13:00-15:00
1. (CPR) (A) (push fast, 100 ) (B) (adequate ventilation, 20 ) (C) (Complete chest recoil) (D) (minimize interruptions in chest compression) 2. end-tidal CO 2 (A) (B) end-tidal CO 2 (C) (D) 3. (Rapid Sequence Intubation) (A) (B) (C) (D) 4. 1 BMI 16 2 3 4 (Mallampati class) 1 2 5 6 (prominent incisors) (A) 1345 (B) 2356 (C) 1235 (D) 2345 5. sodium bicarbonate (A) (coronary perfusion pressure)
(B) (C) (D) 6. (A) (B) 33 o C (C) 32~34 o C (D) 37 o C 7. (A) 6 (B) basic life support(bls) (C) 24~48 (D) 72 somatosensory-evoked potentials 8. 60 160 QRS (regular narrow QRS complex) adenosine 6mg 5 QRS p 160 5 adenosine 160 regular narrow QRS complex (A) Atrial fibrillation with rapid ventricular response (B) Paroxysmal supra-ventricular tachycardia (C) Atrial tachycardia (D) Ventricular tachycardia
9. 60 12 V3~V5 ST 1.0mm(0.1mV) 10 ST (A) ST-elevation MI (B) Unstable angina/non-st-elevation MI (C) Normal changes in ST segment (D) non-diagnostic changes in ST segment 10. Wide-complex tachycardia 1 (VF) 2 WPW (Af with WPW) 3 aberrancy 4 (VT) 5 (Atrial Flutter) (A) 123 (B) 134 (C) 12345 (D) 1234 11. (polymorphic ventricular tachycardia) (A) (synchronized) (B) Amiodarone (C) (D) Magnesium 12. Amiodarone (A) Atrial fibrillation with rapid ventricular response (B) Torsades de Pointes (C) Hemodynamic stable ventricular tachycardia (D) narrow-complex tachycardia 13. mobitz II 30 80/52 mmhg
(A) Dopamine 5-10 ug/ /min (B) Atropine 0.5 mg (C) (D) 100 14. (pulmonary capillary wedge pressure) (preload) 1 2 3 4 (A) 123 (B) 1234 (C) 12 (D) 124 15. (pulse contour analysis) PiCCO (pulmonary artery catheter) (A) (pulse pressure) (B) (C) (D) (extra-vascular lung water) 16. preload (A) ejection fraction LVEF (B) LVEDV (C) LA pressure (D) LVEDP 17. (A)
(B) (C) 5-7 guide wire (D) 18. (A) Pulmonary artery wedge pressure (B) y descent (C) (D) x descent 19. (A) Tension pneumothorax (B) Cardiac tamponade (C) Neurogenic shock (D) Cardiogenic shock 20. Monitor Cardiac output Ejection fraction (A) EKG (B) Transesophageal echocardiogram (TEE) (C) Pulmonary artery catheter (D) Pulse-induced contour cardiac output (PiCCO) 21. VV-ECMO (A) (B) (C) ARDS (D) venous blood
22. VA-ECMO (A) (B) venous blood (C) systemic embolization (D) 23. intra-aortic balloon pump (A) (B) (C) (D) 24. (A) Vasodilator (B) Dobutamine (C) Dopamine (D) IABP 25. Oxygen delivery (A) PaO 2 : 100 mmhg 150 mmhg (B) SaO 2 : 98% 100% (C) Hb: 7 g/dl 12 g/dl (D) C.O.: 4.5 L/min 5.0 L/min 26. ScvO 2 (central venous oxygen saturation) 45% (A) (B) (C) ScvO 2 (D) ScvO 2
27. (mixed venous oxygen saturation) (A) (B) (C) (D) 28. Pneumonectomy pulmonary hypertensive crisis rescue treatment (A) VV-ECMO (B) VA-ECMO (C) Nitric Oxide inhalation (D) Viagra 29. (acute pulmonary embolism) (A) (proximal deep vein thrombosis) 50% (B) Serum D-dimer test (sensitivity (infection, cancer, trauma etc. Serum D-dimer (C) (heparin, low molecular weight heparin, fondaparinux etc.) 5 international normalized ratio 2.0-3.0 (D) 1-2 30. (end inspiratory hold) (P (T PIP Ppla
