icupearls.org Archive

Pearls on Intensive Care Medicine Practice - Project "Critical Care A Day"

Wednesday, October 21, 2026

RESP score

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Q:  A 53-year-old male with viral pneumonia developed severe ARDS post-intubation, requiring deep sedation along with neuromuscular blockade...
Tuesday, October 20, 2026

Acute metronidazole-induced neurotoxicity

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Q:  Metronidazole neurotoxicity can be diagnosed and can be distinguished when many drugs are concomitantly administered via magnetic resona...
Monday, October 19, 2026

spleen size

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Q: The size of the spleen correlates with a person's height, weight, and sex. A) True B) False Answer: A Spleen size correlates with a...
Sunday, October 18, 2026

SGLT2 inhibitors and diabetes-related foot disease

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Q: SGLT2 inhibitors (sodium-glucose cotransporter-2 (SGLT2) inhibitors, also called "flozins" have an extra advantage in patients...
Saturday, October 17, 2026

Etomidate and Seizure

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Q : Etomidate is contraindicated in patients with seizure disorders. A) Yes B) No Answer: B Conventionally, it is believed that etomidate i...
Thursday, October 15, 2026

D-Dimer, PE and crack

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Q: 38-year-old male presented to the ED after a "crack" party with acute shortness of breath. Initial CXR is c/w signs of pulmona...
Wednesday, October 14, 2026

Gadolinium in pregnancy.

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Q:  A 27-year-old female with a 32-week  pregnancy and a past medical history of multiple sclerosis (MS) is admitted with an exacerbation of...
Monday, October 12, 2026

An ENT case!

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Q : 55 years old male originally from Tunisia without any past medical history is admitted to the ICU with severe otitis media and marked ep...
Saturday, October 10, 2026

Colonoscopy prep

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Q : It is required to prepare patients treated with 4L of polyethylene glycol for colonoscopy for the optimum view. A) True B) False Answer ...
Friday, October 9, 2026

Classic neurologic triad of early disseminated Lyme disease

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Q: What is the classic neurologic triad of early disseminated Lyme disease? Answer: Although it may not always present as a triad, in clas...
Thursday, October 8, 2026

PSA level and Acetaminophen

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Q: Regular use of acetaminophen may cause falsely ____________ level of Prostate Specific Antigen (PSA). - Select one A) elevated B) lowered...
Wednesday, October 7, 2026

Danger triangle of face

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Q:  72-year-old patient who is intubated for a week due to severe ARDS after community-acquired pneumonia, noted to have an abscess of 2 x 3...
Tuesday, October 6, 2026

Water Hammer effect

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Q: What is the "water hammer" effect in blunt aortic injury (BAI) during Motor Vehicle Accidents (MVA)? Answer:  The mechanism re...
Monday, October 5, 2026

Night sweats associated with a strong, peculiar, moldy odor

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Q: Which Infectious Disease (ID) may present with night sweats associated with a strong, peculiar, moldy odor? Answer: Brucellosis Althoug...
Sunday, October 4, 2026

"Paradoxical hypokalemia"

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Q : "Paradoxical hypokalemia" is more common in? - Select one A) Hereditary hypokalemic periodic paralysis B) Thyrotoxic hypokalem...
Saturday, October 3, 2026

Tricks of Bougie

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Q:  Endotracheal tube (ETT) introducer, popularly known as a 'Bougie ', should not be bent more than?  - select one A) 10 degrees B)...
Wednesday, September 30, 2026

pulmonary contusion

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Q:  38-year-old male is admitted to the ICU after a motor vehicle accident (MVA) with pulmonary contusion due to rapid inflation of the airb...
Tuesday, September 29, 2026

Drug interactions with Warfarin

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Q:  57-year-old male with a history of atrial fibrillation and stable for the last few years on his medications, including warfarin, is admi...
Monday, September 28, 2026

anti-hypertensive in MH

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Q: Which of the following anti-hypertensives should NOT be used in Malignant Hyperthermia (MH)? - select one A) Beta-Blockers (BBs) B) Calc...
Sunday, September 27, 2026

CAA

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Q: Hemorrhagic stroke in cerebral amyloid angiopathy (CAA) usually occurs at? - Select one A) lobar locations B) basal ganglia  C) brainste...
Wednesday, September 23, 2026

Steroids and HELLP Syndrome

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Q : A 27-year-old female with a first pregnancy at 32 weeks is admitted to the ICU with a subcapsular liver hematoma due to HELLP syndrome. ...
Tuesday, September 22, 2026

Repeat Echo in IE

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Q:  A 56-year-old male with PMH of end-stage renal disease (ESRD) is recovering in the ICU after a bout of infective endocarditis (IE), whil...
Monday, September 21, 2026

Toxic megacolon and radiological FU

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Q:  A 23-year-old male is admitted to the ICU with a flare-up of his ulcerative colitis.  CT scan in ED is consistent with Toxic Megacolon. ...
Sunday, September 20, 2026

routes of succinylcholine

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Q:  54-year-old male with severe vasculopathy started having seizures in the ICU and lost his IV access.  After intramuscular benzodiazepine...
Saturday, September 19, 2026

pericardiocentesis in PH patients

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Q:  Patients with which Pulmonary Hypertension Group (PH) have the highest chance of mortality from pericardial drainage?  - select one A) G...
Thursday, September 17, 2026

iNO weaning

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Q : A 54-year-old female is in the ICU due to Pulmonary Arterial Hypertension (PAH) and has been dependent on inhaled Nitric Oxide (iNO) for...
Tuesday, September 15, 2026

K_Kidney-Liver connection

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Q:  What is the K-Kidney-Liver connection in hepatic encephalopathy? Answer: Exacerbation of hepatic encephalopathy in hypokalemia  Althoug...
Monday, September 14, 2026

VPA side effects

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Q: Valproic Acid (VPA) overdose may cause? - select one A) anion gap metabolic acidosis (AGA) B) non-anion gap metabolic acidosis (NAGA) An...
Sunday, September 13, 2026

CRRT and magnesium

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Q: Use of Regional citrate anticoagulation in Continuous Renal Replacement Therapy (CRRT) will cause? - Select one A) hypermagnesemia B) hy...
Saturday, September 12, 2026

EKG and RVMI

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Q: In acute Right Ventricular Myocardial Infarction (RVMI), which electrocardiogram (EKG) lead's ST-elevation has the highest sensitivit...
Friday, September 11, 2026

SAH, SIADH and CSW

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Q : Hyponatremia in Subarachnoid hemorrhage (SAH) due to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) and cerebra...
Thursday, September 10, 2026

DAPT score

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Q : The DAPT (Dual antiplatelet therapy) score is created to decide whether DAPT should be started, continued, or stopped?  - Select one A) ...
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