2025 Multiprofessional Critical Care Review: Adult Online-Board Review Questions

Video Transcription

Video Summary

This board review session covers critical topics in blood emergencies, kidney injury, and solid organ transplantation and surgery. Key points include the increased perioperative mortality risk in liver transplant patients with portopulmonary hypertension, and recognizing rhabdomyolysis in exertional heatstroke presenting with dark urine positive for blood but no red cells on microscopy. Trauma case management emphasizes prioritizing blunt aortic injury with beta blockers and medical therapy before surgical repair. Coagulopathy evaluation with thromboelastography (TEG) aids in differentiating bleeding causes. In rhabdomyolysis-induced acute kidney injury, aggressive isotonic fluid hydration remains the cornerstone, with limited evidence for urine alkalinization. Timing of renal replacement therapy (RRT) is nuanced; early initiation has not definitively improved survival, and diuresis may be misleading. Trauma with seatbelt sign raises suspicion for delayed intra-abdominal injuries like duodenal or pancreatic trauma. Resuscitation in septic shock favors lactated Ringer’s solution over invasive monitoring. GI bleeding from AV malformations benefits from Pantoprazole post-endoscopic clipping; Octreotide is reserved for variceal bleeding.

Keywords

blood emergencies

kidney injury

solid organ transplantation

portopulmonary hypertension

rhabdomyolysis

thromboelastography

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