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Category: Critical Care Medicine-Renal, Electrolyte and Acid Base Disorders--->Calcium, Phosphate, and Magnesium
Page: 2

Question 6#Print Question

A 54-year-old male presents to the emergency department with agitation. The ED physician orders haloperidol for agitation before learning that patient is taking high-dose methadone for back pain and has a history of substance abuse and dependence. Labs are awaited. His ECG strip on telemetry is shown in the figure that follows. He converts to normal sinus rhythm after receiving 2 g of magnesium. 10 minutes later the arrhythmia shown below recurs. He is alert and talking comfortably Vitals:

  • BP: 110/68 
  • SpO2 : 94% on 2 L/min oxygen via nasal cannula

What should be the next immediate step?

A. Give more magnesium
B. Synchronized cardioversion
C. IV isoproterenol to increase heart rate
D. Overdrive pacing to increase heart rate


Question 7#Print Question

A 45-year-old male with past medical history of COPD is admitted for acute hypoxemic respiratory failure secondary to influenza H1N1. He is intubated for 7 days. On hospital day 7, his P/F ratio has improved to 220 and the patient’s chest x-ray looks improved. He fails spontaneous breathing trial for two consecutive days secondary to low tidal volumes. He has poor cough reflex and was given 5 days of steroids for his acute illness. 

Which electrolyte is most likely to be deficient in this patient?

A. Serum phosphorus
B. Serum free cortisol
C. Serum calcium
D. Serum potassium


Question 8#Print Question

A 65-year-old male nursing home resident with a history of quadriplegia is admitted to the ICU for respiratory failure. He was intubated and placed on mechanical ventilation, and tube feeds were initiated on hospital day 2. Electrolyte levels are as follows on day 3. 

  • Serum calcium: 7.0 mg/dL
  • Serum phosphorus: 0.9 mg/dL
  • Serum magnesium: 1.6 mg/dL
  • Serum potassium: 3.6 mg/dL
  • Serum sodium: 138 mg/dL

Besides electrolyte repletion, what should be the strategy with regard to his nutrition?

A. Stop tube feeds
B. Decrease rate of tube feeds
C. Continue same rate of tube feeds with phosphorus supplementation in feeds
D. Make no change to tube feeds rate/type




Category: Critical Care Medicine-Renal, Electrolyte and Acid Base Disorders--->Calcium, Phosphate, and Magnesium
Page: 2 of 2