Question:
Which option gives the best clinical synopsis of these ICU measurements?

Options:
A. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (142 to 121), MAP rose from 83 to 89, and heart rate was roughly stable (66 to 73). SpO2 started at 97, ended at 99, and fell as low as 87 around hour 1.4; respiratory rate ranged 18-20. For labs and output, white count was 12.2 on its only check, creatinine was 0.7 on its only check, lactate was not available, and urine output fell from 2930 to 380.
B. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (122 to 125), MAP rose from 80 to 86, and heart rate was roughly stable (69 to 70). SpO2 started at 100, ended at 96, and fell as low as 88 around hour 1.6; respiratory rate ranged 16-22. For labs and output, white count was 13.7 on its only check, creatinine was 0.6 on its only check, lactate was not available, and urine output fell from 2850 to 400.
C. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 118 to 121, MAP rose from 84 to 90, and heart rate was roughly stable (65 to 74). SpO2 started at 96, ended at 100, and fell as low as 92 around hour 1.4; respiratory rate ranged 18-20. For labs and output, white count was 11.8 on its only check, creatinine was 0.7 on its only check, lactate was not available, and urine output fell from 2950 to 375.
D. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (92 to 155), MAP rose from 76 to 82, and heart rate was roughly stable (74 to 73). SpO2 started at 96, ended at 92, and fell as low as 84 around hour 1.9; respiratory rate ranged 14-24. For labs and output, white count was 15.9 on its only check, creatinine was 0.4 on its only check, lactate was not available, and urine output fell from 2730 to 430.

Answer: B


Question:
Which clinical summary is best supported by the time-stamped measurements?

Options:
A. Across the recorded window, the heart rate rose from 40 to 50, while MAP fell from 107 to 97. Systolic pressure was labile, ranging 126-164, with the lowest value around hour 21.4. SpO2 briefly dipped to 88 around hour 1.4 before recovering to 88, while respiratory rate peaked at 22 and later settled at 16. The associated labs and urine output showed that white count fell from 13 to 11.4, creatinine was roughly stable (0.8 to 0.7), lactate was not available, and urine output rose from 500 to 600, with recorded outputs ranging 300-700.
B. Across the recorded window, the heart rate rose from 38 to 52, while MAP fell from 105 to 95. Systolic pressure was labile, ranging 130-179, with the lowest value around hour 20.3. SpO2 briefly dipped to 87 around hour 1.2 before recovering to 90, while respiratory rate peaked at 24 and later settled at 15. The associated labs and urine output showed that white count fell from 14 to 10.3, creatinine was roughly stable (0.7 to 0.8), lactate was not available, and urine output rose from 485 to 585, with recorded outputs ranging 315-715.
C. Across the recorded window, the heart rate rose from 44 to 46, while MAP fell from 111 to 100. Systolic pressure was labile, ranging 101-139, with the lowest value around hour 23.3. SpO2 briefly dipped to 92 around hour 2.4 before recovering to 84, while respiratory rate peaked at 24 and later settled at 18. The associated labs and urine output showed that white count fell from 11 to 9.5, creatinine was roughly stable (0.9 to 0.6), lactate was not available, and urine output was roughly stable (525 to 550), with recorded outputs ranging 275-675.
D. Across the recorded window, the heart rate rose from 36 to 54, while MAP fell from 102 to 92. Systolic pressure was labile, ranging 156-194, with the lowest value around hour 19.1. SpO2 briefly dipped to 84 around hour 1.1 before recovering to 92, while respiratory rate peaked at 20 and later settled at 14. The associated labs and urine output showed that white count fell from 15 to 10.6, creatinine stayed around 0.7, lactate was not available, and urine output rose from 500 to 600, with recorded outputs ranging 350-700.

Answer: A


Question:
Which option is most consistent with the actual sequence of measurements?

Options:
A. Clinically, the heart rate stayed around 53, while MAP rose from 55 to 88. Systolic pressure was labile, ranging 142-207, with the lowest value around hour 0.8. SpO2 briefly dipped to 82 around hour 9.7 before recovering to 97, while respiratory rate peaked at 20 and later settled at 20. The associated labs and urine output showed that white count was roughly stable (7.0 to 6.7), creatinine was roughly stable (3.1 to 4), lactate was checked once at 1.6, and urine output fell from 220 to 25, with recorded outputs ranging 25-305.
B. Clinically, the heart rate stayed around 50, while MAP rose from 58 to 85. Systolic pressure was labile, ranging 122-187, with the lowest value around hour 0.7. SpO2 briefly dipped to 85 around hour 8.7 before recovering to 100, while respiratory rate peaked at 22 and later settled at 18. The associated labs and urine output showed that white count was roughly stable (6.5 to 7.2), creatinine was roughly stable (2.9 to 3), lactate was checked once at 1.8, and urine output fell from 200 to 75, with recorded outputs ranging 75-325.
C. Clinically, the heart rate stayed around 54, while MAP rose from 54 to 89. Systolic pressure was labile, ranging 147-212, with the lowest value around hour 0.8. SpO2 briefly dipped to 81 around hour 9.3 before recovering to 96, while respiratory rate peaked at 20 and later settled at 20. The associated labs and urine output showed that white count was roughly stable (7.1 to 6.4), creatinine rose from 3.1 to 3.6, lactate was checked once at 1.6, and urine output fell from 225 to 79, with recorded outputs ranging 71-300.
D. Clinically, the heart rate stayed around 46, while MAP rose from 62 to 80. Systolic pressure was labile, ranging 92-157, with the lowest value around hour 0.5. SpO2 briefly dipped to 90 around hour 7.9 before recovering to 96, while respiratory rate peaked at 24 and later settled at 16. The associated labs and urine output showed that white count was roughly stable (5.8 to 8.0), creatinine was roughly stable (2.6 to 2), lactate was checked once at 2.1, and urine output fell from 170 to 70, with recorded outputs ranging 80-355.

Answer: B


Question:
Which option best reflects the important trends and outliers in this episode?

Options:
A. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 142 to 183, MAP rose from 61 to 88, and heart rate stayed around 47. SpO2 started at 100, ended at 97, and fell as low as 84 around hour 9.2; respiratory rate ranged 10-20. For labs and output, white count was roughly stable (7.0 to 6.7), creatinine was roughly stable (3.1 to 4), lactate was checked once at 1.6, and urine output fell from 220 to 78.
B. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 107 to 202, MAP rose from 56 to 83, and heart rate was roughly stable (52 to 53). SpO2 started at 98, ended at 100, and fell as low as 85 around hour 8.7; respiratory rate ranged 11-24. For labs and output, white count was roughly stable (6.5 to 6.4), creatinine was roughly stable (2.9 to 3), lactate was checked once at 1.8, and urine output fell from 200 to 75.
C. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 147 to 191, MAP rose from 62 to 89, and heart rate stayed around 46. SpO2 started at 100, ended at 96, and fell as low as 89 around hour 9.3; respiratory rate ranged 9-20. For labs and output, white count was roughly stable (7.1 to 6.6), creatinine rose from 3.1 to 3.6, lactate was checked once at 2, and urine output fell from 225 to 79.
D. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 122 to 187, MAP rose from 58 to 85, and heart rate stayed around 50. SpO2 started at 98, ended at 100, and fell as low as 85 around hour 8.7; respiratory rate ranged 11-22. For labs and output, white count was roughly stable (6.5 to 7.2), creatinine was roughly stable (2.9 to 3), lactate was checked once at 1.8, and urine output fell from 200 to 75.

Answer: D


Question:
Which summary best represents the patient's recorded course across the episode?

Options:
A. Over the available measurements, the heart rate stayed around 50, MAP rose from 58 to 85, and diastolic pressure moved from 38 to 49. Systolic pressure ranged 122-187 and ended at 187, and SpO2 recovered to 100 after a low of 85 around hour 8.7. Respiratory rate ended at 18; the available labs showed white count was roughly stable (6.5 to 7.2), creatinine was roughly stable (2.9 to 3), lactate was checked once at 1.8, and urine output fell from 200 to 75.
B. Over the available measurements, the heart rate was roughly stable (48 to 53), MAP rose from 58 to 85, and diastolic pressure moved from 38 to 46. Systolic pressure ranged 122-187 and ended at 187, and SpO2 recovered to 100 after a low of 85 around hour 8.7. Respiratory rate ended at 18; the available labs showed white count was roughly stable (6.5 to 7.2), creatinine was roughly stable (2.9 to 3), lactate was checked once at 1.8, and urine output fell from 200 to 75.
C. Over the available measurements, the heart rate stayed around 54, MAP rose from 54 to 89, and diastolic pressure moved from 42 to 45. Systolic pressure ranged 147-162 and ended at 162, and SpO2 recovered to 96 after a low of 84 around hour 9.3. Respiratory rate ended at 20; the available labs showed white count was roughly stable (5.9 to 6.4), creatinine was roughly stable (3.1 to 2), lactate was checked once at 2.0, and urine output fell from 250 to 71.
D. Over the available measurements, the heart rate stayed around 46, MAP rose from 62 to 88, and diastolic pressure moved from 34 to 54. Systolic pressure ranged 92-217 and ended at 183, and SpO2 recovered to 96 after a low of 90 around hour 9.7. Respiratory rate ended at 16; the available labs showed white count was roughly stable (7.2 to 6.5), creatinine was roughly stable (2.6 to 4), lactate was checked once at 1.5, and urine output fell from 170 to 80.

Answer: A


Question:
Which summary best preserves the direction and size of the recorded changes?

Options:
A. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (73 to 62), diastolic pressure fell from 53 to 47, and heart rate rose from 98 to 110. The lowest MAP was about 40 around hour 11.6, and the lowest valid SpO2 was 88 around hour 1.1; respiratory rate rose as high as 29 but ended at 18. The lower-frequency data fit that summary: temperature stayed around 33-34.8 C, white count fell from 26 to 21.1, creatinine was roughly stable (1.7 to 1.6), lactate stayed broadly stable from 1.3 to 4.8, and urine output was roughly stable (100 to 64)
B. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (68 to 67), diastolic pressure fell from 48 to 42, and heart rate rose from 103 to 110. The lowest MAP was about 35 around hour 14.2, and the lowest valid SpO2 was 83 around hour 0.3; respiratory rate rose as high as 26 but ended at 16. The lower-frequency data fit that summary: temperature stayed around 38-40.0 C, white count fell from 23 to 21.5, creatinine stayed around 1.4, lactate stayed broadly stable from 1.1 to 5.2, and urine output fell from 98 to 13.
C. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (74 to 61), diastolic pressure fell from 54 to 41, and heart rate rose from 97 to 111. The lowest MAP was about 40 around hour 14.1, and the lowest valid SpO2 was 89 around hour 1.1; respiratory rate rose as high as 29 but ended at 19. The lower-frequency data fit that summary: temperature stayed around 32-34.0 C, white count fell from 26 to 20.7, creatinine stayed around 1.8, lactate stayed broadly stable from 1.6 to 4.2, and urine output fell from 96 to 16.
D. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (70 to 65), diastolic pressure fell from 50 to 44, and heart rate rose from 101 to 107. The lowest MAP was about 37 around hour 13.1, and the lowest valid SpO2 was 85 around hour 1.3; respiratory rate rose as high as 27 but ended at 17. The lower-frequency data fit that summary: temperature stayed around 36-37.8 C, white count fell from 24 to 22.6, creatinine stayed around 1.5, lactate stayed broadly stable from 1.3 to 4.8, and urine output fell from 100 to 14.

