FCCS EXAM Questions and Answers
Verified Solutions Latest Update
Question:
A 52yoM presents to the ED with SOB and new-onset lower extremity edema. Vitals:
temp 37 (98.6F), HR 114, RR 28, BP 86/62, SpO2 92% on nonrebreather. Transferred to
ICU, intubated, and central line is placed. TTE shows significantly reduced LV function.
Hgb 9.2, lactic acid 4.2, and central venous oxygen saturation 43%. Which of the
following interventions will significantly improve oxygen delivery? A) administer a 1L
fluid bolus and start antibiotics B) start inotropes to increase cardiac contractility C)
start vasopressors to increase SBP D) transfuse RBCs to a goal of 10 g/dL
Answer:
B) start inotropes to increase cardiac contractility
Question:
Patients presenting with which of the following conditions should be triaged to the cath
lab as soon as possible for early. reperfusion with PCI or CABG? A) NSTEMI with
hemodynamic stability B) NSTE-ACS with atrial bigeminy C) NSTE-ACS with shock D)
NSTEMI with a thrombolysis in MI risk score of 2
Answer:
C) NSTE-ACS with shock
Question:
A 65yoM admitted to the ICU for BRBPR and hemorrhagic shock. PMHx AAA s/p
endovascular aneurysm repair 2 years ago. Intubated and sedated on mechanical
ventilation. Received 6 units PRBCs, 6 units FFP, 5 units platelets, 2 units
cyroprecipitate. Corrected calcium is 10, normothermic with pH 7.35, lactate 4. He
continues to have BRBPR. An NG tube is placed with non-bloody return. Which of the
following is the most appropriate next step? A) gastrointestinal consultation for
endoscopy B) surgical consultation C) IV PPI D) IV octreotide
Answer:
B) surgical consultation
, Question:
An otherwise healthy 46yoF with no significant PMHx presents to the ED for dyspnea.
She is hypotensive, tachycardic, and hypoxic. Vitals: BP 80/40, HR 160, SpO2 88% on
RA. Conversational dyspnea and in moderate respiratory distress. CTa of chest
demonstrates bilateral pulmonary emboli at level of main pulmonary artery. Labs:
lactate 7. Administered 500mL IVF with no hemodynamic improvement. Started on
norepinephrine for hemodynamic support. POCUS demonstrates large hypokinetic RV
and hyperdynamic LV. Which of the following is the most appropriate intervention for
her pulmonary embolism? A) suction thrombectomy B) catheter-directed thrombolysis
C) systemic thrombolysis D) inferior vena cava filter
Answer:
C) systemic thrombolysis
Question:
A 60kg (154lb), 170cm (67in), 69yoF with severe COPD is admitted to the ICU for acute
COPD exacerbation. Despite albuterol, ipratropium, and IV methylprednisolone, she has
become somnolent. ABG on FiO2 0.35 shows pH 7.2, PCO2 110, PO2 108. ICU physician
decides invasive ventilation is needed. Patient receives IV ketamine, 120 mg, to
facilitate endotracheal intubation which is accomplished easily. Ventilator is set to
assist control/volume control, with TV 440, rate 24, PEEP 5, FiO2 0.35, and orders a
CXR. 15 min later, BP has fallen to 70/40. Breath sounds equal, chest rise symmetrical.
Ppeak 59, Pplat 18. Airway after end-expiratory hold is 18. Emergent ECG and cardiac
enzymes normal. Which of the following is the most likely explanation for her
hypotension? A) myocardial ischemia B) tension pneumothroax C) intrinsic PEEP
(auto-PEEP) D) intubation medication
Answer:
C) intrinsic PEEP (auto-PEEP)
Question:
A 24yoM admitted to ICU after falling from roof. Admission CT reveals left frontal lobe
contusion. No intubation is required. Patient on 3L NC. Observed to have a generalized
seizure. Which of the following best characterizes the most appropriate initial
management? A) phenytoin, 18-20 mg/kg IV, should be administered as rapidly as
possible B) no drug therapy indicated unless ICP exceeds 25 mmHg C) IV
benzodiazepine, such as lorazepam, 0.1 mg/kg, administered at the onset of seizure
activity, may terminate the seizure D) IV neuromuscular relaxant such as vecuronium
(10,g) should be administered to decrease the cerebral oxygen requirement
Answer:
Verified Solutions Latest Update
Question:
A 52yoM presents to the ED with SOB and new-onset lower extremity edema. Vitals:
temp 37 (98.6F), HR 114, RR 28, BP 86/62, SpO2 92% on nonrebreather. Transferred to
ICU, intubated, and central line is placed. TTE shows significantly reduced LV function.
