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.)
Thec bestc managementc forc ac patientc withc ac posteriorc kneec dislocationc -c CORRECTc ANSWERc -
Arteriogram.
(Thec patientc mayc havec fairlyc normalc pulsesc andc stillc havec anc intimalc injuryc ofc thec poplitealc arteryc t
h
atc isc similarc toc thec intimalc disruptionc thatc canc bec seenc inc aorticc isthmusc injury.)
thec possiblec etiologiesc ofc multiorganc failurec -c CORRECTc ANSWERc --
Anticytokinec antibodiesc havec shownc therapeuticc promisec inc animalc studies.
- Evidencec hasc shownc thatc intestinalc mucosac isc madec permeablec byc sepsis.
- Thec "two-
hit"c hypothesisc postulatesc thatc aſterc mountingc anc appropriatec responsec toc somec physiologicc insult,c t
hec patientc isc leſtc withc ac primedc immunec systemc whichc manifestsc anc exaggeratedc immunec response
toc ac secondc challenge.
-
Thec earlyc stagesc aſterc injuryc actuallyc appearc toc consistc ofc anc immediatec proinflammatoryc statec asc t
hec organismc triesc toc addressc thec physiologicc insult.c Whenc properlyc modulated,c thisc isc anc appropriat
ec function.c Whenc overexpressed,c thisc proinflammatoryc statec leadsc toc thec systemicc inflammatoryc res
ponsec syndrome.c Later,c anti-
inflammatoryc andc immunosuppressivec mechanismsc arec broughtc intoc playc toc bringc thec organismc bac
kc toc homeostasis.c Ifc overmanifested,c theyc canc leadc toc ac relativec generalizedc immunosuppressionc an
dc latec incidentsc ofc sepsisc orc multiorganc failure.
,c
compensatoryc mechanismsc inc shockc -c CORRECTc ANSWERc -
Antidiureticc hormonec causesc thec reabsorptionc ofc freec waterc byc thec kidneyc andc hasc vasoconstrictive
properties.
(Antidiureticc hormonec isc releasedc fromc thec posteriorc pituitaryc wherec itc stimulatesc freec waterc retenti
onc byc thec kidneyc andc actsc asc ac powerfulc vasoconstrictor.)
Ac 71-year-
oldc manc withc colonc cancerc isc inc thec intensivec carec unitc followingc ac leſtc hemicolectomy.c Hisc bloodc
p
ressure
94%c on c is
c c272/38 mmc Hg,
c Lc ofccoxygen c pulse
c by c rate
c nasal c isc 114/min,
c cannulae. c respiratory
c Ac pulmonary c rate
c artery isc 23/min,
c ccatheter c andccaoxygen
c shows c saturation
c central ci
c venousc pr
s e c ofc 8c cmc Hc O,c ac pulmonaryc arteryc pressurec ofc 22/8c mmc Hg,c ac pulmonaryc arteryc wedgec press
ssure
u
rec ofc 6c mmc Hg,c andc ac cardiacc outputc ofc 3.4c L/min.c Thec nextc stepc inc managementc shouldc bec thec i
n
travenousc administrationc ofc -c CORRECTc ANSWERc -ac fluidc bolus
pulmonaryc arteryc cathetersc -c CORRECTc ANSWERc -
Allowc accuratec approximationc ofc leſtc atrialc pressure.
Thec magnitudec ofc ac leſt-to-
rightc shuntc inc thec presencec ofc anc ASDc isc determinedc byc -
CORRECTc ANSWERc -Differencec inc compliancec betweenc leſtc andc rightc ventricles.
(Thec bloodc willc tendc toc fillc thec morec compliantc ventriclec whichc willc usuallyc bec thec right,c untilc chron
i
cc pulmonaryc hypertensionc yieldsc rightc ventricularc hypertrophy.)
