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

Options:
A. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (75 to 65), diastolic pressure was roughly stable (64 to 59), and heart rate fell from 98 to 93. The lowest MAP was about 69 around hour 7.0, and the lowest valid SpO2 was 88 around hour 0; respiratory rate rose as high as 34 but ended at 26. The lower-frequency data fit that summary: temperature stayed around 32.6-34.1 C, white count rose from 10 to 11.5, creatinine fell from 1.8 to 1.4, lactate was not available, and urine output rose from 97 to 270.
B. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (70 to 70), diastolic pressure was roughly stable (59 to 54), and heart rate fell from 103 to 88. The lowest MAP was about 64 around hour 7.9, and the lowest valid SpO2 was 83 around hour 0.6; respiratory rate rose as high as 33 but ended at 24. The lower-frequency data fit that summary: temperature stayed around 37.9-39.4 C, white count rose from 9 to 11.6, creatinine fell from 1.5 to 1.3, lactate was not available, and urine output rose from 98 to 300.
C. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (72 to 68), diastolic pressure was roughly stable (61 to 56), and heart rate fell from 101 to 90. The lowest MAP was about 66 around hour 7.5, and the lowest valid SpO2 was 85 around hour 0.5; respiratory rate rose as high as 31 but ended at 25. The lower-frequency data fit that summary: temperature stayed around 35.6-37.1 C, white count rose from 9 to 10.5, creatinine fell from 1.6 to 1.2, lactate was not available, and urine output rose from 100 to 250.
D. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (68 to 72), diastolic pressure fell from 56 to 53, and heart rate fell from 106 to 86. The lowest MAP was about 68 around hour 8.5, and the lowest valid SpO2 was 80 around hour 0.7; respiratory rate rose as high as 26 but ended at 23. The lower-frequency data fit that summary: temperature stayed around 40.1-41.6 C, white count rose from 8 to 12.8, creatinine fell from 1.3 to 0.9, lactate was not available, and urine output rose from 96 to 220.

Answer: C

Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (72 to 68), diastolic pressure was roughly stable (61 to 56), and heart rate fell from 101 to 90. The lowest MAP was about 66 around hour 7.5, and the lowest valid SpO2 was 85 around hour 0.5; respiratory rate rose as high as 31 but ended at 25. The lower-frequency data fit that summary: temperature ranged from 96.1 to 98.7, white count rose from 9 to 10.5, creatinine fell from 1.6 to 1.2, lactate was not available, and urine output rose from 100 to 250.


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

Options:
A. Over the available measurements, the heart rate fell from 87 to 75, while MAP fell from 89 to 61. Systolic pressure was labile, ranging 26-114, with the lowest value around hour 4.7. SpO2 briefly dipped to 88 around hour 1.6 before recovering to 93, while respiratory rate peaked at 22 and later settled at 18. The associated labs and urine output showed that white count was roughly stable (9.1 to 11.1), creatinine was roughly stable (0.7 to 0.7), lactate fell from 4.2 to 2.9, and urine output fell from 1823 to 15, with recorded outputs ranging 15-1823.
B. Over the available measurements, the heart rate fell from 82 to 80, while MAP fell from 84 to 61. Systolic pressure was labile, ranging 28-149, with the lowest value around hour 3.8. SpO2 briefly dipped to 83 around hour 2.4 before recovering to 98, while respiratory rate peaked at 20 and later settled at 16. The associated labs and urine output showed that white count rose from 11.7 to 13.2, creatinine stayed around 0.5, lactate fell from 4.6 to 2.8, and urine output fell from 1763 to 0, with recorded outputs ranging 0-1883.
C. Over the available measurements, the heart rate fell from 84 to 78, while MAP fell from 86 to 58. Systolic pressure was labile, ranging 27-134, with the lowest value around hour 4.2. SpO2 briefly dipped to 85 around hour 1.4 before recovering to 96, while respiratory rate peaked at 21 and later settled at 17. The associated labs and urine output showed that white count rose from 10.6 to 11.9, creatinine stayed around 0.6, lactate fell from 4.2 to 2.9, and urine output fell from 1823 to 15, with recorded outputs ranging 10-1823.
D. Over the available measurements, the heart rate fell from 80 to 77, while MAP fell from 82 to 54. Systolic pressure was labile, ranging 31-164, with the lowest value around hour 3.5. SpO2 briefly dipped to 86 around hour 1.1 before recovering to 100, while respiratory rate peaked at 23 and later settled at 15. The associated labs and urine output showed that white count rose from 12.8 to 14.3, creatinine stayed around 0.4, lactate fell from 5.0 to 2.6, and urine output fell from 1703 to 17, with recorded outputs ranging 8-1943.

Answer: C


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 fell from 89 to 55, diastolic pressure rose from 24 to 52, and heart rate fell from 81 to 78. The lowest MAP was about 60 around hour 23.7, and the lowest valid SpO2 was 88 around hour 1.2; respiratory rate rose as high as 23 but ended at 18. The lower-frequency data fit that summary: temperature stayed around 32.2-34.5 C, white count rose from 12.1 to 13.6, creatinine was roughly stable (0.7 to 0.7), lactate fell from 4.2 to 2.9, and urine output fell from 1823 to 65.
B. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 84 to 60, diastolic pressure rose from 21 to 46, and heart rate fell from 86 to 76. The lowest MAP was about 58 around hour 26, and the lowest valid SpO2 was 83 around hour 1.5; respiratory rate rose as high as 20 but ended at 16. The lower-frequency data fit that summary: temperature stayed around 37.5-39.8 C, white count rose from 9.5 to 13.0, creatinine stayed around 0.5, lactate fell from 3.8 to 3.0, and urine output fell from 1763 to 14.
C. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 90 to 54, diastolic pressure rose from 24 to 53, and heart rate was roughly stable (80 to 81). The lowest MAP was about 61 around hour 23.3, and the lowest valid SpO2 was 89 around hour 0.4; respiratory rate rose as high as 23 but ended at 19. The lower-frequency data fit that summary: temperature stayed around 31.5-33.8 C, white count rose from 12.5 to 14.0, creatinine stayed around 0.7, lactate fell from 4.8 to 2.6, and urine output fell from 1923 to 17.
D. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 86 to 58, diastolic pressure rose from 22 to 49, and heart rate fell from 84 to 78. The lowest MAP was about 57 around hour 25.2, and the lowest valid SpO2 was 85 around hour 1.4; respiratory rate rose as high as 21 but ended at 17. The lower-frequency data fit that summary: temperature stayed around 35.2-37.5 C, white count rose from 10.6 to 11.9, creatinine stayed around 0.6, lactate fell from 4.2 to 2.9, and urine output fell from 1823 to 15.

Answer: D

Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 86 to 58, diastolic pressure rose from 22 to 49, and heart rate fell from 84 to 78. The lowest MAP was about 57 around hour 25.2, and the lowest valid SpO2 was 85 around hour 1.4; respiratory rate rose as high as 21 but ended at 17. The lower-frequency data fit that summary: temperature ranged from 35.2 to 37.5, white count rose from 10.6 to 11.9, creatinine stayed around 0.6, lactate fell from 4.2 to 2.9, and urine output fell from 1823 to 15.


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

Options:
A. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 45 to 94, MAP fell from 86 to 58, and heart rate fell from 84 to 78. SpO2 started at 100, ended at 96, and fell as low as 85 around hour 1.4; respiratory rate ranged 12-21. For labs and output, white count rose from 10.6 to 11.9, creatinine stayed around 0.6, lactate fell from 4.2 to 2.9, and urine output fell from 1823 to 15.
B. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 43 to 96, MAP fell from 84 to 56, and heart rate was roughly stable (86 to 81). SpO2 started at 98, ended at 94, and fell as low as 83 around hour 1.5; respiratory rate ranged 11-23. For labs and output, white count was roughly stable (11.7 to 11.1), creatinine stayed around 0.5, lactate fell from 4.6 to 2.8, and urine output fell from 1763 to 16.
C. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 49 to 90, MAP fell from 90 to 61, and heart rate fell from 80 to 77. SpO2 started at 96, ended at 100, and fell as low as 84 around hour 1.1; respiratory rate ranged 14-19. For labs and output, white count rose from 8.7 to 13.8, creatinine stayed around 0.7, lactate fell from 3.6 to 3.1, and urine output fell from 1923 to 13.
D. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 40 to 98, MAP fell from 82 to 54, and heart rate fell from 88 to 74. SpO2 started at 96, ended at 92, and fell as low as 80 around hour 1.7; respiratory rate ranged 10-23. For labs and output, white count rose from 12.8 to 14.3, creatinine was roughly stable (0.4 to 0.7), lactate fell from 4.4 to 2.9, and urine output fell from 1823 to 15.

