Facharzt FMH Intensivmedizin Practice Questions - Facharzt FMH für Intensivmedizin Spécialiste FMH en médecine intensive Exam - Facharzt FMH Intensivmedizin Practice Questions - Facharzt FMH für Intensivmedizin Spécialiste FMH en médecine intensive Exam

Question 1

A 68-year-old man is admitted to the ICU with septic shock secondary to acute ascending cholangitis. After receiving 30 mL/kg of balanced crystalloids, his mean arterial pressure (MAP) is 52 mmHg, heart rate is 118 bpm, and central venous lactate is 4.2 mmol/L. Bedside echocardiography demonstrates a hyperdynamic left ventricle without pericardial effusion. According to the Surviving Sepsis Campaign (SSC) guidelines, what is the initial vasopressor strategy of choice?

Initiate norepinephrine as the first-line vasopressor to target a MAP ≥ 65 mmHg, and add vasopressin (0.03 units/min) if norepinephrine dosage escalates Initiate dopamine monotherapy at 10-20 mcg/kg/min to increase both systemic vascular resistance and renal blood flow Start phenylephrine infusion as the first-line agent to avoid worsening tachycardia while achieving vasoconstriction Administer epinephrine monotherapy as the first-line vasopressor before attempting any other catecholamine

Correct Answer:

Initiate norepinephrine as the first-line vasopressor to target a MAP ≥ 65 mmHg, and add vasopressin (0.03 units/min) if norepinephrine dosage escalates

Question 2

A 58-year-old intubated woman with severe bilateral pulmonary infiltrates and refractory hypoxemia undergoes transpulmonary thermodilution monitoring (PiCCO). The device reports an Extravascular Lung Water Index (EVLWI) of 16 mL/kg (normal 3-7 mL/kg), a Pulmonary Vascular Permeability Index (PVPI) of 3.8 (normal 1.0-3.0), and a Global End-Diastolic Volume Index (GEDVI) of 680 mL/m² (normal 680-800 mL/m²). How should these hemodynamic findings be interpreted?

Cardiogenic pulmonary edema due to left ventricular volume overload and elevated hydrostatic pressures Non-cardiogenic pulmonary edema characteristic of Acute Respiratory Distress Syndrome (ARDS) with increased capillary permeability Severe intravascular hypovolemia without true pulmonary parenchymal fluid accumulation Isolated right ventricular failure with pulmonary arterial hypertension and normal alveolar permeability

Correct Answer:

Non-cardiogenic pulmonary edema characteristic of Acute Respiratory Distress Syndrome (ARDS) with increased capillary permeability

Question 3

A patient with a pulmonary artery catheter (PAC) in place exhibits the following hemodynamic profile: Mean Arterial Pressure (MAP) 55 mmHg, Central Venous Pressure (CVP) 18 mmHg, Pulmonary Artery Occlusion Pressure (PAOP) 22 mmHg, Cardiac Index (CI) 1.6 L/min/m², Systemic Vascular Resistance Index (SVRI) 2600 dyn·s·cm⁻⁵·m², and Mixed Venous Oxygen Saturation (SvO2) 48%. Which clinical condition is most consistent with these measurements?

Early hyperdynamic septic shock Severe unresuscitated hemorrhagic hypovolemic shock Acute cardiogenic shock secondary to extensive anterior myocardial infarction Massive acute pulmonary embolism with acute cor pulmonale

Correct Answer:

Acute cardiogenic shock secondary to extensive anterior myocardial infarction

Question 4

An intensivist assesses fluid responsiveness in a 64-year-old mechanically ventilated patient with septic shock who has spontaneous respiratory efforts and sinus tachycardia. Which diagnostic maneuver provides the highest diagnostic accuracy to predict an increase in cardiac output with volume administration?

Measurement of Central Venous Pressure (CVP) target of 12 mmHg Calculation of Inferior Vena Cava (IVC) respiratory collapsibility index on M-mode ultrasound Pulse Pressure Variation (PPV) calculation during spontaneous breathing Passive Leg Raising (PLR) test coupled with continuous real-time stroke volume monitoring

Correct Answer:

Passive Leg Raising (PLR) test coupled with continuous real-time stroke volume monitoring

Question 5

On day 4 following an extensive anterior STEMI, a 71-year-old man abruptly develops severe dyspnea, hypotension (BP 78/44 mmHg), and a new harsh holosystolic murmur with a palpable thrill at the lower left sternal border. Pulmonary artery catheterization reveals a right atrial oxygen saturation of 58% and a pulmonary artery oxygen saturation of 82%. What is the definitive diagnosis?

Post-infarction Ventricular Septal Rupture (VSR) Acute papillary muscle rupture with severe mitral regurgitation Left ventricular free wall rupture with acute cardiac tamponade Acute pulmonary embolism complicating myocardial infarction

Correct Answer:

Post-infarction Ventricular Septal Rupture (VSR)

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Prepare with the Facharzt FMH Intensivmedizin Practice Questions - Facharzt FMH für Intensivmedizin Spécialiste FMH en médecine intensive Exam practice quiz. This question bank includes 100 questions covering year-old, mmhg, pressure, severe, and patient. Use it to review important concepts, identify knowledge gaps, and build confidence for the related exam, course, or assessment.

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Facharzt FMH Intensivmedizin Practice Questions - Facharzt FMH für Intensivmedizin Spécialiste FMH en médecine intensive Exam

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Facharzt FMH Intensivmedizin Practice Questions - Facharzt FMH für Intensivmedizin Spécialiste FMH en médecine intensive Exam

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