Comparedc toc conventionalc ventilationc (endotrachealc intubation),c noninvasivec ventilationc (mask,c conti
nuousc positivec airwayc pressure)c isc -c CORRECTc ANSWERc -
contraindicatedc inc hemodynamicallyc unstablec patients
Accordingc toc thec Americanc Collegec ofc Chestc Physicians/Societyc ofc Criticalc Carec Medicinec Consensus
Conference,c whichc ofc thec followingc arec notc partc ofc thec diagnosticc criteriac forc sepsis?c -
CORRECTc ANSWERc -Hypotensionc definedc asc ac systolicc bloodc pressurec lessc thanc 90c mmc Hg.
(Sepsisc isc definedc asc bacteriologicc evidencec ofc infectionc superimposedc onc ac clinicalc picturec ofc SIRS.
Accordingc toc thec ACCP/SCCM,c byc definitionc thesec patientsc arec hemodynamicallyc stable.c Ifc theyc shou
ldc becomec hemodynamicallyc unstablec (definedc asc ac systolicc bloodc pressurec <90c mmc Hg),c thec name
forc thec conditionc changesc toc "severec sepsis.")
SIRSc -c CORRECTc ANSWERc --c Temperaturec greaterc thanc 38°Cc orc lessc thanc 36°C.
,c
- Heartc ratec greaterc thanc 90c bpm.
- Respiratoryc ratec greaterc thanc 22c bpm
- Whitec bloodc cellc countc greaterc thanc 12,000c orc lessc thanc 4,000c andc greaterc thanc 10%c bands
.
abdominalc compartmentc syndromec -c CORRECTc ANSWERc -
Oncec diagnosed,c treatmentc consistsc ofc reopeningc thec abdomenc includingc doingc soc atc thec bedsidec if
necessary.
(Thec presencec ofc anc abdominalc compartmentc syndromec requiresc decompressionc ofc thec abdomen.c If
thec patientc isc tooc unstablec toc bec transportedc toc thec operatingc room,c thec abdomenc shouldc bec pro
mptlyc reopenedc atc thec bedside.)
carotidc bruitc -c CORRECTc ANSWERc -ac markerc forc generalizedc atherosclerosis
(Inc fact,c studiesc havec shownc thatc ac carotidc bruitc isc ac riskc factorc forc coronaryc arteryc diseasec andc fu
t
urec myocardialc infarction.)
alveolarc ventilationc -c CORRECTc ANSWERc -
Thec alveolarc gasc equationc characterizesc thec potentialc forc oxygenc uptakec andc carbonc dioxidec removal
.
(Tachypneac atc ac givenc minutec ventilationc increasesc anatomicc dead-
spacec ventilation,c notc alveolarc ventilation.c Minutec ventilationc isc thec volumec ofc gasc thatc isc inspiredc a
ndc expiredc atc thec nasopharynxc andc isc differentc thanc thatc occurringc atc thec alveolusc byc thec anatomic
dead-
spacec volume.c Althoughc arterialc Pcoc isc proportionalc toc alveolarc ventilation,c arterialc Poc isc notc asc itc
m
ayc bec affectedc byc physiologicc shunting,c diffusionc block,c andc soc on.c Thec RQc isc constantc underc norma
lc physiologicalc conditionsc atc ±c 0.8;c however,c itc mayc changec substantiallyc underc conditionsc suchc asc a
naerobicc metabolism,c overfeeding,c andc soc on.c Becausec thec alveolarc gasc equationc characterizesc the
partialc pressuresc ofc individualc gasesc withinc thec alveolus,c whichc inc turnc determinec thec individualc gra
dientsc forc diffusion,c thec equationc doesc characterizec thec potentialc forc oxygen/carbonc dioxidec exchang
e.c )
thec followingc mayc constitutec thec physiologicalc deadc spacec ofc thec respiratoryc systemc -
CORRECTc ANSWERc --c Emphysematousc lung.
- Lungc involvedc withc ac pulmonaryc embolus.
- Proximalc twoc thirdsc subsegmentalc bronchi.
- Zonec onec 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.)
