MCQ 16

Birbeck bodies are seen in

a - Pulmonary Langerhans' cell histiocytosis

b - Lymphangitic carcinomatosis

c - Lipoid pneumonia

d - Hypersensitivity pneumonitis

Ans: a - Pulmonary Langerhans' cell histiocytosis

MCQ 14:

All increase oxygenation except:

a. FiO2

b. Minute volume

c. PEEP

d. None of the above

Ans: Minute volume

MCQ 13:

Patient having asynchrony on Assist Control Ventilation,

What will you not do?

a. Adjust the trigger sensitivity

b. Change the inspiratory:expiratory time

c. Change the tidal volume

d. Change the mode of ventilation

Ans: c. Change the Tidal Volume

MCQ 11:

All the following drugs are dialysable except:

a – Salicylate

b – Sertaline

c - Ethylene Glycol

d - Methanol

(This question appeared both in 2008 and 2009 FNB Entrance)

Ans: b – Sertaline

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MCQ 8:

Patient is having ARDS with a Peak Inspiratory Pressure of 65 cm H2O; develops a pneumothorax, what will you do?

a – Increase the Fractional concentration of O2

b – Switch over to Pressure Control Ventilation

c – Decrease the tidal volume

d – Decrease the respiratory rate

Ans: Switch over to Pressure control ventilation

MCQ 7:

All are active against anaerobes except:

a – Metronidazole

b – Clindamycin

c – Meropenem

d – Levofloxacin

Ans : Levofloxacin

MCQ 6:

All can be given in Aortic Dissection except:

a – Analgesics

b – Sodium Nitroprusside

c – Labetalol

d – Sodium Nitroprusside + Labetalol

Ans B – Sodium Nitroprusside

This is the best answer by exclusion! All of above can be given!Sodium Nitroprusside should be used only in the presence of rate controlling agents.

Care should be taken to avoid direct acting vasodilators in the absence of negative chronotropic medications, as they may induce reflex tachycardia, increasing dP/dT with worsening dissection. (ref: Washington Manual of Critical Care)

MCQ 5:

All are markers of decreased tissue perfusion, except:

a – Lactate

b – Central venous oxygen saturation

c – Ammonia

d – None of above

Ans: C

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MCQ 4:

Decrease in spO2 is seen in all except:

a – Meth-hemoglobinemia

b- Carboxy-hemoglobinemia

c – Sulfhemoglobinemia

d – Fetal hemoglobin

 

Ans: Carboxy-hemoglobinemia

 

The effect of HbCO may be discerned by examining its absorption spectrum. At 920 nm, HbCO has an extremely low absorbance and therefore does not contribute to total absorbance. At 660 nm,
however, HbCO has an absorbance very similar to that of HbO2 , and SpO2 will therefore be falsely high. (ref: Miller)

COHb is typically read by a two-diode oximeter as 90% oxyhemoglobin and 10% reduced hemoglobin, resulting in false elevations of SpO₂. In the emergency department setting or shortly after ICU admission, a gap between pulse oximetry and Po₂ or cooximetrically measured oxygen saturation may suggest elevated COHb levels, particularly in patients with smoke inhalation or potential carbon monoxide poisoning. (Ref: Irwin and Rippe)

MCQ 3:

A patient has a pulse oximeter saturation (spO2) of 85%, where as his saturation on ABG (saO2) is 93%, what is the likely cause???

Possible diagnosis:

a – Carboxyhemoglobin

b – Methhemoglobin

c – Fetal hemoglobin

d – sulfhemoglobin

Ans: b – Methhemoglobinemia.

Because methemoglobin absorbs more light at 660 nm than at 990 nm, it affects pulse oximetry readings when methemoglobin levels exceed 6%. Moreover, higher levels of methemoglobin tend to bias the reading toward 85% to 90%. (Ref: Irwin and Rippe.)

In the presence of high HbMet concentrations, the measured SpO2 approaches 85%, independently of the actual arterial oxygenation. (Ref: Miller)

MCQ 2:

Non Caloric Protein requirement in an critically ill patient:

a – 0.8 g/kg/day

b – 1.0 g/kg/day

c – 1.5 g/kg/day

d – 2.0 g/kg/day 

 

Answer: 1.5 g/kg/day

Read here about recommended daily protein intake