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A) Administer a 250 mL crystalloid fluid challenge

B) Commence noradrenaline infusion

C) Increase inspired oxygen concentration

D) Reduce tidal volume on the ventilator

A) Tidal volume of 8 mL/kg ideal body weight

B) Atrial fibrillation with controlled ventricular rate of 78 bpm

C) Moderate PEEP of 8 cmH2O

D) Intraoperative use of a neuromuscular blocking agent

A) Distributive (septic) shock

B) Hypovolaemic shock

C) Cardiogenic shock

D) Obstructive shock from tension pneumothorax

A) 45-55%

B) 60-80%

C) 85-95%

D) 35-45%

A) Non-responder; no further fluid should be given

B) Responder; the patient is preload-dependent and further fluid may be beneficial

C) Indeterminate; repeat the bolus with a larger volume

D) Abnormal; this degree of increase suggests cardiac tamponade

A) It increases myocardial contractility through beta-1 agonism as its primary mechanism

B) It increases systemic vascular resistance through alpha-1 agonism, raising MAP and improving coronary perfusion pressure

C) It reduces heart rate, improving diastolic filling time and stroke volume

D) It acts primarily on beta-2 receptors to cause splanchnic vasoconstriction

A) Hartmann’s solution (lactated Ringer’s)

B) 4% gelatin (Gelofusine)

C) 0.9% sodium chloride

D) Plasmalyte-148

A) Adrenaline 100 micrograms intravenously

B) Phenylephrine 100 micrograms intravenously

C) Ephedrine 6 mg intravenously

D) Metaraminol 0.5 mg intravenously followed by infusion

A) Detecting deep vein thrombosis; a positive result is calf pain on dorsiflexion

B) Assessing fluid responsiveness; a positive result is a >=10% increase in cardiac output within 60-90 seconds

C) Diagnosing aortic stenosis; a positive result is a drop in BP greater than 20 mmHg

D) Testing autonomic function; a positive result is a heart rate increase of more than 30 bpm

A) CVP below 8 mmHg reliably predicts fluid responsiveness

B) CVP above 12 mmHg reliably predicts fluid non-responsiveness

C) A single static CVP measurement is a poor predictor of fluid responsiveness

D) CVP is the gold standard for assessing preload in critically ill patients

A) Spontaneously breathing patients with an open chest

B) Patients in atrial fibrillation receiving pressure-controlled ventilation

C) Mechanically ventilated patients in sinus rhythm receiving tidal volumes of >=8 mL/kg with no spontaneous respiratory effort

D) Patients with right ventricular failure and severe tricuspid regurgitation

A) 680 dynes.s.cm^-5

B) 1360 dynes.s.cm^-5

C) 850 dynes.s.cm^-5

D) 425 dynes.s.cm^-5

A) Hydroxyethyl starches (HES) are safe and recommended for volume resuscitation in septic patients

B) Human albumin solution is associated with improved survival compared to crystalloids in all surgical patient groups

C) HES solutions are associated with increased rates of acute kidney injury and are contraindicated in critically ill patients

D) Gelatins have been proven superior to crystalloids in reducing postoperative ileus after colorectal surgery

A) Administering a fixed volume of intravenous fluid (e.g., 10 mL/kg/hour) throughout all surgical procedures

B) Restricting all intraoperative fluids to less than 500 mL regardless of surgical blood loss

C) Using haemodynamic monitors to titrate fluid and vasoactive drug administration to predefined endpoints such as stroke volume and tissue perfusion markers

D) Targeting a CVP of 8-12 mmHg in all surgical patients as the primary fluid endpoint

A) Administer 1 litre of 0.9% saline rapidly over 15 minutes

B) Assess fluid responsiveness with a small fluid challenge and initiate inotropic support with dobutamine if output remains low

C) Immediately commence high-dose vasopressin infusion

D) Reduce volatile anaesthetic agent and administer metaraminol 2 mg intravenously

A) Hypovolaemia requiring immediate fluid resuscitation

B) Vasodilation or volume overload

C) Severe aortic stenosis

D) Right ventricular outflow tract obstruction

A) Targeting a MAP of 85-90 mmHg to ensure organ perfusion in all trauma patients

B) Accepting a lower MAP of 50-65 mmHg to limit dilution of clotting factors and avoid worsening haemorrhage before surgical control

C) Withholding all fluids until the operating theatre regardless of haemodynamic status

D) Using high-dose vasopressors to maintain normal blood pressure while minimising volume infused

A) Dissolved oxygen in plasma (PaO2 x 0.003)

B) Haemoglobin concentration

C) Cardiac output

D) Arterial oxygen saturation (SaO2)

A) The lactate is a normal postoperative finding requiring no intervention

B) Tissue hypoperfusion during surgery led to anaerobic metabolism and lactate accumulation, indicating occult hypoperfusion

C) Routine administration of Hartmann’s solution causes lactate elevation from the lactate component of the fluid

D) Hepatic failure is the most likely cause and liver function tests should be the immediate priority

A) Hypoxia, hypercapnia, and hypotension

B) Hypothermia, acidosis, and coagulopathy

C) Hyponatraemia, hyperkalaemia, and hypocalcaemia

D) Tachycardia, thrombocytopenia, and hypoalbuminaemia