Introducing the Newest Critical Care Medicine Qbank

June 9, 2023
Reviewed By: Amy Rontal
In today’s rapidly evolving medical landscape, critical care has emerged as one of the most crucial and demanding specialties, playing a pivotal role in the continuum of patient care by focusing on life-threatening conditions and complex medical emergencies. For physicians of any specialty who are preparing for the critical care certification exam, we’re introducing an all-new Critical Care Qbank to enhance your critical care skills in the ED, ICU, and OR.

Who is the Critical Care Qbank for?

The Rosh Review Critical Care Qbank was designed for critical care fellows and physicians who are preparing for their in-training exam, certification exam, or maintenance of certification exam in critical care medicine. It is also an invaluable resource for any practicing physician seeking to enhance their knowledge in this specialized field. 

In addition, this Qbank may act as a supplement for residents in emergency medicine, internal medicine, anesthesiology, and general surgery whose curricula is heavily weighted toward critical care medicine.

Which topics are covered in the Critical Care Qbank?

The Critical Care Qbank covers topics following the ABIM, ABA, and ABS content outlines for the critical care certification exam. These high-yield topics include:

  • Cardiovascular Disorders
  • Critical Care Ultrasound Scanning
  • Gastrointestinal Disorders
  • Hematologic, Oncologic, and Immunologic Disorders
  • Infectious Disease
  • Neurologic Disorders
  • Pharmacology and Toxicology
  • Pulmonary Disorders
  • Renal, Endocrine, and Metabolic Disorders
  • Research, Administration, and Ethics
  • Surgery, Trauma, and Transplantation

How many questions are in the Critical Care Qbank?

The Critical Care Qbank contains 150 Critical Care Medicine questions authored by fellowship-trained physicians. Each question includes teaching images, detailed explanations for correct and incorrect answers, hyperlinked references, and more.

View a sample question below:

A 58-year-old man with a history of chronic obstructive pulmonary disease and cirrhosis with a Model for End-Stage Liver Disease score of 28 presents to the emergency department after several episodes of large-volume hematemesis. He has altered mental status, tachycardia, and hypotension. The team proceeds with intubation, and the initial endoscopic intervention is aborted due to profuse bleeding at the gastric fundus. A Sengstaken-Blakemore tube is placed to tamponade the bleeding. Chest X-ray images taken 4 hours apart are shown above (A and B). What is the most likely explanation for the findings in image B?

  1. The patient aspirated during emesis
  2. The Sengstaken-Blakemore tube was inserted into lung
  3. The Sengstaken-Blakemore tube was overinflated in the stomach
  4. There was an esophageal rupture

Correct answer: D

A Sengstaken-Blakemore (SB) tube is a two-balloon device that provides tamponade to esophageal and gastric bleeding through direct compression. It is used as a temporary life-saving intervention in cases of massive bleeding unresponsive to initial medical and endoscopic treatment. The SB tube is inserted in the stomach, with auscultation used to verify initial placement before partial gastric balloon inflation with 50 mL of air. A chest X-ray is used to confirm the gastric balloon position in the stomach before full inflation of the balloon with an additional 200 mL of air. The esophageal balloon is then inflated to 30 mm Hg with a manometer connected to the esophageal port. If bleeding persists, the pressure can be increased to a maximum of 45 mm Hg. Balloon inflation should be used transiently (for a minimum of 4 hours and never longer than 24 hours) because of the high rate of complications, including esophageal perforation, mucosal necrosis, and airway obstruction. Image B shows a lucency overlying the left chest consistent with an SB balloon in the chest, which suggests a rupture of the esophagus by a gastric balloon inflated in the esophagus, an overinflated esophageal balloon, or one that was kept in place longer than necessary.

An aspiration (A) event is possible in this patient presenting with large-volume hematemesis and altered mental status, which would be evident on chest X-ray with opacities in the right chest. Inserting the SB tube into the lung (B) post intubation would be challenging, given the endotracheal tube in situ, and this is likely to manifest with increased airway resistance, which is not mentioned. The lucency is present in the chest, consistent with an esophageal rupture from overinflation of a balloon in the esophagus, not the gastric balloon in the stomach (C).

What are some additional features of the Qbank?

All Rosh Review Qbanks include the following “uncommon delights” to supplement your learning:

  • Powerful performance analytics to identify your areas of weakness and compare your progress with peers
  • Customizable practice exams
  • Free, highly-rated iOS & Android mobile app for studying on-the-go
  • Educators On Call (real MDs who respond in a timely manner) and speedy support
  • One Step Further questions (a bonus question to help bolster information)
  • Group subscription savings

Can I earn CME by using this Qbank?

Yes! Both the Standard and Premium packages of the Qbank will also earn you 15 AMA PRA Cat 1 credits. Learn more about redeeming CME credits using a Qbank.

Where do I get started?

Head to the Critical Care Qbank page to learn more about the product, view your package options, or start with a free trial.

By The Rosh Review Team

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