Hgb 9.2, lactic acid 4.2, and central venous oxygen saturation 43%. Which of the
following interventions will significantly improve oxygen delivery? A) administer a 1L
fluid bolus and start antibiotics B) start inotropes to increase cardiac contractility C)
start vasopressors to increase SBP D) transfuse RBCs to a goal of 10 g/dL
Answer:
B) start inotropes to increase cardiac contractility
Question:
Patients presenting with which of the following conditions should be triaged to the cath
lab as soon as possible for early. reperfusion with PCI or CABG? A) NSTEMI with
hemodynamic stability B) NSTE-ACS with atrial bigeminy C) NSTE-ACS with shock D)
NSTEMI with a thrombolysis in MI risk score of 2
Answer:
C) NSTE-ACS with shock
Question:
A 65yoM admitted to the ICU for BRBPR and hemorrhagic shock. PMHx AAA s/p
endovascular aneurysm repair 2 years ago. Intubated and sedated on mechanical
ventilation. Received 6 units PRBCs, 6 units FFP, 5 units platelets, 2 units
cyroprecipitate. Corrected calcium is 10, normothermic with pH 7.35, lactate 4. He
continues to have BRBPR. An NG tube is placed with non-bloody return. Which of the
following is the most appropriate next step? A) gastrointestinal consultation for
endoscopy B) surgical consultation C) IV PPI D) IV octreotide
Answer:
B) surgical consultation
, Question:
An otherwise healthy 46yoF with no significant PMHx presents to the ED for dyspnea.
She is hypotensive, tachycardic, and hypoxic. Vitals: BP 80/40, HR 160, SpO2 88% on
RA. Conversational dyspnea and in moderate respiratory distress. CTa of chest
demonstrates bilateral pulmonary emboli at level of main pulmonary artery. Labs:
lactate 7. Administered 500mL IVF with no hemodynamic improvement. Started on
norepinephrine for hemodynamic support. POCUS demonstrates large hypokinetic RV
and hyperdynamic LV. Which of the following is the most appropriate intervention for
her pulmonary embolism? A) suction thrombectomy B) catheter-directed thrombolysis
C) systemic thrombolysis D) inferior vena cava filter
Answer:
C) systemic thrombolysis
Question:
A 60kg (154lb), 170cm (67in), 69yoF with severe COPD is admitted to the ICU for acute
COPD exacerbation. Despite albuterol, ipratropium, and IV methylprednisolone, she has
become somnolent. ABG on FiO2 0.35 shows pH 7.2, PCO2 110, PO2 108. ICU physician
decides invasive ventilation is needed. Patient receives IV ketamine, 120 mg, to
facilitate endotracheal intubation which is accomplished easily. Ventilator is set to
assist control/volume control, with TV 440, rate 24, PEEP 5, FiO2 0.35, and orders a
CXR. 15 min later, BP has fallen to 70/40. Breath sounds equal, chest rise symmetrical.
Ppeak 59, Pplat 18. Airway after end-expiratory hold is 18. Emergent ECG and cardiac
enzymes normal. Which of the following is the most likely explanation for her
hypotension? A) myocardial ischemia B) tension pneumothroax C) intrinsic PEEP
(auto-PEEP) D) intubation medication
Answer:
C) intrinsic PEEP (auto-PEEP)
Question:
A 24yoM admitted to ICU after falling from roof. Admission CT reveals left frontal lobe
contusion. No intubation is required. Patient on 3L NC. Observed to have a generalized
seizure. Which of the following best characterizes the most appropriate initial
management? A) phenytoin, 18-20 mg/kg IV, should be administered as rapidly as
possible B) no drug therapy indicated unless ICP exceeds 25 mmHg C) IV
benzodiazepine, such as lorazepam, 0.1 mg/kg, administered at the onset of seizure
activity, may terminate the seizure D) IV neuromuscular relaxant such as vecuronium
(10,g) should be administered to decrease the cerebral oxygen requirement
Answer:
