Oryginał (EN): Which supraglottic airway device does not require inflation of an air cuff - First-generation laryngeal mask / Second-generation laryngeal mask / Laryngeal tube / Combitube / I-gel

Oryginał (EN): During ALS in an adult patient, after several minutes of CPR, tracheal intubation was performed using a videolaryngoscope. After connecting waveform capnography, no ETCO2 trace is obtained despite ongoing chest compressions. According to the ERC 2025 Guidelines, the most appropriate management is: - Terminate CPR, because absence of ETCO2 always indicates no chance of ROSC due to lack of blood perfusion in peripheral tissues / Suspect oesophageal intubation, remove the tube and return to ventilation using a bag-valve mask or a supraglottic airway device / Increase tidal volume and ventilation rate, without changing the airway management method, as inadequate expired volume may be undetectable by capnography / Continue ventilation through the tube, because capnography is less reliable during CPR, especially in the presence of impaired peripheral perfusion / Stop chest compressions for 30 seconds in order to assess the ETCO2 trace

Oryginał (EN): A 68-year-old man presents to the Hospital with a history of hypertension. For the past 2 hours he has experienced severe palpitations, dyspnea, and chest pain – for the first time in his life. On examination: confused, diaphoretic. Vital signs: HR ~160/min (irregular), BP 70/35 mmHg, SpO2 90%. ECG: rapid atrial fibrillation. What is the most appropriate management? - Adenosine 6 mg IV / Slow administration of digoxin and observation / Initiation of oral β-blocker therapy / Synchronized electrical cardioversion / Passive oxygen therapy and fluid administration

Oryginał (EN): After 3 minutes of ALS in an adult patient in cardiac arrest, successful tracheal intubation was achieved. According to the ERC 2025 Guidelines, after confirming correct tube placement, appropriate ventilation management includes: - Ventilation at a rate of 16–18 breaths per minute, synchronized in a 30:2 ratio with compressions / Ventilation only if cyanosis occurs, without a specified target respiratory rate / Ventilation at a rate of 6–8 breaths per minute, with complete cessation of chest compressions / Ventilation at a rate of 20–24 breaths per minute, with cessation of compressions during each inspiration / Ventilation at a rate of approximately 10 breaths per minute, without interrupting chest compressions

Oryginał (EN): During ALS in an adult patient with cardiac arrest in VF/pVT rhythm, one of the key priorities is the quality of chest compressions. According to the ERC 2025 guidelines, the recommended compression parameters are: - Rate 100–120/min, depth approximately 5–6 cm, full chest recoil and minimal interruptions / Rate 80–100/min, depth 3–4 cm, pauses up to 10 s for rhythm assessment / Rate > 130/min, depth > 6 cm, frequent pauses to assess the pulse / Rate 60–80/min, depth approximately 4 cm, no importance of chest recoil / Rate 100–120/min, depth 5–6 cm, but with pauses of 10–15 s before each defibrillation

Oryginał (EN): Below are five different situations of patients referred for ICU admission qualification. Which situations best meet the criteria of priority I and II ICU admission? 1. A 55-year-old patient with worsening respiratory failure in the course of pneumonia, deterioration of gas exchange, need to consider intubation. 2. A 29-year-old patient with symptoms of mild dehydration, after oral and intravenous fluid replacement, hemodynamically stable. 3. A 78-year-old patient in an advanced stage of a neurodegenerative disease, without reversible causes of sudden deterioration. 4. A 61-year-old patient with acute heart failure, cardiogenic shock, requiring continuous vasopressor infusions, with potential for causal treatment. 5. A 50-year-old patient after neurosurgical removal of a brain tumor, in a stable condition, without signs of circulatory or respiratory failure. - 1, 3 / 2, 3 / 4, 5 / 3, 5 / 1, 4

Oryginał (EN): One of the mechanical complications of CVC placement is injury to adjacent structures. Which of the following is an early complication? - Catheter-related sepsis / Local site infection / Thrombosis at insertion site / Catheter occlusion after one week / Pneumothorax

Oryginał (EN): Mark the false statements regarding differences between lidocaine and bupivacaine: 1. Bupivacaine has a shorter duration of action than lidocaine. 2. Bupivacaine has a higher cardiotoxic potential than lidocaine. 3. Lidocaine has a faster onset of action than bupivacaine. 4. Both belong to the amide group. 5. Lidocaine is preferred in continuous epidural anesthesia. - 1, 3 / 1, 2, 3 / 2, 3, 4 / 2, 3, 5 / 1, 5

Oryginał (EN): Which drug most often causes significant reduction in arterial blood pressure during intravenous induction? - Etomidate / Lidocaine / Propofol / Midazolam / Ketamine