Answer: A


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

Options:
A. In broad terms, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 55 to 81, diastolic pressure rose from 46 to 64, and heart rate fell from 93 to 70. The lowest MAP was about 47 around hour 0.3, and the lowest valid SpO2 was 80 around hour 108.8; respiratory rate rose as high as 34 but ended at 16. The lower-frequency data fit that summary: temperature stayed around 35-36.7 C, white count fell from 15 to 8.5, creatinine was roughly stable (1.5 to 1.9), lactate stayed broadly stable from 1.7 to 0.9, and urine output fell from 2950 to 100.
B. In broad terms, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 53 to 83, diastolic pressure rose from 44 to 62, and heart rate fell from 95 to 73. The lowest MAP was about 45 around hour 0.4, and the lowest valid SpO2 was 78 around hour 107.8; respiratory rate rose as high as 32 but ended at 15. The lower-frequency data fit that summary: temperature stayed around 37-39.0 C, white count fell from 14 to 8.9, creatinine was roughly stable (1.4 to 1.8), lactate stayed broadly stable from 1.9 to 0.8, and urine output fell from 2890 to 98.
C. In broad terms, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 59 to 77, diastolic pressure rose from 50 to 68, and heart rate fell from 89 to 74. The lowest MAP was about 51 around hour 0.2, and the lowest valid SpO2 was 84 around hour 105.0; respiratory rate rose as high as 36 but ended at 18. The lower-frequency data fit that summary: temperature stayed around 31-33.0 C, white count fell from 17 to 7.9, creatinine was roughly stable (1.8 to 2), lactate stayed broadly stable from 1.4 to 1.0, and urine output fell from 3050 to 150.
D. In broad terms, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 50 to 86, diastolic pressure rose from 42 to 61, and heart rate fell from 98 to 66. The lowest MAP was about 50 around hour 1.3, and the lowest valid SpO2 was 76 around hour 113.3; respiratory rate rose as high as 30 but ended at 14. The lower-frequency data fit that summary: temperature stayed around 40-41.2 C, white count fell from 13 to 9.2, creatinine was roughly stable (1.2 to 1.6), lactate stayed broadly stable from 2.0 to 0.8, and urine output fell from 2830 to 96.

Answer: A

In broad terms, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 55 to 81, diastolic pressure rose from 46 to 64, and heart rate fell from 93 to 70. The lowest MAP was about 47 around hour 0.3, and the lowest valid SpO2 was 80 around hour 108.8; respiratory rate rose as high as 34 but ended at 16. The lower-frequency data fit that summary: temperature ranged from 95 to 98.1, white count fell from 15 to 8.5, creatinine was roughly stable (1.5 to 1.9), lactate stayed broadly stable from 1.7 to 0.9, and urine output fell from 2950 to 100.


Question:
Which summary best captures the overall course shown by the serial data?

Options:
A. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 82 to 62, diastolic pressure fell from 70 to 56, and heart rate rose from 88 to 97. The lowest MAP was about 57 around hour 23.6, and the lowest valid SpO2 was 88 around hour 2.6; respiratory rate rose as high as 40 but ended at 20. The lower-frequency data fit that summary: temperature stayed around 32.4-34.9 C, white count fell from 22.7 to 18.3, creatinine rose from 0.6 to 0.7, lactate was checked once at 2.4, and urine output rose from 220 to 410.
B. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 77 to 67, diastolic pressure fell from 65 to 50, and heart rate rose from 93 to 98. The lowest MAP was about 57 around hour 26.1, and the lowest valid SpO2 was 83 around hour 3.5; respiratory rate rose as high as 36 but ended at 18. The lower-frequency data fit that summary: temperature stayed around 37.6-40.1 C, white count fell from 20.1 to 18.6, creatinine was roughly stable (0.4 to 0.5), lactate was checked once at 2.8, and urine output rose from 185 to 345.
C. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 83 to 61, diastolic pressure fell from 71 to 57, and heart rate rose from 87 to 103. The lowest MAP was about 58 around hour 23.2, and the lowest valid SpO2 was 89 around hour 2.1; respiratory rate rose as high as 42 but ended at 21. The lower-frequency data fit that summary: temperature stayed around 31.6-34.1 C, white count fell from 23.1 to 17.9, creatinine was roughly stable (0.6 to 0.7), lactate was checked once at 2.4, and urine output rose from 225 to 385.
D. Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 79 to 65, diastolic pressure fell from 67 to 53, and heart rate rose from 91 to 100. The lowest MAP was about 54 around hour 25.1, and the lowest valid SpO2 was 85 around hour 3.1; respiratory rate rose as high as 38 but ended at 19. The lower-frequency data fit that summary: temperature stayed around 35.4-37.9 C, white count fell from 21.2 to 19.8, creatinine was roughly stable (0.5 to 0.6), lactate was checked once at 2.6, and urine output rose from 200 to 360.

Answer: D

Clinically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 79 to 65, diastolic pressure fell from 67 to 53, and heart rate rose from 91 to 100. The lowest MAP was about 54 around hour 25.1, and the lowest valid SpO2 was 85 around hour 3.1; respiratory rate rose as high as 38 but ended at 19. The lower-frequency data fit that summary: temperature ranged from 35.4 to 98.2, white count fell from 21.2 to 19.8, creatinine was roughly stable (0.5 to 0.6), lactate was checked once at 2.6, and urine output rose from 200 to 360.


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

Options:
A. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure stayed around 99, MAP fell from 79 to 65, and heart rate rose from 91 to 100. SpO2 started at 100, ended at 97, and fell as low as 85 around hour 3.1; respiratory rate ranged 5-38. For labs and output, white count fell from 21.2 to 19.8, creatinine was roughly stable (0.5 to 0.6), lactate was checked once at 2.6, and urine output rose from 200 to 360.
B. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure stayed around 97, MAP fell from 81 to 63, and heart rate rose from 89 to 103. SpO2 started at 98, ended at 99, and fell as low as 83 around hour 2.7; respiratory rate ranged 5-40. For labs and output, white count fell from 20.1 to 19, creatinine was roughly stable (0.4 to 0.5), lactate was checked once at 2.8, and urine output rose from 185 to 345.
C. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (100 to 95), MAP fell from 79 to 68, and heart rate rose from 91 to 100. SpO2 started at 100, ended at 97, and fell as low as 84 around hour 3.1; respiratory rate ranged 5-38. For labs and output, white count fell from 21.2 to 19.8, creatinine was roughly stable (0.5 to 0.6), lactate was checked once at 2.6, and urine output rose from 200 to 360.
D. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure stayed around 94, MAP fell from 84 to 60, and heart rate rose from 86 to 96. SpO2 started at 96, ended at 100, and fell as low as 80 around hour 2.4; respiratory rate ranged 6-42. For labs and output, white count fell from 18.9 to 17.4, creatinine rose from 0.3 to 0.7, lactate was checked once at 2.8, and urine output rose from 170 to 330.

Answer: A


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

Options:
A. Across the recorded window, the heart rate fell from 81 to 12, while MAP fell from 90 to 79. Systolic pressure was labile, ranging 100-157, with the lowest value around hour 3.2. SpO2 briefly dipped to 85 around hour 0.1 before recovering to 95, while respiratory rate peaked at 38 and later settled at 35. The associated labs and urine output showed that white count fell from 12.3 to 9.6, creatinine was roughly stable (0.9 to 0.8), lactate was not available, and urine output rose from 60 to 220, with recorded outputs ranging 45-650.
B. Across the recorded window, the heart rate fell from 79 to 13, while MAP fell from 88 to 77. Systolic pressure was labile, ranging 98-172, with the lowest value around hour 2.8. SpO2 briefly dipped to 83 around hour 0.0 before recovering to 97, while respiratory rate peaked at 36 and later settled at 33. The associated labs and urine output showed that white count fell from 13.4 to 8.8, creatinine stayed around 0.8, lactate was not available, and urine output rose from 60 to 220, with recorded outputs ranging 60-650.
C. Across the recorded window, the heart rate fell from 85 to 10, while MAP fell from 94 to 82. Systolic pressure was labile, ranging 96-132, with the lowest value around hour 3.8. SpO2 briefly dipped to 89 around hour 1.1 before recovering to 91, while respiratory rate peaked at 42 and later settled at 39. The associated labs and urine output showed that white count fell from 10.4 to 10.2, creatinine was roughly stable (1.0 to 0.7), lactate was not available, and urine output rose from 64 to 170, with recorded outputs ranging 41-625.
D. Across the recorded window, the heart rate fell from 76 to 14, while MAP fell from 86 to 74. Systolic pressure was labile, ranging 104-187, with the lowest value around hour 2.5. SpO2 briefly dipped to 86 around hour 0.0 before recovering to 100, while respiratory rate peaked at 40 and later settled at 30. The associated labs and urine output showed that white count fell from 14.6 to 8.8, creatinine was roughly stable (0.8 to 1.0), lactate was not available, and urine output rose from 56 to 190, with recorded outputs ranging 50-680.

