Multiple Choice Questions (MCQ)

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Category: Critical Care Medicine-Cardiovascular Disorders--->Vascular Disorders
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Question 1# Print Question

A 56-year-old male is admitted to the intensive care unit (ICU) with a diagnosis of an acute descending thoracic aortic dissection. Which of the following echocardiographic findings is MOST helpful when distinguishing the true lumen from the false lumen?

A. The false lumen is usually smaller than the true lumen
B. The false lumen expands during systole
C. Intimal remnants (cobwebs) can often be seen in the true lumen
D. Color-flow Doppler pattern is in-phase with the cardiac cycle in the true lumen

Question 2# Print Question

A patient presents to the hospital for elective abdominal aortic aneurysm (AAA) repair. Which of the patients would MOST likely benefit from surgical intervention?

A. A 60-year-old male patient with asymptomatic 5.3-cm aneurysm discovered during abdominal computer tomography (CT) scan for colon cancer staging
B. A 46-year-old male patient with a 5.2-cm aneurysm with back pain
C. A 52-year-old female patient with a 4.9-cm aneurysm awaiting kidney transplant
D. A 40-year-old female patient with a known aneurysm measuring 5.1-cm on follow-up imaging with prior study demonstrating a size of 5.0 cm 2 years ago

Question 3# Print Question

A 78-year-old female with a previous history of a thoracic endovascular aortic repair (TEVAR) complicated by endoleak presents to the ICU after undergoing additional endovascular graft placement for extension of the original repair.

Which of the following IS NOT a risk factor for postoperative spinal cord ischemia (SCI)?

A. History of prior aneurysm repair
B. Extension of the repair to include coverage of the left subclavian artery
C. Mild intraoperative hypothermia
D. Pre-existing chronic renal insufficiency

Question 4# Print Question

A 56-year-old male is diagnosed with a contained rupture of a thoracic aortic aneurysm and was emergently taken to the operating room for thoracic endovascular aortic repair. On postoperative day 1, he begins to complain of loss of motor function in his lower extremities. When reviewing the patient’s medication history, which of the following would place him at highest risk of developing a spinal hematoma after spinal drain placement?

A. Aspirin 81 mg taken the morning of surgery
B. Apixaban stopped 3 days before placement
C. Dabigatran stopped 4 days before placement
D. Enoxaparin DVT prophylaxis 14 hours before placement

Question 5# Print Question

A 59-year-old female with a past medical history of hypertension, chronic kidney disease, and heart failure with preserved ejection fraction underwent repair of AAA.

Which of the following interventions and goals is MOST likely to reduce her risk of postoperative acute kidney injury?

A. Furosemide to maintain urine output >/= 0.5 mL/kg/hr
B. Bicarbonate containing IV fluid to maintain pH >7.3
C. Volume expansion to maintain CI >2.0
D. Mannitol 0.5 g/kg before aortic cross clamp

Category: Critical Care Medicine-Cardiovascular Disorders--->Vascular Disorders
Page: 1 of 2