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Module 15 · Anaesthesia Blueprints

Critical care medicine: exam notes and MCQs

Prepare critical care medicine for postgraduate anaesthesia examinations with structured notes, exam-style questions and referenced explanations from standard textbooks and current guidelines.

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Exam notes in this module

Sepsis, septic shock and ARDS
Sepsis-3 definitions, early resuscitation and lung-protective ventilation.
Mechanical ventilation — modes, settings and weaning
Physiology of positive pressure, common modes, lung-protective settings, asynchrony and liberation.
Acute kidney injury and renal replacement therapy
Definitions, causes, prevention, indications, modalities, dose and anticoagulation.
Brain(stem) death and organ donor care
Preconditions, clinical testing, apnoea test, ancillary tests, legal framework in India and donor management.
Anaesthesia and critical care for burns
Burn size, inhalation injury, fluid resuscitation, drug changes, theatre management and complications.
Sedation, analgesia, delirium and ICU liberation
PADIS principles, sedation scales and drugs, delirium detection, and the ABCDEF bundle.
Acid–base, fluids and electrolyte emergencies in ICU
A step-by-step ABG method, anion gap and delta ratio, fluid choice, and sodium, potassium and glucose emergencies.
Poisoning and toxicology for the anaesthesiologist
General approach, toxidromes, and specific management of organophosphates, paracetamol, methanol, snakebite and carbon monoxide.
Perioperative fluid therapy
Body fluid compartments, the revised Starling principle, crystalloids vs colloids, maintenance prescribing, goal-directed therapy and fluid overload.

Sample questions

Q1. ARDSNet lung-protective ventilation uses a tidal volume of:

  1. 4 mL/kg PBW
  2. 6 mL/kg PBW
  3. 8 mL/kg actual weight
  4. 10 mL/kg PBW
Show answer

Answer B: 6 mL/kg PBW

6 mL/kg predicted (ideal) body weight, with plateau pressure below 30 cmH2O. Higher PEEP and prone positioning help in severe ARDS (PaO2/FiO2 below 150).

Exam style: DHA

Q2. For sepsis-induced hypoperfusion, current guidance recommends initial resuscitation with:

  1. 10 mL/kg colloid within 1 hour
  2. At least 30 mL/kg crystalloid within the first 3 hours
  3. 20 mL/kg 5% albumin within 6 hours
  4. Fluid only after vasopressors have been started
Show answer

Answer B: At least 30 mL/kg crystalloid within the first 3 hours

At least 30 mL/kg of balanced crystalloid should be given within the first three hours of resuscitation, guided thereafter by dynamic measures of fluid responsiveness, lactate and capillary refill, with noradrenaline as first-line vasopressor to a MAP ≥ 65 mmHg.

Exam style: NEET-SS Critical Care

Q3. Which finding defines KDIGO stage 3 acute kidney injury?

  1. Serum creatinine 1.5–1.9 × baseline
  2. Urine output < 0.5 mL/kg/h for 6–12 h
  3. Serum creatinine ≥ 3 × baseline, or urine output < 0.3 mL/kg/h for ≥ 24 h, or anuria for ≥ 12 h
  4. Rise in creatinine ≥ 0.3 mg/dL within 48 h
Show answer

Answer C: Serum creatinine ≥ 3 × baseline, or urine output < 0.3 mL/kg/h for ≥ 24 h, or anuria for ≥ 12 h

KDIGO stage 3: creatinine ≥ 3.0 × baseline OR creatinine ≥ 4.0 mg/dL OR initiation of RRT (or eGFR < 35 in < 18 y), OR urine output < 0.3 mL/kg/h for ≥ 24 h, OR anuria ≥ 12 h.

Exam style: NEET-SS Critical Care

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