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 often preceded with a bacteria. Which one? …..

4. Question 3 1.Sinustachycardia 2.Atrial Fibrillation 3.Atrial Flutter 4.Sinus Rhythm

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

6. Question 5 Nutrition of the patient with major burns what is NOT TRUE: 1.High calorie feeding reduces mortality 2.Enteral feeding is preferred to parenteral 3.Protein requirement is 1.5- 2g/kg/day 4.Glutamine supplement is not beneficial 5.Hyperglycaemia should be treated aggressively

7. Question 6 All of the following increase the likelihood of a patient acquiring an antimicrobial-resitant infection EXCEPT: 1.Use of cefotaxime 2.High nursing workload 3.Prolonged MV 4.Brief hospital admission 5.Understaffing in the ICU

8. Question 7 Critical Illness Polyneuropathy In patients treated by mechanical ventilation more than 5-7 days the incidence of CIPNP is 1.10% 2.20% 3.30% 4.>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: 1.subclavian-jugular-femoral 2.jugular-femoral-subclavian 3.femoral-subclavian-jugular 4.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 Profylactic antibiotics during operation should be continued for: 1. one day 2. 3 days 3. one week 4. should not be continued

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

16. Question 15 To decrease CO 2 you can: 1. set inspiration- expiration ratio to 1:1 2. increase FiO2 3. decrease frequency 4. increase PS

17. Question 16 At the FIFA ranking, The Netherlands are placed: 1.1st 2.2nd 3.3rd 4.6th

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 ventilated with 5 PEEP and PS of 5. A tracheostoma has just been placed. When can you start weaning?: 1. immedietly 2. after 2 days 3. after 1 week 4. after 1-2 weeks

21. Question 20 In a septic patient albumin should be given in case of: 1.hypotension 2.hypoalbuminaemia 3.if vasopressors are at maximum dose 4.there is no evidence that albumin is beneficial

22. ANSWERS Quiz-Exam

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

24. Answer 1 Within 24-48 hours You want avoid him to be katabolic 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 often preceded with a bacteria. Which one? …..

26. Answer 2 Guillain Barre Syndrome is often preceded with a bacteria. Which one? Campylobacter jejuni

27. Question 3 1.Sinustachycardia 2.Atrial Fibrillation 3.Atrial Flutter 4.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 5 Nutrition of the patient with major burns what is NOT TRUE: 1.High calorie feeding reduces mortality 2.Enteral feeding is preferred to parenteral 3.Protein requirement is 1.5- 2g/kg/day 4.Glutamine supplement is not beneficial 5.Hyperglycaemia should be treated aggressively

32. Answer 5 Nutrition of the patient with major burns 1.High calorie feeding reduces mortality is NOT TRUE

33. Question 6 All of the following increase the likelihood of a patient acquiring an antimicrobial-resitant infection EXCEPT: 1.Use of cefotaxime 2.High nursing workload 3.Prolonged MV 4.Brief hospital admission 5.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 7 Critical Illness Polyneuropathy In patients treated by mechanical ventilation more than 5-7 days the incidence of CIPNP is 1.10% 2.20% 3.30% 4.>50%

36. Answer 7 Critical 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 c larithromycin)

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: 1.subclavian-jugular-femoral 2.jugular-femoral-subclavian 3.femoral-subclavian-jugular 4.subclavian-femoral-jugular

42. Answer 10 Preferable placement of CVL is: 1.subclavian-jugular-femoral associated with less 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 Profylactic antibiotics during operation should be continued for: 1. one day 2. 3 days 3. one week 4. should not be 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

51. Question 15 To decrease CO 2 you can: 1. set inspiration- expiration ratio to 1:1 2. increase FiO2 3. decrease frequency 4. increase PS

52. Answer 15 To decrease CO 2 you can: 4. increase PS

53. Question 16 At the FIFA ranking, The Netherlands are placed: 1.1st 2.2nd 3.3rd 4.6th

54. Answer 16 At the FIFA ranking, The Netherlands are placed: 2. 2nd (after Spain)

55. 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? ……

56. Answer 17 A patient opens his eyes on pain stimulus, bows one of his arms, but don’t make a sound. What is the GCS? 2+4+1=7

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

58. Answer 18 A patient opens his eyes when talked to, localize, and speak single words. What is the GCS? 3+5+3=11

59. Question 19 A patients is ventilated with 5 PEEP and PS of 5. A tracheostoma has just been placed. When can you start weaning?: 1. immedietly 2. after 2 days 3. after 1 week 4. after 1-2 weeks

60. Answer 19 A patients is ventilated with 5 PEEP and PS of 5. A tracheostoma has just been placed. When can you start weaning?: 1. immedietly

61. Question 20 In a septic patient albumin should be given in case of: 1.hypotension 2.hypoalbuminaemia 3.if vasopressors are at maximum dose 4.there is no evidence that albumin is beneficial

62. Answer 20 In a septic patient albumin should be given in case of: 4. there is no evidence that albumin is beneficial

63. and the winner is....?