Questions

1. Oesophageal varices:
a. Formation of pathological porto-systemic shunts relieves portal hypertension.
b. Risk of developing varices is about 40% for patients with Child’s C cirrhosis.
c. A large proportion of patients presenting with variceal haemorrhage are no longer bleeding at the time of endoscopy.
d. A paper reviewed in this issue of the Monitor demonstrates that the addition of endoscopic band ligation to terlipressin infusion reduces very early re-bleeding in patients with variceal haemorrhage but without active bleeding at emergency endoscopy.

2. Staphylococci:
a. S. epidemidis is an important cause of CAPD peritonitis.
b. S. saprophyticus is usually of pathogenic significance when isolated from respiratory secretions.
c. Metastatic infection only occurs in a small percentage of with patients S. aureus bacteraemia.
d. A paper reviewed in this issue of the Monitor suggests that point of care testing for MRSA may be feasible.

3. High frequency ventilation:
a. The stroke volume of a high volume oscillator is less than anatomical dead space.
b. In HFOV carbon dioxide removal is a function of bias gas flow.
c. High frequency ventilation allows adequate ventilation with a disrupted airway.
d. A paper reviewed in this issue of the Monitor suggests that HFOV may result in better outcomes in patients with acute lung injury or ARDS.

4. Abdominal aortic aneurysm:
a. Rupture may present with groin pain.
b. Congestive cardiac failure and renal failure may result from an aortocaval fistula.
c. Rupture tends to occur at a smaller diameter in men than in women.
d. A paper reviewed in this issue of the Monitor shows that endovascular stenting of large diameter aneurysms reduces mortality in patients physically ineligible for open repair.

Correct answers will be available on the Intensive Care Monitor website www.intensive-care-monitor.com from October 1st 2010 and will also be published in the next issue of Intensive Care Monitor.