Oryginał (EN): The laryngeal tube (laryngotube/LT) has two sealing cuffs. Where should it be correctly positioned after insertion? - In the pharynx and esophagus / In the trachea and oral cavity / In the nasopharynx and trachea / Between the vocal cords and pharynx / In the trachea and above the epiglottis

Oryginał (EN): Which statement about oxycodone is correct - Is weaker than paracetamol / Is safe in respiratory failure / May require dose modification and carries a risk of dependence / Does not cause central nervous system effects / Does not require dose adjustment in metabolic disorders

Oryginał (EN): After ROSC the patient is intubated. Target saturation according to ERC 2025: - Target 80–85%, as mild hypoxia after ROSC is neuroprotective / Any, if blood pressure is normal / 90–92% in all patients regardless of age, sex or comorbidities / Approximately 94–98% / Always 100%, in order to avoid hypoxia

Oryginał (EN): In which clinical situations is norepinephrine the first-line drug? 1. Septic shock 2. Severe bradyarrhythmias with normal arterial blood pressure 3. Cardiogenic shock with high peripheral resistance 4. Anaphylactic shock 5. Acute heart failure without hypotension - 2, 4 / 2, 3, 5 / 1 / 1, 4 / 3, 5

Oryginał (EN): Epinephrine is used in various emergency conditions. In which of the following situations is its use not justified? - Anaphylactic shock / Croup syndrom (nebulized administration) / Symptomatic bradycardia refractory to first-line treatment / Ventricular fibrillation / Stable supraventricular tachycardia

Oryginał (EN): In a 46-year-old victim of a traffic accident with a rapid, weakly filled pulse, eFAST shows the presence of hypoechogenic content in the hepatorenal recess (Morison's pouch). What is the most probable source of the abnormality? - Bleeding into the right pleural cavity / Cervical spine injury / Complete small bowel obstruction / Presence of air due to disruption of the diaphragm / Bleeding into the peritoneal cavity from the epigastric region

Oryginał (EN): In a 62-year-old patient, in-hospital cardiac arrest occurs. After 20 minutes of CPR the rhythm remains asystole, ETCO2 remains 6 mmHg, no reversible causes, history of lung cancer with metastases to the liver and lungs, no prior wishes regarding prolongation of therapy. According to ALS 2025 guidelines, the most appropriate action is: - Automatic termination of CPR after 20 minutes in every patient / Continuing CPR until ETCO2 > 30 mmHg is achieved regardless of time / Continuing CPR only due to the lack of a formal futile therapy protocol document / Continuing CPR, because every initiated resuscitation must last ≥ 40 minutes, and only after that time consider termination / Considering termination of resuscitation based on lack of response to treatment, long CPR duration, unfavorable rhythm, very low ETCO2 and severe underlying disease

Oryginał (EN): Epinephrine is used in various emergency conditions. In which of the following situations is its use not justified? - Symptomatic bradycardia refractory to first-line treatment / Anaphylactic shock / Croup (nebulized administration) / PEA / Stable supraventricular tachycardia

Oryginał (EN): When should behavioral scales be used to assess pain in children? - When the pain is very severe / When the pain concerns only the limbs / Only in children with psychiatric disorders / When the child understands the VAS scale / When the child can not reliably communicate pain intensity

Oryginał (EN): Indicate the false statements regarding antimicrobial management in sepsis 1. Microbiological samples should be collected before antibiotic administration. 2. Antibiotic therapy should be initiated immediately based on clinical and epidemiological criteria. 3. Monitoring procalcitonin may be helpful in deciding when to shorten antibiotic therapy. 4. Antibiotic therapy in cases of resistant bacteria should be continued for a long duration ( more than 2 weeks), especially in critically ill patients. 5. Short courses of antibiotic therapy (1–7 days) may be indicated in selected clinical situations. - 4, 5 / 2, 4 / 1, 2, 3 / 2, 3 / 4

Oryginał (EN): A 6-year-old child qualified for elective inguinal hernia surgery. General anesthesia with the addition of an ultrasound-guided unilateral iliohypogastric and ilioinguinal nerve block was considered. Which statement best describes the role of regional anesthesia in children? - It is an element of multimodal analgesia and allows reduction of systemically administered opioid doses / In pediatrics, peripheral nerve blocks are not used, only central blocks / Regional blocks in children are performed exclusively without ultrasound due to the too small size of nerves that are not visible on ultrasound / Regional anesthesia has no impact on the postoperative course in children, therefore there are no strong recommendations regarding its use / It is contraindicated up to the age of 10 due to a high risk of LAST

Oryginał (EN): A 30-year-old woman, one week after vaginal delivery conducted with epidural anesthesia, presented to the hospital. She currently reports fever up to 38.4 degrees C, severe back pain along the lumbar spine, progressive weakness of leg muscle strength, and difficulty urinating. The most urgent diagnosis to be excluded is: - Acute pyelonephritis / Spinal canal abscess / Acute sciatica / Post-dural puncture headache / Restless legs syndrome

