Critical care: ARDS definition: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anaesthesia · Critical care: ARDS definition

Sample item

Which finding is required for a diagnosis of ARDS by the Berlin definition?

AUnilateral infiltrate with PaO2/FiO2 above 400BChronic onset over monthsCAcute onset, bilateral opacities, PaO2/FiO2 of 300 or less with PEEP of 5 or more, not fully explained by cardiac failureDRaised left atrial pressure

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Acute onset, bilateral opacities, PaO2/FiO2 of 300 or less with PEEP of 5 or more, not fully explained by cardiac failure

ARDS develops within a week of a known insult and is graded by PaO2/FiO2 into mild (200 to 300), moderate (100 to 200) and severe (under 100). Cardiogenic oedema must be excluded.

Option by option

A. Unilateral infiltrate with PaO2/FiO2 above 400
A unilateral infiltrate with good oxygenation is not ARDS.
B. Chronic onset over months
ARDS has an acute onset.
C. Acute onset, bilateral opacities, PaO2/FiO2 of 300 or less with PEEP of 5 or more, not fully explained by cardiac failure (correct)
Correct. This is the Berlin definition.
D. Raised left atrial pressure
Raised left atrial pressure suggests cardiogenic oedema.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is C, Acute onset, bilateral opacities, PaO2/FiO2 of 300 or less with PEEP of 5 or more, not fully explained by cardiac failure. ARDS develops within a week of a known insult and is graded by PaO2/FiO2 into mild (200 to 300), moderate (100 to 200) and severe (under 100).

Why is "Unilateral infiltrate with PaO2/FiO2 above 400" not the answer?

A unilateral infiltrate with good oxygenation is not ARDS.

Why is "Chronic onset over months" not the answer?

ARDS has an acute onset.

Why is "Raised left atrial pressure" not the answer?

Raised left atrial pressure suggests cardiogenic oedema.

What concept does this question test?

It tests Critical care: ARDS definition in Anaesthesia. Cardiogenic oedema must be excluded.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Critical care: ARDS definition?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.