Thec bestc managementc forc ac patientc withc ac posteriorc kneec dislocationc -c CORRECTc ANSWERc -
Arteriogram.
(Thec patientc mayc havec fairlyc normalc pulsesc andc stillc havec anc intimalc injuryc ofc thec poplitealc arteryc t
h
atc isc similarc toc thec intimalc disruptionc thatc canc bec seenc inc aorticc isthmusc injury.)
thec possiblec etiologiesc ofc multiorganc failurec -c CORRECTc ANSWERc --
Anticytokinec antibodiesc havec shownc therapeuticc promisec inc animalc studies.
- Evidencec hasc shownc thatc intestinalc mucosac isc madec permeablec byc sepsis.
- Thec "two-
hit"c hypothesisc postulatesc thatc aſterc mountingc anc appropriatec responsec toc somec physiologicc insult,c t
hec patientc isc leſtc withc ac primedc immunec systemc whichc manifestsc anc exaggeratedc immunec response
toc ac secondc challenge.
-
Thec earlyc stagesc aſterc injuryc actuallyc appearc toc consistc ofc anc immediatec proinflammatoryc statec asc t
hec organismc triesc toc addressc thec physiologicc insult.c Whenc properlyc modulated,c thisc isc anc appropriat
ec function.c Whenc overexpressed,c thisc proinflammatoryc statec leadsc toc thec systemicc inflammatoryc res
ponsec syndrome.c Later,c anti-
inflammatoryc andc immunosuppressivec mechanismsc arec broughtc intoc playc toc bringc thec organismc bac
kc toc homeostasis.c Ifc overmanifested,c theyc canc leadc toc ac relativec generalizedc immunosuppressionc an
dc latec incidentsc ofc sepsisc orc multiorganc failure.
,c
compensatoryc mechanismsc inc shockc -c CORRECTc ANSWERc -
Antidiureticc hormonec causesc thec reabsorptionc ofc freec waterc byc thec kidneyc andc hasc vasoconstrictive
properties.
(Antidiureticc hormonec isc releasedc fromc thec posteriorc pituitaryc wherec itc stimulatesc freec waterc retenti
onc byc thec kidneyc andc actsc asc ac powerfulc vasoconstrictor.)
Ac 71-year-
oldc manc withc colonc cancerc isc inc thec intensivec carec unitc followingc ac leſtc hemicolectomy.c Hisc bloodc
p
ressure
94%c on c is
c c272/38 mmc Hg,
c Lc ofccoxygen c pulse
c by c rate
c nasal c isc 114/min,
c cannulae. c respiratory
c Ac pulmonary c rate
c artery isc 23/min,
c ccatheter c andccaoxygen
c shows c saturation
c central ci
c venousc pr
s e c ofc 8c cmc Hc O,c ac pulmonaryc arteryc pressurec ofc 22/8c mmc Hg,c ac pulmonaryc arteryc wedgec press
ssure
u
rec ofc 6c mmc Hg,c andc ac cardiacc outputc ofc 3.4c L/min.c Thec nextc stepc inc managementc shouldc bec thec i
n
travenousc administrationc ofc -c CORRECTc ANSWERc -ac fluidc bolus
pulmonaryc arteryc cathetersc -c CORRECTc ANSWERc -
Allowc accuratec approximationc ofc leſtc atrialc pressure.
Thec magnitudec ofc ac leſt-to-
rightc shuntc inc thec presencec ofc anc ASDc isc determinedc byc -
CORRECTc ANSWERc -Differencec inc compliancec betweenc leſtc andc rightc ventricles.
(Thec bloodc willc tendc toc fillc thec morec compliantc ventriclec whichc willc usuallyc bec thec right,c untilc chron
i
cc pulmonaryc hypertensionc yieldsc rightc ventricularc hypertrophy.)