Oryginał (EN): Which of the following statements are examples of clinical indications (renal and non-renal) to continue or initiate Continuous Renal Replacement Therapy (CRRT) in the ICU? 1. Hyperkalemia > 6.5 mmol/l refractory to treatment 2. Fluid overload leading to pulmonary edema despite use of diuretics 3. Oliguria in the course of dehydration 4. Metformin poisoning 5. Severe rhabdomyolysis in the course of multi-organ trauma - 2, 3, 5 / 1, 2, 5 / 1, 2, 4, 5 / 2, 4, 5 / 3, 4, 5

Oryginał (EN): Mark the correct statements regarding the use of magnesium in ALS 2025: 1. Routine use of magnesium sulfate in refractory VF/pVT is not recommended. 2. Magnesium may be considered in the case of torsade de pointes or hypomagnesemia as a reversible cause. 3. Magnesium is a first-line antiarrhythmic drug in every refractory VF/pVT. 4. Administration of magnesium always replaces the need for amiodarone or lidocaine. 5. In cardiac arrest magnesium is administered exclusively via the intraosseous route. - 2, 4 / 3, 5 / 2, 3 / 1, 3 / 1, 2

Oryginał (EN): Pulse oximetry may be unreliable in the situation of: 1. anemia < 7 g/dl 2. methemoglobinemia 3. intense ambient light 4. carbon monoxide poisoning 5. severe peripheral perfusion disorders - 1, 3 / 2, 5 / 1, 4 / 2, 4, 5 / 1, 2, 3

Oryginał (EN): Norepinephrine – indicate the dominant mechanism of action: - Strong stimulation of a1 receptors / Increased conduction in the AV node / Calcium channel blockade / Arterial vasodilation via NO / Inhibition of β2 receptors

Oryginał (EN): Which analgesic drug acts both on μ opioid receptors and affects serotonergic and noradrenergic transmission? - Tramadol / Morphine / Ketoprofen / Paracetamol / Metamizole

Oryginał (EN): In the modern RSI algorithm, the following elements play a special role: 1. Preoxygenation 2. Routine cricoid pressure 3. Administration of drugs without a ventilation period, except in selected situations 4. Videolaryngoscopy as the first-choice method 5. Confirmation of intubation exclusively by auscultation - 2, 3, 4 / 1, 4, 5 / 1, 2, 5 / 3, 4, 5 / 1, 3, 4

Oryginał (EN): In a patient in the 3rd trimester of pregnancy, sudden cardiac arrest occurs. During advanced resuscitation procedures, modification of management resulting from the physiology of pregnancy must be considered. Which action is necessary regardless of further therapeutic decisions? - Displacement of the uterus to the left or tilting the patient to the left / Immediate performance of emergency hysterectomy before starting CPR / Routine reduction of resuscitation drug doses / Placing the patient in the Trendelenburg position / Prohibition of defibrillation due to risk to the fetus

Oryginał (EN): Indications for central venous catheter (CVC) placement despite adequate peripheral venous access include: 1. Need for administration of high-flow catecholamines 2. Parenteral nutrition with osmolarity of a solution 1000 mOsm/L 3. Fluid resuscitation with balanced electrolyte solutions 4. Monitoring of central venous pressure (CVP) 5. Administration of antibiotics such as cefalosporins - 3, 4, 5 / 1, 3, 5 / 2, 4, 5 / 2, 3, 4 / 1, 2, 4

Oryginał (EN): A patient after head trauma following a motorcycle accident opens eyes to verbal command, speaks inappropriate words and withdraws from painful stimulations. What GCS? - 9 / 10 / 8 / 7 / 12

Oryginał (EN): The most common adverse effect of opioids used for postoperative pain is: - Urinary incontinence / Thyroid failure / Acute myocardial injury / Nausea and vomiting / Diarrhea

Oryginał (EN): Indirect calorimetry is primarily used to assess: - PaO2/FiO2 ratio / Lactate concentration / Resting energy expenditure / Glomerular filtration rate / Central venous pressure

Oryginał (EN): Which supraglottic airway device does not require inflation of an air cuff - First-generation laryngeal mask / Second-generation laryngeal mask / Laryngeal tube / Combitube / I-gel

Oryginał (EN): A 45-year-old patient presented to the ED due to rash, weakness and dyspnea. Symptoms have been worsening for 30-60 min. Vital signs: HR 125/min, NIBP 95/75, Sat 89% without oxygen supplementation, RR 25/min. On the skin of the trunk and limbs – urticaria with wheals. From the medical history, the patient spent time in a garden befor accident. Which drug should be administered first: - Adrenaline 0.5 mg iv. / Adrenaline 1 mg iv. / Hydrocortisone 100 mg iv. / Adrenaline 0.5 mg im. / Hydrocortisone 100 mg im.

