Critical Care 3

21. Factors that determine cardiac output are all of the listed below, EXCEPT:

Cardiogenic shock results from:

Which of the following is TRUE regarding phosphodiesterase inhibitors?

20. The direct Fick method determines cardiac output as a measure of:

Treatment of low cardiac output does NOT include:

Which of the following is NOT an appropriate treatment for a patient with multiple rib fractures?

16. The diagnostic imaging “gold standard” for aortic injury is:

5. The best method of identifying and localizing traumatic tracheobronchial injuries is:

9. A 35 year-old man presents to your ER after a stab wound to the epigastrum. He is awake, tachycardic and diaphoretic. As you are performing a FAST exam, he loses consciousness and becomes pulseless. You note moderate fluid in the pericardial space. The most appropriate next step is:

8. A 43 year-old man presents with a stab wound to the left flank. Other than some pain at the stab wound site, he reports no symptoms. There is no pneumothorax on CXR. The remainder of his exam in unremarkable. What is the most appropriate next step?

Which of the following structures CANNOT be easily reached from a right posterolateral thoracotomy?

7. A 24 year-old man presents to the ER via ambulance after sustaining a gunshot wound to the right chest. He is slightly tachycardic, but not hypotensive and he is oriented despite the smell of alcohol on his breath. A CXR reveals a pneumothorax on the right. Tube thoracostomy is performed and food particles are noted in the atrium reservoir. How would you repair this injury?

6. Of the following fractures, which is most likely to be associated with a concomitant injury?

Which of the following may NOT be amenable to treatment via VATS?

15. In a patient with a traumatic hemopneumothorax, which of the following is NOT an indication for urgent exploration?

3. During exploration for a stab wound to the chest, you encounter an injury to the mid LAD. What is the best next step in management?

1. A 23 year-old female undergoes an emergent left anterolateral thoracotomy in the emergency department following a single stab wound to the heart. She is noted to have a full thickness defect in the wall of the right ventricle. Which of the following is NOT an appropriate method of temporary damage control?

14. A 36-year-old female presents to your trauma center following a single vehicle accident. She was an unrestrained rear-seat passenger and there was a death in the same vehicle. As she is turned to remove the EMS backboard, she suddenly loses consciousness and no pulse can be palpated. A left anterior thoracotomy is performed and the pericardium is opened, but does not contain a heart. The next appropriate step is to:

13. A 45-year-old male unrestrained driver presents to your trauma center after a head-on motor vehicle accident at moderate speed. He is hemodynamically stable but complains of chest pain. You notice a wide complex QRS on the cardiac monitor. All of the following are part of appropriate management EXCEPT:

1. An obese 55 year-old female with end-stage renal disease undergoes percutaneous placement of a large bore dialysis catheter. Due to numerous other attempts at dialysis catheter placement, the only available point of access was her left subclavian. Just before the dialysis nurse arrives to initiate hemodialysis, she is noted to be hypotensive. On exam, she has very prominent neck veins and her heart sounds are muffled. Of the following, what is the most appropriate next step?