ABSITE - CRITICAL CARE QUESTIONS WITH CORRECT ANSWERS 2025

ABSITE - CRITICAL CARE QUESTIONS
WITH CORRECT ANSWERS 2025
AllMareMpotentialMcausesMofMcardiogenicMshockMexcept:

-MMyocardialMinfarction.

-MPericardialMtamponade.

-MTensionMpneumothorax.

-MCardiacMarrhythmias.

-MExcessiveMpreload.M-MCORRECTMANSWERM-ExcessiveMpreload.

(ExcessiveMpreloadMisMtypicallyMnotMaMcauseMofMcardiogenicMshock,MbutMisMaMresultMofMcardiogenicMshock.
)



AM60-year-
oldMmanMhasManMarterialMPOMofM60MmmMHgMwhenMtheMcalculatedMalveolarMPOMisM94MmmMHg.MThisMdiffer
enceMisMmostMcommonlyMdueMtoM-MCORRECTMANSWERM-aMventilation-perfusionMmismatch



oxygenMdeliveryMandMconsumptionM-MCORRECTMANSWERM--
MUnderMnormalMcircumstances,MapproximatelyM20%MtoM30%MofMtheMoxygenMdeliveredMtoMtheMcapillaryMb

edMisMextractedMbyMtheMtissues.

-
MInMconditionsMofMdecreasedMdeliveryMofMoxygen,MtissuesMareMcapableMofMextractingMupMtoM50%MtoM60%M
ofMtheMoxygenMcontentMinMtheMcapillaryMblood.

-MWhenMcellularMoxygenMsupplyMdoesMnotMmeetMdemand,ManaerobicMrespirationMresults.

(TheMvariablesMinMtheMequationMforMtheMdeliveryMofMoxygenMareMcardiacMoutput,MhemoglobinMlevel,Moxyg
enMsaturationMofMhemoglobin,MandMtheMpartialMpressureMofMoxygenMdissolvedMinMblood.MIncreasesMinMth
eMfirstMthreeMvariablesMallMyieldMsignificantMincreasesMinMtheMtotalMamountMofMoxygenMcarriedMbyMblood.M
TheMpartialMpressureMofMoxygenMisMmultipliedMbyMaMfactorMofM0.003,Mhowever,MandMthereforeMhasMaMmin
isculeMcontributionMtoMtheMtotalMoxygenMcontent.)



DopamineMatMdosesMofM5MtoM10Mμg/kg/minM-MCORRECTMANSWERM-hasMaMlargelyMinotropicMactionMprofile

(DopamineMhasMaMdose-
dependentMactionMprofile.MAtM3MtoM5Mμg/kg/min,MitsMactionsMareMlargelyMtoMincreaseMrenalMbloodMflow.M
AtMdosesMofM5MtoM10Mμg/kg/min,MitMlargelyMactsMtoMstimulateMmyocardialMβMreceptorsMandMhasManMinotr

,opicMeffect.MAtMdosesMgreaterMthanM10Mμg/kg/min,MitMstimulatesMαMreceptorsMandMhasMaMchronotropicMe
ffect.)



AsMoxygenMdeliveryMincreasesMonMtheMflatMhorizontalMportionMofMtheMoxygenMconsumption-
deliveryMcurveM-MCORRECTMANSWERM-OxygenMconsumptionMremainsMtheMsame

(OnMtheMflatMhorizontalMportionMofMtheMoxygenMconsumption-
deliveryMcurve,MoxygenMdeliveryMmeetsMcellularMdemandMofMoxygen;MasMoxygenMdeliveryMincreases,Moxyg
enMconsumptionMremainsMtheMsame.)



MostMdisorganizedMventricularMarrhythmiasM(frequentMPVCs,MventricularMfibrillation)MareMcausedMbyM-
MCORRECTMANSWERM-MetabolicMderangements.



(MostMdisorganizedMventricularMarrhythmiasMareMcausedMbyMsomeMsortMofMmetabolicMderangementMsuc
hMasMischemiaMorMmagnesiumMorMpotassiumMdeficiencies.MTheseMabnormalitiesMareMnotMwellMtreatedMby
MantiarrhythmicMmedications.)