Oryginał (EN): Which parameter is not included in the Aldrete score? - Saturation or skin color / Motor activity / Circulation / Assessment of postoperative pain / Respiration

Oryginał (EN): A 65-year-old man, ASA III (hypertension, insulin-dependent diabetes, history of myocardial infarction 3 years ago) qualified for a urological TURP (Transurethral Resection of the Prostate). Spinal anesthesia was performed. A few minutes after drug administration, you observe a hypotension and bradycardia. The most likely mechanism is: - Air embolism into the pulmonary circulation / LAST syndrome / Sympathetic blockade with vasodilation and reduced venous return / Vasovagal reflex related to insertion of the urinary catheter / Allergic reaction to the used local anesthetic

Oryginał (EN): In the high-dependency area of the emergency department, cardiac arrest occurs in a 55-year-old patient due to massive traumatic hemorrhage. On the monitor you identify PEA. According to ALS principles in trauma and hypovolemia, the priority will be: - Immediate control of the source of bleeding and aggressive volume replacement with parallel CPR, instead of focusing exclusively on vasopressor drugs / Performing CPR with a recommendation to administer high doses of adrenaline (2-4 mg) in a rapid bolus as the main strategy until ROSC, then control of the bleeding source / Termination of CPR after 3 loops without ROSC, due to high mortality of traumatic cardiac arrest and poor prognosis / Application of chest compressions, with emphasis on replenishing the vessels with balanced crystalloids, avoiding blood products until a complete blood count is obtained / Delaying CPR, apart from administering adrenaline IV in boluses every 3-5 min, until full transfusion of blood equal to the estimated volume lost during trauma

Oryginał (EN): In an internal medicine ward, a 48-year-old patient admitted due to dyspnea develops cardiac arrest in the mechanism of PEA. Standard management for in-hospital cardiac arrest is initiated. Due to a history of malignancy and visualization on bedside ultrasound of a fresh thrombus in the venous vessels of both lower limbs, suspicion of cardiac arrest due to massive pulmonary embolism is raised. Which of the following additional actions is consistent with special circumstances of resuscitation? - Use of higher-than-standard doses of adrenaline (2-4 mg IV) every 2 loops (3-5 min) / Termination of resuscitation after 10 minutes if there is no response to adrenaline / Consideration of immediate systemic thrombolysis during ALS / Withholding CPR until urgent CT pulmonary angiography is performed / Avoidance of thrombolytic drugs during resuscitation, as they are always contraindicated until confirmation by CT angiography

Oryginał (EN): A patient with sepsis, after hemodynamic stabilization, requires further treatment in the ICU. Which element is important in preventing complications? - Continuous deep sedation / Routine use of sedative medications / Monitoring of vital signs only / Early rehabilitation and prevention of complications of immobilization / Limitation of patient mobilization

Oryginał (EN): A 64-year-old man is brought to the emergency department with sudden chest pain, after which he rapidly loses consciousness. He is not breathing normally, no pulse. The monitor shows VF. After three defibrillations with appropriate energy and 2-minute CPR cycles, VF persists. According to the ERC 2025 guidelines, the first antiarrhythmic drug at this stage will be: - Sotalol 80 mg IV / Amiodarone 150 mg IV in a 20-minute infusion / Lidocaine 50 mg IV, followed by an infusion / Adenosine 6 mg IV as a rapid bolus / Amiodarone 300 mg IV as a rapid bolus

Oryginał (EN): In an internal medicine in a high-dependency unit, there is a sudden deterioration in the condition of a 72-year-old patient being treated for heart failure. You find no pulse in the carotid and femoral arteries, no response to stimulation, and pathological respiratory effort. The monitor shows regular electrical cardiac activity at a rate of 65/min. According to the ERC 2025 Guidelines, which of the following actions is most appropriate at this stage? - Initiating CPR, then delivering a single defibrillator shock of 150 J and continuing CPR with rhythm assessment every 2 minutes / Immediate termination of resuscitation, as in-hospital mortality in PEA is too high / Initiating CPR and delaying adrenaline administration until three 2-minute CPR cycles have been completed / Withholding CPR until a full bedside echocardiographic examination is performed to rule out pseudo-PEA / Initiating CPR, immediate administration of 1 mg intravenous adrenaline, and continuation of CPR with rhythm assessment every 2 minutes

Oryginał (EN): The least effective therapy in the treatment of ARDS includes: - prone position / FiO2 control / high tidal volumes (VT 10-12 ml/kg) / PEEP adjusted to the patient / protective ventilation (VT 4-6 ml/kg)

