1. Quiz & Exam Chittagong 2011 Walter van den Bergh

2. Question 1 If this ICU patient is intubated, feeding must be attempted within: ……

3. Question 2 Guillain Barre Syndrome is oftenprecededwith a bacteria. Whichone? …..

4. Question 3 • Sinustachycardia • AtrialFibrillation • Atrial Flutter • Sinus Rhythm

5. Question 4 In CPR the ratio Chest compression - Rescue breaths is? ……..

6. Question 5Nutrition of the patientwith major burns what is NOT TRUE: • High calorie feedingreducesmortality • Enteralfeeding is preferredtoparenteral • Proteinrequirement is 1.5-2g/kg/day • Glutamine supplement is notbeneficial • Hyperglycaemiashouldbetreatedaggressively

7. Question 6 All of the followingincrease the likelihood of a patientacquiringanantimicrobial-resitantinfection EXCEPT: • Use of cefotaxime • High nursingworkload • Prolonged MV • Brief hospitaladmission • Understaffing in the ICU

8. Question 7Critical Illness Polyneuropathy In patients treated by mechanical ventilation more than 5-7 days the incidence of CIPNP is • 10% • 20% • 30% • >50%

9. Question 8 In severe CAP, what would be your first choice of antibiotic(s)? ……

10. Question 9 The first choice vasopressor in sepsis is: …….

11. Question 10 Preferable placement of CVL is: • subclavian-jugular-femoral • jugular-femoral-subclavian • femoral-subclavian-jugular • subclavian-femoral-jugular

12. Question 11 Recommended amount of energy in enteral fed ICU patients is: …… kcal/kg/day

13. Question 12 Considering low tidal ventilation, in a patient weighting 50 kg, tidal volume should be: …… ml

14. Question 13 Profylacticantibioticsduringoperationshouldbecontinuedfor: • oneday • 3 days • one week • shouldnotbe continued

15. Question 14 What is shown on this brain-CT? …..

16. Question 15 Todecrease CO2youcan: • set inspiration-expiration ratio to 1:1 • increase FiO2 • decreasefrequency • increase PS

17. Question 16 At the FIFA ranking, The Netherlands are placed: • 1st • 2nd • 3rd • 6th

18. Question 17 A patient opens his eyes on pain stimulus, bows one of his arms, but don’t make a sound. What is the GCS? ……

19. Question 18 A patient opens his eyes when talked to, localize, and speak single words. What is the GCS? ……

20. Question 19 A patients is ventilatedwith 5 PEEP and PS of 5. A tracheostoma has just been placed. Whencanyou start weaning?: • immedietly • after 2 days • after 1 week • after 1-2 weeks

21. Question 20 In a septic patientalbuminshouldbegiven in case of: • hypotension • hypoalbuminaemia • ifvasopressors are at maximum dose • there is no evidencethatalbumin is beneficial

22. Quiz-Exam Answers

23. Question 1 If this ICU patient is intubated, feeding must be attempted within: ……

24. Answer 1 Within 24-48 hours You want avoidhimtobekatabolic Doig GS, Heighes PT, Simpson F, Sweetman EA, Davies AR. Early enteral nutrition, provided within 24 h of injury or intensive care unit admission, significantly reduces mortality in critically ill patients: a meta-analysis of randomised controlled trials. Intensive Care Med 2009; 35:2018-27.

25. Question 2 Guillain Barre Syndrome is oftenprecededwith a bacteria. Whichone? …..

26. Answer 2 Guillain Barre Syndrome is oftenprecededwith a bacteria. Whichone? Campylobacter jejuni

27. Question 3 • Sinustachycardia • AtrialFibrillation • Atrial Flutter • Sinus Rhythm

28. Answer 3 2. atrial fibrillation

29. Question 4 In CPR the ratio Chest compression - Rescue breaths is? ……..

30. Answer 4 In CPR the ratio Chest compression - Rescue breaths is? 30:2

31. Question 5Nutrition of the patientwith major burns what is NOT TRUE: • High calorie feedingreducesmortality • Enteralfeeding is preferredtoparenteral • Proteinrequirement is 1.5-2g/kg/day • Glutamine supplement is notbeneficial • Hyperglycaemiashouldbetreatedaggressively

32. Answer 5Nutrition of the patientwith major burns • High calorie feeding reduces mortality is NOT TRUE

33. Question 6 All of the followingincrease the likelihood of a patientacquiringanantimicrobial-resitantinfection EXCEPT: • Use of cefotaxime • High nursingworkload • Prolonged MV • Brief hospitaladmission • Understaffing in the ICU

34. Answer 6 4. Brief hospital admission Poor hand hygiene also contributes to the development of antibiotic-resistent infections

35. Question 7Critical Illness Polyneuropathy In patients treated by mechanical ventilation more than 5-7 days the incidence of CIPNP is • 10% • 20% • 30% • >50%

36. Answer 7Critical illness polyneuropathy 4. >50% • adds to morbidity and mortality • delaying weaning from ventilator support

37. Question 8 In severe CAP, what would be your first choice of antibiotic(s)? ……

38. Answer 8 In severe CAP, what would be your first choice of antibiotic(s)? amoxycillin-clavulanic acid or ceftriaxon (or cefotaxim) with erythromycin (or clarithromycin)

39. Question 9 The first choice vasopressor in sepsis is: …….

40. Answer 9 The first choice vasopressor in sepsis is: Noradrenaline

41. Question 10 Preferable placement of CVL is: • subclavian-jugular-femoral • jugular-femoral-subclavian • femoral-subclavian-jugular • subclavian-femoral-jugular

42. Answer 10 Preferable placement of CVL is: • subclavian-jugular-femoral associatedwithless infections

43. Question 11 Recommended amount of energy in enteral fed ICU patients is: …… kcal/kg/day

44. Answer 11 Recommended amount of energy in enteral fed ICU patients is: 25-30 kcal/kg/day

45. Question 12 Considering low tidal ventilation, in a patient weighting 50 kg, tidal volume should be: …… ml

46. Answer 12 Considering low tidal ventilation, in a patient weighting 50 kg, tidal volume should be: 50x 6 ml/kg (ideal weight) 300 ml

47. Question 13 Profylacticantibioticsduringoperationshouldbecontinuedfor: • oneday • 3 days • one week • shouldnotbe continued

48. Answer 13 Profylactic antibiotics during operation should be continued for: 4. should not be continued

49. Question 14 What is shown on this brain-CT? …..

50. Answer 14 What is shown on this brain-CT? Epidural hematoma