Answer: A


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

Options:
A. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 93 to 76, diastolic pressure was roughly stable (70 to 65), and heart rate fell from 78 to 14. The lowest MAP was about 73 around hour 4.7, and the lowest valid SpO2 was 88 around hour 0.0; respiratory rate rose as high as 40 but ended at 38. The lower-frequency data fit that summary: temperature stayed around 32.7-34.3 C, white count fell from 13.8 to 9.1, creatinine stayed around 1.0, lactate was not available, and urine output rose from 60 to 270.
B. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 90 to 79, diastolic pressure was roughly stable (67 to 62), and heart rate fell from 81 to 12. The lowest MAP was about 70 around hour 5.2, and the lowest valid SpO2 was 85 around hour 0.1; respiratory rate rose as high as 38 but ended at 35. The lower-frequency data fit that summary: temperature stayed around 35.7-37.3 C, white count fell from 12.3 to 9.6, creatinine was roughly stable (0.9 to 0.8), lactate was not available, and urine output rose from 60 to 220.
C. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 94 to 75, diastolic pressure was roughly stable (71 to 66), and heart rate fell from 77 to 15. The lowest MAP was about 74 around hour 4.6, and the lowest valid SpO2 was 89 around hour 0; respiratory rate rose as high as 42 but ended at 39. The lower-frequency data fit that summary: temperature stayed around 32.0-33.5 C, white count fell from 14.2 to 9.0, creatinine was roughly stable (1.0 to 0.9), lactate was not available, and urine output rose from 56 to 245.
D. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 86 to 84, diastolic pressure fell from 62 to 59, and heart rate fell from 86 to 10. The lowest MAP was about 73 around hour 6.2, and the lowest valid SpO2 was 80 around hour 0.2; respiratory rate rose as high as 34 but ended at 30. The lower-frequency data fit that summary: temperature stayed around 40.2-41.8 C, white count fell from 10.1 to 8.6, creatinine was roughly stable (0.8 to 0.7), lactate was not available, and urine output rose from 64 to 190.

Answer: B

Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 90 to 79, diastolic pressure was roughly stable (67 to 62), and heart rate fell from 81 to 12. The lowest MAP was about 70 around hour 5.2, and the lowest valid SpO2 was 85 around hour 0.1; respiratory rate rose as high as 38 but ended at 35. The lower-frequency data fit that summary: temperature ranged from 96.2 to 99.1, white count fell from 12.3 to 9.6, creatinine was roughly stable (0.9 to 0.8), lactate was not available, and urine output rose from 60 to 220.


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

Options:
A. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 159 to 111, MAP fell from 93 to 82, and heart rate fell from 78 to 15. SpO2 started at 97, ended at 98, and fell as low as 88 around hour 0.0; respiratory rate ranged 12-40. For labs and output, white count fell from 10.8 to 8.8, creatinine was roughly stable (1.0 to 0.7), lactate was not available, and urine output rose from 63 to 240.
B. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 124 to 104, MAP fell from 88 to 82, and heart rate fell from 83 to 11. SpO2 started at 98, ended at 93, and fell as low as 84 around hour 0.2; respiratory rate ranged 9-40. For labs and output, white count fell from 13.4 to 9.2, creatinine was roughly stable (0.8 to 0.9), lactate was not available, and urine output rose from 58 to 205.
C. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 139 to 131, MAP fell from 90 to 79, and heart rate fell from 81 to 12. SpO2 started at 100, ended at 95, and fell as low as 85 around hour 0.1; respiratory rate ranged 10-38. For labs and output, white count fell from 12.3 to 9.6, creatinine was roughly stable (0.9 to 0.8), lactate was not available, and urine output rose from 60 to 220.
D. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 109 to 89, MAP fell from 86 to 74, and heart rate fell from 86 to 10. SpO2 started at 96, ended at 90, and fell as low as 80 around hour 0.2; respiratory rate ranged 8-42. For labs and output, white count fell from 14.6 to 8.8, creatinine was roughly stable (1 to 0.9), lactate was not available, and urine output rose from 56 to 190.

Answer: C


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

Options:
A. Over the available measurements, the heart rate fell from 160 to 74, MAP fell from 84 to 75, and diastolic pressure moved from 66 to 65. Systolic pressure ranged 80-179 and ended at 116, and SpO2 recovered to 96 after a low of 82 around hour 124.6. Respiratory rate ended at 23; the available labs showed white count rose from 12.8 to 15.3, creatinine was roughly stable (0.7 to 0.8), lactate was checked once at 0.9, and urine output fell from 500 to 100.
B. Over the available measurements, the heart rate fell from 145 to 77, MAP fell from 82 to 73, and diastolic pressure moved from 68 to 62. Systolic pressure ranged 78-164 and ended at 114, and SpO2 recovered to 98 after a low of 80 around hour 109.6. Respiratory rate ended at 24; the available labs showed white count rose from 11.7 to 14.2, creatinine was roughly stable (0.8 to 0.7), lactate was checked once at 0.8, and urine output fell from 515 to 98.
C. Over the available measurements, the heart rate fell from 185 to 70, MAP fell from 88 to 78, and diastolic pressure moved from 62 to 69. Systolic pressure ranged 84-204 and ended at 112, and SpO2 recovered to 92 after a low of 86 around hour 125.6. Respiratory rate ended at 21; the available labs showed white count rose from 14.7 to 17.2, creatinine was roughly stable (0.6 to 0.9), lactate was checked once at 1.0, and urine output fell from 475 to 96.
D. Over the available measurements, the heart rate fell from 130 to 78, MAP fell from 80 to 70, and diastolic pressure moved from 70 to 60. Systolic pressure ranged 76-149 and ended at 112, and SpO2 recovered to 100 after a low of 81 around hour 94.6. Respiratory rate ended at 25; the available labs showed white count was roughly stable (10.6 to 14.5), creatinine was roughly stable (0.8 to 0.7), lactate was checked once at 0.8, and urine output fell from 550 to 96.

Answer: A


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

Options:
A. Overall, the heart rate rose from 50 to 80, while MAP rose from 76 to 83. Systolic pressure was labile, ranging 94-148, with the lowest value around hour 24.3. SpO2 briefly dipped to 85 around hour 0.1 before recovering to 94, while respiratory rate peaked at 26 and later settled at 20. The associated labs and urine output showed that white count rose from 7.7 to 9.2, creatinine rose from 1.1 to 1.3, lactate fell from 259 to 2.2, and urine output fell from 220 to 65, with recorded outputs ranging 20-220.
B. Overall, the heart rate rose from 48 to 82, while MAP rose from 74 to 81. Systolic pressure was labile, ranging 96-163, with the lowest value around hour 23.2. SpO2 briefly dipped to 83 around hour 0.0 before recovering to 96, while respiratory rate peaked at 25 and later settled at 19. The associated labs and urine output showed that white count was roughly stable (8.1 to 8.4), creatinine rose from 1.0 to 1.4, lactate fell from 244 to 2.1, and urine output fell from 235 to 63, with recorded outputs ranging 65-205.
C. Overall, the heart rate rose from 54 to 76, while MAP rose from 80 to 86. Systolic pressure was labile, ranging 90-123, with the lowest value around hour 26.2. SpO2 briefly dipped to 89 around hour 1.1 before recovering to 90, while respiratory rate peaked at 28 and later settled at 22. The associated labs and urine output showed that white count rose from 7.1 to 9.8, creatinine rose from 1.4 to 1.6, lactate fell from 284 to 2.5, and urine output fell from 195 to 15, with recorded outputs ranging 15-245.
D. Overall, the heart rate rose from 46 to 84, while MAP rose from 72 to 78. Systolic pressure was labile, ranging 98-178, with the lowest value around hour 22.1. SpO2 briefly dipped to 80 around hour 0.0 before recovering to 98, while respiratory rate peaked at 28 and later settled at 18. The associated labs and urine output showed that white count rose from 8.4 to 8.9, creatinine rose from 0.8 to 1.6, lactate fell from 229 to 1.9, and urine output fell from 250 to 60, with recorded outputs ranging 18-190.