Answer: D

Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (70 to 65), diastolic pressure fell from 50 to 44, and heart rate rose from 101 to 107. The lowest MAP was about 37 around hour 13.1, and the lowest valid SpO2 was 85 around hour 1.3; respiratory rate rose as high as 27 but ended at 17. The lower-frequency data fit that summary: temperature ranged from 96.8 to 100.1, white count fell from 24 to 22.6, creatinine stayed around 1.5, lactate stayed broadly stable from 1.3 to 4.8, and urine output fell from 100 to 14.


Question:
Which synopsis best matches the observed sequence rather than a plausible alternative?

Options:
A. Clinically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 152 to 105, MAP was roughly stable (95 to 96), and heart rate fell from 70 to 66. SpO2 started at 93, ended at 100, and fell as low as 99 around hour 8.7; respiratory rate ranged 18-20. For labs and output, white count rose from 10.3 to 13.6, creatinine was roughly stable (0.5 to 0.4), lactate was not available, and urine output was not recorded.
B. Clinically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 132 to 125, MAP was roughly stable (92 to 93), and heart rate fell from 73 to 63. SpO2 started at 96, ended at 97, and fell as low as 96 around hour 9.2; respiratory rate ranged 16-18. For labs and output, white count rose from 11.8 to 14.4, creatinine was roughly stable (0.4 to 0.5), lactate was not available, and urine output was not recorded.
C. Clinically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 157 to 121, MAP was roughly stable (96 to 96), and heart rate fell from 69 to 67. SpO2 started at 92, ended at 100, and fell as low as 95 around hour 8.6; respiratory rate ranged 16-18. For labs and output, white count rose from 9.9 to 16.3, creatinine was roughly stable (0.5 to 0.4), lactate was not available, and urine output was not recorded.
D. Clinically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 102 to 82, MAP was roughly stable (88 to 88), and heart rate fell from 78 to 58. SpO2 started at 100, ended at 92, and fell as low as 92 around hour 9.9; respiratory rate ranged 14-20. For labs and output, white count rose from 14.1 to 15.6, creatinine rose from 0.2 to 0.6, lactate was not available, and urine output was not recorded.

Answer: B


Question:
Which clinical synopsis would you choose after reviewing the data chronologically?

Options:
A. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 97 to 79, diastolic pressure rose from 70 to 78, and heart rate rose from 64 to 86. The lowest MAP was about 68 around hour 25.4, and the lowest valid SpO2 was 88 around hour 1.0; respiratory rate rose as high as 27 but ended at 16. The lower-frequency data fit that summary: temperature stayed around 33.3-34 C, white count was 14.0 on its only check, creatinine was 0.6 on its only check, lactate was not available, and urine output fell from 2830 to 350.
B. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 94 to 82, diastolic pressure rose from 67 to 75, and heart rate rose from 67 to 83. The lowest MAP was about 65 around hour 26.9, and the lowest valid SpO2 was 85 around hour 1.2; respiratory rate rose as high as 25 but ended at 14. The lower-frequency data fit that summary: temperature stayed around 36.3-37 C, white count was 12.5 on its only check, creatinine was 0.7 on its only check, lactate was not available, and urine output fell from 2750 to 300.
C. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 98 to 78, diastolic pressure rose from 71 to 79, and heart rate rose from 63 to 86. The lowest MAP was about 69 around hour 25.0, and the lowest valid SpO2 was 89 around hour 0.2; respiratory rate rose as high as 27 but ended at 16. The lower-frequency data fit that summary: temperature stayed around 32.5-33 C, white count was 14.4 on its only check, creatinine was 0.6 on its only check, lactate was not available, and urine output fell from 2850 to 325.
D. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 90 to 86, diastolic pressure was roughly stable (62 to 72), and heart rate rose from 72 to 78. The lowest MAP was about 68 around hour 27.9, and the lowest valid SpO2 was 80 around hour 1.5; respiratory rate rose as high as 23 but ended at 12. The lower-frequency data fit that summary: temperature stayed around 40.8-42 C, white count was 10.2 on its only check, creatinine was 0.8 on its only check, lactate was not available, and urine output fell from 2630 to 270.

Answer: B

For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 94 to 82, diastolic pressure rose from 67 to 75, and heart rate rose from 67 to 83. The lowest MAP was about 65 around hour 26.9, and the lowest valid SpO2 was 85 around hour 1.2; respiratory rate rose as high as 25 but ended at 14. The lower-frequency data fit that summary: temperature ranged from 97.4 to 98.6, white count was 12.5 on its only check, creatinine was 0.7 on its only check, lactate was not available, and urine output fell from 2750 to 300.


Question:
Which brief chart summary best matches the measurement sequence?

Options:
A. Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (69 to 67), diastolic pressure was roughly stable (62 to 65), and heart rate was roughly stable (87 to 95). The lowest MAP was about 65 around hour 7.7, and the lowest valid SpO2 was 86 around hour 1.0; respiratory rate rose as high as 25 but ended at 18. The lower-frequency data fit that summary: temperature stayed around 33.8-34.7 C, white count rose from 4.8 to 7.6, creatinine was roughly stable (0.7 to 0.7), lactate fell from 349 to 2.2, and urine output rose from 400 to 550.
B. Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (64 to 72), diastolic pressure stayed around 57, and heart rate was roughly stable (90 to 92). The lowest MAP was about 65 around hour 9.2, and the lowest valid SpO2 was 83 around hour 1.2; respiratory rate rose as high as 23 but ended at 16. The lower-frequency data fit that summary: temperature stayed around 36.8-37.7 C, white count rose from 4.3 to 8.1, creatinine stayed around 0.6, lactate fell from 349 to 2.2, and urine output rose from 400 to 500.
C. Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (66 to 70), diastolic pressure was roughly stable (59 to 62), and heart rate was roughly stable (90 to 92). The lowest MAP was about 62 around hour 8.2, and the lowest valid SpO2 was 83 around hour 1.2; respiratory rate rose as high as 23 but ended at 16. The lower-frequency data fit that summary: temperature stayed around 36.8-37.7 C, white count rose from 4.3 to 8.1, creatinine stayed around 0.6, lactate fell from 349 to 2.2, and urine output rose from 400 to 500.
D. Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (62 to 74), diastolic pressure was roughly stable (54 to 58), and heart rate was roughly stable (94 to 95). The lowest MAP was about 58 around hour 8.9, and the lowest valid SpO2 was 78 around hour 0.2; respiratory rate rose as high as 21 but ended at 14. The lower-frequency data fit that summary: temperature stayed around 41.3-42.2 C, white count rose from 3.5 to 8.8, creatinine stayed around 0.4, lactate fell from 319 to 2.5, and urine output rose from 370 to 470.

Answer: C

Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (66 to 70), diastolic pressure was roughly stable (59 to 62), and heart rate was roughly stable (90 to 92). The lowest MAP was about 62 around hour 8.2, and the lowest valid SpO2 was 83 around hour 1.2; respiratory rate rose as high as 23 but ended at 16. The lower-frequency data fit that summary: temperature ranged from 37 to 99.9, white count rose from 4.3 to 8.1, creatinine stayed around 0.6, lactate fell from 349 to 2.2, and urine output rose from 400 to 500.


Question:
After checking the full sequence of measurements, which handoff is most accurate?

Options:
A. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 93 to 95, MAP was roughly stable (69 to 73), and heart rate was roughly stable (87 to 95). SpO2 started at 97, ended at 99, and fell as low as 86 around hour 1.0; respiratory rate ranged 12-25. For labs and output, white count rose from 3.8 to 7.3, creatinine stayed around 0.7, lactate fell from 329 to 2.4, and urine output rose from 420 to 480.
B. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 88 to 100, MAP was roughly stable (64 to 68), and heart rate was roughly stable (92 to 90). SpO2 started at 98, ended at 94, and fell as low as 81 around hour 1.4; respiratory rate ranged 9-24. For labs and output, white count rose from 4.7 to 7.7, creatinine was roughly stable (0.5 to 0.7), lactate fell from 349.2 to 2.2, and urine output rose from 400 to 500.
C. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (94 to 94), MAP rose from 70 to 73, and heart rate was roughly stable (86 to 96). SpO2 started at 96, ended at 100, and fell as low as 82 around hour 0.9; respiratory rate ranged 12-21. For labs and output, white count rose from 3.7 to 8.7, creatinine stayed around 0.7, lactate fell from 324 to 2.5, and urine output rose from 425 to 475.
D. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 90 to 98, MAP was roughly stable (66 to 70), and heart rate was roughly stable (90 to 92). SpO2 started at 100, ended at 96, and fell as low as 83 around hour 1.2; respiratory rate ranged 10-23. For labs and output, white count rose from 4.3 to 8.1, creatinine stayed around 0.6, lactate fell from 349 to 2.2, and urine output rose from 400 to 500.

Answer: D


Question:
Which handoff summary best matches the measured ICU course?

Options:
A. In broad terms, the heart rate was roughly stable (90 to 92), MAP was roughly stable (66 to 70), and diastolic pressure moved from 59 to 62. Systolic pressure ranged 85-140 and ended at 98, and SpO2 recovered to 96 after a low of 83 around hour 1.2. Respiratory rate ended at 16; the available labs showed white count rose from 4.3 to 8.1, creatinine stayed around 0.6, lactate fell from 349 to 2.2, and urine output rose from 400 to 500.
B. In broad terms, the heart rate was roughly stable (88 to 94), MAP rose from 64 to 73, and diastolic pressure moved from 61 to 60. Systolic pressure ranged 83-125 and ended at 94, and SpO2 recovered to 98 after a low of 81 around hour 2.2. Respiratory rate ended at 17; the available labs showed white count rose from 3.9 to 7.7, creatinine stayed around 0.7, lactate fell from 334 to 2.1, and urine output rose from 415 to 485.
C. In broad terms, the heart rate was roughly stable (94 to 95), MAP was roughly stable (70 to 74), and diastolic pressure moved from 55 to 59. Systolic pressure ranged 89-165 and ended at 100, and SpO2 recovered to 92 after a low of 87 around hour 1.4. Respiratory rate ended at 14; the available labs showed white count rose from 4.9 to 8.7, creatinine stayed around 0.5, lactate fell from 374 to 2.5, and urine output rose from 375 to 525.
D. In broad terms, the heart rate was roughly stable (86 to 96), MAP was roughly stable (62 to 66), and diastolic pressure moved from 64 to 58. Systolic pressure ranged 80-110 and ended at 94, and SpO2 recovered to 100 after a low of 82 around hour 0.9. Respiratory rate ended at 18; the available labs showed white count rose from 3.5 to 7.3, creatinine stayed around 0.8, lactate fell from 319 to 1.9, and urine output was roughly stable (450 to 470)

Answer: A


Question:
Which summary best represents the patient's recorded course across the episode?

