icupearls.org Archive

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

Tuesday, December 31, 2019

octreotide in chylothorax

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Q: How octreotide helps in chylothorax?   Answer: Octreotide can be an important adjunct therapy in chylothorax. It works via two mecha...
Monday, December 30, 2019

murmur in venous air embolism

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Q : Which murmur is heard in venous air embolism? Answer: Millwheel murmur   A millwheel murmur is a churning sound that can be heard t...
Sunday, December 29, 2019

Clonidine toxicity

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Q: Which of the following is recommended for clonidine toxicity? A)  Naloxone  B) Tolazoline C) Yohimbine D) Hemodialysis E) Beta-blo...
Saturday, December 28, 2019

BB and Dobutamine

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Q: Which Beta-blocker is particularly more potent in blocking the effectiveness of Dobutamine? Answer:    Carvedilol In patients who ar...
Friday, December 27, 2019

LGIB - high risk features

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Q: A non-tender abdomen is considered a high risk feature in presumed acute lower gastro-intestinal (GI) bleeding. A) True B) False An...
Thursday, December 26, 2019

earplugs in ICU

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Q: Use of earplugs may decrease the incidence of delirium in ICU patients? A) True B) False Answer: A At least one randomized trial ...
Tuesday, December 24, 2019

plasma osmolality during ICH

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Q: What is the goal of plasma osmolality with mannitol therapy during the management of intracranial hemorrhage (ICH)?  Answer: 300 to ...
Monday, December 23, 2019

dialysis dementia

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Q; Which element is considered to be responsible for dementia in dialysis patient, commonly known as dialysis dementia?    Answer:  Alu...
Sunday, December 22, 2019

SDD

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Q: What is the rationale behind "Short daily dialysis (SDD)? Answer: Studies have shown benefits from SDD both in terms of dialysis ...
Saturday, December 21, 2019

Fenoldopam

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Q:  Which one advantage Fenoldopam has over other parenteral anti-hypertensives?  Answer : Although Fenoldopam is not much-used in ICUs, ...
Friday, December 20, 2019

Aspiration Pneumonia and unusual interventions

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Q: Mention two unconventional interventions that have shown benefit in acute aspiration pneumonia? Answer: Mechanical ventilation is the...
Thursday, December 19, 2019

SK and allergic reaction

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Q: 44-year-old male developed an allergic reaction during Streptokinase (SK) infusion for massive pulmonary embolism with fever, shivering,...
Wednesday, December 18, 2019

postprandial syndrome

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Q: Postprandial hypoglycemia syndrome requires the nadir of blood glucose to at least which concentration?    Answer : None   Postprandi...
Tuesday, December 17, 2019

IE and procedure indicated

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Q: For patients who develop infective endocarditis (IE) due to group D streptococci and E. faecalis, which non-cardiac procedure should be ...
Monday, December 16, 2019

pupillary responses of hepatic encephalopathy

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Q: How the pupillary response differs at different grades of hepatic encephalopathy? Answer:   Cerebral edema correlates with the degree ...
Sunday, December 15, 2019

Angled chest tube

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Q: 'Angled' chest tubes are best suited to reach which pleural area? Answer: Posterior costophrenic sulcus Posterior costophren...
Saturday, December 14, 2019

chronic DIC

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Q: All of the following can be a finding in chronic Disseminated Intravascular Coagulation (DIC) except ? A) Mild thrombocytopenia B) Mil...
Friday, December 13, 2019

Platelets storage

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Q: In contrast to other blood products why platelets are stored at room temperature? Answer:  Platelets are recommended to be stored at...
Thursday, December 12, 2019

Heparin, bleeding and PTT

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Q: "Bleeding due to heparin is usually directly proportional to the level of aPTT." This statement is A) True B) False Answe...
Wednesday, December 11, 2019

Tacrolimus and hypertension

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Q: After organ transplantation, the patients who are on Calcium Channel Blockers (CCBs), the dose of tacrolimus should be? (select one) A)...
Tuesday, December 10, 2019

VA ECMO and cardiac thrombosis

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Q: What's the etiology behind cardiac thrombosis in extracorporeal membrane oxygenation (ECMO) inserted through femoral vessels? Answ...
Monday, December 9, 2019

prolonged postop ileus

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Q: In general, how many days after surgery, if no bowel motility returns are considered as 'prolonged postoperative ileus'? Answ...
Sunday, December 8, 2019

Electrical burn injury

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Q:  Why deep tissue surrounding the long bones are prone to highest damage during electrical burn injury? Answer: Bones have the highest r...
Saturday, December 7, 2019

ACS

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Q: Which is the one required component to diagnose acute chest syndrome (ACS) in patients with sickle cell disease? Answer: Radiograp...
Friday, December 6, 2019

ILE

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Q: What are the three mechanisms by which Intravenous Lipid Emulsion (ILE) Therapy works in toxicology? Answer: The first question is to...
Thursday, December 5, 2019

OCS

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Q: You have been called to evaluate a patient's eyes who is on high PEEP. Nurse at the start of her shift noticed patient's eyelids ...
Wednesday, December 4, 2019

Bivalirudin and HD

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Q: Is Bivalirudin (Angiomax) dialyzable? A) Yes B) No Answer: A Bivalirudin is metabolized by many organs in the body including the ...
Tuesday, December 3, 2019

Sudden onset headache

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Q: All of the following presents as a sudden-onset headache except ?  A) Subarachnoid hemorrhage (SAH) B) Vertebral artery dissection ...
Monday, December 2, 2019

ASV

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Q: ASV is a mode of ventilation that stands for? A) Assisted support ventilation B) Adaptive support ventilation Answer: B The objec...
Sunday, December 1, 2019

iNO

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Q: What is the major concern when inhaled nitric oxide (iNO) is administrated via nasal prong, face mask or Non-invasive positive pressure (...
Saturday, November 30, 2019

Maze

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Q: What are the three principal goals of surgical intervention in atrial fibrillation? Answer:  Creation of conduction block to disrupt...
Friday, November 29, 2019

Axillary A line

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Q: While inserting axillary arterial line, it should be ideally placed A) as high as possible within the axilla B) at low as possible w...
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