Answer: A


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

Options:
A. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 155 to 175, MAP rose from 79 to 86, and heart rate rose from 47 to 83. SpO2 started at 82, ended at 97, and fell as low as 88 around hour 0.0; respiratory rate ranged 12-28. For labs and output, white count was roughly stable (7.2 to 8.4), creatinine rose from 1.3 to 1.5, lactate fell from 279 to 2.4, and urine output fell from 200 to 68.
B. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 120 to 163, MAP rose from 74 to 81, and heart rate rose from 52 to 78. SpO2 started at 87, ended at 92, and fell as low as 83 around hour 0.2; respiratory rate ranged 10-27. For labs and output, white count rose from 8.1 to 8.8, creatinine rose from 1.0 to 1.4, lactate fell from 259.2 to 2.1, and urine output fell from 170 to 63.
C. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 135 to 148, MAP rose from 76 to 83, and heart rate rose from 50 to 80. SpO2 started at 85, ended at 94, and fell as low as 85 around hour 0.1; respiratory rate ranged 11-26. For labs and output, white count rose from 7.7 to 9.2, creatinine rose from 1.1 to 1.3, lactate fell from 259 to 2.2, and urine output fell from 220 to 65.
D. Over the available measurements, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 105 to 144, MAP rose from 72 to 86, and heart rate rose from 54 to 76. SpO2 started at 90, ended at 90, and fell as low as 84 around hour 0.2; respiratory rate ranged 9-28. For labs and output, white count rose from 8.4 to 8.9, creatinine rose from 0.8 to 1.6, lactate fell from 229 to 1.9, and urine output fell from 250 to 60.

Answer: C


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

Options:
A. Taken together, the heart rate rose from 53 to 77, MAP rose from 79 to 86, and diastolic pressure moved from 48 to 64. Systolic pressure ranged 97-168 and ended at 144, and SpO2 recovered to 91 after a low of 88 around hour 1.1. Respiratory rate ended at 18; the available labs showed white count rose from 8.2 to 9.7, creatinine rose from 0.9 to 1.5, lactate fell from 279 to 2.0, and urine output fell from 240 to 68.
B. Taken together, the heart rate rose from 48 to 83, MAP rose from 74 to 81, and diastolic pressure moved from 53 to 58. Systolic pressure ranged 92-133 and ended at 133, and SpO2 recovered to 96 after a low of 83 around hour 0.0. Respiratory rate ended at 21; the available labs showed white count rose from 7.3 to 8.8, creatinine rose from 1.2 to 1.4, lactate fell from 244 to 2.4, and urine output fell from 205 to 63.
C. Taken together, the heart rate rose from 54 to 76, MAP rose from 80 to 87, and diastolic pressure moved from 47 to 65. Systolic pressure ranged 98-173 and ended at 173, and SpO2 recovered to 90 after a low of 84 around hour 0.2. Respiratory rate ended at 18; the available labs showed white count was roughly stable (8.3 to 8.4), creatinine rose from 0.9 to 1.6, lactate fell from 284 to 2.0, and urine output fell from 270 to 69.
D. Taken together, the heart rate rose from 50 to 80, MAP rose from 76 to 83, and diastolic pressure moved from 51 to 61. Systolic pressure ranged 94-148 and ended at 148, and SpO2 recovered to 94 after a low of 85 around hour 0.1. Respiratory rate ended at 20; the available labs showed white count rose from 7.7 to 9.2, creatinine rose from 1.1 to 1.3, lactate fell from 259 to 2.2, and urine output fell from 220 to 65.

Answer: D


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

Options:
A. In broad terms, the heart rate rose from 50 to 97, MAP fell from 86 to 70, and diastolic pressure moved from 55 to 52. Systolic pressure ranged 100-153 and ended at 126, and SpO2 recovered to 94 after a low of 73 around hour 62.8. Respiratory rate ended at 25; the available labs showed white count rose from 8.4 to 10, creatinine stayed around 0.9, lactate was not available, and urine output fell from 160 to 35.
B. In broad terms, the heart rate rose from 48 to 99, MAP fell from 84 to 68, and diastolic pressure moved from 57 to 50. Systolic pressure ranged 98-138 and ended at 111, and SpO2 recovered to 96 after a low of 72 around hour 60.5. Respiratory rate ended at 26; the available labs showed white count was roughly stable (8.0 to 9.2), creatinine stayed around 1.0, lactate was not available, and urine output fell from 210 to 33.
C. In broad terms, the heart rate rose from 54 to 100, MAP fell from 90 to 74, and diastolic pressure moved from 51 to 49. Systolic pressure ranged 96-178 and ended at 151, and SpO2 recovered to 90 after a low of 77 around hour 66.5. Respiratory rate ended at 23; the available labs showed white count rose from 9.0 to 12, creatinine stayed around 0.8, lactate was not available, and urine output fell from 185 to 39.
D. In broad terms, the heart rate rose from 46 to 100, MAP fell from 82 to 73, and diastolic pressure moved from 60 to 48. Systolic pressure ranged 96-123 and ended at 122, and SpO2 recovered to 98 after a low of 68 around hour 63.8. Respiratory rate ended at 27; the available labs showed white count rose from 7.7 to 8, creatinine stayed around 1.1, lactate was not available, and urine output fell from 130 to 30.

Answer: A


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

Options:
A. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (123 to 117), MAP fell from 87 to 74, and heart rate was roughly stable (57 to 56). SpO2 started at 99, ended at 100, and fell as low as 85 around hour 113.1; respiratory rate ranged 8-31. For labs and output, white count fell from 10 to 6.6, creatinine fell from 1.6 to 0.9, lactate fell from 164 to 2.1, and urine output was roughly stable (275 to 300)
B. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 108 to 105, MAP fell from 85 to 77, and heart rate was roughly stable (59 to 54). SpO2 started at 100, ended at 98, and fell as low as 84 around hour 115.3; respiratory rate ranged 8-33. For labs and output, white count fell from 11 to 6.2, creatinine fell from 1.5 to 1.0, lactate fell from 149 to 2.0, and urine output was roughly stable (290 to 285)
C. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (148 to 113), MAP fell from 91 to 78, and heart rate was roughly stable (53 to 60). SpO2 started at 95, ended at 96, and fell as low as 89 around hour 109.3; respiratory rate ranged 9-27. For labs and output, white count fell from 8 to 7.2, creatinine fell from 1.9 to 1, lactate fell from 164.2 to 2.4, and urine output was roughly stable (250 to 325)
D. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (93 to 122), MAP fell from 82 to 70, and heart rate was roughly stable (62 to 59). SpO2 started at 100, ended at 96, and fell as low as 80 around hour 117.6; respiratory rate ranged 7-33. For labs and output, white count fell from 12 to 5.8, creatinine fell from 1.3 to 1.1, lactate fell from 134 to 1.8, and urine output was roughly stable (305 to 270)

Answer: A


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

Options:
A. Over the available measurements, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (62 to 67), diastolic pressure rose from 39 to 53, and heart rate rose from 50 to 86. The lowest MAP was about 54 around hour 14.5, and the lowest valid SpO2 was 85 around hour 0.1; respiratory rate rose as high as 25 but ended at 15. The lower-frequency data fit that summary: temperature stayed around 36.2-37.4 C, white count was 7.8 on its only check, creatinine was 0.6 on its only check, lactate was not available, and urine output was roughly stable (400 to 400)
B. Over the available measurements, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (60 to 69), diastolic pressure rose from 37 to 51, and heart rate rose from 52 to 84. The lowest MAP was about 52 around hour 15.6, and the lowest valid SpO2 was 83 around hour 0.2; respiratory rate rose as high as 27 but ended at 14. The lower-frequency data fit that summary: temperature stayed around 38.5-39.6 C, white count was 7.4 on its only check, creatinine was 0.7 on its only check, lactate was not available, and urine output was roughly stable (385 to 450)
C. Over the available measurements, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (66 to 63), diastolic pressure rose from 43 to 57, and heart rate rose from 46 to 89. The lowest MAP was about 58 around hour 12.6, and the lowest valid SpO2 was 89 around hour 0; respiratory rate rose as high as 27 but ended at 17. The lower-frequency data fit that summary: temperature stayed around 32.5-33.6 C, white count was 8.4 on its only check, creatinine was 0.5 on its only check, lactate was not available, and urine output was roughly stable (425 to 425)
D. Over the available measurements, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (58 to 72), diastolic pressure rose from 34 to 50, and heart rate rose from 54 to 82. The lowest MAP was about 57 around hour 15.5, and the lowest valid SpO2 was 80 around hour 0.2; respiratory rate rose as high as 23 but ended at 13. The lower-frequency data fit that summary: temperature stayed around 40.7-41.9 C, white count was 7.0 on its only check, creatinine was 0.8 on its only check, lactate was not available, and urine output was roughly stable (370 to 370)