Options:
A. Clinically, the heart rate fell from 81 to 66, MAP was roughly stable (97 to 97), and diastolic pressure moved from 83 to 86. Systolic pressure ranged 95-174 and ended at 137, and SpO2 recovered to 96 after a low of 88 around hour 1.4. Respiratory rate ended at 20; the available labs showed white count fell from 15.9 to 13.3, creatinine rose from 0.8 to 1.3, lactate fell from 1309 to 517, and urine output was roughly stable (170 to 145)
B. Clinically, the heart rate fell from 76 to 72, MAP fell from 98 to 92, and diastolic pressure moved from 88 to 80. Systolic pressure ranged 90-139 and ended at 126, and SpO2 recovered to 100 after a low of 83 around hour 0.3. Respiratory rate ended at 22; the available labs showed white count fell from 13.3 to 10.7, creatinine rose from 1.0 to 1.2, lactate fell from 1169 to 552, and urine output was roughly stable (135 to 110)
C. Clinically, the heart rate fell from 82 to 65, MAP fell from 96 to 93, and diastolic pressure moved from 82 to 87. Systolic pressure ranged 96-179 and ended at 166, and SpO2 recovered to 95 after a low of 84 around hour 0.5. Respiratory rate ended at 19; the available labs showed white count fell from 16.3 to 11, creatinine rose from 0.8 to 1.4, lactate fell from 1329 to 512, and urine output was roughly stable (200 to 150)
D. Clinically, the heart rate fell from 78 to 69, MAP fell from 100 to 94, and diastolic pressure moved from 86 to 83. Systolic pressure ranged 92-154 and ended at 141, and SpO2 recovered to 99 after a low of 85 around hour 0.4. Respiratory rate ended at 21; the available labs showed white count fell from 14.4 to 11.8, creatinine rose from 0.9 to 1.1, lactate fell from 1229 to 537, and urine output was roughly stable (150 to 125)

Answer: D


Question:
Which option is most consistent with the actual sequence of measurements?

Options:
A. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 71 to 90, diastolic pressure rose from 56 to 82, and heart rate rose from 75 to 104. The lowest MAP was about 67 around hour 5.1, and the lowest valid SpO2 was 93 around hour 15.3; respiratory rate rose as high as 28 but ended at 26. The lower-frequency data fit that summary: temperature stayed around 33.4-34.1 C, white count fell from 12.1 to 8.6, creatinine rose from 0.7 to 1.0, lactate stayed broadly stable from 1.6 to 2, and urine output rose from 78 to 180.
B. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 66 to 95, diastolic pressure rose from 51 to 77, and heart rate rose from 80 to 99. The lowest MAP was about 62 around hour 6.0, and the lowest valid SpO2 was 88 around hour 17.4; respiratory rate rose as high as 29 but ended at 23. The lower-frequency data fit that summary: temperature stayed around 38.6-39.4 C, white count fell from 9.5 to 9.0, creatinine rose from 0.5 to 1, lactate stayed broadly stable from 2.0 to 2, and urine output rose from 73 to 250.
C. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 68 to 93, diastolic pressure rose from 53 to 79, and heart rate rose from 78 to 101. The lowest MAP was about 64 around hour 5.6, and the lowest valid SpO2 was 90 around hour 16.3; respiratory rate rose as high as 27 but ended at 24. The lower-frequency data fit that summary: temperature stayed around 36.4-37.1 C, white count fell from 10.6 to 9.1, creatinine rose from 0.6 to 0.9, lactate stayed broadly stable from 1.8 to 2, and urine output rose from 75 to 200.
D. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 64 to 98, diastolic pressure rose from 48 to 76, and heart rate rose from 82 to 96. The lowest MAP was about 67 around hour 6.6, and the lowest valid SpO2 was 86 around hour 18.6; respiratory rate rose as high as 25 but ended at 22. The lower-frequency data fit that summary: temperature stayed around 40.9-41.6 C, white count fell from 8.3 to 7.8, creatinine rose from 0.4 to 0.8, lactate stayed broadly stable from 2.1 to 2, and urine output rose from 70 to 230.

Answer: C

Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 68 to 93, diastolic pressure rose from 53 to 79, and heart rate rose from 78 to 101. The lowest MAP was about 64 around hour 5.6, and the lowest valid SpO2 was 90 around hour 16.3; respiratory rate rose as high as 27 but ended at 24. The lower-frequency data fit that summary: temperature ranged from 97.6 to 98.8, white count fell from 10.6 to 9.1, creatinine rose from 0.6 to 0.9, lactate stayed broadly stable from 1.8 to 2, and urine output rose from 75 to 200.


Question:
After reviewing the recorded vitals, labs, and urine output, which summary is most accurate?

Options:
A. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 104 to 132, MAP rose from 71 to 96, and heart rate rose from 75 to 104. SpO2 started at 94, ended at 96, and fell as low as 89 around hour 14.8; respiratory rate ranged 6-26. For labs and output, white count fell from 9.1 to 8.6, creatinine rose from 0.7 to 0.8, lactate stayed broadly stable from 2.0 to 2, and urine output rose from 72 to 220.
B. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 99 to 151, MAP rose from 66 to 91, and heart rate rose from 80 to 99. SpO2 started at 99, ended at 91, and fell as low as 88 around hour 17.4; respiratory rate ranged 6-29. For labs and output, white count fell from 11.7 to 8.7, creatinine rose from 0.5 to 1, lactate stayed broadly stable from 2 to 2, and urine output rose from 77 to 185.
C. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 105 to 111, MAP rose from 72 to 97, and heart rate rose from 74 to 104. SpO2 started at 93, ended at 97, and fell as low as 94 around hour 14.4; respiratory rate ranged 7-29. For labs and output, white count fell from 8.7 to 8.3, creatinine rose from 0.7 to 0.8, lactate stayed broadly stable from 2.0 to 2, and urine output rose from 71 to 225.
D. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 101 to 136, MAP rose from 68 to 93, and heart rate rose from 78 to 101. SpO2 started at 97, ended at 93, and fell as low as 90 around hour 16.3; respiratory rate ranged 6-27. For labs and output, white count fell from 10.6 to 9.1, creatinine rose from 0.6 to 0.9, lactate stayed broadly stable from 1.8 to 2, and urine output rose from 75 to 200.

Answer: D


Question:
Which summary should be used for rounds based on the recorded course?

Options:
A. Over the available measurements, the heart rate was roughly stable (98 to 93), while MAP rose from 79 to 93. Systolic pressure was labile, ranging 68-118, with the lowest value around hour 22.1. SpO2 briefly dipped to 86 around hour 11.6 before recovering to 95, while respiratory rate peaked at 27 and later settled at 26. The associated labs and urine output showed that white count fell from 12.8 to 2, creatinine was roughly stable (0.7 to 0.6), lactate stayed broadly stable from 6.9 to 4.2, and urine output fell from 805 to 170, with recorded outputs ranging 16-845.
B. Over the available measurements, the heart rate was roughly stable (93 to 98), while MAP rose from 74 to 88. Systolic pressure was labile, ranging 66-153, with the lowest value around hour 19.5. SpO2 briefly dipped to 83 around hour 9.0 before recovering to 100, while respiratory rate peaked at 24 and later settled at 24. The associated labs and urine output showed that white count fell from 15.4 to 1.2, creatinine rose from 0.5 to 0.8, lactate stayed broadly stable from 6.0 to 3.3, and urine output fell from 840 to 135, with recorded outputs ranging 64-810.
C. Over the available measurements, the heart rate was roughly stable (95 to 96), while MAP rose from 76 to 90. Systolic pressure was labile, ranging 64-138, with the lowest value around hour 20.6. SpO2 briefly dipped to 85 around hour 10.1 before recovering to 98, while respiratory rate peaked at 25 and later settled at 25. The associated labs and urine output showed that white count fell from 14.3 to 2, creatinine was roughly stable (0.6 to 0.7), lactate stayed broadly stable from 6.4 to 3.7, and urine output fell from 825 to 150, with recorded outputs ranging 14-825.
D. Over the available measurements, the heart rate was roughly stable (90 to 100), while MAP rose from 72 to 93. Systolic pressure was labile, ranging 68-168, with the lowest value around hour 18.4. SpO2 briefly dipped to 80 around hour 11.1 before recovering to 100, while respiratory rate peaked at 23 and later settled at 23. The associated labs and urine output showed that white count fell from 16.6 to 2, creatinine was roughly stable (0.4 to 0.8), lactate stayed broadly stable from 5.7 to 3.0, and urine output fell from 855 to 100, with recorded outputs ranging 12-795.

Answer: C


Question:
Which summary best avoids misstating the observed ICU course?

Options:
A. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 79 to 87, diastolic pressure was roughly stable (74 to 73), and heart rate was roughly stable (92 to 99). The lowest MAP was about 48 around hour 19.1, and the lowest valid SpO2 was 88 around hour 9.1; respiratory rate rose as high as 26 but ended at 26. The lower-frequency data fit that summary: temperature stayed around 31.2-34.3 C, white count fell from 15.8 to 2, creatinine was roughly stable (0.7 to 0.8), lactate stayed broadly stable from 5.9 to 4.2, and urine output fell from 845 to 130.
B. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 74 to 92, diastolic pressure was roughly stable (69 to 68), and heart rate was roughly stable (97 to 94). The lowest MAP was about 43 around hour 21.7, and the lowest valid SpO2 was 83 around hour 11.2; respiratory rate rose as high as 27 but ended at 24. The lower-frequency data fit that summary: temperature stayed around 36.5-39.5 C, white count fell from 13.2 to 2, creatinine rose from 0.5 to 0.8, lactate stayed broadly stable from 6.8 to 3.3, and urine output fell from 810 to 200.
C. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 80 to 86, diastolic pressure was roughly stable (75 to 67), and heart rate was roughly stable (91 to 100). The lowest MAP was about 48 around hour 21.6, and the lowest valid SpO2 was 89 around hour 8.2; respiratory rate rose as high as 27 but ended at 27. The lower-frequency data fit that summary: temperature stayed around 30.5-33.5 C, white count fell from 16.2 to 2, creatinine was roughly stable (0.7 to 0.8), lactate stayed broadly stable from 5.8 to 4.3, and urine output fell from 850 to 125.
D. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 76 to 90, diastolic pressure was roughly stable (71 to 70), and heart rate was roughly stable (95 to 96). The lowest MAP was about 45 around hour 20.6, and the lowest valid SpO2 was 85 around hour 10.1; respiratory rate rose as high as 25 but ended at 25. The lower-frequency data fit that summary: temperature stayed around 34.2-37.3 C, white count fell from 14.3 to 2, creatinine was roughly stable (0.6 to 0.7), lactate stayed broadly stable from 6.4 to 3.7, and urine output fell from 825 to 150.

