ABSITE Critical Care Study Guide Updated
2025 Complete Exam Questions with
Elaborated Correct Answers||A+
GRADED||100% GUARANTEED
PASS!!!<<LATEST VERSION>>
This guide covers high-yield topics organized by system and concept, formatted as Q&A
for efficient review.
I. Shock & Resuscitation
1. What are the four main types of shock?
ANSWER ✓ Cardiogenic (pump failure), Hypovolemic (volume
loss), Distributive (vasodilation, e.g., septic, neurogenic, anaphylactic),
and Obstructive (physical obstruction, e.g., tamponade, tension pneumothorax, massive
PE).
2. What is the first and most important step in managing hemorrhagic shock?
ANSWER ✓ Control the source of bleeding. Resuscitation with blood products is
simultaneous and critical, but without source control (e.g., in the OR, IR, or endoscopy),
the patient will continue to exsanguinate.
3. What are the endpoints of resuscitation in shock?
ANSWER ✓ Normalization of lactate (<2.0 mmol/L) is a key metabolic marker. Others
include urine output >0.5 mL/kg/hr, normalizing base deficit, and adequate
mentation. hemodynamic goals like MAP >65 mmHg and CVP 8-12 mmHg are
traditional but less specific.
4. What is the definition of SIRS (Systemic Inflammatory Response Syndrome)?
ANSWER ✓ Two or more of the following:
, Temp >38°C or <36°C
HR >90 bpm
RR >20 or PaCO2 <32 mmHg
WBC >12,000, <4,000, or >10% bands
5. How is Sepsis defined?
ANSWER ✓ Life-threatening organ dysfunction caused by a dysregulated host
response to infection. Operationally, it is suspected infection + a SOFA score ≥ 2.
6. How is Septic Shock defined?
ANSWER ✓ Sepsis with persisting hypotension requiring vasopressors to maintain
MAP ≥65 mmHg and having a serum lactate level >2 mmol/L (18 mg/dL) despite
adequate volume resuscitation.
7. What is the "Sepsis Six" or 1-hour bundle for sepsis management?
ANSWER ✓ Within the first hour:
1. Measure lactate level.
2. Obtain blood cultures before antibiotics.
3. Administer broad-spectrum antibiotics.
4. Begin rapid fluid resuscitation with 30 mL/kg crystalloid for hypotension or lactate ≥4.
5. Administer vasopressors if hypotensive during or after fluid resuscitation to maintain
MAP ≥65 mmHg.
6. Reassess volume status and perfusion frequently.
8. What is the preferred initial fluid for resuscitation in sepsis and hypovolemic
shock?
ANSWER ✓ Balanced crystalloids (e.g., Lactated Ringer's, Plasma-Lyte) are now
preferred over normal saline due to lower risk of hyperchloremic metabolic acidosis and
possibly better renal outcomes.
, 9. When should vasopressors be started in septic shock?
ANSWER ✓ If hypotension persists after an initial 30 mL/kg fluid bolus. Do not
delay vasopressors to give more fluid if the patient remains hypotensive.
10. What is the first-line vasopressor for septic shock?
ANSWER ✓ Norepinephrine. It increases MAP primarily through vasoconstriction with
minimal effect on heart rate and cardiac output.
11. When is Vasopressin used in septic shock?
ANSWER ✓ As a second-line agent to norepinephrine, typically at a fixed dose of 0.03
units/min to reduce the required dose of norepinephrine.
12. When is Epinephrine used in septic shock?
ANSWER ✓ As a first-line alternative to norepinephrine or as an add-on second-line
agent in refractory shock. It increases cardiac output and heart rate while also causing
vasoconstriction.
13. When should hydrocortisone be considered in septic shock?
ANSWER ✓ In patients with refractory shock requiring ongoing high-dose
vasopressor support (e.g., >0.25 mcg/kg/min of norepinephrine) despite adequate
fluid resuscitation and source control.
14. What is the mechanism of action and complication of Phenylephrine?
ANSWER ✓ Pure alpha-1 agonist causing potent vasoconstriction. It can cause reflex
bradycardia and should generally be avoided in septic shock due to its negative effects
on stroke volume and cardiac output.
15. What is the mechanism of action of Dobutamine?
ANSWER ✓ Beta-1 agonist primarily, leading to increased inotropy (contractility)
and chronotropy (heart rate). It is used in cardiogenic shock to increase cardiac output.