Oryginał (EN): A patient with bradycardia (30/min) was given 0.5 mg of atropine IV, with no improvement in the patient's condition. Which of the following statements incorrectly describes possible further management? - High-dose insulin therapy may be used in cases of beta-blocker overdose / Transcutaneous pacing should be considered if pharmacological treatmnt is ineffective / Epinephrine may be administered as an infusion / Other alternative drugs include aminophylline and dopamine / Glycopyrrolate may be used as an alternative to atropine

Oryginał (EN): The most important parameter confirming correct placement of the endotracheal tube after completion of the procedure: - Absence of air over the stomach / Maintenance of saturation above 95% / Absence of laryngeal vibration / Presence of a persistent capnographic waveform / Symmetry of chest movements

Oryginał (EN): In a patient with irregular breathing, collapse of the tongue base is observed. Which criterion best determines correct selection of an oropharyngeal airway size? - Measurement from the corner of the mouth to the earlobe or from the angle of the mandible to the incisors / Measurement from the tip of the nose to the angle of the mandible / Random selection of the airway depending on body weight / Measurement from the cheek to the base of the nose / Measurement from the earlobe to the angle of the mandible

Oryginał (EN): A sudden increase in ETCO2 during CPR may indicate: - Hypoglycemia / Worsening prognosis / Detachment of ECG electrodes / Return of spontaneous circulation (ROSC) / CO poisoning

Oryginał (EN): In a patient scheduled for general anesthesia, airway assessment is performed. Which of the following parameters and scales are useful in predicting difficult intubation? - 1. Mallampati score / 2. Patil test (thyromental distance) / 3. Cormack-Lehane grade IV documented in the past / 4. Mouth opening < 2 cm / 5. Glasgow Coma Scale / 1, 4 / 2, 3, 4 / 1, 2, 3, 4 / 1, 3, 4 / 3, 4, 5

Oryginał (EN): In a patient with diagnosed sepsis, activation of proinflammatory cytokines and immunological mediators leads to vasodilation and increased vascular permeability. This pathophysiological mechanism most often leads to: - Increase in hematocrit / Constriction of peripheral veins / Decrease in central temperature / Atrioventricular conduction disturbances / Decrease in vascular resistance and hypotension

Oryginał (EN): In the emergency department, cardiac arrest in the mechanism of VF was diagnosed in a 12-year-old (40 kg). After connecting the defibrillator, defibrillation with an energy of 4 J/kg was delivered, followed by 2 minutes of CPR. On rhythm assessment, VF persists. What is consistent with current PLS? - Another defibrillation 4 J/kg and immediate resumption of CPR for 2 min / Another defibrillation with lower energy of 2 J/kg and immediate resumption of CPR for 2 min / Interrupt CPR for 60 s to assess the pulse after defibrillation / Immediate change of energy to 8 J/kg at the second shock and immediate resumption of CPR for 2 min / Withholding defibrillation, then immediate administration of adrenaline and amiodarone

Oryginał (EN): In the diagnosis of septic shock one should assess: - 1. creatinine as an indicator of renal function / 2. arterial blood gas analysis as an indicator of oxygenation and acidosis / 3. coagulation parameters such as INR/d-dimers / 4. markers of CNS injury such as tau protein / 5. procalcitonin and CRP levels as inflammatory markers / 1, 2, 4, 5 / 1, 2, 3 / 1, 3, 5 / 1, 2, 3, 5 / 3, 4, 5

Oryginał (EN): An 89-year-old female patient was admitted to the orthopedic clinic due to an intertrochanteric fracture. She was qualified for surgical treatment. The patient is unable to give informed consent for anesthesia procedures, but the procedure is not urgent. What should be done in such a situation? - Consent to the procedure based on a previous verbal declaration by the patient / Obtain consent from the closest family member / Apply for consent from the guardianship court or legal guardian / Perform the procedure after the form is signed by a nurse / Cancel the procedure or postpone it to another elective date

Oryginał (EN): A patient treated in an internal medicine ward for sepsis has results showing PaO2/FiO2 = 95 mmHg, platelets 60 000/µl, total bilirubin 2 mg/dl, creatinine 1.0 mg/dl. What best describes the interpretation of SOFA? - The score will be elevated in several components, indicating multi-organ failure / Single abnormalities do not affect SOFA / Only the respiratory score will increase / Impossible to assess without data on diuresis / SOFA can be determined only on the basis of circulation

Oryginał (EN): During ALS in an adult patient, rapid intravenous access cannot be obtained. You consider intraosseous access. Correct statements are: - 1. Intraosseous access is an accepted alternative to intravenous access in ALS. / 2. Adrenaline can be administered via the intraosseous route in the same doses as IV. / 3. After each IV/IO drug, flushing and continuation of chest compressions are recommended. / 4. The dose of adrenaline via the intraosseous route should be twice as high as intravenously. / 5. Intraosseous access is contraindicated in cardiac arrest. / 1, 3, 5 / 2, 4, 5 / 3, 4, 5 / 1, 2, 3 / 1, 2, 4