Answer: D

Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 76 to 90, diastolic pressure was roughly stable (71 to 70), and heart rate was roughly stable (95 to 96). The lowest MAP was about 45 around hour 20.6, and the lowest valid SpO2 was 85 around hour 10.1; respiratory rate rose as high as 25 but ended at 25. The lower-frequency data fit that summary: temperature ranged from 34.2 to 97.5, white count fell from 14.3 to 2, creatinine was roughly stable (0.6 to 0.7), lactate stayed broadly stable from 6.4 to 3.7, and urine output fell from 825 to 150.


Question:
Which synopsis best matches the observed sequence rather than a plausible alternative?

Options:
A. Overall, the heart rate fell from 76 to 57, MAP was roughly stable (91 to 89), and diastolic pressure moved from 77 to 85. Systolic pressure ranged 91-154 and ended at 112, and SpO2 recovered to 82 after a low of 74 around hour 64. Respiratory rate ended at 24; the available labs showed white count was roughly stable (7.1 to 6.1), creatinine stayed around 0.8, lactate fell from 228 to 2.1, and urine output rose from 105 to 300.
B. Overall, the heart rate fell from 71 to 63, MAP was roughly stable (86 to 84), and diastolic pressure moved from 82 to 79. Systolic pressure ranged 86-119 and ended at 114, and SpO2 recovered to 87 after a low of 69 around hour 61.4. Respiratory rate ended at 26; the available labs showed white count was roughly stable (6.2 to 5.2), creatinine stayed around 1.0, lactate fell from 193 to 1.8, and urine output rose from 140 to 265.
C. Overall, the heart rate fell from 73 to 60, MAP was roughly stable (88 to 86), and diastolic pressure moved from 80 to 82. Systolic pressure ranged 88-134 and ended at 116, and SpO2 recovered to 85 after a low of 71 around hour 63.6. Respiratory rate ended at 25; the available labs showed white count was roughly stable (6.6 to 5.6), creatinine stayed around 0.9, lactate fell from 208 to 1.9, and urine output rose from 125 to 280.
D. Overall, the heart rate fell from 68 to 64, MAP was roughly stable (84 to 82), and diastolic pressure moved from 84 to 78. Systolic pressure ranged 84-104 and ended at 112, and SpO2 recovered to 90 after a low of 70 around hour 59.1. Respiratory rate ended at 27; the available labs showed white count fell from 5.8 to 4.8, creatinine stayed around 1.1, lactate fell from 178 to 1.6, and urine output rose from 175 to 250.

Answer: C


Question:
Which summary best represents the patient's recorded course across the episode?

Options:
A. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 105 to 80, diastolic pressure fell from 79 to 59, and heart rate fell from 88 to 43. The lowest MAP was about 77 around hour 34, and the lowest valid SpO2 was 88 around hour 8; respiratory rate rose as high as 28 but ended at 20. The lower-frequency data fit that summary: temperature stayed around 33.8-34.4 C, white count rose from 4.4 to 5.4, creatinine fell from 1.5 to 1.3, lactate stayed broadly stable from 6.3 to 2.6, and urine output was roughly stable (280 to 180)
B. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 102 to 83, diastolic pressure fell from 76 to 62, and heart rate fell from 91 to 40. The lowest MAP was about 74 around hour 33, and the lowest valid SpO2 was 85 around hour 8; respiratory rate rose as high as 26 but ended at 18. The lower-frequency data fit that summary: temperature stayed around 36.8-37.4 C, white count rose from 3.9 to 5.9, creatinine fell from 1.3 to 1.1, lactate stayed broadly stable from 6.8 to 2.4, and urine output was roughly stable (260 to 200)
C. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 106 to 79, diastolic pressure fell from 80 to 66, and heart rate fell from 87 to 43. The lowest MAP was about 78 around hour 29, and the lowest valid SpO2 was 89 around hour 7; respiratory rate rose as high as 28 but ended at 20. The lower-frequency data fit that summary: temperature stayed around 33.0-33.6 C, white count rose from 4.5 to 5.3, creatinine fell from 1.6 to 1.4, lactate stayed broadly stable from 6.2 to 2.6, and urine output was roughly stable (285 to 175)
D. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 98 to 88, diastolic pressure fell from 72 to 58, and heart rate fell from 96 to 36. The lowest MAP was about 70 around hour 38, and the lowest valid SpO2 was 80 around hour 9; respiratory rate rose as high as 28 but ended at 16. The lower-frequency data fit that summary: temperature stayed around 41.3-41.9 C, white count rose from 3.1 to 6.7, creatinine was roughly stable (1.0 to 1.2), lactate stayed broadly stable from 7.5 to 2.1, and urine output was roughly stable (230 to 250)

Answer: B

For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 102 to 83, diastolic pressure fell from 76 to 62, and heart rate fell from 91 to 40. The lowest MAP was about 74 around hour 33, and the lowest valid SpO2 was 85 around hour 8; respiratory rate rose as high as 26 but ended at 18. The lower-frequency data fit that summary: temperature ranged from 98.3 to 99.3, white count rose from 3.9 to 5.9, creatinine fell from 1.3 to 1.1, lactate stayed broadly stable from 6.8 to 2.4, and urine output was roughly stable (260 to 200)


Question:
Which handoff summary best matches the measured ICU course?

Options:
A. Taken together, the heart rate fell from 94 to 37, MAP fell from 105 to 86, and diastolic pressure moved from 73 to 65. Systolic pressure ranged 117-201 and ended at 157, and SpO2 recovered to 85 after a low of 84 around hour 8. Respiratory rate ended at 16; the available labs showed white count rose from 4.4 to 5.1, creatinine fell from 1.1 to 0.9, lactate stayed broadly stable from 7.3 to 2.2, and urine output fell from 310 to 220.
B. Taken together, the heart rate fell from 89 to 42, MAP fell from 100 to 86, and diastolic pressure moved from 78 to 60. Systolic pressure ranged 112-166 and ended at 133, and SpO2 recovered to 90 after a low of 83 around hour 9. Respiratory rate ended at 19; the available labs showed white count rose from 3.5 to 5.5, creatinine fell from 1.5 to 1.0, lactate stayed broadly stable from 6.4 to 2.5, and urine output was roughly stable (245 to 185)
C. Taken together, the heart rate fell from 95 to 43, MAP fell from 106 to 87, and diastolic pressure moved from 72 to 59. Systolic pressure ranged 118-206 and ended at 162, and SpO2 recovered to 84 after a low of 89 around hour 9. Respiratory rate ended at 16; the available labs showed white count rose from 4.5 to 6.5, creatinine fell from 1.1 to 0.9, lactate stayed broadly stable from 7.4 to 2.1, and urine output was roughly stable (285 to 225)
D. Taken together, the heart rate fell from 91 to 40, MAP fell from 102 to 83, and diastolic pressure moved from 76 to 62. Systolic pressure ranged 114-181 and ended at 137, and SpO2 recovered to 88 after a low of 85 around hour 8. Respiratory rate ended at 18; the available labs showed white count rose from 3.9 to 5.9, creatinine fell from 1.3 to 1.1, lactate stayed broadly stable from 6.8 to 2.4, and urine output was roughly stable (260 to 200)

Answer: D


Question:
Which summary best avoids misstating the observed ICU course?

Options:
A. For handoff, the heart rate rose from 70 to 72, MAP rose from 60 to 67, and diastolic pressure moved from 42 to 51. Systolic pressure ranged 81-159 and ended at 112, and SpO2 recovered to 93 after a low of 88 around hour 1.5. Respiratory rate ended at 14; the available labs showed white count rose from 2 to 12, creatinine fell from 37 to 2.0, lactate fell from 304 to 1.3, and urine output fell from 420 to 97.
B. For handoff, the heart rate rose from 67 to 75, MAP rose from 57 to 64, and diastolic pressure moved from 45 to 48. Systolic pressure ranged 78-139 and ended at 116, and SpO2 recovered to 96 after a low of 85 around hour 0.5. Respiratory rate ended at 16; the available labs showed white count rose from 0 to 11, creatinine fell from 40 to 1.8, lactate fell from 284 to 1.5, and urine output fell from 400 to 100.
C. For handoff, the heart rate rose from 71 to 74, MAP rose from 61 to 68, and diastolic pressure moved from 41 to 52. Systolic pressure ranged 82-164 and ended at 120, and SpO2 recovered to 92 after a low of 84 around hour 0.6. Respiratory rate ended at 14; the available labs showed white count rose from 2 to 10.2, creatinine fell from 36 to 2.0, lactate fell from 309 to 1.2, and urine output fell from 450 to 96.
D. For handoff, the heart rate rose from 62 to 78, MAP rose from 52 to 60, and diastolic pressure moved from 50 to 45. Systolic pressure ranged 74-109 and ended at 112, and SpO2 recovered to 100 after a low of 80 around hour 0.3. Respiratory rate ended at 18; the available labs showed white count rose from 0 to 9, creatinine fell from 44 to 1.5, lactate fell from 254 to 1.8, and urine output fell from 370 to 96.

Answer: B


Question:
Which handoff summary best matches the measured ICU course?

Options:
A. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 65 to 97, diastolic pressure rose from 58 to 86, and heart rate fell from 102 to 93. The lowest MAP was about 65 around hour 0.5, and the lowest valid SpO2 was 88 around hour 0; respiratory rate rose as high as 35 but ended at 20. The lower-frequency data fit that summary: temperature stayed around 32.9-33.9 C, white count fell from 40.8 to 25.3, creatinine fell from 2.5 to 1.5, lactate fell from 311 to 2, and urine output was roughly stable (83 to 57)
B. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 62 to 100, diastolic pressure rose from 55 to 83, and heart rate fell from 105 to 90. The lowest MAP was about 62 around hour 0.6, and the lowest valid SpO2 was 85 around hour 0.3; respiratory rate rose as high as 32 but ended at 18. The lower-frequency data fit that summary: temperature stayed around 35.9-36.9 C, white count fell from 37.8 to 26.8, creatinine fell from 2.3 to 1.3, lactate fell from 331 to 2, and urine output was roughly stable (80 to 60)
C. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 66 to 96, diastolic pressure rose from 59 to 80, and heart rate fell from 101 to 94. The lowest MAP was about 66 around hour 1.6, and the lowest valid SpO2 was 89 around hour 0.2; respiratory rate rose as high as 36 but ended at 20. The lower-frequency data fit that summary: temperature stayed around 32.1-33.1 C, white count fell from 41.5 to 24.9, creatinine fell from 2.5 to 1.6, lactate fell from 306 to 2, and urine output was roughly stable (84 to 56)
D. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 58 to 96, diastolic pressure rose from 50 to 78, and heart rate fell from 110 to 86. The lowest MAP was about 58 around hour 0.8, and the lowest valid SpO2 was 80 around hour 0.5; respiratory rate rose as high as 34 but ended at 16. The lower-frequency data fit that summary: temperature stayed around 40.4-41.4 C, white count fell from 33.3 to 29.1, creatinine fell from 2.0 to 1.4, lactate fell from 361 to 2, and urine output was roughly stable (76 to 110)

Answer: B

Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 62 to 100, diastolic pressure rose from 55 to 83, and heart rate fell from 105 to 90. The lowest MAP was about 62 around hour 0.6, and the lowest valid SpO2 was 85 around hour 0.3; respiratory rate rose as high as 32 but ended at 18. The lower-frequency data fit that summary: temperature ranged from 96.6 to 98.5, white count fell from 37.8 to 26.8, creatinine fell from 2.3 to 1.3, lactate fell from 331 to 2, and urine output was roughly stable (80 to 60)


Question:
Which summary most accurately describes the patient's changes over the episode?

