Clinical Question Banks

Acute, diffuse inflammatory lung injury causing hypoxemia and bilateral infiltrates not fully explained by cardiac failure or fluid overload.

Core taxonomy (Types I–IV), alveolar gas exchange physiology, work-of-breathing mechanics, and escalation thresholds in acute respiratory failure.

Complete clinical topic overview. For the full 10-level interactive course, visit Master MV. Covers core ventilator modes, respiratory mechanics (Cstat, Raw, driving pressure), waveform dyssynchrony analysis, VILI prevention, and liberation protocols.

Tension physiology, point-of-care ultrasound diagnosis, needle/finger/tube thoracostomy, and management of bronchopleural fistulas on mechanical ventilation.

Pathophysiologic mechanisms (shunt vs V/Q mismatch), dynamic ROX index trajectories, P-SILI prevention, and evidence-based oxygen escalation ladders.

Mechanism-based diagnosis of acute and acute-on-chronic hypercapnia, controlled oxygen, NIV, invasive ventilation, auto-PEEP troubleshooting, neuromuscular monitoring, and post-acute planning.

Pathophysiology of acute-on-chronic hypercapnia, controlled oxygen targets (88–92%), evidence-based NIV, and auto-PEEP matching mechanics.

Pathophysiology of dynamic hyperinflation, auto-PEEP hemodynamics, stepped acute pharmacotherapy, and ventilator mechanics in status asthmaticus.

IDSA/ATS severe CAP criteria, rapid microbiology, targeted empiric antimicrobial regimens, and landmark adjunctive hydrocortisone evidence (CAPE COD).

Pulmonary vascular occlusion, acute RV pressure overload, ESC/AHA risk stratification, systemic thrombolysis, catheter-directed therapies, and hemodynamic support.

Acute exacerbation and decompensated ILD: differential diagnosis, HRCT patterns, oxygen/NIV/HFNC, ventilation strategy, immunosuppression limits, and transplant decisions.

Pattern-based ICU pneumonia approach: severe CAP, HAP/VAP, aspiration, viral, necrotizing, immunocompromised and nonresolving pneumonia.

Airway-first management of clinically significant hemoptysis with localization, bronchoscopy and bronchial artery embolization

Diagnosis and source control of complicated parapneumonic effusion and empyema with drainage, tPA/DNase and surgical escalation

Safe diagnostic and therapeutic bronchoscopy in hypoxemic, mechanically ventilated and bleeding ICU patients

Cellular dysoxia, DO2/VO2 physiology, the 4 shock phenotypes, dynamic fluid responsiveness (PLR/PPV) vs fluid tolerance (VExUS), and vasoactive pharmacology.

Hydrostatic pulmonary edema physiology, SCAPE vs decompensated HF vs cardiogenic shock, NIV, titrated vasodilators when hypertensive, diuresis, and sequential nephron blockade.

The subset of sepsis with profound circulatory and cellular/metabolic abnormality — clinically identified by a vasopressor requirement to maintain MAP ≥ 65 mmHg plus lactate > 2 mmol/L despite adequate fluid resuscitation.

Primary pump failure, SCAI staging (A–E), PAC hemodynamics (CPO, PAPi), inotrope selection, emergent revascularization, and mechanical circulatory support.

Extracardiac mechanical barriers to filling or ejection: Massive PE, Cardiac Tamponade, Tension Pneumothorax, and Auto-PEEP.

RV anatomy and ischemia spiral, ventricular interdependence (D-sign), echocardiographic metrics (TAPSE, S', PAPi, VExUS), and the 4-pillar resuscitation strategy.

Algorithmic tachy- and bradyarrhythmia management, new-onset ICU atrial fibrillation, wide-complex tachycardia differentiation, and refractory Torsades overdrive pacing protocols.

Plaque rupture, coronary thrombosis, STEMI vs NSTEMI risk stratification, emergent reperfusion, DAPT/anticoagulation, and mechanical/electrical ICU complications.

Hemodynamic phenotypes (SCAPE vs ADHF vs Cardiogenic Shock), non-invasive positive pressure ventilation, high-dose vasodilator algorithms, loop diuretics, and sequential nephron blockade.

Multimodal resuscitation, post-cardiac arrest syndrome management, targeted temperature control, and delayed neuroprognostication.

Emergency classification, anti-impulse medical stabilization, and surgical vs endovascular management of aortic dissection, intramural hematoma, and penetrating atherosclerotic ulcer.