Answer: A

Over the available measurements, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (62 to 67), diastolic pressure rose from 39 to 53, and heart rate rose from 50 to 86. The lowest MAP was about 54 around hour 14.5, and the lowest valid SpO2 was 85 around hour 0.1; respiratory rate rose as high as 25 but ended at 15. The lower-frequency data fit that summary: temperature ranged from 97.1 to 99.3, white count was 7.8 on its only check, creatinine was 0.6 on its only check, lactate was not available, and urine output was roughly stable (400 to 400)


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

Options:
A. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 143 to 108, MAP was roughly stable (65 to 70), and heart rate rose from 47 to 89. SpO2 started at 82, ended at 98, and fell as low as 88 around hour 0.0; respiratory rate ranged 14-27. For labs and output, white count was 7.3 on its only check, creatinine was 0.7 on its only check, lactate was not available, and urine output was roughly stable (420 to 380)
B. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 123 to 111, MAP was roughly stable (62 to 67), and heart rate rose from 50 to 86. SpO2 started at 85, ended at 95, and fell as low as 85 around hour 0.1; respiratory rate ranged 13-25. For labs and output, white count was 7.8 on its only check, creatinine was 0.6 on its only check, lactate was not available, and urine output was roughly stable (400 to 400)
C. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 148 to 107, MAP was roughly stable (66 to 71), and heart rate rose from 46 to 83. SpO2 started at 81, ended at 99, and fell as low as 89 around hour 0.0; respiratory rate ranged 15-23. For labs and output, white count was 7.2 on its only check, creatinine was 0.7 on its only check, lactate was not available, and urine output was roughly stable (425 to 375)
D. Taken together, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 93 to 90, MAP rose from 58 to 70, and heart rate rose from 54 to 82. SpO2 started at 90, ended at 90, and fell as low as 84 around hour 0.2; respiratory rate ranged 11-27. For labs and output, white count was 8.6 on its only check, creatinine was 0.4 on its only check, lactate was not available, and urine output was roughly stable (370 to 430)

Answer: B


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

Options:
A. Across the recorded window, the heart rate rose from 76 to 97, while MAP rose from 66 to 79. Systolic pressure was labile, ranging 29-133, with the lowest value around hour 8. SpO2 briefly dipped to 85 around hour 19.8 before recovering to 94, while respiratory rate peaked at 27 and later settled at 21. The associated labs and urine output showed that white count was roughly stable (17.1 to 16.6), creatinine rose from 0.8 to 1, lactate stayed broadly stable from 2.2 to 2.1, and urine output was roughly stable (250 to 175), with recorded outputs ranging 10-250.
B. Across the recorded window, the heart rate rose from 74 to 99, while MAP rose from 64 to 82. Systolic pressure was labile, ranging 30-148, with the lowest value around hour 8. SpO2 briefly dipped to 83 around hour 20.8 before recovering to 96, while respiratory rate peaked at 26 and later settled at 20. The associated labs and urine output showed that white count was roughly stable (18.2 to 15.5), creatinine rose from 0.7 to 1, lactate stayed broadly stable from 2.1 to 2.0, and urine output fell from 265 to 125, with recorded outputs ranging 9-235.
C. Across the recorded window, the heart rate rose from 80 to 93, while MAP rose from 70 to 83. Systolic pressure was labile, ranging 33-108, with the lowest value around hour 9. SpO2 briefly dipped to 86 around hour 21.7 before recovering to 90, while respiratory rate peaked at 29 and later settled at 23. The associated labs and urine output showed that white count was roughly stable (15.2 to 18.5), creatinine rose from 0.9 to 1, lactate stayed broadly stable from 2.5 to 2.4, and urine output was roughly stable (225 to 200), with recorded outputs ranging 12-275.
D. Across the recorded window, the heart rate rose from 72 to 100, while MAP rose from 62 to 74. Systolic pressure was labile, ranging 31-163, with the lowest value around hour 7. SpO2 briefly dipped to 80 around hour 17.6 before recovering to 98, while respiratory rate peaked at 25 and later settled at 19. The associated labs and urine output showed that white count fell from 19.4 to 15.8, creatinine rose from 0.7 to 1.1, lactate stayed broadly stable from 1.9 to 1.8, and urine output was roughly stable (280 to 145), with recorded outputs ranging 60-220.

Answer: A


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 39 to 103, MAP rose from 69 to 82, and heart rate rose from 73 to 100. SpO2 started at 97, ended at 97, and fell as low as 84 around hour 18.3; respiratory rate ranged 16-26. For labs and output, white count was roughly stable (15.6 to 18.1), creatinine rose from 0.9 to 1, lactate stayed broadly stable from 2.4 to 2.3, and urine output was roughly stable (230 to 195)
B. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 34 to 109, MAP rose from 64 to 77, and heart rate rose from 78 to 95. SpO2 started at 98, ended at 92, and fell as low as 83 around hour 20.9; respiratory rate ranged 13-28. For labs and output, white count was roughly stable (18.2 to 15.5), creatinine rose from 0.7 to 1.1, lactate fell from 2.4 to 2.0, and urine output was roughly stable (265 to 160)
C. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 36 to 107, MAP rose from 66 to 79, and heart rate rose from 76 to 97. SpO2 started at 100, ended at 94, and fell as low as 85 around hour 19.8; respiratory rate ranged 14-27. For labs and output, white count was roughly stable (17.1 to 16.6), creatinine rose from 0.8 to 1, lactate stayed broadly stable from 2.2 to 2.1, and urine output was roughly stable (250 to 175)
D. In broad terms, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 32 to 112, MAP rose from 62 to 74, and heart rate rose from 80 to 100. SpO2 started at 96, ended at 90, and fell as low as 80 around hour 22.1; respiratory rate ranged 12-29. For labs and output, white count fell from 19.4 to 15.8, creatinine rose from 0.7 to 1, lactate stayed broadly stable from 1.9 to 1.8, and urine output was roughly stable (280 to 145)

Answer: C


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

Options:
A. Clinically, the heart rate rose from 79 to 94, MAP rose from 69 to 82, and diastolic pressure moved from 20 to 74. Systolic pressure ranged 30-153 and ended at 103, and SpO2 recovered to 91 after a low of 88 around hour 20.8. Respiratory rate ended at 20; the available labs showed white count was roughly stable (18.6 to 18.1), creatinine rose from 0.7 to 1, lactate stayed broadly stable from 2.4 to 1.9, and urine output was roughly stable (270 to 195)
B. Clinically, the heart rate rose from 74 to 99, MAP rose from 64 to 77, and diastolic pressure moved from 23 to 69. Systolic pressure ranged 28-118 and ended at 105, and SpO2 recovered to 96 after a low of 84 around hour 18.7. Respiratory rate ended at 22; the available labs showed white count fell from 16.0 to 15.8, creatinine rose from 0.9 to 1, lactate stayed broadly stable from 2.1 to 2.2, and urine output fell from 300 to 160.
C. Clinically, the heart rate rose from 80 to 100, MAP rose from 70 to 83, and diastolic pressure moved from 20 to 68. Systolic pressure ranged 31-158 and ended at 111, and SpO2 recovered to 90 after a low of 89 around hour 21.7. Respiratory rate ended at 19; the available labs showed white count was roughly stable (19.0 to 18.5), creatinine rose from 0.7 to 1, lactate stayed broadly stable from 2.5 to 1.9, and urine output was roughly stable (275 to 200)
D. Clinically, the heart rate rose from 76 to 97, MAP rose from 66 to 79, and diastolic pressure moved from 22 to 71. Systolic pressure ranged 29-133 and ended at 107, and SpO2 recovered to 94 after a low of 85 around hour 19.8. Respiratory rate ended at 21; the available labs showed white count was roughly stable (17.1 to 16.6), creatinine rose from 0.8 to 1, lactate stayed broadly stable from 2.2 to 2.1, and urine output was roughly stable (250 to 175)