Options:
A. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 100 to 132, MAP rose from 65 to 97, and heart rate fell from 102 to 93. SpO2 started at 82, ended at 100, and fell as low as 88 around hour 0.2; respiratory rate ranged 10-29. For labs and output, white count fell from 34.8 to 28.3, creatinine fell from 2.5 to 1.4, lactate fell from 331.2 to 2, and urine output was roughly stable (77 to 63)
B. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 96 to 148, MAP rose from 60 to 103, and heart rate fell from 107 to 88. SpO2 started at 87, ended at 95, and fell as low as 84 around hour 0.4; respiratory rate ranged 9-34. For labs and output, white count fell from 40.0 to 25.7, creatinine fell from 2.1 to 1.5, lactate fell from 316 to 2, and urine output was roughly stable (82 to 58)
C. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 98 to 152, MAP rose from 62 to 100, and heart rate fell from 105 to 90. SpO2 started at 85, ended at 97, and fell as low as 85 around hour 0.3; respiratory rate ranged 9-32. For labs and output, white count fell from 37.8 to 26.8, creatinine fell from 2.3 to 1.3, lactate fell from 331 to 2, and urine output was roughly stable (80 to 60)
D. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 94 to 182, MAP rose from 58 to 96, and heart rate fell from 110 to 93. SpO2 started at 90, ended at 92, and fell as low as 80 around hour 0.5; respiratory rate ranged 8-34. For labs and output, white count fell from 42.3 to 26, creatinine fell from 2.0 to 1.6, lactate fell from 301 to 2, and urine output was roughly stable (84 to 56)

Answer: C


Question:
Which option best summarizes the hemodynamic, respiratory, lab, and urine-output pattern?

Options:
A. Clinically, the heart rate fell from 108 to 87, MAP rose from 65 to 97, and diastolic pressure moved from 52 to 86. Systolic pressure ranged 91-177 and ended at 172, and SpO2 recovered to 94 after a low of 84 around hour 0.4. Respiratory rate ended at 16; the available labs showed white count fell from 40.8 to 26, creatinine fell from 2.1 to 1.5, lactate fell from 351 to 2, and urine output was roughly stable (130 to 63)
B. Clinically, the heart rate fell from 103 to 92, MAP rose from 60 to 103, and diastolic pressure moved from 57 to 81. Systolic pressure ranged 86-142 and ended at 148, and SpO2 recovered to 99 after a low of 83 around hour 1.3. Respiratory rate ended at 19; the available labs showed white count fell from 35.5 to 25.7, creatinine fell from 2.4 to 1.1, lactate fell from 316 to 2, and urine output was roughly stable (78 to 58)
C. Clinically, the heart rate fell from 109 to 93, MAP rose from 66 to 96, and diastolic pressure moved from 51 to 80. Systolic pressure ranged 92-182 and ended at 177, and SpO2 recovered to 93 after a low of 89 around hour 0.4. Respiratory rate ended at 16; the available labs showed white count fell from 41.5 to 28.7, creatinine fell from 2.0 to 1.6, lactate fell from 356 to 2, and urine output was roughly stable (84 to 64)
D. Clinically, the heart rate fell from 105 to 90, MAP rose from 62 to 100, and diastolic pressure moved from 55 to 83. Systolic pressure ranged 88-157 and ended at 152, and SpO2 recovered to 97 after a low of 85 around hour 0.3. Respiratory rate ended at 18; the available labs showed white count fell from 37.8 to 26.8, creatinine fell from 2.3 to 1.3, lactate fell from 331 to 2, and urine output was roughly stable (80 to 60)

Answer: D


Question:
After checking the full sequence of measurements, which handoff is most accurate?

Options:
A. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 73 to 76, diastolic pressure rose from 20 to 69, and heart rate fell from 84 to 68. The lowest MAP was about 59 around hour 21.3, and the lowest valid SpO2 was 88 around hour 1.5; respiratory rate rose as high as 30 but ended at 24. The lower-frequency data fit that summary: temperature stayed around 31.5-34 C, white count rose from 12.7 to 14.2, creatinine rose from 0.9 to 1, lactate stayed broadly stable from 1.1 to 1.7, and urine output was roughly stable (33 to 97)
B. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 68 to 78, diastolic pressure rose from 17 to 63, and heart rate fell from 89 to 63. The lowest MAP was about 59 around hour 23.8, and the lowest valid SpO2 was 83 around hour 2.6; respiratory rate rose as high as 27 but ended at 21. The lower-frequency data fit that summary: temperature stayed around 36.8-39 C, white count rose from 10.1 to 13.6, creatinine rose from 0.7 to 1, lactate stayed broadly stable from 1.5 to 1.4, and urine output was roughly stable (28 to 98)
C. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 70 to 76, diastolic pressure rose from 18 to 66, and heart rate fell from 87 to 65. The lowest MAP was about 56 around hour 22.8, and the lowest valid SpO2 was 85 around hour 2.5; respiratory rate rose as high as 28 but ended at 22. The lower-frequency data fit that summary: temperature stayed around 34.5-37 C, white count rose from 11.2 to 12.5, creatinine rose from 0.8 to 1, lactate stayed broadly stable from 1.3 to 1.5, and urine output was roughly stable (30 to 100)
D. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 66 to 80, diastolic pressure rose from 16 to 62, and heart rate fell from 92 to 60. The lowest MAP was about 52 around hour 25.1, and the lowest valid SpO2 was 80 around hour 2.8; respiratory rate rose as high as 30 but ended at 20. The lower-frequency data fit that summary: temperature stayed around 39.0-42 C, white count rose from 8.9 to 14.8, creatinine rose from 0.7 to 1.1, lactate stayed broadly stable from 1.6 to 1.2, and urine output rose from 26 to 150.

Answer: C

Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 70 to 76, diastolic pressure rose from 18 to 66, and heart rate fell from 87 to 65. The lowest MAP was about 56 around hour 22.8, and the lowest valid SpO2 was 85 around hour 2.5; respiratory rate rose as high as 28 but ended at 22. The lower-frequency data fit that summary: temperature ranged from 34.5 to 98.1, white count rose from 11.2 to 12.5, creatinine rose from 0.8 to 1, lactate stayed broadly stable from 1.3 to 1.5, and urine output was roughly stable (30 to 100)


Question:
Which option is most consistent with the actual sequence of measurements?

Options:
A. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 45 to 97, MAP rose from 73 to 79, and heart rate fell from 84 to 68. SpO2 started at 97, ended at 100, and fell as low as 84 around hour 2.3; respiratory rate ranged 12-26. For labs and output, white count rose from 9.7 to 14.0, creatinine rose from 0.9 to 1, lactate stayed broadly stable from 1.5 to 1.7, and urine output was roughly stable (27 to 97)
B. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 40 to 103, MAP rose from 68 to 74, and heart rate fell from 89 to 68. SpO2 started at 98, ended at 95, and fell as low as 83 around hour 2.6; respiratory rate ranged 9-30. For labs and output, white count was roughly stable (12.3 to 11.7), creatinine rose from 0.7 to 1, lactate stayed broadly stable from 1.1 to 1.4, and urine output was roughly stable (32 to 98)
C. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 46 to 97, MAP rose from 74 to 80, and heart rate fell from 83 to 69. SpO2 started at 96, ended at 100, and fell as low as 89 around hour 2.2; respiratory rate ranged 12-26. For labs and output, white count rose from 9.3 to 14.4, creatinine rose from 0.9 to 1.1, lactate stayed broadly stable from 1.5 to 1.8, and urine output was roughly stable (26 to 96)
D. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 42 to 101, MAP rose from 70 to 76, and heart rate fell from 87 to 65. SpO2 started at 100, ended at 97, and fell as low as 85 around hour 2.5; respiratory rate ranged 10-28. For labs and output, white count rose from 11.2 to 12.5, creatinine rose from 0.8 to 1, lactate stayed broadly stable from 1.3 to 1.5, and urine output was roughly stable (30 to 100)

Answer: D


Question:
Which summary best represents the patient's recorded course across the episode?

Options:
A. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 88 to 39, MAP fell from 67 to 40, and heart rate rose from 47 to 152. SpO2 started at 90, ended at 98, and fell as low as 91 around hour 10.2; respiratory rate ranged 12-37. For labs and output, white count rose from 24.3 to 65.5, creatinine rose from 0.9 to 2.1, lactate stayed broadly stable from 7.6 to 16.6, and urine output fell from 180 to 8.
B. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 83 to 44, MAP fell from 62 to 35, and heart rate rose from 52 to 135. SpO2 started at 95, ended at 93, and fell as low as 86 around hour 12.8; respiratory rate ranged 10-42. For labs and output, white count rose from 26.9 to 61.7, creatinine rose from 0.7 to 2, lactate stayed broadly stable from 7.0 to 14.0, and urine output fell from 215 to 8.
C. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 85 to 42, MAP fell from 64 to 37, and heart rate rose from 50 to 132. SpO2 started at 93, ended at 95, and fell as low as 88 around hour 11.7; respiratory rate ranged 11-40. For labs and output, white count rose from 25.8 to 62.5, creatinine rose from 0.8 to 2, lactate stayed broadly stable from 7.4 to 15.1, and urine output fell from 200 to 8.
D. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 80 to 38, MAP fell from 60 to 40, and heart rate rose from 54 to 102. SpO2 started at 98, ended at 90, and fell as low as 87 around hour 13.9; respiratory rate ranged 9-44. For labs and output, white count rose from 28.1 to 58.0, creatinine rose from 0.7 to 2, lactate stayed broadly stable from 6.7 to 12.8, and urine output fell from 230 to 7.

Answer: C


Question:
Which clinical synopsis would you choose after reviewing the data chronologically?

