Multiple Choice Questions (MCQ)

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Category: Critical Care Medicine-Gastrointestinal, Nutrition and Genitourinary Disorders--->Genitourinary
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Question 1# Print Question

A 38-year-old male suffered two gunshot wounds to the abdomen and was admitted to the ICU after an exploratory laparotomy with small bowel resection, sigmoid colon resection, and one intraabdominal drain placement. Postoperatively, the patient is extubated in the ICU without complications. On postoperative day # 1, he acutely develops decreasing urine output, rising creatinine, and drain output with moderate serous output. The ICU team suspects Acute Kidney Injury. They obtain a fractional excretion of urine sodium, which is between 1% to 2%, and a bedside renal ultrasound demonstrates a normal collecting duct system.

What is the BEST next step? 

A. Continue to monitor and discuss fluid balance
B. Intra-abdominal drain studies
C. CT abdomen and pelvis
D. Patient is stable, send to the floor, and have the surgical team obtain a nephrology consult

Question 2# Print Question

A 65-year-old patient 12 hours status post renal biopsy presents to the ICU with gross hematuria, acute blood loss anemia, and tachycardia. After two units of packed RBCs and DDAVP, with a normal INR and platelet counts, the patient continues to have significant gross hematuria with continued tachycardia and downtrending hemoglobin with a systolic blood pressure of 90 mm Hg.

What is the next BEST step?

A. Surgical and Interventional radiology consultation
B. CT angiography of the abdomen
C. Continue to monitor and transfuse as needed
D. Start Levophed

Question 3# Print Question

A 25-year-old male was involved in a motor vehicle crash in which he was clearly intoxicated. On presentation to the emergency department he is tachycardic and hypotensive and has suffered bilateral superior and inferior pubic rami fractures, with resulting acute blood loss anemia. He is transfused two units of packed RBCs. On presentation to the ICU, his blood pressure remains 100/70 mm Hg. On complete evaluation of the patient, you notice a small amount of blood at the penile meatus and no foley had been placed in the ED.

What is the NEXT appropriate management of this patient?

A. No need for foley placement as he is alert with stable vital signs. Once he voids, send for urinalysis
B. Place a foley and obtain a urinalysis
C. CT Cystogram
D. Retrograde Urethrogram

Question 4# Print Question

All the medications below can lead to acute urinary retention EXCEPT:

A. Dopamine
B. Diltiazem infusion
C. Phenylephrine
D. Hydralazine

Category: Critical Care Medicine-Gastrointestinal, Nutrition and Genitourinary Disorders--->Genitourinary
Page: 1 of 1