TheMbestMmanagementMforMaMpatientMwithMaMposteriorMkneeMdislocationM-MCORRECTMANSWERM-
Arteriogram.

(TheMpatientMmayMhaveMfairlyMnormalMpulsesMandMstillMhaveManMintimalMinjuryMofMtheMpoplitealMarteryMth
atMisMsimilarMtoMtheMintimalMdisruptionMthatMcanMbeMseenMinMaorticMisthmusMinjury.)



theMpossibleMetiologiesMofMmultiorganMfailureM-MCORRECTMANSWERM--
MAnticytokineMantibodiesMhaveMshownMtherapeuticMpromiseMinManimalMstudies.



-MEvidenceMhasMshownMthatMintestinalMmucosaMisMmadeMpermeableMbyMsepsis.

-MTheM"two-
hit"MhypothesisMpostulatesMthatMafterMmountingManMappropriateMresponseMtoMsomeMphysiologicMinsult,Mt
heMpatientMisMleftMwithMaMprimedMimmuneMsystemMwhichMmanifestsManMexaggeratedMimmuneMresponseM
toMaMsecondMchallenge.

-
MTheMearlyMstagesMafterMinjuryMactuallyMappearMtoMconsistMofManMimmediateMproinflammatoryMstateMasMt
heMorganismMtriesMtoMaddressMtheMphysiologicMinsult.MWhenMproperlyMmodulated,MthisMisManMappropriat
eMfunction.MWhenMoverexpressed,MthisMproinflammatoryMstateMleadsMtoMtheMsystemicMinflammatoryMres
ponseMsyndrome.MLater,Manti-
inflammatoryMandMimmunosuppressiveMmechanismsMareMbroughtMintoMplayMtoMbringMtheMorganismMbac
kMtoMhomeostasis.MIfMovermanifested,MtheyMcanMleadMtoMaMrelativeMgeneralizedMimmunosuppressionMan
dMlateMincidentsMofMsepsisMorMmultiorganMfailure.

,compensatoryMmechanismsMinMshockM-MCORRECTMANSWERM-
AntidiureticMhormoneMcausesMtheMreabsorptionMofMfreeMwaterMbyMtheMkidneyMandMhasMvasoconstrictiveM
properties.

(AntidiureticMhormoneMisMreleasedMfromMtheMposteriorMpituitaryMwhereMitMstimulatesMfreeMwaterMretenti
onMbyMtheMkidneyMandMactsMasMaMpowerfulMvasoconstrictor.)



AM71-year-
oldMmanMwithMcolonMcancerMisMinMtheMintensiveMcareMunitMfollowingMaMleftMhemicolectomy.MHisMbloodMp
ressureMisM72/38MmmMHg,MpulseMrateMisM114/min,MrespiratoryMrateMisM23/min,MandMoxygenMsaturationMis
M94%MonM2MLMofMoxygenMbyMnasalMcannulae.MAMpulmonaryMarteryMcatheterMshowsMaMcentralMvenousMpre

ssureMofM8McmMHMO,MaMpulmonaryMarteryMpressureMofM22/8MmmMHg,MaMpulmonaryMarteryMwedgeMpressu
reMofM6MmmMHg,MandMaMcardiacMoutputMofM3.4ML/min.MTheMnextMstepMinMmanagementMshouldMbeMtheMin
travenousMadministrationMofM-MCORRECTMANSWERM-aMfluidMbolus



pulmonaryMarteryMcathetersM-MCORRECTMANSWERM-
AllowMaccurateMapproximationMofMleftMatrialMpressure.



TheMmagnitudeMofMaMleft-to-rightMshuntMinMtheMpresenceMofManMASDMisMdeterminedMbyM-
MCORRECTMANSWERM-DifferenceMinMcomplianceMbetweenMleftMandMrightMventricles.



(TheMbloodMwillMtendMtoMfillMtheMmoreMcompliantMventricleMwhichMwillMusuallyMbeMtheMright,MuntilMchroni
cMpulmonaryMhypertensionMyieldsMrightMventricularMhypertrophy.)