Options:
A. Taken together, the heart rate rose from 53 to 135, MAP fell from 67 to 40, and diastolic pressure moved from 55 to 29. Systolic pressure ranged 45-160 and ended at 45, and SpO2 recovered to 92 after a low of 91 around hour 13.2. Respiratory rate ended at 10; the available labs showed white count rose from 27.3 to 65.5, creatinine rose from 0.7 to 2, lactate stayed broadly stable from 7.9 to 13.6, and urine output fell from 220 to 8.
B. Taken together, the heart rate rose from 48 to 147, MAP fell from 62 to 40, and diastolic pressure moved from 60 to 30. Systolic pressure ranged 38-125 and ended at 38, and SpO2 recovered to 97 after a low of 86 around hour 12.7. Respiratory rate ended at 13; the available labs showed white count rose from 24.7 to 60.2, creatinine rose from 0.9 to 2, lactate stayed broadly stable from 7.0 to 16.2, and urine output fell from 185 to 8.
C. Taken together, the heart rate rose from 54 to 107, MAP fell from 68 to 41, and diastolic pressure moved from 54 to 36. Systolic pressure ranged 46-165 and ended at 46, and SpO2 recovered to 91 after a low of 87 around hour 13.6. Respiratory rate ended at 10; the available labs showed white count rose from 27.7 to 61.7, creatinine rose from 0.7 to 2, lactate stayed broadly stable from 8.0 to 13.2, and urine output fell from 250 to 9.
D. Taken together, the heart rate rose from 50 to 132, MAP fell from 64 to 37, and diastolic pressure moved from 58 to 32. Systolic pressure ranged 42-140 and ended at 42, and SpO2 recovered to 95 after a low of 88 around hour 11.7. Respiratory rate ended at 12; the available labs showed white count rose from 25.8 to 62.5, creatinine rose from 0.8 to 2, lactate stayed broadly stable from 7.4 to 15.1, and urine output fell from 200 to 8.

Answer: D


Question:
After reviewing the recorded vitals, labs, and urine output, which summary is most accurate?

Options:
A. Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 98 to 103, diastolic pressure rose from 86 to 98, and heart rate rose from 47 to 66. The lowest MAP was about 84 around hour 20, and the lowest valid SpO2 was 88 around hour 0; respiratory rate rose as high as 26 but ended at 12. The lower-frequency data fit that summary: temperature stayed around 33.5-34.4 C, white count was 6 on its only check, creatinine was 0.8 on its only check, lactate was not available, and urine output was roughly stable (520 to 520)
B. Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 93 to 108, diastolic pressure rose from 81 to 93, and heart rate rose from 52 to 61. The lowest MAP was about 79 around hour 23, and the lowest valid SpO2 was 83 around hour 0.4; respiratory rate rose as high as 26 but ended at 9. The lower-frequency data fit that summary: temperature stayed around 38.8-39.6 C, white count was 6 on its only check, creatinine was 1.0 on its only check, lactate was not available, and urine output was roughly stable (485 to 550)
C. Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 95 to 106, diastolic pressure rose from 83 to 95, and heart rate rose from 50 to 63. The lowest MAP was about 81 around hour 22, and the lowest valid SpO2 was 85 around hour 0.3; respiratory rate rose as high as 24 but ended at 10. The lower-frequency data fit that summary: temperature stayed around 36.5-37.4 C, white count was 6 on its only check, creatinine was 0.9 on its only check, lactate was not available, and urine output was roughly stable (500 to 500)
D. Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 90 to 110, diastolic pressure rose from 78 to 92, and heart rate rose from 54 to 58. The lowest MAP was about 84 around hour 23, and the lowest valid SpO2 was 80 around hour 0.5; respiratory rate rose as high as 22 but ended at 8. The lower-frequency data fit that summary: temperature stayed around 41.0-41.9 C, white count was 5 on its only check, creatinine was 1.1 on its only check, lactate was not available, and urine output was roughly stable (470 to 470)

Answer: C

Across the recorded window, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 95 to 106, diastolic pressure rose from 83 to 95, and heart rate rose from 50 to 63. The lowest MAP was about 81 around hour 22, and the lowest valid SpO2 was 85 around hour 0.3; respiratory rate rose as high as 24 but ended at 10. The lower-frequency data fit that summary: temperature ranged from 97.7 to 99.3, white count was 6 on its only check, creatinine was 0.9 on its only check, lactate was not available, and urine output was roughly stable (500 to 500)


Question:
Which option best reflects the important trends and outliers in this episode?

Options:
A. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (143 to 129), MAP rose from 98 to 109, and heart rate rose from 47 to 66. SpO2 started at 82, ended at 97, and fell as low as 84 around hour 0.2; respiratory rate ranged 8-22. For labs and output, white count was 6 on its only check, creatinine was 1.0 on its only check, lactate was not available, and urine output was roughly stable (520 to 480)
B. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 108 to 148, MAP rose from 92 to 104, and heart rate rose from 52 to 61. SpO2 started at 87, ended at 98, and fell as low as 83 around hour 0.4; respiratory rate ranged 7-25. For labs and output, white count was 6 on its only check, creatinine was 0.8 on its only check, lactate was not available, and urine output was roughly stable (485 to 515)
C. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 148 to 168, MAP rose from 99 to 110, and heart rate rose from 46 to 66. SpO2 started at 81, ended at 96, and fell as low as 89 around hour 0.2; respiratory rate ranged 8-26. For labs and output, white count was 5 on its only check, creatinine was 1.0 on its only check, lactate was not available, and urine output was roughly stable (525 to 475)
D. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 123 to 133, MAP rose from 95 to 106, and heart rate rose from 50 to 63. SpO2 started at 85, ended at 100, and fell as low as 85 around hour 0.3; respiratory rate ranged 7-24. For labs and output, white count was 6 on its only check, creatinine was 0.9 on its only check, lactate was not available, and urine output was roughly stable (500 to 500)

Answer: D


Question:
Which summary best preserves the direction and size of the recorded changes?

Options:
A. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 65 to 51, diastolic pressure rose from 14 to 36, and heart rate was roughly stable (79 to 90). The lowest MAP was about 50 around hour 66.7, and the lowest valid SpO2 was 88 around hour 3.7; respiratory rate rose as high as 34 but ended at 30. The lower-frequency data fit that summary: temperature stayed around 32.4-35.3 C, white count fell from 11.7 to 8.0, creatinine rose from 1.0 to 1.8, lactate fell from 3.3 to 1, and urine output fell from 310 to 37.
B. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 60 to 56, diastolic pressure rose from 11 to 37, and heart rate was roughly stable (84 to 85). The lowest MAP was about 45 around hour 68.0, and the lowest valid SpO2 was 83 around hour 4.6; respiratory rate rose as high as 33 but ended at 28. The lower-frequency data fit that summary: temperature stayed around 37.6-40.5 C, white count fell from 9.1 to 8.9, creatinine rose from 0.8 to 1.7, lactate fell from 4.2 to 1, and urine output fell from 275 to 90.
C. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 66 to 50, diastolic pressure rose from 14 to 43, and heart rate rose from 78 to 90. The lowest MAP was about 51 around hour 62.0, and the lowest valid SpO2 was 89 around hour 3.2; respiratory rate rose as high as 35 but ended at 31. The lower-frequency data fit that summary: temperature stayed around 31.6-34.5 C, white count fell from 12.1 to 7.9, creatinine rose from 1.0 to 1.9, lactate fell from 3.2 to 1, and urine output fell from 315 to 36.
D. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 62 to 54, diastolic pressure rose from 12 to 39, and heart rate was roughly stable (82 to 87). The lowest MAP was about 47 around hour 65.7, and the lowest valid SpO2 was 85 around hour 4.2; respiratory rate rose as high as 31 but ended at 29. The lower-frequency data fit that summary: temperature stayed around 35.4-38.3 C, white count fell from 10.2 to 8.5, creatinine rose from 0.9 to 1.6, lactate fell from 3.8 to 1, and urine output fell from 290 to 40.

Answer: D

Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 62 to 54, diastolic pressure rose from 12 to 39, and heart rate was roughly stable (82 to 87). The lowest MAP was about 47 around hour 65.7, and the lowest valid SpO2 was 85 around hour 4.2; respiratory rate rose as high as 31 but ended at 29. The lower-frequency data fit that summary: temperature ranged from 36 to 97.5, white count fell from 10.2 to 8.5, creatinine rose from 0.9 to 1.6, lactate fell from 3.8 to 1, and urine output fell from 290 to 40.


Question:
Which option correctly summarizes the serial measurements for this ICU stay?

Options:
A. Across the recorded window, the heart rate fell from 149 to 83, MAP rose from 94 to 112, and diastolic pressure moved from 77 to 96. Systolic pressure ranged 111-185 and ended at 147, and SpO2 recovered to 96 after a low of 91 around hour 2.8. Respiratory rate ended at 14; the available labs showed white count was 9.6 on its only check, creatinine fell from 0.9 to 0.5, lactate was checked once at 3.6, and urine output fell from 920 to 380.
B. Across the recorded window, the heart rate fell from 114 to 88, MAP rose from 89 to 107, and diastolic pressure moved from 82 to 91. Systolic pressure ranged 106-150 and ended at 136, and SpO2 recovered to 100 after a low of 87 around hour 1.6. Respiratory rate ended at 16; the available labs showed white count was 8.7 on its only check, creatinine fell from 0.7 to 0.6, lactate was checked once at 2.7, and urine output fell from 950 to 415.
C. Across the recorded window, the heart rate fell from 129 to 86, MAP rose from 91 to 109, and diastolic pressure moved from 80 to 93. Systolic pressure ranged 108-165 and ended at 151, and SpO2 recovered to 99 after a low of 88 around hour 1.8. Respiratory rate ended at 15; the available labs showed white count was 9.1 on its only check, creatinine fell from 0.8 to 0.6, lactate was checked once at 3.1, and urine output fell from 900 to 400.
D. Across the recorded window, the heart rate fell from 99 to 89, MAP rose from 86 to 104, and diastolic pressure moved from 84 to 90. Systolic pressure ranged 104-135 and ended at 121, and SpO2 recovered to 100 after a low of 84 around hour 1.5. Respiratory rate ended at 17; the available labs showed white count was 8.3 on its only check, creatinine fell from 0.7 to 0.6, lactate was checked once at 2.4, and urine output fell from 870 to 430.

Answer: C


Question:
Which clinical synopsis would you choose after reviewing the data chronologically?