Comparedc toc conventionalc ventilationc (endotrachealc intubation),c noninvasivec ventilationc (mask,c conti
nuousc positivec airwayc pressure)c isc -c CORRECTc ANSWERc -
contraindicatedc inc hemodynamicallyc unstablec patients
Accordingc toc thec Americanc Collegec ofc Chestc Physicians/Societyc ofc Criticalc Carec Medicinec Consensus
Conference,c whichc ofc thec followingc arec notc partc ofc thec diagnosticc criteriac forc sepsis?c -
CORRECTc ANSWERc -Hypotensionc definedc asc ac systolicc bloodc pressurec lessc thanc 90c mmc Hg.
(Sepsisc isc definedc asc bacteriologicc evidencec ofc infectionc superimposedc onc ac clinicalc picturec ofc SIRS.
Accordingc toc thec ACCP/SCCM,c byc definitionc thesec patientsc arec hemodynamicallyc stable.c Ifc theyc shou
ldc becomec hemodynamicallyc unstablec (definedc asc ac systolicc bloodc pressurec <90c mmc Hg),c thec name
forc thec conditionc changesc toc "severec sepsis.")
SIRSc -c CORRECTc ANSWERc --c Temperaturec greaterc thanc 38°Cc orc lessc thanc 36°C.
,c
- Heartc ratec greaterc thanc 90c bpm.
- Respiratoryc ratec greaterc thanc 22c bpm
- Whitec bloodc cellc countc greaterc thanc 12,000c orc lessc thanc 4,000c andc greaterc thanc 10%c bands
.
abdominalc compartmentc syndromec -c CORRECTc ANSWERc -
Oncec diagnosed,c treatmentc consistsc ofc reopeningc thec abdomenc includingc doingc soc atc thec bedsidec if
necessary.
(Thec presencec ofc anc abdominalc compartmentc syndromec requiresc decompressionc ofc thec abdomen.c If
thec patientc isc tooc unstablec toc bec transportedc toc thec operatingc room,c thec abdomenc shouldc bec pro
mptlyc reopenedc atc thec bedside.)
carotidc bruitc -c CORRECTc ANSWERc -ac markerc forc generalizedc atherosclerosis
(Inc fact,c studiesc havec shownc thatc ac carotidc bruitc isc ac riskc factorc forc coronaryc arteryc diseasec andc fu
t
urec myocardialc infarction.)
alveolarc ventilationc -c CORRECTc ANSWERc -
Thec alveolarc gasc equationc characterizesc thec potentialc forc oxygenc uptakec andc carbonc dioxidec removal
.
(Tachypneac atc ac givenc minutec ventilationc increasesc anatomicc dead-
spacec ventilation,c notc alveolarc ventilation.c Minutec ventilationc isc thec volumec ofc gasc thatc isc inspiredc a
ndc expiredc atc thec nasopharynxc andc isc differentc thanc thatc occurringc atc thec alveolusc byc thec anatomic
dead-
spacec volume.c Althoughc arterialc Pcoc isc proportionalc toc alveolarc ventilation,c arterialc Poc isc notc asc itc
m
ayc bec affectedc byc physiologicc shunting,c diffusionc block,c andc soc on.c Thec RQc isc constantc underc norma
lc physiologicalc conditionsc atc ±c 0.8;c however,c itc mayc changec substantiallyc underc conditionsc suchc asc a
naerobicc metabolism,c overfeeding,c andc soc on.c Becausec thec alveolarc gasc equationc characterizesc the
partialc pressuresc ofc individualc gasesc withinc thec alveolus,c whichc inc turnc determinec thec individualc gra
dientsc forc diffusion,c thec equationc doesc characterizec thec potentialc forc oxygen/carbonc dioxidec exchang
e.c )
thec followingc mayc constitutec thec physiologicalc deadc spacec ofc thec respiratoryc systemc -
CORRECTc ANSWERc --c Emphysematousc lung.
- Lungc involvedc withc ac pulmonaryc embolus.
- Proximalc twoc thirdsc subsegmentalc bronchi.
- Zonec onec alveoli.
