MOH EXAM QUESTIONS MAY 2017
1. Ms. Deepa Joseph suddenly develops a decrease in her level of consciousness, even though she has not received any additional sedatives or analgesics. She is on broad spectrum antibiotics, levophed, vasopressin, steroids and intensive insulin. She is being fed via a nasal gastric feeding tube. She develops gastric distention with residual volumes equal to 6 hours feeding volume. Which one of the
following interventions is a priority?
a. Change feeding tube to small bowel placement
b. Obtain a blood glucose measurement
c. Initiate a prokinetic agent
d. Change feeds to elemental solution
2. Which one of the following pharmacological agents should be administered with levothyroxine for the treatment of myxedema coma?
a. Insulin
b. Glucagon
c. Epinephrine
d. Steroids
3. Manjusha is admitted following a motor vehicle collision. Her past medical history includes daily
prednisone for the treatment of systemic lupus. Despite fluid replacement therapy and initiation of
levophed, her blood pressure remains low. Which one of the following interventions is the priority?
a. Cosyntropinin
b. Epinephrine
c. Hydrocortisone
d. Vasopressin
4. After successful completion of a spontaneous breathing trial, extubation is considered. Which one of
the following findings would be a contraindication to extubation?
a. FiO2 0.4
b. PEEP 5
c. GCS 4
d. Minute volume 10 L/min
following interventions is a priority?
a. Change feeding tube to small bowel placement
b. Obtain a blood glucose measurement
c. Initiate a prokinetic agent
d. Change feeds to elemental solution
a. Insulin
b. Glucagon
c. Epinephrine
d. Steroids
3. Manjusha is admitted following a motor vehicle collision. Her past medical history includes daily
prednisone for the treatment of systemic lupus. Despite fluid replacement therapy and initiation of
levophed, her blood pressure remains low. Which one of the following interventions is the priority?
a. Cosyntropinin
b. Epinephrine
c. Hydrocortisone
d. Vasopressin
4. After successful completion of a spontaneous breathing trial, extubation is considered. Which one of
the following findings would be a contraindication to extubation?
a. FiO2 0.4
b. PEEP 5
c. GCS 4
d. Minute volume 10 L/min
MOH EXAM QUESTIONS
5. Mr. Geetha Joh underwent coronary bypass surgery. Four hours following admission to the critical careunit, his BP begins to fall, his HR rises to 130 and his urine output decreases to 35 ml/hr. His CVP
increases to 22 and his PWP 18. The critical care nurse notifies the cardiovascular surgeon. Pending
the surgeons arrival, which intervention is the priority?
a. Milrinone
b. Dobutamine
c. Lasix
d. Fluid
6. Following an inferior wall infarction, Mrs. Shoba Banner develops a sinus rhythm with Wenkebach
phenomena. She develops episodes of symptomatic bradycardia. Which one of the following
interventions would be the priority?
a. Epinephrine
b. Cardioversion
c. Atropine
d. Dopamine
7. Mr. Lio George has been on home ventilation for several years with severe COPD. He was admitted for exacerbation of COPD due to pneumonia. At home, he varies his support between Pressure Control
ventilation and spontaneous breathing. His pneumonia has now resolved and the plan is to return
him to his baseline ventilation. He calls you to his bedside and asks you what his ventilator is set to
because he feels short of breath. You tell him he is on Pressure Support, and he becomes very
angry. He tells you that he told the respiratory therapist that he has tried Pressure Support in the past
and he does not like it. When you speak to the respiratory therapist, she had placed the patient on PS
to see if he noticed the difference. Which one of the following is an appropriate response?
a. Encourage Mr. Lio George to stay on the Pressure Support and give it a chance to work
b. Have the respiratory therapists speak to Mr. Lio George to explain her interventions
c. Facilitate a meeting between you, the respiratory therapist and Mr. Lio George to develop a plan for weaning
d. Tell Mr. Lio George that his lungs have changed and the previous mode might not work the same way
8. Mr. Anup Unnikrishnan is admitted with hypoxemic and hypercarbic respiratory arrest requiring intubation and ventilation. He has a RLL consolidation on xray, with copious purulent secretions. WBC is 24,000 T 39.4. BP 88/56 HR 136 and CVP 18 after 6 L of 0.9% normal saline. Urine output is 10 ml/hr. Which
one of the following interventions is a priority?
a. Levophed
b. Dopamine
c. Dobutamine
d. Labetolol
9. Mr. Padmanabha Ayyangar is admitted with alcoholic pancreatitis. He has a T 38.2 WBC 14,000 (with left shift and increased neutrophils). Following 4 litres of normal saline, his BP increases to 114/80 from 70/50, HR decreases from 144 to 92 and urine output increases from 10 to 60 ml/hr. He requires intubation for worsening hypoxemia. Which one of the following best explains these findings?
