Multiple Choice Questions (MCQ)

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Category: Critical Care Medicine-Surgery, Trauma, and Transplantation--->Hemorrhage and Resuscitation
Page: 2

Question 6# Print Question

A 76-year-old female with a history of hepatitis C cirrhosis and CAD status post three-vessel coronary artery bypass grafting (CABG) 2 years prior is admitted to the ICU with 1 day of melena and hematemesis. She has another episode of hematemesis on arrival to the ICU, with 50 mL bright red blood collected in a basin. Initial vital signs are:

  • HR 105
  • BP 96/45
  • RR 14
  • SpO2 99% on room air

Labs return with:

  • Hgb 7.8
  • platelets 76
  • electrolytes within normal limits
  • lactate 1.8

Large bore IV access is established, and the plan is made for an esophagogastroduodenoscopy (EGD).

What is the best transfusion threshold in this patient? 

A. Transfuse for Hgb <9 g/dL
B. Transfuse for Hgb <7 g/dL
C. Transfuse for platelets <100 000/mm3
D. Transfuse for MAP <65

Question 7# Print Question

A 34-year-old female with no significant past medical history is now gravida 2, para 2 (G2P2) after cesarean section of a term neonate for placenta accreta. Large bore IV access was established preoperatively, and a type and screen was sent in anticipation of intraoperative blood loss. The patient’s blood type is O, and she is RhD−.

Which blood product is most suitable to transfuse?

A. FFP, type AB, RhD+
B. Platelets, type AB, RhD+
C. FFP, type O, RhD−
D. Platelets, type O, RhD−

Question 8# Print Question

A 34-year-old male with a history of Hodgkin lymphoma and atrial fibrillation on warfarin presents after a 5-foot fall from a ladder. He was intubated in the field because of obtundation, and a noncontrast head computed tomography (CT) on arrival demonstrates a left subdural hematoma with midline shift. Other trauma burden on primary survey includes left-displaced radial fracture and contusions to the left side of the thorax. The patient is sent to the OR for emergent craniotomy for decompression. Vital signs on arrival to the OR are:

  • HR 95
  • BP 96/47
  • SpO2 95% on 100% FiO2

labs show:

  • Hgb 6.5 g/dL
  • platelets 56 000/mm3

How should blood products be prepared for this patient?

A. Leukoreduction
B. Washing
C. Irradiation
D. No special preparation needed

Question 9# Print Question

A 19-year-old male who sustained two gunshot wounds to the chest is brought in by ambulance. His initial vitals are BP 75/30 and HR 144. While securing the airway, large bore IV access is established.

Which of the following catheters is the best choice for rapid volume resuscitation?

A. 18G 45 mm catheter
B. 16G 50 mm catheter
C. 18G port on a triple lumen central line
D. 16G port on a triple lumen central line

Question 10# Print Question

A 45-year-old female with no past medical history is brought in via ambulance after a motor vehicle accident. Her initial vitals are BP 62/30 and HR 157. On primary survey, she is noted to have significant ecchymosis across her abdomen. Focused assessment with sonography in trauma (FAST) is positive, and she is taken emergently to the OR for ex-lap. In the OR, they find multiple liver lacerations with diffuse bleeding. Along with volume resuscitation, what would be a useful adjunct to obtain hemostasis?

A. Cryoprecipitate in equal numbers with PRBCs
B. Prothrombin complex concentrate
C. Vitamin K
D. Tranexamic acid

Category: Critical Care Medicine-Surgery, Trauma, and Transplantation--->Hemorrhage and Resuscitation
Page: 2 of 2