ComparedMtoMconventionalMventilationM(endotrachealMintubation),MnoninvasiveMventilationM(mask,Mconti
nuousMpositiveMairwayMpressure)MisM-MCORRECTMANSWERM-
contraindicatedMinMhemodynamicallyMunstableMpatients



AccordingMtoMtheMAmericanMCollegeMofMChestMPhysicians/SocietyMofMCriticalMCareMMedicineMConsensusM
Conference,MwhichMofMtheMfollowingMareMnotMpartMofMtheMdiagnosticMcriteriaMforMsepsis?M-
MCORRECTMANSWERM-HypotensionMdefinedMasMaMsystolicMbloodMpressureMlessMthanM90MmmMHg.



(SepsisMisMdefinedMasMbacteriologicMevidenceMofMinfectionMsuperimposedMonMaMclinicalMpictureMofMSIRS.M
AccordingMtoMtheMACCP/SCCM,MbyMdefinitionMtheseMpatientsMareMhemodynamicallyMstable.MIfMtheyMshou
ldMbecomeMhemodynamicallyMunstableM(definedMasMaMsystolicMbloodMpressureM<90MmmMHg),MtheMnameM
forMtheMconditionMchangesMtoM"severeMsepsis.")



SIRSM-MCORRECTMANSWERM--MTemperatureMgreaterMthanM38°CMorMlessMthanM36°C.

, -MHeartMrateMgreaterMthanM90Mbpm.

-MRespiratoryMrateMgreaterMthanM22Mbpm

-MWhiteMbloodMcellMcountMgreaterMthanM12,000MorMlessMthanM4,000MandMgreaterMthanM10%Mbands.



abdominalMcompartmentMsyndromeM-MCORRECTMANSWERM-
OnceMdiagnosed,MtreatmentMconsistsMofMreopeningMtheMabdomenMincludingMdoingMsoMatMtheMbedsideMif
Mnecessary.



(TheMpresenceMofManMabdominalMcompartmentMsyndromeMrequiresMdecompressionMofMtheMabdomen.MIf
MtheMpatientMisMtooMunstableMtoMbeMtransportedMtoMtheMoperatingMroom,MtheMabdomenMshouldMbeMpro

mptlyMreopenedMatMtheMbedside.)



carotidMbruitM-MCORRECTMANSWERM-aMmarkerMforMgeneralizedMatherosclerosis

(InMfact,MstudiesMhaveMshownMthatMaMcarotidMbruitMisMaMriskMfactorMforMcoronaryMarteryMdiseaseMandMfut
ureMmyocardialMinfarction.)



alveolarMventilationM-MCORRECTMANSWERM-
TheMalveolarMgasMequationMcharacterizesMtheMpotentialMforMoxygenMuptakeMandMcarbonMdioxideMremoval
.

(TachypneaMatMaMgivenMminuteMventilationMincreasesManatomicMdead-
spaceMventilation,MnotMalveolarMventilation.MMinuteMventilationMisMtheMvolumeMofMgasMthatMisMinspiredMa
ndMexpiredMatMtheMnasopharynxMandMisMdifferentMthanMthatMoccurringMatMtheMalveolusMbyMtheManatomic
Mdead-

spaceMvolume.MAlthoughMarterialMPcoMisMproportionalMtoMalveolarMventilation,MarterialMPoMisMnotMasMitMm
ayMbeMaffectedMbyMphysiologicMshunting,MdiffusionMblock,MandMsoMon.MTheMRQMisMconstantMunderMnorma
lMphysiologicalMconditionsMatM±M0.8;Mhowever,MitMmayMchangeMsubstantiallyMunderMconditionsMsuchMasMa
naerobicMmetabolism,Moverfeeding,MandMsoMon.MBecauseMtheMalveolarMgasMequationMcharacterizesMtheM
partialMpressuresMofMindividualMgasesMwithinMtheMalveolus,MwhichMinMturnMdetermineMtheMindividualMgra
dientsMforMdiffusion,MtheMequationMdoesMcharacterizeMtheMpotentialMforMoxygen/carbonMdioxideMexchang
e.M)



theMfollowingMmayMconstituteMtheMphysiologicalMdeadMspaceMofMtheMrespiratoryMsystemM-
MCORRECTMANSWERM--MEmphysematousMlung.



-MLungMinvolvedMwithMaMpulmonaryMembolus.

-MProximalMtwoMthirdsMsubsegmentalMbronchi.

-MZoneMoneMalveoli.