2025 Complete Exam Questions with
Elaborated Correct Answers||A+
GRADED||100% GUARANTEED
PASS!!!<<LATEST VERSION>>
This guide covers high-yield topics organized by system and concept, formatted as Q&A
for efficient review.
I. Shock & Resuscitation
1. What are the four main types of shock?
ANSWER ✓ Cardiogenic (pump failure), Hypovolemic (volume
loss), Distributive (vasodilation, e.g., septic, neurogenic, anaphylactic),
and Obstructive (physical obstruction, e.g., tamponade, tension pneumothorax, massive
PE).
2. What is the first and most important step in managing hemorrhagic shock?
ANSWER ✓ Control the source of bleeding. Resuscitation with blood products is
simultaneous and critical, but without source control (e.g., in the OR, IR, or endoscopy),
the patient will continue to exsanguinate.
3. What are the endpoints of resuscitation in shock?
ANSWER ✓ Normalization of lactate (<2.0 mmol/L) is a key metabolic marker. Others
include urine output >0.5 mL/kg/hr, normalizing base deficit, and adequate
mentation. hemodynamic goals like MAP >65 mmHg and CVP 8-12 mmHg are
traditional but less specific.
4. What is the definition of SIRS (Systemic Inflammatory Response Syndrome)?
ANSWER ✓ Two or more of the following:
, Temp >38°C or <36°C
HR >90 bpm
RR >20 or PaCO2 <32 mmHg
WBC >12,000, <4,000, or >10% bands
5. How is Sepsis defined?
ANSWER ✓ Life-threatening organ dysfunction caused by a dysregulated host
response to infection. Operationally, it is suspected infection + a SOFA score ≥ 2.
6. How is Septic Shock defined?
ANSWER ✓ Sepsis with persisting hypotension requiring vasopressors to maintain
MAP ≥65 mmHg and having a serum lactate level >2 mmol/L (18 mg/dL) despite
adequate volume resuscitation.
7. What is the "Sepsis Six" or 1-hour bundle for sepsis management?
ANSWER ✓ Within the first hour:
1. Measure lactate level.
2. Obtain blood cultures before antibiotics.
3. Administer broad-spectrum antibiotics.
4. Begin rapid fluid resuscitation with 30 mL/kg crystalloid for hypotension or lactate ≥4.
5. Administer vasopressors if hypotensive during or after fluid resuscitation to maintain
MAP ≥65 mmHg.
6. Reassess volume status and perfusion frequently.
8. What is the preferred initial fluid for resuscitation in sepsis and hypovolemic
shock?
ANSWER ✓ Balanced crystalloids (e.g., Lactated Ringer's, Plasma-Lyte) are now
preferred over normal saline due to lower risk of hyperchloremic metabolic acidosis and
possibly better renal outcomes.
, 9. When should vasopressors be started in septic shock?
ANSWER ✓ If hypotension persists after an initial 30 mL/kg fluid bolus. Do not
delay vasopressors to give more fluid if the patient remains hypotensive.
10. What is the first-line vasopressor for septic shock?
ANSWER ✓ Norepinephrine. It increases MAP primarily through vasoconstriction with
minimal effect on heart rate and cardiac output.
11. When is Vasopressin used in septic shock?
ANSWER ✓ As a second-line agent to norepinephrine, typically at a fixed dose of 0.03
units/min to reduce the required dose of norepinephrine.
12. When is Epinephrine used in septic shock?
ANSWER ✓ As a first-line alternative to norepinephrine or as an add-on second-line
agent in refractory shock. It increases cardiac output and heart rate while also causing
vasoconstriction.
13. When should hydrocortisone be considered in septic shock?
ANSWER ✓ In patients with refractory shock requiring ongoing high-dose
vasopressor support (e.g., >0.25 mcg/kg/min of norepinephrine) despite adequate
fluid resuscitation and source control.
14. What is the mechanism of action and complication of Phenylephrine?
ANSWER ✓ Pure alpha-1 agonist causing potent vasoconstriction. It can cause reflex
bradycardia and should generally be avoided in septic shock due to its negative effects
on stroke volume and cardiac output.
15. What is the mechanism of action of Dobutamine?
ANSWER ✓ Beta-1 agonist primarily, leading to increased inotropy (contractility)
and chronotropy (heart rate). It is used in cardiogenic shock to increase cardiac output.
