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Critical Care & Pain Medicine Flashcards

7 cards from real ABA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Critical Care & Pain Medicine flashcards as text

  1. Which vasopressor is recommended as the FIRST-LINE agent in septic shock according to current guidelines?

    Answer: Norepinephrine

    Norepinephrine is the first-line vasopressor for septic shock due to its potent alpha-adrenergic effects with less tachycardia compared to dopamine.

  2. A chronic pain patient on 90 MME/day of oral oxycodone requires conversion to IV morphine infusion. Using standard equianalgesic ratios, what is the appropriate starting IV morphine dose per day?

    Answer: 30 mg/day IV morphine

    Oral oxycodone 90 MME converts to 30 mg/day IV morphine using the equianalgesic ratio (oxycodone oral:morphine IV = 3:1), with clinical titration as needed.

  3. A patient develops ventilator-associated pneumonia (VAP). Which bundle element has the STRONGEST evidence for prevention?

    Answer: Subglottic secretion drainage with specialized ETT

    Subglottic secretion drainage using specialized endotracheal tubes significantly reduces VAP incidence by preventing aspiration of oropharyngeal secretions.

  4. In neuraxial pain management, which complication is MOST specific to intrathecal opioid administration (versus epidural)?

    Answer: Delayed respiratory depression up to 24 hours later

    Intrathecal hydrophilic opioids (e.g., morphine) can cause delayed respiratory depression up to 24 hours post-administration due to cephalad CSF spread to respiratory centers.

  5. Which parameter BEST guides the decision to discontinue vasopressors in a recovering septic shock patient?

    Answer: Lactate clearance >10% and MAP >65 mmHg on decreasing doses

    Serial lactate measurements demonstrating clearance combined with hemodynamic stability on tapering vasopressor doses indicate adequate perfusion restoration.

  6. A patient with postherpetic neuralgia fails gabapentin. Which medication class is the MOST appropriate next-line pharmacological option?

    Answer: Tricyclic antidepressants (e.g., amitriptyline)

    Tricyclic antidepressants have robust evidence for postherpetic neuralgia and are a recommended second-line therapy when gabapentinoids are insufficient or not tolerated.

  7. In ICU patients requiring sedation, which strategy is associated with reduced duration of mechanical ventilation and ICU length of stay?

    Answer: Daily sedation interruption (spontaneous awakening trials)

    Daily sedation interruption (spontaneous awakening trials) paired with spontaneous breathing trials reduces mechanical ventilation duration and ICU length of stay per the ABC trial.