Multiple Choice Questions (MCQ)

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Category: Critical Care Medicine-Renal, Electrolyte and Acid Base Disorders--->Renal Replacement Therapy
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Question 6#Print Question

A 64-year-old female with ESRD and nonischemic cardiomyopathy with a left ventricular ejection fraction of 20% underwent IHD the day before. She developed flash pulmonary edema and is currently on epinephrine infusion for hemodynamic support.

Which of the following modalities would be MOST effective for fluid removal in this patient?

B. Slow continuous ultrafiltration (SCUF)
C. Intravenous furosemide
D. Continuous venovenous hemodialysis

Question 7#Print Question

A 55-year-old male with history of diabetes mellitus, hypertension, and ESRD has been admitted to the ICU following a polytrauma. He suffered a mild concussion of his brain and multiple orthopedic injuries including a fractured pelvis and pelvic bleeding which required coiling in the interventional radiology suite. He is protecting his airway and has been hemodynamically stable for the past 24 hours. He is being started on IHD, as his blood urea nitrogen (BUN) is 180 mg/dL and creatinine is 8 mg/dL. Following IHD, he develops nausea, vomiting, and altered mental status concerning for dialysis disequilibrium syndrome.

Which of the following interventions if used is MOST likely to prevent the occurrence of this syndrome?

A. Use of CRRT with slow removal of fluids and solutes
B. Intubation prior to institution of dialysis
C. Avoiding anticoagulation during dialysis
D. Infusion of mannitol during dialysis

Question 8#Print Question

A 55-year-old female with a history of chronic obstructive pulmonary disease and chronic kidney disease on peritoneal dialysis (PD), presents to the emergency department with fever, dry cough, and wheezing. She does not complain of any abdominal pain. An upper respiratory tract infection is suspected. On admission, her hemoglobin is 9.8 mg/dL, white blood cell count is 11.2 K/µL, and lactate 3.8 mmol/L. Her vital signs are:

  • BP 100/70 mm Hg
  • HR 88 bpm
  • oxygen saturation 95% on room air

She has been afebrile since admission.

What is the MOST appropriate next step in the management of this patient?

A. Abdominal computerized tomography scan to confirm diagnosis of bowel ischemia
B. Admit to the ICU as she is likely to develop peritonitis and septic shock
C. Observation and treatment of symptoms
D. Start on empiric antibiotic therapy

Question 9#Print Question

What is the recommended delivered dose of the effluent in CRRT?

A. 10 to 20 mL/kg/h
B. 20 to 25 mL/kg/h
C. 30 to 40 mL/kg/h
D. 50 to 60 mL/kg/h

Question 10#Print Question

A 34-year-old female with a history of hypertension and diabetes is admitted to the ICU after an exploratory laparotomy following a motor vehicle accident. Her vital signs include HR 110 bpm and BP 90/66 mm Hg. She is currently intubated and mechanically ventilated and has developed AKI requires RRT. It is anticipated that she would need several trips to the operating room in the next few days for debridement and subsequent closure of the abdomen.

Which of the following would be the MOST efficient modality of RRT in this patient?

A. Continuous renal replacement therapy (CRRT)
B. Prolonged intermittent renal replacement therapy (PIRRT)
C. Slow continuous ultrafiltration (SCUF)
D. Intermittent hemodialysis (IHD)

Category: Critical Care Medicine-Renal, Electrolyte and Acid Base Disorders--->Renal Replacement Therapy
Page: 2 of 2