x Ax pulmonary x rate
x artery isx 23/min,
x xcatheter x andxxaoxygen
x shows x saturation
x centralx venousx
isprex ofx 8x cmx Hx O,x ax pulmonaryx arteryx pressurex ofx 22/8x mmx Hg,x ax pulmonaryx arteryx wedgex pre
xssure
ssu
rex ofx 6x mmx Hg,x andx ax cardiacx outputx ofx 3.4x L/min.x Thex nextx stepx inx managementx shouldx bex the
x in
travenousx administrationx ofx -x CORRECTx ANSWERx -ax fluidx bolus
pulmonaryx arteryx cathetersx -x CORRECTx ANSWERx -
Allowx accuratex approximationx ofx leſtx atrialx pressure.
Thex magnitudex ofx ax leſt-to-
rightx shuntx inx thex presencex ofx anx ASDx isx determinedx byx -
CORRECTx ANSWERx -Differencex inx compliancex betweenx leſtx andx rightx ventricles.
(Thex bloodx willx tendx tox fillx thex morex compliantx ventriclex whichx willx usuallyx bex thex right,x untilx chr
oni
cx pulmonaryx hypertensionx yieldsx rightx ventricularx hypertrophy.)
Comparedx tox conventionalx ventilationx (endotrachealx intubation),x noninvasivex ventilationx (mask,x conti
nuousx positivex airwayx pressure)x isx -x CORRECTx ANSWERx -
contraindicatedx inx hemodynamicallyx unstablex patients
Accordingx tox thex Americanx Collegex ofx Chestx Physicians/Societyx ofx Criticalx Carex Medicinex Consensu
s
Conference,x whichx ofx thex followingx arex notx partx ofx thex diagnosticx criteriax forx sepsis?x -
CORRECTx ANSWERx -Hypotensionx definedx asx ax systolicx bloodx pressurex lessx thanx 90x mmx Hg.
(Sepsisx isx definedx asx bacteriologicx evidencex ofx infectionx superimposedx onx ax clinicalx picturex ofx SIRS
.
Accordingx tox thex ACCP/SCCM,x byx definitionx thesex patientsx arex hemodynamicallyx stable.x Ifx theyx sho
u
ldx becomex hemodynamicallyx unstablex (definedx asx ax systolicx bloodx pressurex <90x mmx Hg),x thex nam
e
forx thex conditionx changesx tox "severex sepsis.")
SIRS x -x CORRECTx ANSWERx --
x Temperaturex greaterx thanx 38°Cx orx lessx thanx 36°C.
,x
- Heartx ratex greaterx thanx 90x bpm.
- Respiratoryx ratex greaterx thanx 22x bpm
- Whitex bloodx cellx countx greaterx thanx 12,000x orx lessx thanx 4,000x andx greaterx thanx 10%x band
s.
abdominalx compartmentx syndromex -x CORRECTx ANSWERx -
Oncex diagnosed,x treatmentx consistsx ofx reopeningx thex abdomenx includingx doingx sox atx thex bedsidex
if
necessary.
(Thex presencex ofx anx abdominalx compartmentx syndromex requiresx decompressionx ofx thex abdomen.x I
f
thex patientx isx toox unstablex tox bex transportedx tox thex operatingx room,x thex abdomenx shouldx bex pr
o
mptlyx reopenedx atx thex bedside.)
carotidx bruitx -x CORRECTx ANSWERx -ax markerx forx generalizedx atherosclerosis
(Inx fact,x studiesx havex shownx thatx ax carotidx bruitx isx ax riskx factorx forx coronaryx arteryx diseasex andx
fut
urex myocardialx infarction.)
alveolarx ventilationx -x CORRECTx ANSWERx -
Thex alveolarx gasx equationx characterizesx thex potentialx forx oxygenx uptakex andx carbonx dioxidex remov
al
.
(Tachypneax atx ax givenx minutex ventilationx increasesx anatomicx dead-
spacex ventilation,x notx alveolarx ventilation.x Minutex ventilationx isx thex volumex ofx gasx thatx isx inspired
xa
ndx expiredx atx thex nasopharynxx andx isx differentx thanx thatx occurringx atx thex alveolusx byx thex anatom
ic
dead-
spacex volume.x Althoughx arterialx Pcox isx proportionalx tox alveolarx ventilation,x arterialx Pox isx notx asx itx
m
ayx bex affectedx byx physiologicx shunting,x diffusionx block,x andx sox on.x Thex RQx isx constantx underx nor
ma
lx physiologicalx conditionsx atx ±x 0.8;x however,x itx mayx changex substantiallyx underx conditionsx suchx asx
a
naerobicx metabolism,x overfeeding,x andx sox on.x Becausex thex alveolarx gasx equationx characterizesx the
partialx pressuresx ofx individualx gasesx withinx thex alveolus,x whichx inx turnx determinex thex individualx gr
thex followingx mayx constitutex thex physiologicalx deadx spacex ofx thex respiratoryx systemx
a
-
dientsx forx diffusion,x thex equationx doesx characterizex thex potentialx forx oxygen/carbonx dioxidex exchan
CORRECTx ANSWERx --x Emphysematousx lung.
-g Lungx involvedx withx ax pulmonaryx embolus.
e.x )
- Proximalx twox thirdsx subsegmentalx bronchi.
- Zonex onex 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.)
Thex bestx managementx forx ax patientx withx ax posteriorx kneex dislocationx -
x CORRECTx ANSWERx -
Arteriogram.
(Thex patientx mayx havex fairlyx normalx pulsesx andx stillx havex anx intimalx injuryx ofx thex poplitealx arteryx
th
atx isx similarx tox thex intimalx disruptionx thatx canx bex seenx inx aorticx isthmusx injury.)
thex possiblex etiologiesx ofx multiorganx failurex -x CORRECTx ANSWERx --
Anticytokinex antibodiesx havex shownx therapeuticx promisex inx animalx studies.
- Evidencex hasx shownx thatx intestinalx mucosax isx madex permeablex byx sepsis
.
-
hit"The x "two-
x hypothesis x postulatesx thatx aſterx mountingx anx appropriatex responsex tox somex physiologicx insult,
xt
hex patientx isx leſtx withx ax primedx immunex systemx whichx manifestsx anx exaggeratedx immunex respons
e
-tox ax secondx challenge.
Thex earlyx stagesx aſterx injuryx actuallyx appearx tox consistx ofx anx immediatex proinflammatoryx statex as
xt
hex organismx triesx tox addressx thex physiologicx insult.x Whenx properlyx modulated,x thisx isx anx appropria
t
ex function.x Whenx overexpressed,x thisx proinflammatoryx statex leadsx tox thex systemicx inflammatoryx res
ponsex syndrome.x Later,x anti-
inflammatoryx andx immunosuppressivex mechanismsx arex broughtx intox playx tox bringx thex organismx ba
c
kx tox homeostasis.x Ifx overmanifested,x theyx canx leadx tox ax relativex generalizedx immunosuppressionx a
n
dx latex incidentsx ofx sepsisx orx multiorganx failure.
,x
compensatoryx mechanismsx inx shockx -x CORRECTx ANSWERx -
Antidiureticx hormonex causesx thex reabsorptionx ofx freex waterx byx thex kidneyx andx hasx vasoconstrictiv
e
properties.
(Antidiureticx hormonex isx releasedx fromx thex posteriorx pituitaryx wherex itx stimulatesx freex waterx reten
ti
onx byx thex kidneyx andx actsx asx ax powerfulx vasoconstrictor.)
Ax 71-year-
oldx manx withx colonx cancerx isx inx thex intensivex carex unitx followingx ax leſtx hemicolectomy.x Hisx blood
xp
ressure
94%x on x is
x x272/38 mmx Hg,
x Lx ofx oxygen x pulse
x by x rate
x nasal x isx 114/min,
x cannulae. x respiratory
x Ax pulmonary x rate
x artery isx 23/min,
x xcatheter x andxxaoxygen
x shows x saturation
x centralx venousx
isprex ofx 8x cmx Hx O,x ax pulmonaryx arteryx pressurex ofx 22/8x mmx Hg,x ax pulmonaryx arteryx wedgex pre
xssure
ssu
rex ofx 6x mmx Hg,x andx ax cardiacx outputx ofx 3.4x L/min.x Thex nextx stepx inx managementx shouldx bex the
x in
travenousx administrationx ofx -x CORRECTx ANSWERx -ax fluidx bolus
pulmonaryx arteryx cathetersx -x CORRECTx ANSWERx -
Allowx accuratex approximationx ofx leſtx atrialx pressure.
Thex magnitudex ofx ax leſt-to-
rightx shuntx inx thex presencex ofx anx ASDx isx determinedx byx -
CORRECTx ANSWERx -Differencex inx compliancex betweenx leſtx andx rightx ventricles.
(Thex bloodx willx tendx tox fillx thex morex compliantx ventriclex whichx willx usuallyx bex thex right,x untilx chr
oni
cx pulmonaryx hypertensionx yieldsx rightx ventricularx hypertrophy.)
Comparedx tox conventionalx ventilationx (endotrachealx intubation),x noninvasivex ventilationx (mask,x conti
nuousx positivex airwayx pressure)x isx -x CORRECTx ANSWERx -
contraindicatedx inx hemodynamicallyx unstablex patients
Accordingx tox thex Americanx Collegex ofx Chestx Physicians/Societyx ofx Criticalx Carex Medicinex Consensu
s
Conference,x whichx ofx thex followingx arex notx partx ofx thex diagnosticx criteriax forx sepsis?x -
CORRECTx ANSWERx -Hypotensionx definedx asx ax systolicx bloodx pressurex lessx thanx 90x mmx Hg.
(Sepsisx isx definedx asx bacteriologicx evidencex ofx infectionx superimposedx onx ax clinicalx picturex ofx SIRS
.
Accordingx tox thex ACCP/SCCM,x byx definitionx thesex patientsx arex hemodynamicallyx stable.x Ifx theyx sho
u
ldx becomex hemodynamicallyx unstablex (definedx asx ax systolicx bloodx pressurex <90x mmx Hg),x thex nam
e
forx thex conditionx changesx tox "severex sepsis.")
SIRS x -x CORRECTx ANSWERx --
x Temperaturex greaterx thanx 38°Cx orx lessx thanx 36°C.
,x
- Heartx ratex greaterx thanx 90x bpm.
- Respiratoryx ratex greaterx thanx 22x bpm
- Whitex bloodx cellx countx greaterx thanx 12,000x orx lessx thanx 4,000x andx greaterx thanx 10%x band
s.
abdominalx compartmentx syndromex -x CORRECTx ANSWERx -
Oncex diagnosed,x treatmentx consistsx ofx reopeningx thex abdomenx includingx doingx sox atx thex bedsidex
if
necessary.
(Thex presencex ofx anx abdominalx compartmentx syndromex requiresx decompressionx ofx thex abdomen.x I
f
thex patientx isx toox unstablex tox bex transportedx tox thex operatingx room,x thex abdomenx shouldx bex pr
o
mptlyx reopenedx atx thex bedside.)
carotidx bruitx -x CORRECTx ANSWERx -ax markerx forx generalizedx atherosclerosis
(Inx fact,x studiesx havex shownx thatx ax carotidx bruitx isx ax riskx factorx forx coronaryx arteryx diseasex andx
fut
urex myocardialx infarction.)
alveolarx ventilationx -x CORRECTx ANSWERx -
Thex alveolarx gasx equationx characterizesx thex potentialx forx oxygenx uptakex andx carbonx dioxidex remov
al
.
(Tachypneax atx ax givenx minutex ventilationx increasesx anatomicx dead-
spacex ventilation,x notx alveolarx ventilation.x Minutex ventilationx isx thex volumex ofx gasx thatx isx inspired
xa
ndx expiredx atx thex nasopharynxx andx isx differentx thanx thatx occurringx atx thex alveolusx byx thex anatom
ic
dead-
spacex volume.x Althoughx arterialx Pcox isx proportionalx tox alveolarx ventilation,x arterialx Pox isx notx asx itx
m
ayx bex affectedx byx physiologicx shunting,x diffusionx block,x andx sox on.x Thex RQx isx constantx underx nor
ma
lx physiologicalx conditionsx atx ±x 0.8;x however,x itx mayx changex substantiallyx underx conditionsx suchx asx
a
naerobicx metabolism,x overfeeding,x andx sox on.x Becausex thex alveolarx gasx equationx characterizesx the
partialx pressuresx ofx individualx gasesx withinx thex alveolus,x whichx inx turnx determinex thex individualx gr
thex followingx mayx constitutex thex physiologicalx deadx spacex ofx thex respiratoryx systemx
a
-
dientsx forx diffusion,x thex equationx doesx characterizex thex potentialx forx oxygen/carbonx dioxidex exchan
CORRECTx ANSWERx --x Emphysematousx lung.
-g Lungx involvedx withx ax pulmonaryx embolus.
e.x )
- Proximalx twox thirdsx subsegmentalx bronchi.
- Zonex onex alveoli.
