This document contains 5 multiple choice questions regarding patients on ventilators in the ICU. Each question provides details about a patient's condition and medical history, and asks how the respondent would diagnose, manage ventilation settings, or address challenges for that specific clinical case. The questions cover a range of respiratory conditions and post-operative patients, assessing knowledge of appropriate ventilation goals and strategies.

1. Q 1: You are called in medical emergency department of JHL to evaluate a patient. There is 45-year-old man
weighing around 55 kg presents in emergency department with severe shortness of breath. He can hardly
complete a sentence while speaking. You observe that he is using his accessory muscles of respiration. On
examination he as audible wheeze and duty doctor informs you that the patient has been ventilated continuously
with Ventolin for last hour but his condition hasn’t improved. You see the ABG’s from five minutes ago and decide
to electively ventilate the patient.
A) What is your diagnosis in this patient?
B) What are your ventilation goals in this patient?
Q 2: A 73 years old male patient presents in the emergency department with pain in abdomen. He is planned to
undergo exploratory laparotomy for suspected intestinal obstruction. He weighs around 60 kg and has been a
chain smoker for almost two decades. You receive this patient in ICU as he failed his extubation trial.
A) What could be the reason for failed extubation in this patient?
B) How will you ventilate this patient in the ICU?
Q 3: A 40-year-old man is being ventilated in the ICU after he was rescued from a swimming pool. On second day in
the ICU, his saturation begins to fall. You ventilate the patient on T- piece and find that his lung compliance is
decreased. You order a chest x-ray immediately. It reveals bilateral infiltrates.
A) What is your provisional diagnosis?
B) How will you confirm your diagnosis?
C) How will you manage this patient’s ventilation in light of this diagnosis?
Q 4: A fifty years old patient underwent exploratory laparotomy after blunt abdominal trauma. He is being
ventilated in your ICU post-operatively. On third post-operative day, the bed nurse informs you that the patient
has developed fever since last night. Morning TLC is raised. You remove the dressing to find a healthy wound with
good approximation of the margins. On examination, there is a bruise on the right lower side of his chest. On
auscultation you hear crepts on the right basal region. Left side is clear. You order a chest x-ray. It reveals an
opacity.
A) What is your provisional diagnosis?
B) What is the primary challenge faced in patients with this diagnosis?
C) How will you adjust the ventilation in this patient?
Q 5: A forty-nine-year-old patient underwent exploratory laparotomy CBD tumor. He weighs approximately 65 kgs.
His surgery was complicated by the extent of the tumor. Whipple procedure was performed. Anesthesia team
informs you that the patient has no metastasis and no other co-morbid. His saturation was normal preoperatively
and chest was clear. They want to shift the patient to the ICU due to prolonged surgery. You receive the patient in
the ICU.
A) How will you set the ventilator for this patient?
B) What are your concerns in this patient?