Oryginał (EN): Indicate the false statement regarding intracranial pressure (ICP) monitoring: - ICP sensors may be placed in the lateral ventricles, subarachnoid space or subdural space / Presence of blood in the ventricular system may constitute an indication for placement of an ICP sensor / Intracerebral hematomas not requiring surgical treatment may be an indication for ICP monitoring / Normal ICP values in adults exceed 15 cm H2O at rest / ICP monitoring is indicated in patients with severe head injury and GCS < 8 points

Oryginał (EN): A patient in septic shock receives intravenous crystalloids and norepinephrine infusion at escalating doses. Despite vasopressor infusion, the patient remains hemodynamically unstable. Which pharmacological approach regarding steroids is most justified in this situation? - Routine use of steroids in every patient with sepsis / Consideration of hydrocortisone in shock refractory to fluid therapy and vasopressors / Introduction of steroids only in fever persisting > 48 hours refractory to treatment / Introduction of steroids after obtaining full culture results to exclude atypical infection / Introduction of steroids as an adjuvant to antibiotics in β-lactam allergy

Oryginał (EN): Which mechanism best explains the action of sugammadex? - Activation of acetylcholine receptors at the neuromuscular junction / Formation of complexes with aminosteroid neuromuscular blocking agents via direct binding / Activation of GABA receptors in the CNS causing sedation / Inhibition of opioid receptors leading to loss of analgesia / Blocking sodium channels in axons causes a reversible blockade of nerve conduction

Oryginał (EN): On the monitor of a patient in the intensive care unit an isoelectric line is visible. The patient is unconscious, not breathing normally, no pulse in the carotid and femoral arteries. According to the ERC 2025 guidelines the correct first action is: - Immediate administration of amiodarone 300 mg IV as the first drug, then after 2 min of CPR 1 mg adrenaline IV / Delay CPR until placement of central venous access, then perform CPR and administer 1 mg adrenaline / Immediate initiation of chest compressions, brief confirmation of asystole in at least two leads, administration of 1 mg adrenaline IV / Immediate delivery of defibrillation 300 J, because every isoelectric line may be fine ventricular fibrillation, then CPR with administration of 1 mg adrenaline IV / Initiation of CPR after performing a full cardiac ultrasound examination

Oryginał (EN): Which laboratory test is key for the diagnosis of refeeding syndrome? - Hypophosphatemia after initiation of feeding / Hyperkalemia on the second day of treatment / Decrease in plasma osmotic pressure / Increase in calcium concentration / Elevated sodium concentration

Oryginał (EN): In the course of hypovolemic shock one observes: - 1. reduction of circulating blood volume / 2. decrease in preload / 3. activation of the sympathetic nervous system / 4. increase in cardiac output / 5. centralization of circulation / 1, 3, 4 / 1, 3, 5 / 1, 3, 4, 5 / 1, 2, 3, 5 / 2, 4, 5

Oryginał (EN): A 45-year-old patient is brought to the emergency department with sudden dyspnea, wheezing, prolonged expiration. RR 32/min, SpO2 88% on 15 l of oxygen, HR 130/min, blood pressure 120/70 mmHg. According to information from EMS, the patient has hypertension and bronchial asthma. On examination: markedly impaired ventilation. In the emergency department, cardiac arrest occurs in PEA. According to the ERC 2025 ALS guidelines in such a patient after intubation one should: - Use a low respiratory rate with prolonged expiration and avoid hyperventilation, to limit air trapping and dynamic hyperinflation / Regularly obtain arterial blood gas analysis to aim for PaCO2 < 30 mmHg in order to prevent respiratory acidosis / Ventilate rapidly (20-24/min) with a large tidal volume to improve gas exchange as quickly as possible / Avoid bronchodilator drugs so as not to mask symptoms / Immediately initiate therapeutic hypothermia due to high mortality if it is not implemented

Oryginał (EN): In ARDS the PaO2/FiO2 ratio is used for: - Classification of hypoxemia severity / Assessment of metabolic acidosis / Assessment of circulatory efficiency / Assessment of hypercapnia / Estimation of pH

Oryginał (EN): In which condition is norepinephrine indicated as the first-line vasopressor?

Oryginał (EN): What is the target mean arterial pressure (MAP) in septic shock?

Oryginał (EN): What is the preferred first-line vasopressor in septic shock according to ERC/critical care guidelines?

Oryginał (EN): What is correct about intraosseous (IO) access?

Oryginał (EN): What is the preferred site for IO access in adults?

