Explain at least two (2) other factors besides surface area that can affect the rate of diffusion and explain why.

Which feed direction increases tool life when climb milling?

The attending starts discussing adding angiotensin II.  He asks what is the main side effect we need to be concerned with if we started it in PJ?

The team decides to intubate the patient due to impending respiratory failure.  What do you recommend to the team for induction? 

After 3 days on the paralytic, the team feels that PJ’s ARDS is improving.  His calculated PaO2/FiO2 ratio has increased to 410, and the team decides to stop the paralytic infusion.  What adjustments do you want to make to the patient’s regimen?

This 2024 Society of Critical Care Medicine Guidelines on Glycemic control recommends initiating insulin therapy when blood glucose is:

DF is a 32-year-old female (100 kg) who is brought into the emergency department after slipping on her icy driveway and hitting her head.  She is currently confused, only answering “yes” or “no” to questions and complaining of a severe headache.  She is known to be dialysis-dependent and has a mechanical valve for which she is on warfarin.  Her INR on admit is 2.5, and her blood pressure is 216/128 mmHg.  Her pregnancy test is currently pending.  A head CT shows a large subdural hematoma and a smaller subarachnoid hemorrhage, with brain swelling.  A peripheral line is placed for medication administration.    Use Case 2 for questions 37-47

Which of the following appropriately describes a primary analysis conclusion from the Steroids in Septic Shock, Patient Level Meta-Analysis regarding the use of steroids for treatment of sepsis/septic shock?

PJ is a 53-year-old male (92 kg, BMI 32) with a history of Duchenne muscular dystrophy, diabetes mellitus, and hypertension who resides in a skilled nursing facility.  He is brought to the hospital with confusion, shortness of breath, cough, and increased sputum production consistent with pneumonia.  One month prior to presentation he received a 10 day course of ciprofloxacin for a suspected urinary tract infection.  Vitals/labs on arrival include BP 71/48 (MAP 58), HR 127 beats/min, SCr 4.9 (baseline ~0.6), estimated CrCl = 21 ml/min, urine output 78 ml in last 4 hours, K = 5 (normal range = 3.5-5.1), RR 32 breaths/min, PaO2 = 54 on Room Air (PaO2/FiO2 ratio = 257), Glasgow Coma Scale (GCS) = 9, T 39.0 C, WBC 13.8 (normal range = 3.8-10.5), plt 350 (normal range = 160-370), ALT = 182 (normal range = 13-59), AST = 121 (normal range = 0-40), bilirubin = 1.4 (normal range = 0-1.4).    Use Case 1 for questions 1-36

What lab(s) should be drawn to diagnose septic shock?