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 fell from 96 to 70, diastolic pressure fell from 73 to 58, and heart rate rose from 53 to 86. The lowest MAP was about 76 around hour 58.1, and the lowest valid SpO2 was 84 around hour 20.3; respiratory rate rose as high as 26 but ended at 14. The lower-frequency data fit that summary: temperature stayed around 33.4-34.3 C, white count fell from 9.6 to 6.7, creatinine fell from 1 to 0.9, lactate was checked once at 164, and urine output rose from 78 to 370.
B. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 91 to 75, diastolic pressure fell from 68 to 59, and heart rate rose from 52 to 81. The lowest MAP was about 71 around hour 59.4, and the lowest valid SpO2 was 79 around hour 22.9; respiratory rate rose as high as 27 but ended at 12. The lower-frequency data fit that summary: temperature stayed around 38.6-39.5 C, white count fell from 8.7 to 7.6, creatinine was roughly stable (1 to 0.9), lactate was checked once at 199, and urine output rose from 73 to 400.
C. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 93 to 73, diastolic pressure fell from 70 to 61, and heart rate rose from 50 to 83. The lowest MAP was about 73 around hour 57.1, and the lowest valid SpO2 was 81 around hour 21.8; respiratory rate rose as high as 25 but ended at 13. The lower-frequency data fit that summary: temperature stayed around 36.4-37.3 C, white count fell from 9.1 to 7.2, creatinine fell from 1 to 0.8, lactate was checked once at 184, and urine output rose from 75 to 350.
D. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 88 to 78, diastolic pressure fell from 66 to 56, and heart rate rose from 54 to 86. The lowest MAP was about 68 around hour 61.6, and the lowest valid SpO2 was 76 around hour 20.8; respiratory rate rose as high as 23 but ended at 11. The lower-frequency data fit that summary: temperature stayed around 40.9-41.8 C, white count fell from 8.3 to 8.0, creatinine fell from 1 to 0.7, lactate was checked once at 214, and urine output rose from 70 to 320.

Answer: C

Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 93 to 73, diastolic pressure fell from 70 to 61, and heart rate rose from 50 to 83. The lowest MAP was about 73 around hour 57.1, and the lowest valid SpO2 was 81 around hour 21.8; respiratory rate rose as high as 25 but ended at 13. The lower-frequency data fit that summary: temperature ranged from 97.6 to 99.2, white count fell from 9.1 to 7.2, creatinine fell from 1 to 0.8, lactate was checked once at 184, and urine output rose from 75 to 350.


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 fell from 161 to 94, MAP fell from 96 to 76, and heart rate rose from 47 to 86. SpO2 started at 85, ended at 100, and fell as low as 84 around hour 20.3; respiratory rate ranged 10-24. For labs and output, white count fell from 8.6 to 7.7, creatinine was roughly stable (1 to 0.9), lactate was checked once at 184.2, and urine output rose from 78 to 330.
B. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 126 to 99, MAP fell from 91 to 71, and heart rate rose from 52 to 86. SpO2 started at 90, ended at 95, and fell as low as 79 around hour 22.9; respiratory rate ranged 9-27. For labs and output, white count fell from 9.5 to 6.4, creatinine fell from 1 to 0.9, lactate was checked once at 169, and urine output rose from 73 to 365.
C. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 166 to 93, MAP fell from 97 to 76, and heart rate rose from 46 to 87. SpO2 started at 84, ended at 100, and fell as low as 80 around hour 19.9; respiratory rate ranged 10-23. For labs and output, white count fell from 8.5 to 7.8, creatinine fell from 1 to 0.7, lactate was checked once at 209, and urine output rose from 79 to 325.
D. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 141 to 97, MAP fell from 93 to 73, and heart rate rose from 50 to 83. SpO2 started at 88, ended at 97, and fell as low as 81 around hour 21.8; respiratory rate ranged 9-25. For labs and output, white count fell from 9.1 to 7.2, creatinine fell from 1 to 0.8, lactate was checked once at 184, and urine output rose from 75 to 350.

Answer: D


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

Options:
A. Over the available measurements, the heart rate rose from 50 to 83, MAP fell from 93 to 73, and diastolic pressure moved from 70 to 61. Systolic pressure ranged 97-178 and ended at 97, and SpO2 recovered to 97 after a low of 81 around hour 21.8. Respiratory rate ended at 13; the available labs showed white count fell from 9.1 to 7.2, creatinine fell from 1 to 0.8, lactate was checked once at 184, and urine output rose from 75 to 350.
B. Over the available measurements, the heart rate rose from 48 to 85, MAP fell from 91 to 71, and diastolic pressure moved from 72 to 59. Systolic pressure ranged 95-163 and ended at 95, and SpO2 recovered to 99 after a low of 80 around hour 20.7. Respiratory rate ended at 14; the available labs showed white count fell from 8.7 to 6.4, creatinine fell from 1 to 0.7, lactate was checked once at 169, and urine output rose from 125 to 335.
C. Over the available measurements, the heart rate rose from 54 to 79, MAP fell from 97 to 76, and diastolic pressure moved from 66 to 65. Systolic pressure ranged 93-203 and ended at 93, and SpO2 recovered to 93 after a low of 85 around hour 22.8. Respiratory rate ended at 11; the available labs showed white count fell from 9.7 to 7.8, creatinine fell from 1 to 0.9, lactate was checked once at 209, and urine output rose from 71 to 375.
D. Over the available measurements, the heart rate rose from 46 to 86, MAP fell from 88 to 68, and diastolic pressure moved from 74 to 58. Systolic pressure ranged 92-148 and ended at 92, and SpO2 recovered to 100 after a low of 76 around hour 19.6. Respiratory rate ended at 15; the available labs showed white count fell from 8.3 to 6.5, creatinine fell from 1 to 0.7, lactate was checked once at 154, and urine output rose from 80 to 320.

Answer: A


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

Options:
A. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 99 to 78, diastolic pressure fell from 88 to 60, and heart rate fell from 82 to 62. The lowest MAP was about 42 around hour 45, and the lowest valid SpO2 was 93 around hour 13.3; respiratory rate rose as high as 28 but ended at 16. The lower-frequency data fit that summary: temperature stayed around 32.9-35 C, white count was roughly stable (10.4 to 8.9), creatinine stayed around 1.4, lactate was not available, and urine output fell from 345 to 180.
B. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 94 to 83, diastolic pressure fell from 83 to 61, and heart rate fell from 87 to 57. The lowest MAP was about 37 around hour 47.1, and the lowest valid SpO2 was 88 around hour 15.9; respiratory rate rose as high as 29 but ended at 13. The lower-frequency data fit that summary: temperature stayed around 38.1-40 C, white count was roughly stable (9.5 to 11.5), creatinine was roughly stable (1.0 to 1.3), lactate was not available, and urine output was roughly stable (325 to 250)
C. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 100 to 77, diastolic pressure fell from 89 to 67, and heart rate fell from 81 to 62. The lowest MAP was about 43 around hour 41.1, and the lowest valid SpO2 was 94 around hour 13.8; respiratory rate rose as high as 29 but ended at 16. The lower-frequency data fit that summary: temperature stayed around 32.1-34 C, white count was roughly stable (10.5 to 8.5), creatinine stayed around 1.4, lactate was not available, and urine output fell from 350 to 175.
D. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 96 to 81, diastolic pressure fell from 85 to 63, and heart rate fell from 85 to 59. The lowest MAP was about 39 around hour 44.9, and the lowest valid SpO2 was 90 around hour 14.8; respiratory rate rose as high as 27 but ended at 14. The lower-frequency data fit that summary: temperature stayed around 35.9-38 C, white count was roughly stable (9.9 to 10.4), creatinine stayed around 1.2, lactate was not available, and urine output fell from 325 to 200.

Answer: D

Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP fell from 96 to 81, diastolic pressure fell from 85 to 63, and heart rate fell from 85 to 59. The lowest MAP was about 39 around hour 44.9, and the lowest valid SpO2 was 90 around hour 14.8; respiratory rate rose as high as 27 but ended at 14. The lower-frequency data fit that summary: temperature ranged from 96.6 to 100.4, white count was roughly stable (9.9 to 10.4), creatinine stayed around 1.2, lactate was not available, and urine output fell from 325 to 200.