P PIP PIP P Plat P Plat T (A) (high resistance) (B) (compliance) (C) (D) 31. (Ventilation mode (Close-loop ventilation (A) ASV (Adaptive Support Ventilation) (B) PRVC (Pressure Regulated Volume Controlled) (C) PSV (Pressure Support Ventilation) (D) PAV (Proportional assist ventilation) 32. (weaning (A) (B) maximum inspiratory pressure (Pimax) Rapid-Shallow Breathing Index (RSI,f/Vt) >105 (SBT, Spontaneous Breathing Trial) (C) (SBT) T (un-assist T- piece) PSV(Pressure Support Ventilation) (D) (NIPPV, Non-invasive Positive Pressure Ventilation) (COPD) 33. (Non-invasive Positive Pressure Ventilator)
(A) (B) (C), (Immunocompromised) (D) (COPD) 34. (Acute Respiratory Distress Syndrome), (A) (Vt) 4-6 ml/kg of PBW (B) (High-Frequency Oscillatory Ventilator) (C) (Prone Position) (D) PEEP(Positive End-Expiratory Pressure) (Lung Recruitment) (Plateau Pressure) 30cmH2O 35. PEEP(Positive End-Expiratory Pressure) (A) PEEP (B) PEEP (C) PEEP intrinsic PEE (D) PEEP Pressure-Volume Curve LIP (Low Inflection Point ) 2 cmh2 36. (oxygenation) (A) (Inhaled Nitric Oxide) (B) PEEP (C) (D) (FiO2>80%)
37. (A) (B) (corticosteroid) (C) (inhaled bronchodilator) (D) (Chest Physiotherapy) 38. COPD A/C mode, FiO2 0.4, f=18( 28/min Vt 400ml (PBW 55kg), PEEP=5cmH2O, I:E=1:1.5, flow=60 litter/min, PIP =42 cmh2o, Minute volume=10.4 litter. 30 ABG PH7.32, PaCO2 70mmHg, PaO2 73 mmhg. SpO2 94% 92/65 (A) machine rate 30/min (B) (C) Vt 500 ml (D) PEEP 10 cmh2o 39. ( ) 2 80/50mmHg SpO2 88-90% 20/min (A) (B) (C) (Brochospasm) (D) (Septic shock)
40. ALI / ARDS (A) (B) (C) (D) 41. ALI/ARDS, (A) ARDS multiple organ failure (B) Transfusion related acute lung injury (TRALI) ALI/ARDS (C) Positive fluid balance (D) ARDS severe hypoxemia 42. NIH ARDSnetwork Low PEEP/FiO2 Table, FiO2 0.8 PEEP cmh2o (A) 8 (B) 10 (C) 12 (D) 14 43. corticosteroid ARDS (A) Moderate-dose corticosteroid early severe ARDS unresolving ARDS 14 (B) Early severe ARDS 1 mg/kg/d Dexamethasone (C) Septic shock and early ARDS, corticosteroid 7 tapering (D) Early ARDS corticosteroid 14 tapering 44. biomarker ALI (A) IL-6
(B) IL-8 (C) Protein C (D) Surfactant protein D 45. predisposing factor ARDS (A) Aspiration (B) Multiple transfusion (C) Sepsis syndrome (D) Drug overdose 46. ARDS combined PEEP and FiO2 oxygenatio PaO2 SpO2 goal (A) PaO2= 90-100 mm Hg SpO2 = 98-99% (B) PaO2= 80-90 mm Hg SpO2 = 95-98% (C) PaO2= 70-80 mm Hg SpO2 = 93-95% (D) PaO2= 55-80 mm Hg SpO2 = 88-95% 47. Recruitment maneuver (RM) ARDS (A) (B) early stage, (C) CPAP 40 cmh2o 40sec 3 (D) 48. (hypoxic respiratory failure) X X 1 2 (right-to-left shunt) 3 4 5 6 (A) 1235 (B) 2345 (C) 12345
(D) 123456 49. (A) (B) (C) (D) 50. (hypercarbic) (hypoxic) 1 ; 2 ;3 (idiopathic pulmonary fibrosis);4 ;5 (myasthenia gravis);6 (A) 134 (B) 234 (C) 156 (D) 356 51. 2008 Surviving Sepsis Campaign: International guidelines for management of severe sepsis and septic shoc (A) (B) colloid fluid crystalloid fluid (C) (D) 52. 55 clindamycin 36 ICU
