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d)

Graded
compression
stockings on the
left lege)

Intermittent
pneumatic
compression
boots applied to
both legs27.
Which of the
following
pharmacological
agents best
achieves
prevention of
stressulcer
bleeding (stress
ulcer prophylaxis)
in intensive
care patients?a)

Histamine 2
receptor
antagonists such
as Ranitidine b)

Soluble antacids
such as sodium
bicarbonatec)

Agents with
cytoprotective
effects such as
sucralfated)

Agents that
decrease gastro-
intestinal
secretions such as
octreotidee)
Proton pump
inhibitors such as
omeprazole28. A
70kg man who
has developed
sepsis after
multiple trauma
and is ventilated
in theICU. He
requires the
following rate of
a standard enteral
nutrition formula
such as Isocalto
provide adequate
calorie intake.a)
Approximately
100 ml/hour. b)

Approximately 40
ml/hour.c)

Approximately
200 ml/hour.d)
Approximately
1000 ml/day.e)

Approximately 20
ml/hour.29. A
patient with septic
shock has a mean
arterial pressure
60 mmHg, CVP 4
mmHg,heart rate
120/min and
oxygen saturation
97% (on FiO
2
0.3). He is
acidotic, oliguric
andconfused. He
is in positive fluid
balance of 3L
over the first 12 h
of his ICU
admission.The
most appropriate
next step in his
resuscitation is:a)
No further
resuscitation is
required b)

500 ml colloid
over 30 minutesc)
Start
norepinephrine
infusiond)

Start dopamine
infusione)

Start dobutamine
infusion30. Dual
antibiotic therapy
is recommended
for:a)

Methicillin
resistant
Staphylococcus
aureus
pneumonia b)
Penicillin
sensitive
Streptococcus
pneumoniae
pneumoniac)

E. coli
bacteraemiad)
Enterobacter
pneumoniae)

Meningococcal
meningitis31.
Rear impact
motor
vehicle accidents
are particularly
associated with:a)

Aortic
dissection b)

Flail chestc)

Head injuryd)
Acetabular
fracturee)

Cervical spine
injury
32. A 24 year old
trauma victim has
cold pale
peripheries, ashen
grey face,
blood pressure
90/40 mmHg and
respiratory rate
22/min. He is
confused. His
estimated
bloodloss is:a)
10% b)

15%c)

20%d)

30%e)
45%33. The first
priority in
managing a
severely head
injured patient
is:a)

Reduce the
intracranial
pressure with
mannitol b)

Perform a CT
scan of the
brainc)

Exclude cervical
spine injuryd)
Restore a normal
blood pressure
and oxygen
saturatione)

Sedate the patient


to prevent a rise
in intracranial
pressure due to
agitation
orcoughing34. In
a patient with
status epilepticus
and a normal
blood glucose
concentration, the
drugof choice to
terminate the fits
is:a)

Sodium Valproate
400 mg IV b)

Lorazepam 0.1
mg/kgc)
Diazepam 0.2
mg/kgd)

Phenytoin 15-20
mg/kge)

Midazolam 0.1
mg/kg35. A
patient on oxygen
15L/min via
reservoir
facemask has
the following
arterial bloodgas
result: pH 6.9,
PaCO
2
7.2 kPa (54
mmHg), PaO
2
10 kPa (75
mmHg), HCO
3-
10mmol/L. His
acid base
abnormality is
typical of:a)
Diabetic
ketoacidosis b)

Severe acute
pulmonary
oedemac)

Hepatic and renal


failured)
Renal tubular
acidosise)

A patient with
chronic
obstructive
pulmonary
disease who has
been treated
withdiuretics36.
A patient has
the following
arterial blood gas
result: pH 7.34,
PaCO
2
8.0 (60
mmHg),PaO
2
7.5 kPa (56
mmHg), HCO
3-
32.1 mmol/L, BE
8. His acid-
base abnormality
is:a)
Metabolic
acidosis b)

Metabolic
alkalosisc)

Respiratory
acidosisd)
Respiratory
alkalosise)

Mixed metabolic
acidosis and
respiratory
alkalosis37. The
optimal level of
sedation
corresponds to a
Richmond
Agitation
Sedation
Scoreof:a)

0
b)
–1c)

+1d)

–4e)

depends on the
patient’s clinical
condition38. The
intravenous dose
of
suxamethonium
for rapid sequence
induction is:a)

0.1 mg/kg b)

0.5 mg/kgc)
10 mg/kgd)

1 mg/kge)

0.2 mg/kg39.
When a
mechanical
ventilator is
employed during
patient transport
which of
thefollowing must
be in continuous
usea)

minute ventilation
display b)
tidal volume
alarmc)

flow volume
loopd)

high airway
pressure alarme)
pressure volume
loop40. Which of
the
following stateme
nts regarding
interhospital
transport of
critically
ill patients is
INCORRECT?a)

At least three
appropriately
trained staff
should
accompany each
patient b)
A self inflating
bag valve
resuscitator with
PEEP valve
should be
consideredessenti
al equipmentc)
End-tidal CO
2
monitoring
should be used for
all ventilated
patientsd)

Intravenous
glucose should be
availablee)
Epinephrine
should be
available41. A
treated
hypertensive
patient presents
with an acute
confusional state.
Results
ofinvestigations
were: plasma
sodium 112
mmol/l,
potassium
3.5 mmol/l, serum
osmolality245
mOsm/l, urine
osmolality 302
mOsml/l, urine
sodium
72 mmol/l. Her
jugular
venous pressure
was 8 cm above
her sternal angle.
The most
appropriate
treatment is:a)

Hypertonic saline
infusion b)

Normal saline
infusionc)
Arginine
vasopressind)

Fluid restrictione)

Steroid
replacement