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

Options:
A. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 129 to 138, MAP fell from 96 to 81, and heart rate fell from 85 to 59. SpO2 started at 100, ended at 96, and fell as low as 90 around hour 14.8; respiratory rate ranged 9-27. For labs and output, white count was roughly stable (9.9 to 10.4), creatinine stayed around 1.2, lactate was not available, and urine output fell from 325 to 200.
B. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 114 to 153, MAP fell from 99 to 79, and heart rate fell from 87 to 57. SpO2 started at 98, ended at 94, and fell as low as 88 around hour 15.9; respiratory rate ranged 9-28. For labs and output, white count was roughly stable (10.3 to 9.3), creatinine was roughly stable (1.0 to 1.3), lactate was not available, and urine output fell from 325 to 200.
C. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (154 to 134), MAP fell from 100 to 84, and heart rate fell from 81 to 63. SpO2 started at 96, ended at 100, and fell as low as 89 around hour 12.9; respiratory rate ranged 10-25. For labs and output, white count was roughly stable (9.3 to 12.3), creatinine stayed around 1.4, lactate was not available, and urine output fell from 300 to 225.
D. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 99 to 168, MAP fell from 92 to 76, and heart rate fell from 90 to 62. SpO2 started at 96, ended at 92, and fell as low as 86 around hour 17.1; respiratory rate ranged 8-29. For labs and output, white count was roughly stable (10.7 to 9.6), creatinine stayed around 0.9, lactate was not available, and urine output fell from 355 to 170.

Answer: A


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

Options:
A. Viewed chronologically, the heart rate fell from 86 to 70, while MAP was roughly stable (55 to 54). Systolic pressure was labile, ranging 84-156, with the lowest value around hour 26. SpO2 briefly dipped to 88 around hour 12.1 before recovering to 93, while respiratory rate peaked at 34 and later settled at 28. The associated labs and urine output showed that white count was roughly stable (5.4 to 6.0), creatinine rose from 0.8 to 2, lactate was checked once at 461, and urine output fell from 170 to 50, with recorded outputs ranging 33-530.
B. Viewed chronologically, the heart rate fell from 81 to 75, while MAP was roughly stable (50 to 49). Systolic pressure was labile, ranging 89-191, with the lowest value around hour 23. SpO2 briefly dipped to 83 around hour 10.0 before recovering to 98, while respiratory rate peaked at 29 and later settled at 25. The associated labs and urine output showed that white count fell from 6.3 to 4.7, creatinine rose from 0.6 to 2.1, lactate was checked once at 426, and urine output was roughly stable (135 to 98), with recorded outputs ranging 80-565.
C. Viewed chronologically, the heart rate fell from 87 to 69, while MAP was roughly stable (56 to 55). Systolic pressure was labile, ranging 91-151, with the lowest value around hour 26. SpO2 briefly dipped to 86 around hour 13.0 before recovering to 92, while respiratory rate peaked at 33 and later settled at 28. The associated labs and urine output showed that white count was roughly stable (5.3 to 6.1), creatinine rose from 0.8 to 2, lactate was checked once at 466, and urine output was roughly stable (175 to 96), with recorded outputs ranging 34-525.
D. Viewed chronologically, the heart rate fell from 83 to 73, while MAP was roughly stable (52 to 51). Systolic pressure was labile, ranging 87-176, with the lowest value around hour 24. SpO2 briefly dipped to 85 around hour 11.1 before recovering to 96, while respiratory rate peaked at 31 and later settled at 26. The associated labs and urine output showed that white count was roughly stable (5.9 to 5.5), creatinine rose from 0.7 to 2, lactate was checked once at 441, and urine output was roughly stable (150 to 100), with recorded outputs ranging 30-550.

Answer: D


Question:
Which summary best captures the overall course shown by the serial data?

Options:
A. In broad terms, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (52 to 51), diastolic pressure rose from 21 to 38, and heart rate fell from 83 to 73. The lowest MAP was about 46 around hour 36, and the lowest valid SpO2 was 85 around hour 11.1; respiratory rate rose as high as 31 but ended at 26. The lower-frequency data fit that summary: temperature stayed around 36.1-37.2 C, white count was roughly stable (5.9 to 5.5), creatinine rose from 0.7 to 2, lactate was checked once at 441, and urine output was roughly stable (150 to 100)
B. In broad terms, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (50 to 53), diastolic pressure rose from 20 to 36, and heart rate fell from 85 to 76. The lowest MAP was about 44 around hour 38, and the lowest valid SpO2 was 83 around hour 10.1; respiratory rate rose as high as 29 but ended at 25. The lower-frequency data fit that summary: temperature stayed around 38.4-39.5 C, white count was roughly stable (5.5 to 5.9), creatinine rose from 0.6 to 2, lactate was checked once at 456, and urine output was roughly stable (135 to 98)
C. In broad terms, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (56 to 47), diastolic pressure rose from 23 to 42, and heart rate fell from 79 to 77. The lowest MAP was about 50 around hour 32, and the lowest valid SpO2 was 89 around hour 9.2; respiratory rate rose as high as 33 but ended at 28. The lower-frequency data fit that summary: temperature stayed around 32.4-33.5 C, white count was roughly stable (6.5 to 4.9), creatinine rose from 0.8 to 2.1, lactate was checked once at 416, and urine output was roughly stable (175 to 150)
D. In broad terms, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (48 to 56), diastolic pressure rose from 19 to 35, and heart rate fell from 88 to 68. The lowest MAP was about 49 around hour 37, and the lowest valid SpO2 was 80 around hour 13.3; respiratory rate rose as high as 26 but ended at 24. The lower-frequency data fit that summary: temperature stayed around 40.6-41.7 C, white count was roughly stable (5.2 to 6.2), creatinine rose from 0.5 to 2, lactate was checked once at 471, and urine output was roughly stable (120 to 96)

Answer: A

In broad terms, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (52 to 51), diastolic pressure rose from 21 to 38, and heart rate fell from 83 to 73. The lowest MAP was about 46 around hour 36, and the lowest valid SpO2 was 85 around hour 11.1; respiratory rate rose as high as 31 but ended at 26. The lower-frequency data fit that summary: temperature ranged from 96.9 to 99, white count was roughly stable (5.9 to 5.5), creatinine rose from 0.7 to 2, lactate was checked once at 441, and urine output was roughly stable (150 to 100)


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 fell from 192 to 135, MAP fell from 142 to 95, and heart rate was roughly stable (82 to 93). SpO2 started at 82, ended at 99, and fell as low as 84 around hour 0.0; respiratory rate ranged 6-20. For labs and output, white count fell from 20 to 18, creatinine was roughly stable (2 to 1.4), lactate fell from 184 to 1.4, and urine output fell from 160 to 97.
B. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 157 to 154, MAP fell from 107 to 90, and heart rate rose from 87 to 93. SpO2 started at 87, ended at 94, and fell as low as 83 around hour 0.2; respiratory rate ranged 6-23. For labs and output, white count fell from 22 to 18.2, creatinine was roughly stable (2 to 1.8), lactate fell from 149 to 1.0, and urine output fell from 195 to 98.
C. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 197 to 114, MAP fell from 147 to 96, and heart rate was roughly stable (81 to 94). SpO2 started at 81, ended at 100, and fell as low as 89 around hour 0.0; respiratory rate ranged 7-19. For labs and output, white count fell from 19 to 18, creatinine was roughly stable (2 to 1.7), lactate fell from 164.2 to 1.4, and urine output fell from 155 to 50.
D. Viewed chronologically, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 172 to 139, MAP fell from 122 to 92, and heart rate was roughly stable (85 to 90). SpO2 started at 85, ended at 96, and fell as low as 85 around hour 0.1; respiratory rate ranged 6-21. For labs and output, white count fell from 21 to 19, creatinine was roughly stable (2 to 1.6), lactate fell from 164 to 1.2, and urine output fell from 180 to 100.

