ACCS ACCS Neurological and Renal Care

Question 1

A critically ill patient has a Glasgow Coma Scale (GCS) score of 8. What is the priority intervention?

Accepted Answer

Secure the airway with endotracheal intubation

Answer

Administer IV fluids

Answer

Obtain a CT scan immediately

Answer

Start empiric antibiotics

Question 2

Which finding on a head CT is most consistent with increased intracranial pressure (ICP) requiring urgent intervention?

Accepted Answer

Midline shift greater than 5 mm

Answer

Diffuse cerebral atrophy

Answer

Small subdural hematoma without mass effect

Answer

Mild cerebral edema

Question 3

What is the recommended cerebral perfusion pressure (CPP) target in patients with traumatic brain injury?

Accepted Answer

60–70 mmHg

Answer

40–50 mmHg

Answer

50–60 mmHg

Answer

80–90 mmHg

Question 4

A patient with acute kidney injury (AKI) in the ICU develops a potassium level of 6.8 mEq/L with peaked T waves on ECG. What is the first-line emergency treatment?

Accepted Answer

Calcium gluconate IV

Answer

Sodium bicarbonate IV

Answer

Furosemide IV

Answer

Kayexalate (sodium polystyrene sulfonate)

Question 5

According to the KDIGO criteria, which of the following defines Stage 3 acute kidney injury?

Accepted Answer

Creatinine increase ≥3× baseline or initiation of renal replacement therapy

Answer

Creatinine increase ≥0.3 mg/dL within 48 hours

Answer

Creatinine increase ≥1.5× baseline within 7 days

Answer

Urine output <0.5 mL/kg/hr for 6 hours

Question 6

Which continuous renal replacement therapy (CRRT) mode removes both solutes by diffusion and convection?

Accepted Answer

Continuous venovenous hemodiafiltration (CVVHDF)

Answer

Continuous venovenous hemofiltration (CVVH)

Answer

Continuous venovenous hemodialysis (CVVHD)

Answer

Slow continuous ultrafiltration (SCUF)