CICM question of the week.
Week of 26 October 2026. Have a go, then see the reasoning behind every option.
Which nephron segment and principal apical transport mechanism account for the largest share of filtered sodium reabsorption?
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CICM-style questions, marked with a reason for every option. Free account, no card.
Earlier weeks
A 62-year-old man with cirrhosis and tense ascites has 7 litres drained in one session. His creatinine is 95 micromol/L. Which plasma volume replacement is most appropriate?
A 69-year-old man taking aspirin and clopidogrel four months after a drug-eluting coronary stent is admitted to intensive care with an upper gastrointestinal bleed from a duodenal ulcer, treated endoscopically. Long-term proton pump inhibitor therapy is planned while dual antiplatelet therapy continues. Which approach best preserves the antiplatelet effect of clopidogrel?
A 70-year-old man is on day 4 of septic shock from pneumonia, receiving noradrenaline and hydrocortisone 50 mg 6-hourly. He has no history of thyroid disease. Free T3 is 2.1 pmol/L (reference 3.5–6.5), free T4 10 pmol/L (10–20) and TSH 0.3 mU/L (0.4–4.0). What is the most appropriate management of these results?
A patient on an unfractionated heparin infusion of 40 000 units/day for a pulmonary embolism has an APTT that remains near normal. The anti-Xa level is 0.1 units/mL (target 0.3 to 0.7), and antithrombin activity is 38%. What best explains the poor response?
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