Target organ damage assessment, intravenous antihypertensive titration, and emergency-specific blood pressure targets.

Hemodynamic classification, right ventricular afterload reduction, selective pulmonary vasodilation, and pulmonary hypertensive crisis management.

Critical AS, acute AR/MR mechanics, prosthetic valve emergencies, and infective endocarditis with multidisciplinary surgical triggers.

Transient stress-associated ventricular dysfunction that can mimic ACS and cause pulmonary edema, arrhythmia, LVOTO, thrombus, or cardiogenic shock.

From arterial and venous waveforms to PA catheterization, echo, fluid responsiveness, pressure-volume loops, and integrated shock phenotyping.

Principles of convection vs diffusion, filtration fraction, delivered effluent dosing (20–25 mL/kg/h), Regional Citrate Anticoagulation, and citrate toxicity.

Stepwise 6-step interpretation algorithm, compensation formulas, albumin-corrected anion gap, delta ratio, and Stewart physicochemical (SID) principles.

Differential diagnosis (GOLD MARK vs HARDCARP), toxic alcohol osmolar gaps, Urine Anion Gap, and current sodium bicarbonate evidence including BICAR-ICU and BICARICU-2.

Nernst resting potential mechanics, ECG progression, the 3-step resuscitation framework (Stabilize, Shift, Eliminate), and post-dialysis rebound kinetics.

Sepsis-AKI microcirculatory decoupling, KDIGO staging, Furosemide Stress Test (FST), urine microscopy, and the AEIOU dialysis threshold framework.

Tonicity assessment, etiologic classification, 3% hypertonic saline bolus protocols, individualized ODS-safe correction limits, DDAVP relowering, DI diagnostics, and evidence-aware hypernatremia correction.

ICU care of the kidney-transplant recipient: allograft dysfunction, vascular/urologic emergencies, rejection, infection, immunosuppression toxicity and renal replacement decisions

Quantitative lower tract sampling (ETA vs BAL), rapid multiplex PCR panels and stewardship interpretation, PK/PD extended beta-lactams, 7-day duration, and the SHEA prevention bundle.

Nosocomial pneumonia developing ≥ 48 hours after admission in non-ventilated patients, host and antibiogram MDR risk tailoring, nasal MRSA PCR screening, and 7-day de-escalation.

Molecular resistance mechanisms (ESBL, AmpC, KPC, NDM, OXA-48, DTR-Pseudomonas, CRAB), the MERINO trial, and modern novel beta-lactamase inhibitor therapeutics.

Life-threatening organ dysfunction caused by a dysregulated host response to infection — recognized by an acute rise in SOFA score, not by infection plus fever alone.

A surgical source-control emergency: recognize rapidly progressive deep infection, involve surgery immediately, start broad antimicrobials, resuscitate shock, and re-explore until source control is complete.

Host immune defects, neutropenic sepsis, acute respiratory failure (PJP/Aspergillus), tumor lysis syndrome, leukostasis, CAR-T CRS/ICANS, and ICU triage.

ICU recognition and treatment of candidemia and invasive candidiasis, including source control, repeat cultures, step-down therapy and metastatic infection.

Recognition and rescue management of fulminant C. difficile infection with shock, ileus or toxic megacolon.

Time-critical ICU management of fever and organ dysfunction during neutropenia, with early antipseudomonal therapy and source-directed escalation.

ARAS neuroanatomy, structural vs toxic-metabolic coma, the comprehensive Coma Exam (pupils, cold calorics, posturing), FOUR score, and CAM-ICU delirium.

Recognition and time-sensitive escalation of care for prolonged or repeated seizures.

Monro-Kellie doctrine, ICP waveforms (P2>P1, Lundberg A-waves), CPP targets (60–70 mmHg), herniation syndromes, and the 4-tier BTF management protocol.

2023 AAN/AAP/CNS/SCCM consensus guideline: prerequisites, brainstem reflex examination, apnea testing on and off ECMO, valid ancillary tests, plus separate post-declaration donor-management principles.

Core vs penumbra dynamics, ASPECTS & CT perfusion, Tenecteplase/Alteplase thrombolysis, DAWN/DEFUSE 3 extended thrombectomy, BP targets, and malignant MCA hemicraniectomy.