380 mg/dl (A) (B) (C) (D) cover Gram-negative 53. 80 85/55 mmhg 110/ (stress ulcerations or stress-related erosive syndrome) (A) (B) H2 receptor antagonists, proton-pump inhibitors sucralfate (C) (gastric feedings) (D) (gastric lavage) 54. (A) (Plasminogen activator inhibitor I, PAI-1) (B) (cytokine) III (antithrombin III) C (C) (fibrinolysis) (D) (intrinsic coagulation pathway) (thrombin) 55. (oxygen supply) (oxygen consumption)
(A) (B) (C) (D) 56. (A) (B) (C) (D) (intramucosal ph) 57. (septic encephalopathy) (A) (diffuse slowing wave) (B) (C) (delirium) (D) (tremor) (asterixis) 58. (A) (B) (NO) (endothelin) (C) (D) 59. VAP (Ventilator Associated Pneumona) (A) (B) (Tracheal Aspirates)
(C) 5 (D) VAP (>14 ) 60. (colonization (A) Proton-pump inhibitors (B) H2-receptor antagonists (C) Sucralfate (D) Antacids 61. (A) 24 (B) (C) (D) 62. [Oral Decontamination (OD)] [Selective Digestive Decontamination (SDD)] (A) SDD (Septicemia) (B) OD (C) SDD (D) SDD 63. contrast-induced renal failure (A) 72 (B) 2
(C) intravenous hydration antioxidant N-acetylcysteine (D) acute renal failure 64. AKIN (Acute Kidney Injury Network) acute kidney injury(aki) criteria stage (A) Serum BUN Serum Cr (B) Serum Cr Urine output (C) Cardiac output Serum Cr (D) Serum Cr Urine output 65. (A) Low dose dopamine renal function (B) Hyperoncotic solution fluid resuscitation renal dysfuction (C) ALI/ARDS lung protective ventilator strategy acute kidney injury acute renal injury (D) Continuous venoveno hemofiltration (CVVH) hypotensive 66. ICU oliguric acute renal failure (A) Acute tubular necrosis (B) Papillary necrosis (C) Drugs that impair renal autoregulation (D) Ureteral obstruction 67. 48 Na + 137 meq/l, K + 4.7 meq/l, Cl - 109 meq/l, HCO3-18.5 meq/l, BUN 28 mg/dl, Cr 1.5 mg/dl, Glucose 180 mg/dl Ethanol 4.6 mg/dl (Anion gap) (calculated osmolarity) (A) 7.5 285 mosm/l (B) 9.5 295 mosm/l
(C) 11.5 305 mosm/l (D) 17.5 315 mosm/l 68. (A) (Ureterosigmoidostomy) (B) (Renal tubular acidosis) (C) (Salicylate overdose) (D) (Pancreatic fistula) 69. 58 Na + 135 meq/l, K + 4.7 meq/l, Cl - 98 meq/l, HCO3-16.2 meq/l, BUN 28 mg/dl, Cr 1.8 mg/dl, Glucose 432 mg/dl Ethanol (-) (A) (Hyperglycemic hyperosmolar state) (B) (Ethylene glycol poisoing) (C) (Isopropanol poisoning) (D) (Lactic acidosis) 70. (Alcoholic ketoacidosis) (Glucose) (Alcohol) (Ketones) (Anion gap) (A) (B) (C) (D) 71. (DKA) (A) 4 6 3 5 2 3 3 5 meq KCL (B) 0.1 / / (C) 200 mg/dl (D) 1.0 mg/dl
72. 65 Na + 123 meq/l, K + 4.9 meq/l, Cl - 104 meq/l, HCO3-19.5 meq/l, BUN 42 mg/dl, Cr 1.8 mg/dl, Glucose 208 mg/dl, Ethanol (-) Na + 28 meq/l 135 mosm/kg H2O (A) (Pneumonia) (B) (Meningitis) (C) (Hyperthyroidism) (D) (Diuretics) Thiadize 73. (Myxedema) (A) (Hypernatremia) (Water retention) (B) (Hypoventilation) (Hypoxia) (C) (Hypothermia) (D) (Bradycardia) 74. 54 20 170 50 (BMI) 17 (A) (B) (C) (D) 75.