a. Sepsis
b. Severe sepsis
c. Septic shock
d. Systemic Inflammatory Response Syndrome
10. Mrs. Sanjana Gandhi is a Type II diabetic with a history of TIA and congestive heart failure. She is admitted to the critical care unit for monitoring following a Hartmann’s procedure for colon cancer. Two hours post operatively, she develops new onset uncontrolled atrial fibrillation with hypotension. Which one of the following interventions is the priority?
a. Lidocaine
b. Amiodarone
c. Coumadin
d. IV heparin
5. Mr. Geetha Joh underwent coronary bypass surgery. Four hours following admission to the critical careunit, his BP begins to fall, his HR rises to 130 and his urine output decreases to 35 ml/hr. His CVP
increases to 22 and his PWP 18. The critical care nurse notifies the cardiovascular surgeon. Pending
the surgeons arrival, which intervention is the priority?
a. Milrinone
b. Dobutamine
c. Lasix
d. Fluid
6. Following an inferior wall infarction, Mrs. Shoba Banner develops a sinus rhythm with Wenkebach
phenomena. She develops episodes of symptomatic bradycardia. Which one of the following
interventions would be the priority?
a. Epinephrine
b. Cardioversion
c. Atropine
d. Dopamine
7. Mr. Lio George has been on home ventilation for several years with severe COPD. He was admitted for exacerbation of COPD due to pneumonia. At home, he varies his support between Pressure Control
ventilation and spontaneous breathing. His pneumonia has now resolved and the plan is to return
him to his baseline ventilation. He calls you to his bedside and asks you what his ventilator is set to
because he feels short of breath. You tell him he is on Pressure Support, and he becomes very
angry. He tells you that he told the respiratory therapist that he has tried Pressure Support in the past
and he does not like it. When you speak to the respiratory therapist, she had placed the patient on PS
to see if he noticed the difference. Which one of the following is an appropriate response?
a. Encourage Mr. Lio George to stay on the Pressure Support and give it a chance to work
b. Have the respiratory therapists speak to Mr. Lio George to explain her interventions
c. Facilitate a meeting between you, the respiratory therapist and Mr. Lio George to develop a plan for weaning
d. Tell Mr. Lio George that his lungs have changed and the previous mode might not work the same way
8. Mr. Anup Unnikrishnan is admitted with hypoxemic and hypercarbic respiratory arrest requiring intubation and ventilation. He has a RLL consolidation on xray, with copious purulent secretions. WBC is 24,000 T 39.4. BP 88/56 HR 136 and CVP 18 after 6 L of 0.9% normal saline. Urine output is 10 ml/hr. Which
one of the following interventions is a priority?
a. Levophed
b. Dopamine
c. Dobutamine
d. Labetolol
9. Mr. Padmanabha Ayyangar is admitted with alcoholic pancreatitis. He has a T 38.2 WBC 14,000 (with left shift and increased neutrophils). Following 4 litres of normal saline, his BP increases to 114/80 from 70/50, HR decreases from 144 to 92 and urine output increases from 10 to 60 ml/hr. He requires intubation for worsening hypoxemia. Which one of the following best explains these findings?
a. Sepsis
b. Severe sepsis
c. Septic shock
d. Systemic Inflammatory Response Syndrome
10. Mrs. Sanjana Gandhi is a Type II diabetic with a history of TIA and congestive heart failure. She is admitted to the critical care unit for monitoring following a Hartmann’s procedure for colon cancer. Two hours post operatively, she develops new onset uncontrolled atrial fibrillation with hypotension. Which one of the following interventions is the priority?
a. Lidocaine
b. Amiodarone
c. Coumadin
d. IV heparin
I had absolutely no symptoms or warnings that I had cancer. In March 2007 I suddenly felt like I had diarrhea but it was all blood and I went to the ER. I bled profusely through the rectum for an hour or so until they got it stopped. The doctor did a colonoscopy and found a stage II cancer, i was devastated when my doctor broke the sad news to me because i thought that was the end for me because i have heard so much news about how cancer have stolen away the lives of patients. With time i developed a 'belly' when all my life my abdomen was flat. I was still in my search for a cure after undergoing chemo and radiation thrice Until a friend of mine directed me to doctor Amber and advised me to try alternative medicine, which i did because then my doctor was no longer helpful at all and i had given up on myself. I got the herbal medicine which was relatively small in size, which i took for 10 weeks. For the past two and half years, I have had two additional colonoscopies and two CT scans, plus blood tests. So far, no recurrence, i am indeed really grafeful to GOD and Dr.Amber who stood by me and made all this happen through his medicine. Never give up hope and if you find yourself in the situation i was some years ago you can also contact him too via his personal email drambermurray@gmail.com
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