Options:
A. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 90 to 61, diastolic pressure fell from 68 to 55, and heart rate fell from 77 to 74. The lowest MAP was about 55 around hour 24.2, and the lowest valid SpO2 was 88 around hour 3.1; respiratory rate rose as high as 22 but ended at 20. The lower-frequency data fit that summary: temperature stayed around 33.4-34.4 C, white count fell from 13.2 to 8.6, creatinine rose from 1.3 to 1.5, lactate was not available, and urine output was roughly stable (47 to 80)
B. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 87 to 64, diastolic pressure fell from 65 to 52, and heart rate fell from 80 to 71. The lowest MAP was about 52 around hour 25.7, and the lowest valid SpO2 was 85 around hour 3.6; respiratory rate rose as high as 20 but ended at 19. The lower-frequency data fit that summary: temperature stayed around 36.4-37.4 C, white count fell from 11.7 to 9.1, creatinine was roughly stable (1.1 to 1.2), lactate was not available, and urine output was roughly stable (50 to 30)
C. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 91 to 60, diastolic pressure fell from 69 to 49, and heart rate fell from 76 to 75. The lowest MAP was about 55 around hour 26.7, and the lowest valid SpO2 was 89 around hour 3.0; respiratory rate rose as high as 22 but ended at 21. The lower-frequency data fit that summary: temperature stayed around 32.6-33.6 C, white count fell from 13.6 to 8.5, creatinine was roughly stable (1.4 to 1.4), lactate was not available, and urine output was roughly stable (46 to 34)
D. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 82 to 68, diastolic pressure fell from 60 to 48, and heart rate fell from 84 to 74. The lowest MAP was about 48 around hour 27.9, and the lowest valid SpO2 was 80 around hour 2.6; respiratory rate rose as high as 18 but ended at 17. The lower-frequency data fit that summary: temperature stayed around 40.9-41.9 C, white count fell from 9.4 to 8.9, creatinine was roughly stable (0.8 to 0.9), lactate was not available, and urine output was roughly stable (54 to 26)

Answer: B

Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 87 to 64, diastolic pressure fell from 65 to 52, and heart rate fell from 80 to 71. The lowest MAP was about 52 around hour 25.7, and the lowest valid SpO2 was 85 around hour 3.6; respiratory rate rose as high as 20 but ended at 19. The lower-frequency data fit that summary: temperature ranged from 97.6 to 99.4, white count fell from 11.7 to 9.1, creatinine was roughly stable (1.1 to 1.2), lactate was not available, and urine output was roughly stable (50 to 30)


Question:
Which summary best combines the vital-sign trends with the available labs and output?

Options:
A. In broad terms, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 91 to 82, diastolic pressure fell from 77 to 61, and heart rate rose from 40 to 72. The lowest MAP was about 70 around hour 26.8, and the lowest valid SpO2 was 85 around hour 0; respiratory rate rose as high as 25 but ended at 18. The lower-frequency data fit that summary: temperature stayed around 36.4-37.2 C, white count fell from 14.6 to 13, creatinine stayed around 1.3, lactate fell from 227 to 1.1, and urine output fell from 375 to 225.
B. In broad terms, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 89 to 84, diastolic pressure fell from 75 to 59, and heart rate rose from 42 to 75. The lowest MAP was about 68 around hour 27.9, and the lowest valid SpO2 was 83 around hour 2; respiratory rate rose as high as 24 but ended at 17. The lower-frequency data fit that summary: temperature stayed around 38.6-39.5 C, white count fell from 13.5 to 12, creatinine stayed around 1.1, lactate fell from 212 to 1.2, and urine output fell from 360 to 210.
C. In broad terms, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 95 to 78, diastolic pressure fell from 81 to 65, and heart rate rose from 36 to 76. The lowest MAP was about 74 around hour 24.9, and the lowest valid SpO2 was 89 around hour 0; respiratory rate rose as high as 27 but ended at 20. The lower-frequency data fit that summary: temperature stayed around 32.6-33.5 C, white count fell from 16.5 to 11, creatinine was roughly stable (1.6 to 1.4), lactate fell from 227 to 1.1, and urine output fell from 375 to 275.
D. In broad terms, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 86 to 83, diastolic pressure fell from 72 to 58, and heart rate rose from 44 to 68. The lowest MAP was about 73 around hour 27.8, and the lowest valid SpO2 was 80 around hour 3; respiratory rate rose as high as 23 but ended at 16. The lower-frequency data fit that summary: temperature stayed around 40.9-41.7 C, white count fell from 12.3 to 11, creatinine stayed around 1.0, lactate fell from 197 to 1.4, and urine output fell from 345 to 195.

Answer: A

In broad terms, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 91 to 82, diastolic pressure fell from 77 to 61, and heart rate rose from 40 to 72. The lowest MAP was about 70 around hour 26.8, and the lowest valid SpO2 was 85 around hour 0; respiratory rate rose as high as 25 but ended at 18. The lower-frequency data fit that summary: temperature ranged from 97.5 to 99, white count fell from 14.6 to 13, creatinine stayed around 1.3, lactate fell from 227 to 1.1, and urine output fell from 375 to 225.


Question:
After reviewing the serial ICU measurements, which summary is most accurate?

Options:
A. Clinically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 164 to 128, MAP fell from 94 to 85, and heart rate rose from 37 to 75. SpO2 started at 82, ended at 99, and fell as low as 84 around hour 0; respiratory rate ranged 12-24. For labs and output, white count fell from 13.1 to 12, creatinine stayed around 1.5, lactate fell from 207 to 1.3, and urine output fell from 395 to 205.
B. Clinically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 144 to 132, MAP fell from 91 to 82, and heart rate rose from 40 to 72. SpO2 started at 85, ended at 96, and fell as low as 85 around hour 0; respiratory rate ranged 10-25. For labs and output, white count fell from 14.6 to 13, creatinine stayed around 1.3, lactate fell from 227 to 1.1, and urine output fell from 375 to 225.
C. Clinically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 169 to 107, MAP fell from 95 to 86, and heart rate rose from 36 to 75. SpO2 started at 81, ended at 100, and fell as low as 89 around hour 0; respiratory rate ranged 12-27. For labs and output, white count fell from 12.7 to 12.2, creatinine stayed around 1.6, lactate fell from 202 to 1.4, and urine output fell from 400 to 200.
D. Clinically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 114 to 94, MAP fell from 86 to 78, and heart rate rose from 44 to 68. SpO2 started at 90, ended at 92, and fell as low as 80 around hour 3; respiratory rate ranged 8-27. For labs and output, white count fell from 16.9 to 11, creatinine was roughly stable (1.0 to 1.4), lactate fell from 227.2 to 1.1, and urine output fell from 375 to 225.

Answer: B


Question:
Which option gives the best clinical synopsis of these ICU measurements?

Options:
A. Overall, the heart rate rose from 43 to 69, MAP fell from 94 to 85, and diastolic pressure moved from 74 to 64. Systolic pressure ranged 106-184 and ended at 128, and SpO2 recovered to 93 after a low of 88 around hour 1. Respiratory rate ended at 16; the available labs showed white count fell from 16.1 to 14, creatinine stayed around 1.1, lactate fell from 247 to 1.3, and urine output fell from 355 to 245.
B. Overall, the heart rate rose from 38 to 74, MAP fell from 89 to 80, and diastolic pressure moved from 79 to 59. Systolic pressure ranged 101-149 and ended at 117, and SpO2 recovered to 98 after a low of 84 around hour 0. Respiratory rate ended at 19; the available labs showed white count fell from 13.5 to 12.2, creatinine stayed around 1.5, lactate fell from 212 to 1.0, and urine output fell from 425 to 210.
C. Overall, the heart rate rose from 40 to 72, MAP fell from 91 to 82, and diastolic pressure moved from 77 to 61. Systolic pressure ranged 103-164 and ended at 132, and SpO2 recovered to 96 after a low of 85 around hour 0. Respiratory rate ended at 18; the available labs showed white count fell from 14.6 to 13, creatinine stayed around 1.3, lactate fell from 227 to 1.1, and urine output fell from 375 to 225.
D. Overall, the heart rate rose from 36 to 75, MAP fell from 86 to 78, and diastolic pressure moved from 82 to 58. Systolic pressure ranged 98-134 and ended at 102, and SpO2 recovered to 100 after a low of 80 around hour 0. Respiratory rate ended at 20; the available labs showed white count fell from 12.3 to 11, creatinine stayed around 1.6, lactate fell from 197 to 0.8, and urine output fell from 405 to 195.

Answer: C


Question:
Which summary most accurately describes the patient's changes over the episode?

Options:
A. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (73 to 72), diastolic pressure was roughly stable (62 to 65), and heart rate was roughly stable (78 to 78). The lowest MAP was about 44 around hour 20.7, and the lowest valid SpO2 was 88 around hour 10.2; respiratory rate rose as high as 33 but ended at 22. The lower-frequency data fit that summary: temperature stayed around 33.6-35.3 C, white count was roughly stable (9.7 to 8.7), creatinine was roughly stable (0.8 to 0.9), lactate was checked once at 152, and urine output rose from 520 to 1080.
B. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (70 to 75), diastolic pressure was roughly stable (59 to 62), and heart rate fell from 81 to 75. The lowest MAP was about 41 around hour 22.2, and the lowest valid SpO2 was 85 around hour 11.2; respiratory rate rose as high as 30 but ended at 21. The lower-frequency data fit that summary: temperature stayed around 36.6-38.3 C, white count was roughly stable (9.2 to 10.2), creatinine was roughly stable (0.7 to 0.8), lactate was checked once at 172, and urine output rose from 500 to 1000.
C. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (74 to 71), diastolic pressure was roughly stable (63 to 66), and heart rate fell from 77 to 74. The lowest MAP was about 45 around hour 20.3, and the lowest valid SpO2 was 89 around hour 9.3; respiratory rate rose as high as 32 but ended at 23. The lower-frequency data fit that summary: temperature stayed around 32.9-34.5 C, white count was roughly stable (9.8 to 8.3), creatinine rose from 0.8 to 0.9, lactate was checked once at 147, and urine output rose from 525 to 1050.
D. For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (66 to 80), diastolic pressure stayed around 54, and heart rate fell from 81 to 75. The lowest MAP was about 44 around hour 23.2, and the lowest valid SpO2 was 85 around hour 11.2; respiratory rate rose as high as 30 but ended at 21. The lower-frequency data fit that summary: temperature stayed around 36.6-38.3 C, white count was roughly stable (9.2 to 10.2), creatinine was roughly stable (0.7 to 0.8), lactate was checked once at 172, and urine output rose from 500 to 1000.

Answer: B

For handoff, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (70 to 75), diastolic pressure was roughly stable (59 to 62), and heart rate fell from 81 to 75. The lowest MAP was about 41 around hour 22.2, and the lowest valid SpO2 was 85 around hour 11.2; respiratory rate rose as high as 30 but ended at 21. The lower-frequency data fit that summary: temperature ranged from 97.8 to 101, white count was roughly stable (9.2 to 10.2), creatinine was roughly stable (0.7 to 0.8), lactate was checked once at 172, and urine output rose from 500 to 1000.


Question:
Which option best summarizes the hemodynamic, respiratory, lab, and urine-output pattern?