1 2 10-14 3 4 w-3 (A) 13 (B) 23 (C) 14 (D) 24 76. 75 150 55 200 1 30-45 2 prokinetic agents (metoclopramide erythromycin) 3 4 5 6 (A) 123456 (B) 12456 (C) 1234 (D) 124 77. 21 H1N1 108/60 mm Hg 34/min FiO 2 100%, PCV AC mode, ph 7.17, PaO 2 67 mm Hg, PaCO 2 61 mm Hg, HCO 3-22.3 meq/l, BE -6.6
1 2 peptide 3 (borage oil), 4 (glutamine) (A) 1234 (B) 123 (C) 124 (D) 13 78. (Ethylene glycol poisoning) (A) (Anion gap) /Ethanol (B) (Calcium oxalate) /Fomepizole (C) (Hyperkalemia)/Fomepizole (D) (Hypocalcemia)/Ethanol 79. 32 15 Acetaminophen (500mg /tab) 40 Acetaminophen 120 µg/ml (A) Acetaminophen (B) Asparate aminotransferase (AST) Acetaminophen (C) AST 24~72 72~96 (D) Acetaminophen 15 Acetaminophen 120 µg/ml N-acetylcysteine 140 mg/kg 70 17 80. 28 4 (Benzodiazepine) [Tricyclic
Antidepressant (TCA)] 40 (GCS) E1V2M4 (A) avr R ( 40 ) TCA (B) Flumazenil (Anexate) Benzodiazepine (C) (D) NaHCO3 TCA 81. 60 1 ( 150mL) 1.0mm (A) (B) (Toxidrome) (Nicotinic Effect) (C) (D) Atropine 82. (Eclampsia) (Preeclampsia) (A) Phenytoin (B) Phenobarbital (C) Carbamazepine (D) Magnesium Sulfate 83. (A) (B) (C)
(D) 24 4 5 84. 76 (A) (senile dementia) (B) (delirium) (C) (organic brain syndrome) (D) (ICU psychosis) 85., (A) (B) (C) (D), 86. 68, diazepam CT CT 45 ICU (A) (status epilepticus) (B) (MRI) (C) (D) (CT) 87. status epilepticus, 24 (A) 5mg/min diazepam 0.2mg/kg EEG
20mg/kg phenobarbital (B) 2mg/min lorazepam 0.1mg/kg EEG 20mg/kg phenytoin (C) 150mg/min phenytoin 20mg/kg EEG 20mg/kg phenobarbital (D) propofol 3mg/kg 1mg/kg/hr 4 0.5mg/kg/hr EEG 88. Guillain-Barre syndrome (A) (B) (C) (D) 89. 81 ARDS (A) (B) Guillan Barre syndrome (acute idiopathic demyelinating polyneuropathy) (C) (critical illness myopathy) (D) critical illness polyneuropathy
90. tissue plasminogen activator (rt-pa) (A) 37.8 C (B) 250 mg/dl (C) warfarin INR 1.2 (D) 190/98 mmhg 91. (A) 220/140mmHg (B) 200/120mmHg (C) 180/100mmHg (D) 160/90mmHg 92. 56 1 160/95mmHg 80/min 22/min (NIHSS) 20, tpa 1 50 NIHSS: 24, 175/96mmHg 100/min 28/min 37.2 C (A) (B) labetalol 160/90mmHg (C) lorazepam 2mg (D) phenytoin 1g 93. (A) (B) (C)
(D) 14 (vasospasm) 94. (ICP) (A) 22 E1M4V1 (B) 50 E3M5V2 128/ 86/54mmHg SaO2 98 (C) 27 E3M5V2 90/ 120/80mmHg SaO2 99 (D) 56 E1M5V1 40 95. E1M5V2 85/55 mmhg 135/min SaO 2 98% (A) 1500c.c (B) (C) (D) 96. 27 SaO 2 98% 130/82 mmhg 80/min E1M5VT ICP 20mmHg CPP 65mmHg (A) PaCO2 30mmHg (B) mannitol 150 (C) (D)
97. 32 E1M5VT 1 E2M5VT ICP14mmHg CPP 65mmHg 80/ 2 E2M5VT 20mmHg 70mmHg 84/ propofol 5 (A) (B) (C) (D) PaCO2 98. 52 E1M1V1 E1M1VT DNR (A) (B) (C) (D) 99. 78 4 E1M2VT DNR (A) (B) (C) (D)
100. DNR (A) DNR (B) 70 21 (C) DNR (D) DNR