Oryginał (EN): What is the correct positioning for a pregnant patient during resuscitation?

Oryginał (EN): Why is left uterine displacement important in pregnancy?

Oryginał (EN): What are the correct parameters for high-quality CPR?

Oryginał (EN): What compression-to-ventilation ratio is used in adult CPR without an advanced airway?

Oryginał (EN): What is the recommended chest compression depth in adults?

Oryginał (EN): Which induction agent can cause seizure-like activity or myoclonus?

Oryginał (EN): Which induction agent is preferred in hemodynamically unstable patients?

Oryginał (EN): How do you measure the correct size of an oropharyngeal airway (OPA)?

Oryginał (EN): In which patient should an OPA NOT be used?

Oryginał (EN): A patient has a Glasgow Coma Scale (GCS) score of 6. What does this indicate?

Oryginał (EN): At what GCS score should intubation generally be considered?

Oryginał (EN): A patient presents with back pain, fever, and neurological deficits. What is the most likely diagnosis?

Oryginał (EN): What imaging modality is best for diagnosing spinal epidural abscess?

Oryginał (EN): FAST ultrasound shows a hypoechoic area in the Pouch of Douglas. What does this indicate?

Oryginał (EN): In a woman of reproductive age with free fluid in the Pouch of Douglas and shock, what diagnosis must be excluded first?

Oryginał (EN): What does ARDS stand for?

Oryginał (EN): What is the most common cause of ARDS?

Oryginał (EN): What are other common causes of ARDS?

Oryginał (EN): What is the hallmark pathophysiology of ARDS?

Oryginał (EN): What is the Berlin definition criterion for ARDS oxygenation severity?

Oryginał (EN): What PaO₂/FiO₂ ratio defines mild ARDS?

Oryginał (EN): What PaO₂/FiO₂ ratio defines moderate ARDS?

Oryginał (EN): What PaO₂/FiO₂ ratio defines severe ARDS?

Oryginał (EN): What does FiO₂ mean?

Oryginał (EN): What is normal room air FiO₂?

Oryginał (EN): What is the purpose of the PaO₂/FiO₂ ratio?

Oryginał (EN): What ventilation strategy is recommended in ARDS?

Oryginał (EN): What PEEP strategy is used in ARDS?

Oryginał (EN): What positioning improves oxygenation in severe ARDS?

Oryginał (EN): What is a target plateau pressure in ARDS ventilation?

Oryginał (EN): What does ETCO₂ measure?

Oryginał (EN): What is the normal ETCO₂ range?

Oryginał (EN): What is the gold standard to confirm endotracheal tube placement?

Oryginał (EN): What does a sudden drop in ETCO₂ during CPR suggest?

Oryginał (EN): What ETCO₂ value during CPR is associated with better-quality compressions?

Oryginał (EN): What is an advantage of inhalational anesthetics over intravenous anesthesia?

Oryginał (EN): Which postoperative analgesia is best for an obese diabetic patient after laparoscopic hemicolectomy?

Oryginał (EN): What is a key principle of the 2025 airway guidelines?

Oryginał (EN): What device is recommended as first-line for intubation in the 2025 airway guidelines?

Oryginał (EN): What is the preferred method of preoxygenation before intubation?

Oryginał (EN): What is the purpose of apneic oxygenation during intubation?

Oryginał (EN): What is the first-line rescue device in difficult airway management?

Oryginał (EN): What is the most reliable sign of successful intubation?

Oryginał (EN): What does absent ETCO₂ after intubation suggest?

Oryginał (EN): What oxygen saturation target is generally recommended in critically ill adults?

Oryginał (EN): What is the first step in management of tension pneumothorax?

Oryginał (EN): What is the preferred vasopressor if norepinephrine alone is insufficient in septic shock?

Oryginał (EN): Which sedative agent has bronchodilator properties and preserves airway reflexes?

Oryginał (EN): What is the antidote for opioid overdose?

Oryginał (EN): What is the antidote for benzodiazepine overdose?

Oryginał (EN): What is the preferred crystalloid for initial septic shock resuscitation?

Oryginał (EN): What lactate level may indicate tissue hypoperfusion in sepsis?

Oryginał (EN): What is the recommended initial fluid bolus in septic shock?

Oryginał (EN): What rhythm is most commonly associated with sudden cardiac arrest in adults?

Oryginał (EN): Which rhythms are shockable in cardiac arrest?

Oryginał (EN): Which induction agent is associated with muscle twitching/myoclonus?

Oryginał (EN): Which intravenous anesthetic commonly causes respiratory depression with decreased respiratory rate?

Oryginał (EN): Compared with IV anesthesia, what is a characteristic of inhalational anesthesia?

Oryginał (EN): What is the first-line treatment for anaphylactic shock?