Spontaneous ICH vs Aneurysmal SAH, INTERACT-2/ATACH-2 blood pressure targets, emergency anticoagulant reversal, ENRICH minimally invasive evacuation, ISAT coiling, and Nimodipine for delayed cerebral ischemia.

Severe TBI neurocritical care: prevent hypoxemia/hypotension, treat intracranial hypertension, individualize ventilation/CPP, use evidence-based short antiseizure prophylaxis when chosen, and escalate surgery when indicated.

CT-before-LP criteria, CSF interpretation matrix, de Gans Dexamethasone timing, empiric age/host antimicrobial coverage + Ampicillin + Acyclovir, and neurocritical ICP management.

Analgesia-first sedation, light sedation targets, ABCDEF bundle, spontaneous breathing trials, and non-pharmacologic delirium mitigation.

Critical illness polyneuropathy and myopathy: recognition, risk reduction, diagnostic approach, ventilator liberation, rehabilitation, and prognosis.

Dedicated ICU management of myasthenic crisis: respiratory mechanics, airway timing, IVIG/plasma exchange, trigger control, medication hazards, and extubation.

Dedicated ICU GBS care: respiratory surveillance, autonomic instability, IVIG/plasma exchange, airway strategy, pain/DVT prevention, and complications.

Hyperammonemia, cytotoxic cerebral edema, balanced coagulopathy, N-acetylcysteine, 3% saline neuroprotection, CRRT ammonia clearance, and King's College transplant criteria.

Revised Atlanta severity staging, goal-directed fluid resuscitation informed by WATERFALL, oral/enteral nutrition as tolerated, antibiotic avoidance in sterile necrosis, and the PANTER step-up approach.

Risk-stratified non-variceal and variceal hemorrhage care: resuscitation, selective airway protection, individualized transfusion, PPI or portal-pressure therapy, endoscopic hemostasis, and escalation to IR/TIPS/surgery when indicated.

Risk stratification, selective assessment for an upper source, CTA localization of ongoing severe bleeding, endoscopic or catheter therapy, and individualized transfusion/resuscitation.

Rapid biphasic CTA diagnosis, mechanism-specific revascularization (embolism vs thrombosis vs venous thrombosis vs NOMI), individualized therapeutic anticoagulation, and selective second-look laparotomy.

Phased energy and protein delivery, early enteral nutrition when safe, indirect calorimetry, refeeding prevention, feeding-intolerance troubleshooting, and individualized parenteral nutrition timing.

Recognition and organ-support of decompensated cirrhosis and acute-on-chronic liver failure, including bleeding, infection, encephalopathy and transplant triage

Diagnosis and ICU management of HRS-AKI with albumin, vasoconstrictors, respiratory-safety monitoring, RRT and transplant planning

Recognition, antibiotics, resuscitation and urgent biliary source control for severe cholangitis and septic shock

ICU approach to perforation, abscess, postoperative leak, ischemic bowel and complicated intra-abdominal infection

Immediate and subsequent ICU care after liver transplantation: donor type and ischemia exposure, hemodynamics, graft dysfunction, vascular/biliary complications, rejection, infection, AKI, neurotoxicity and immunosuppression

The trauma lethal diamond (hypothermia, acidosis, coagulopathy, hypocalcemia), 1:1:1 massive transfusion (PROPPR trial), early TXA (CRASH-2), and TEG/ROTEM algorithms.

Tissue-factor-driven coagulation activation, antithrombin/protein C depletion, PAI-1-associated fibrinolytic suppression, ISTH 2025 DIC assessment, comparison with TTP/HUS/HIT, and targeted replacement.

PF4-heparin antibody Fc-gamma-RIIa platelet activation, the 4Ts score, ELISA OD values vs Serotonin Release Assay (SRA), and direct thrombin inhibitor protocols.

Patient-specific RBC transfusion thresholds, current platelet/procedural thresholds, plasma/cryoprecipitate use, and the TRALI vs TACO diagnostic matrix.

UFH vs LMWH vs DTIs (Argatroban/Bivalirudin), anti-Xa vs aPTT monitoring, and emergency reversal (Protamine, 4F-PCC, Idarucizumab; historical andexanet evidence with current availability caveats).

Recognition of thrombotic microangiopathy, PLASMIC risk, ADAMTS13 testing, immediate plasma exchange, steroids, caplacizumab, and ICU complications.