Options:
A. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 97 to 119, MAP rose from 73 to 78, and heart rate fell from 78 to 75. SpO2 started at 92, ended at 99, and fell as low as 84 around hour 9.7; respiratory rate ranged 14-27. For labs and output, white count was roughly stable (8.7 to 11.7), creatinine was roughly stable (0.8 to 0.7), lactate was checked once at 192, and urine output rose from 520 to 920.
B. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 98 to 138, MAP was roughly stable (68 to 73), and heart rate was roughly stable (83 to 78). SpO2 started at 97, ended at 94, and fell as low as 83 around hour 12.3; respiratory rate ranged 12-32. For labs and output, white count was roughly stable (9.6 to 9.4), creatinine was roughly stable (0.6 to 0.9), lactate was checked once at 157, and urine output rose from 485 to 1060.
C. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 100 to 123, MAP was roughly stable (70 to 75), and heart rate fell from 81 to 75. SpO2 started at 95, ended at 96, and fell as low as 85 around hour 11.2; respiratory rate ranged 13-30. For labs and output, white count was roughly stable (9.2 to 10.2), creatinine was roughly stable (0.7 to 0.8), lactate was checked once at 172, and urine output rose from 500 to 1000.
D. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 96 to 153, MAP was roughly stable (66 to 70), and heart rate fell from 86 to 70. SpO2 started at 100, ended at 92, and fell as low as 80 around hour 13.4; respiratory rate ranged 11-34. For labs and output, white count was roughly stable (9.9 to 7.9), creatinine rose from 0.5 to 0.9, lactate was checked once at 172.2, and urine output rose from 470 to 1120.

Answer: C


Question:
Which option is most consistent with the actual sequence of measurements?

Options:
A. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (98 to 101), MAP was roughly stable (69 to 68), and heart rate rose from 50 to 74. SpO2 started at 85, ended at 100, and fell as low as 85 around hour 1.4; respiratory rate ranged 10-23. For labs and output, white count was roughly stable (7 to 7.7), creatinine was roughly stable (0.7 to 0.6), lactate was not available, and urine output was roughly stable (150 to 200)
B. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (96 to 103), MAP was roughly stable (67 to 66), and heart rate rose from 52 to 72. SpO2 started at 87, ended at 98, and fell as low as 83 around hour 1.5; respiratory rate ranged 9-24. For labs and output, white count stayed around 7.7, creatinine stayed around 0.7, lactate was not available, and urine output was roughly stable (150 to 200)
C. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (100 to 97), MAP was roughly stable (73 to 72), and heart rate rose from 46 to 77. SpO2 started at 81, ended at 96, and fell as low as 89 around hour 1.1; respiratory rate ranged 12-25. For labs and output, white count was roughly stable (6 to 6.9), creatinine was roughly stable (0.8 to 0.5), lactate was not available, and urine output was roughly stable (175 to 225)
D. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (94 to 97), MAP was roughly stable (64 to 71), and heart rate rose from 54 to 70. SpO2 started at 90, ended at 96, and fell as low as 84 around hour 1.7; respiratory rate ranged 8-25. For labs and output, white count stayed around 7.7, creatinine was roughly stable (0.7 to 0.6), lactate was not available, and urine output was roughly stable (150 to 200)

Answer: A


Question:
Which synopsis best matches the observed sequence rather than a plausible alternative?

Options:
A. Across the recorded window, the heart rate was roughly stable (70 to 72), MAP fell from 119 to 75, and diastolic pressure moved from 110 to 58. Systolic pressure ranged 76-193 and ended at 107, and SpO2 recovered to 94 after a low of 88 around hour 0.8. Respiratory rate ended at 16; the available labs showed white count rose from 11.8 to 18, creatinine was roughly stable (0.5 to 0.6), lactate was checked once at 1.9, and urine output was roughly stable (97 to 97)
B. Across the recorded window, the heart rate was roughly stable (65 to 71), MAP fell from 114 to 75, and diastolic pressure moved from 115 to 59. Systolic pressure ranged 71-158 and ended at 100, and SpO2 recovered to 99 after a low of 83 around hour 1.6. Respiratory rate ended at 18; the available labs showed white count rose from 9.2 to 16, creatinine was roughly stable (0.7 to 0.4), lactate was checked once at 1.5, and urine output was roughly stable (98 to 98)
C. Across the recorded window, the heart rate was roughly stable (67 to 69), MAP fell from 116 to 72, and diastolic pressure moved from 113 to 61. Systolic pressure ranged 73-173 and ended at 104, and SpO2 recovered to 97 after a low of 85 around hour 0.7. Respiratory rate ended at 17; the available labs showed white count rose from 10.3 to 17, creatinine was roughly stable (0.6 to 0.5), lactate was checked once at 1.7, and urine output was roughly stable (100 to 100)
D. Across the recorded window, the heart rate was roughly stable (62 to 74), MAP fell from 112 to 68, and diastolic pressure moved from 118 to 56. Systolic pressure ranged 68-143 and ended at 100, and SpO2 recovered to 100 after a low of 84 around hour 0.5. Respiratory rate ended at 19; the available labs showed white count rose from 8.1 to 16.2, creatinine was roughly stable (0.8 to 0.3), lactate was checked once at 1.4, and urine output was roughly stable (150 to 96)

Answer: C


Question:
Which summary best represents the patient's recorded course across the episode?

Options:
A. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 114 to 76, diastolic pressure fell from 104 to 59, and heart rate fell from 116 to 71. The lowest MAP was about 69 around hour 17.3, and the lowest valid SpO2 was 96 around hour 12.7; respiratory rate rose as high as 34 but ended at 20. The lower-frequency data fit that summary: temperature stayed around 33.5-34.8 C, white count fell from 6.4 to 3.9, creatinine stayed around 1.9, lactate stayed broadly stable from 359 to 306, and urine output rose from 170 to 320.
B. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 111 to 79, diastolic pressure fell from 101 to 62, and heart rate fell from 136 to 68. The lowest MAP was about 66 around hour 16.3, and the lowest valid SpO2 was 93 around hour 14.2; respiratory rate rose as high as 31 but ended at 19. The lower-frequency data fit that summary: temperature stayed around 36.5-37.8 C, white count fell from 5.9 to 4.4, creatinine stayed around 1.7, lactate stayed broadly stable from 339 to 326, and urine output rose from 150 to 300.
C. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 115 to 75, diastolic pressure fell from 105 to 66, and heart rate fell from 111 to 71. The lowest MAP was about 70 around hour 14.4, and the lowest valid SpO2 was 97 around hour 13.2; respiratory rate rose as high as 35 but ended at 21. The lower-frequency data fit that summary: temperature stayed around 32.8-34.0 C, white count fell from 6.5 to 3.8, creatinine stayed around 1.9, lactate stayed broadly stable from 364 to 301, and urine output rose from 175 to 325.
D. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 106 to 84, diastolic pressure fell from 96 to 58, and heart rate fell from 166 to 64. The lowest MAP was about 62 around hour 18.6, and the lowest valid SpO2 was 88 around hour 16.4; respiratory rate rose as high as 33 but ended at 17. The lower-frequency data fit that summary: temperature stayed around 41.0-42.3 C, white count fell from 5.2 to 4.7, creatinine was roughly stable (1.4 to 1.8), lactate stayed broadly stable from 339 to 326, and urine output rose from 150 to 350.

Answer: B

Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 111 to 79, diastolic pressure fell from 101 to 62, and heart rate fell from 136 to 68. The lowest MAP was about 66 around hour 16.3, and the lowest valid SpO2 was 93 around hour 14.2; respiratory rate rose as high as 31 but ended at 19. The lower-frequency data fit that summary: temperature ranged from 97.7 to 100.1, white count fell from 5.9 to 4.4, creatinine stayed around 1.7, lactate stayed broadly stable from 339 to 326, and urine output rose from 150 to 300.


Question:
Which clinical synopsis would you choose after reviewing the data chronologically?

Options:
A. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 168 to 112, MAP fell from 114 to 82, and heart rate fell from 116 to 71. SpO2 started at 91, ended at 99, and fell as low as 96 around hour 12.7; respiratory rate ranged 16-28. For labs and output, white count fell from 5.4 to 4.9, creatinine was roughly stable (1.9 to 1.8), lactate stayed broadly stable from 339.2 to 326, and urine output rose from 150 to 300.
B. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 133 to 113, MAP fell from 109 to 77, and heart rate fell from 151 to 71. SpO2 started at 96, ended at 94, and fell as low as 91 around hour 15.3; respiratory rate ranged 14-33. For labs and output, white count fell from 6.3 to 3.6, creatinine stayed around 1.5, lactate stayed broadly stable from 354 to 311, and urine output rose from 135 to 315.
C. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 148 to 132, MAP fell from 111 to 79, and heart rate fell from 136 to 68. SpO2 started at 94, ended at 96, and fell as low as 93 around hour 14.2; respiratory rate ranged 15-31. For labs and output, white count fell from 5.9 to 4.4, creatinine stayed around 1.7, lactate stayed broadly stable from 339 to 326, and urine output rose from 150 to 300.
D. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 118 to 98, MAP fell from 106 to 82, and heart rate fell from 166 to 64. SpO2 started at 98, ended at 92, and fell as low as 92 around hour 16.4; respiratory rate ranged 13-36. For labs and output, white count fell from 6.7 to 3.7, creatinine stayed around 1.4, lactate stayed broadly stable from 369 to 296, and urine output rose from 120 to 330.

Answer: C


Question:
Which summary best preserves the direction and size of the recorded changes?

Options:
A. Over the available measurements, the heart rate was roughly stable (78 to 75), while MAP fell from 143 to 105. Systolic pressure was labile, ranging 102-174, with the lowest value around hour 20.6. SpO2 briefly dipped to 89 around hour 1 before recovering to 92, while respiratory rate peaked at 27 and later settled at 20. The associated labs and urine output showed that white count rose from 14.7 to 100, creatinine fell from 8.2 to 5.6, lactate was checked once at 0.7, and urine output stayed around 33, with recorded outputs ranging 27-28.
B. Over the available measurements, the heart rate was roughly stable (73 to 80), while MAP fell from 108 to 105. Systolic pressure was labile, ranging 100-209, with the lowest value around hour 18.0. SpO2 briefly dipped to 86 around hour 2 before recovering to 97, while respiratory rate peaked at 24 and later settled at 17. The associated labs and urine output showed that white count rose from 17.3 to 96, creatinine fell from 7.3 to 6.5, lactate was checked once at 0.5, and urine output was roughly stable (28 to 0), with recorded outputs ranging 0-30.
C. Over the available measurements, the heart rate was roughly stable (75 to 78), while MAP fell from 123 to 102. Systolic pressure was labile, ranging 98-194, with the lowest value around hour 19.1. SpO2 briefly dipped to 88 around hour 1 before recovering to 95, while respiratory rate peaked at 25 and later settled at 18. The associated labs and urine output showed that white count rose from 16.2 to 98, creatinine fell from 7.7 to 6.1, lactate was checked once at 0.6, and urine output stayed around 30, with recorded outputs ranging 30-30.
D. Over the available measurements, the heart rate was roughly stable (70 to 82), while MAP fell from 93 to 90. Systolic pressure was labile, ranging 100-224, with the lowest value around hour 16.9. SpO2 briefly dipped to 84 around hour 1 before recovering to 100, while respiratory rate peaked at 23 and later settled at 16. The associated labs and urine output showed that white count rose from 18.4 to 97.2, creatinine fell from 7.0 to 6.2, lactate was checked once at 0.4, and urine output stayed around 26, with recorded outputs ranging 34-80.

Answer: C