Oryginał (EN): In which shock state is norepinephrine considered first-line vasopressor therapy?

Oryginał (EN): According to hypothermia cardiac arrest management, how many defibrillation attempts should initially be performed?

Oryginał (EN): What positioning should be used in a pregnant patient during resuscitation?

Oryginał (EN): A patient opens eyes to pain, makes incomprehensible sounds, and extends arms to pain. What is the GCS?

Oryginał (EN): During intubation, ETCO₂ is absent and esophageal placement is suspected. What should be done?

Oryginał (EN): Which parameter is NOT part of the Aldrete score?

Oryginał (EN): When is a behavioral pain scale mainly used in children?

Oryginał (EN): What does PEA stand for in cardiac arrest?

Oryginał (EN): What medication is given after the third shock in refractory VF/pulseless VT?

Oryginał (EN): What calcium preparation is commonly used during CRRT with citrate anticoagulation?

Oryginał (EN): What does a sudden increase in ETCO₂ during CPR most likely indicate?

Oryginał (EN): What does persistently low ETCO₂ during CPR suggest?

Oryginał (EN): Low ETCO₂ in a ventilated patient may indicate which life-threatening condition?

Oryginał (EN): How is the correct insertion depth of an endotracheal tube estimated in children?

Oryginał (EN): What are the major indications for magnesium sulfate in emergency medicine?

Oryginał (EN): Which of the following is NOT an indication for CRRT? Oliguria due to dehydration

Oryginał (EN): What are indications for CRRT?

Oryginał (EN): What is preferred postoperative analgesia after hemicolectomy?

Oryginał (EN): What is an advantage of regional anesthesia in children?

Oryginał (EN): In the Cormack-Lehane classification, what does Grade IV mean?

Oryginał (EN): One week after epidural anesthesia, a postpartum woman develops fever and neurologic symptoms. What is the likely diagnosis?

Oryginał (EN): Which supraglottic airway device does NOT require cuff inflation?

Oryginał (EN): Which regional anesthesia technique is commonly used for hip surgery/hip arthroscopy analgesia?

Oryginał (EN): An elderly woman with intertrochanteric fracture is confused and unable to consent. What is required before surgery?

Oryginał (EN): What is the PaO₂/FiO₂ ratio used to assess?

Oryginał (EN): What is the main receptor activity of norepinephrine?

Oryginał (EN): Which local anesthetic has a longer duration of action: bupivacaine or lidocaine?

Oryginał (EN): Which opioid has a significant risk of dependence and misuse?

Oryginał (EN): What is the most common side effect of postoperative opioid use?

Oryginał (EN): In cardiac arrest caused by suspected pulmonary embolism, what treatment should be considered?

Oryginał (EN): What causes a left shift of the oxygen-hemoglobin dissociation curve?

Oryginał (EN): Which ICU triage categories should receive ICU admission priority?

Oryginał (EN): A 40-kg child remains in VF during CPR. What defibrillation energy should be used?

Oryginał (EN): FAST ultrasound shows hypoechoic fluid in Morrison’s pouch. What does this indicate?

Oryginał (EN): What ventilation rate is recommended during CPR with an advanced airway?

Oryginał (EN): What is the underlying pathology in ARDS?

Oryginał (EN): Which ventilation strategy is harmful in ARDS?

Oryginał (EN): What is FALSE regarding high-flow nasal oxygen therapy?

Oryginał (EN): What are the correct chest compression parameters in adult CPR?

Oryginał (EN): Which factors can affect pulse oximetry accuracy?

Oryginał (EN): Does anemia significantly affect pulse oximetry saturation readings?

Oryginał (EN): What is the best method to confirm successful intubation?

Oryginał (EN): After ROSC, what oxygen saturation target is recommended?

Oryginał (EN): Rising SOFA score indicates what?

Oryginał (EN): Which parameters are included in the SOFA score?

Oryginał (EN): Are CRP and procalcitonin components of the SOFA score?

Oryginał (EN): In septic shock refractory to fluids and vasopressors, what steroid is recommended?

Oryginał (EN): After prolonged CPR without ROSC in a patient with poor prognosis and terminal malignancy, what should be considered?

Oryginał (EN): What is the recommended tidal volume in ARDS ventilation?

Oryginał (EN): What is the first step after recognizing VF on the monitor?

Oryginał (EN): What rhythm is characterized by electrical activity without a palpable pulse?

Oryginał (EN): What reversible causes should always be considered in PEA?

Oryginał (EN): What are the “4 Ts” in cardiac arrest reversible causes?

Oryginał (EN): What are the “4 Hs” in cardiac arrest reversible causes?

Oryginał (EN): What is the recommended route for adrenaline administration in anaphylaxis?

Oryginał (EN): What finding on capnography strongly suggests esophageal intubation?