ICU approach to isolated immune thrombocytopenia, bleeding severity, IVIG/steroids, platelet transfusion in critical bleeding, and rescue therapy.

Risk-stratified prevention and ICU treatment of tumor lysis syndrome with hyperkalemia, hyperphosphatemia, hypocalcemia, hyperuricemia and AKI.

Adult ICU recognition, trigger investigation and individualized treatment of hemophagocytic lymphohistiocytosis/macrophage activation syndrome.

Read whole-blood clot initiation, propagation, firmness and lysis without treating device-specific values as universal transfusion orders.

The 7 Ps of ICU intubation, the physiologically difficult airway, BOUGIE/DEVICE video laryngoscopy trials, hemodynamic optimization, waveform capnography, and scalpel-bougie cricothyroidotomy.

Ultrasound-guided vascular access, sterile insertion, tip/position confirmation, and rapid recognition of line-related mechanical and infectious complications.

Ultrasound-guided pleural drain selection, insertion safety, troubleshooting and complication management in critically ill adults.

Systematic evaluation of failed liberation, tracheostomy timing/selection, cuff and secretion management, and multidisciplinary weaning.

Pathophysiology, SGLT2i euglycemic DKA, balanced fluid resuscitation, potassium-before-insulin safety rules, dextrose addition kinetics, and subcutaneous transition.

ICU recognition and treatment of severe hyperglycemia, hyperosmolality and dehydration with careful fluid, potassium and insulin sequencing.

Time-critical recognition and empiric treatment of acute cortisol deficiency causing shock, electrolyte disturbance and hypoglycemia.

Bedside recognition and organ-support priorities for thyroid storm, myxedema coma, adrenal crisis, pheochromocytoma crisis, and severe hypercalcemia.

Clinical diagnosis and ICU treatment of decompensated thyrotoxicosis with adrenergic, cardiovascular, neurologic and thermoregulatory failure.

Recognition and ICU treatment of decompensated profound hypothyroidism with altered mental status and multiorgan dysfunction.

ICU evaluation of hypotonic polyuria and hypernatremia with safe fluid replacement, desmopressin use, and differentiation of AVP deficiency from osmotic and nephrogenic causes.

Maternal physiology, preeclampsia/eclampsia, HELLP vs AFLP, postpartum hemorrhage (MTP/TXA), peripartum cardiomyopathy, and arrest.

Resuscitate first, identify toxidromes and ECG/acid-base threats, use toxin-specific antidotes, and escalate early to poison-center, extracorporeal, or ECLS support when physiology demands it.

Safe ICU use of antipsychotics: delirium evidence, agitation control, QTc/torsades risk, NMS, EPS, interactions, and deprescribing.

Recognition and treatment of severe withdrawal, delirium tremens and withdrawal seizures with symptom-triggered or front-loaded GABAergic therapy.

Bedside differentiation and ICU management of serotonin toxicity versus neuroleptic malignant syndrome.

Recognition and resuscitation of sodium-channel blocker poisoning with seizures, QRS widening, ventricular dysrhythmia and shock.

Specialist-level VV/VA ECMO bedside management: selection, cannulation, gas exchange, hemodynamics, anticoagulation, circuit troubleshooting, organ support, ultrasound, ECPR, weaning and decannulation.

Inhalation injury management, endpoint-driven fluid resuscitation, avoidance of fluid creep, bedside escharotomy, and hypermetabolic catabolism support.

Recognition and treatment of intra-abdominal hypertension and abdominal compartment syndrome: bladder pressure, perfusion, decompression, fluids, ventilation, and organ failure.

Immediate epinephrine-first management of airway edema, bronchospasm, vasoplegia and refractory anaphylactic shock in the ICU.

Structured ICU communication, surrogate decision-making, treatment-limitation decisions, symptom control, and compassionate withdrawal of life-sustaining treatment.

Ethically separated death determination, timely organ-procurement referral, and physiology-focused donor support after BD/DNC or planned donation after circulatory death.

Prevention, recognition and follow-up of physical, cognitive and psychological morbidity after critical illness, including ICU-acquired weakness and family impact.

ICU priorities after major multisystem trauma: hemorrhage control, damage-control resuscitation, TBI-aware perfusion, coagulopathy correction, compartment syndromes and staged definitive care.

Systematic postoperative ICU surveillance for bleeding, respiratory failure, myocardial injury, AKI, delirium, infection, pain, nutrition and safe device removal.