Answer: D


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

Options:
A. In broad terms, the heart rate was roughly stable (85 to 90), MAP fell from 122 to 92, and diastolic pressure moved from 106 to 77. Systolic pressure ranged 90-172 and ended at 139, and SpO2 recovered to 96 after a low of 85 around hour 0.1. Respiratory rate ended at 15; the available labs showed white count fell from 21 to 19, creatinine was roughly stable (2 to 1.6), lactate fell from 164 to 1.2, and urine output fell from 180 to 100.
B. In broad terms, the heart rate rose from 83 to 93, MAP fell from 107 to 90, and diastolic pressure moved from 108 to 74. Systolic pressure ranged 88-157 and ended at 124, and SpO2 recovered to 98 after a low of 83 around hour 0.0. Respiratory rate ended at 16; the available labs showed white count fell from 20 to 18, creatinine was roughly stable (2 to 1.5), lactate fell from 149 to 1.4, and urine output fell from 165 to 98.
C. In broad terms, the heart rate was roughly stable (89 to 86), MAP fell from 147 to 96, and diastolic pressure moved from 102 to 81. Systolic pressure ranged 94-197 and ended at 164, and SpO2 recovered to 92 after a low of 84 around hour 0.2. Respiratory rate ended at 13; the available labs showed white count fell from 23 to 18.2, creatinine was roughly stable (2 to 1.9), lactate fell from 189 to 0.9, and urine output fell from 230 to 96.
D. In broad terms, the heart rate was roughly stable (80 to 94), MAP fell from 92 to 89, and diastolic pressure moved from 110 to 72. Systolic pressure ranged 86-142 and ended at 135, and SpO2 recovered to 100 after a low of 80 around hour 1.1. Respiratory rate ended at 17; the available labs showed white count fell from 19 to 17, creatinine was roughly stable (2 to 1.3), lactate fell from 134 to 1.5, and urine output fell from 150 to 96.

Answer: A


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

Options:
A. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 117 to 127, MAP fell from 97 to 83, and heart rate was roughly stable (82 to 80). SpO2 started at 98, ended at 94, and fell as low as 85 around hour 0.5; respiratory rate ranged 6-26. For labs and output, white count rose from 4.8 to 9.3, creatinine was roughly stable (0.8 to 0.7), lactate rose from 2.6 to 290, and urine output was roughly stable (50 to 75)
B. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (115 to 123), MAP fell from 95 to 86, and heart rate was roughly stable (84 to 78). SpO2 started at 100, ended at 92, and fell as low as 84 around hour 0.6; respiratory rate ranged 6-27. For labs and output, white count rose from 5.2 to 8.9, creatinine was roughly stable (0.7 to 0.8), lactate rose from 2.5 to 275, and urine output was roughly stable (52 to 73)
C. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 121 to 141, MAP fell from 100 to 87, and heart rate was roughly stable (78 to 84). SpO2 started at 94, ended at 98, and fell as low as 89 around hour 0.4; respiratory rate ranged 7-24. For labs and output, white count rose from 4.2 to 9.9, creatinine stayed around 0.9, lactate rose from 2.8 to 290, and urine output was roughly stable (50 to 75)
D. Overall, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure rose from 112 to 157, MAP fell from 92 to 78, and heart rate was roughly stable (86 to 83). SpO2 started at 100, ended at 90, and fell as low as 80 around hour 0.7; respiratory rate ranged 5-28. For labs and output, white count rose from 5.5 to 8.5, creatinine was roughly stable (0.7 to 0.8), lactate rose from 2.3 to 260, and urine output was roughly stable (54 to 70)

Answer: A


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

Options:
A. Over the available measurements, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 62 to 103, diastolic pressure rose from 47 to 66, and heart rate fell from 98 to 84. The lowest MAP was about 62 around hour 0.2, and the lowest valid SpO2 was 85 around hour 7.2; respiratory rate rose as high as 24 but ended at 21. The lower-frequency data fit that summary: temperature stayed around 36.9-38.1 C, white count was 11.7 on its only check, creatinine stayed around 0.7, lactate was checked once at 1.4, and urine output was roughly stable (30 to 85)
B. Over the available measurements, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 60 to 105, diastolic pressure rose from 45 to 64, and heart rate fell from 100 to 87. The lowest MAP was about 60 around hour 0.3, and the lowest valid SpO2 was 83 around hour 6.2; respiratory rate rose as high as 23 but ended at 20. The lower-frequency data fit that summary: temperature stayed around 39.1-40.4 C, white count was 10.6 on its only check, creatinine stayed around 0.8, lactate was checked once at 1.2, and urine output was roughly stable (28 to 87)
C. Over the available measurements, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 66 to 99, diastolic pressure rose from 51 to 63, and heart rate fell from 94 to 88. The lowest MAP was about 66 around hour 1.2, and the lowest valid SpO2 was 89 around hour 6.6; respiratory rate rose as high as 26 but ended at 23. The lower-frequency data fit that summary: temperature stayed around 33.1-34.4 C, white count was 13.6 on its only check, creatinine stayed around 0.6, lactate was checked once at 1.6, and urine output was roughly stable (34 to 81)
D. Over the available measurements, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 58 to 108, diastolic pressure rose from 42 to 62, and heart rate fell from 100 to 80. The lowest MAP was about 58 around hour 0.4, and the lowest valid SpO2 was 80 around hour 8.0; respiratory rate rose as high as 26 but ended at 19. The lower-frequency data fit that summary: temperature stayed around 41.4-42.6 C, white count was 9.4 on its only check, creatinine was roughly stable (0.8 to 0.8), lactate was checked once at 1.4, and urine output rose from 30 to 135.

Answer: A

Over the available measurements, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 62 to 103, diastolic pressure rose from 47 to 66, and heart rate fell from 98 to 84. The lowest MAP was about 62 around hour 0.2, and the lowest valid SpO2 was 85 around hour 7.2; respiratory rate rose as high as 24 but ended at 21. The lower-frequency data fit that summary: temperature ranged from 98.4 to 100.5, white count was 11.7 on its only check, creatinine stayed around 0.7, lactate was checked once at 1.4, and urine output was roughly stable (30 to 85)


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

Options:
A. Across the recorded window, the heart rate fell from 100 to 81, MAP rose from 65 to 106, and diastolic pressure moved from 44 to 69. Systolic pressure ranged 111-209 and ended at 164, and SpO2 recovered to 91 after a low of 84 around hour 7.7. Respiratory rate ended at 20; the available labs showed white count was 13.2 on its only check, creatinine stayed around 0.8, lactate was checked once at 1.2, and urine output was roughly stable (80 to 88)
B. Across the recorded window, the heart rate fell from 96 to 87, MAP rose from 60 to 101, and diastolic pressure moved from 49 to 63. Systolic pressure ranged 106-174 and ended at 129, and SpO2 recovered to 96 after a low of 83 around hour 6.8. Respiratory rate ended at 22; the available labs showed white count was 10.6 on its only check, creatinine stayed around 0.6, lactate was checked once at 1.5, and urine output was roughly stable (28 to 83)
C. Across the recorded window, the heart rate fell from 98 to 84, MAP rose from 62 to 103, and diastolic pressure moved from 47 to 66. Systolic pressure ranged 108-189 and ended at 144, and SpO2 recovered to 94 after a low of 85 around hour 7.2. Respiratory rate ended at 21; the available labs showed white count was 11.7 on its only check, creatinine stayed around 0.7, lactate was checked once at 1.4, and urine output was roughly stable (30 to 85)
D. Across the recorded window, the heart rate fell from 94 to 88, MAP rose from 58 to 106, and diastolic pressure moved from 52 to 62. Systolic pressure ranged 104-159 and ended at 140, and SpO2 recovered to 98 after a low of 80 around hour 8.2. Respiratory rate ended at 23; the available labs showed white count was 9.4 on its only check, creatinine stayed around 0.5, lactate was checked once at 1.7, and urine output was roughly stable (26 to 80)

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 rose from 110 to 113, diastolic pressure rose from 96 to 105, and heart rate was roughly stable (67 to 78). The lowest MAP was about 80 around hour 4.7, and the lowest valid SpO2 was 91 around hour 0.6; respiratory rate rose as high as 22 but ended at 20. The lower-frequency data fit that summary: temperature stayed around 32.9-34.1 C, white count fell from 5.3 to 3.0, creatinine was roughly stable (1 to 0.7), lactate fell from 160 to 0.9, and urine output was roughly stable (320 to 350)
B. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 107 to 113, diastolic pressure rose from 93 to 102, and heart rate was roughly stable (70 to 75). The lowest MAP was about 77 around hour 5.2, and the lowest valid SpO2 was 88 around hour 0.7; respiratory rate rose as high as 20 but ended at 18. The lower-frequency data fit that summary: temperature stayed around 35.9-37.1 C, white count fell from 4.8 to 3.5, creatinine was roughly stable (1 to 0.6), lactate fell from 180 to 0.8, and urine output was roughly stable (300 to 300)
C. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 111 to 114, diastolic pressure rose from 97 to 99, and heart rate was roughly stable (66 to 79). The lowest MAP was about 80 around hour 6.2, and the lowest valid SpO2 was 92 around hour 0.6; respiratory rate rose as high as 22 but ended at 20. The lower-frequency data fit that summary: temperature stayed around 32.1-33.4 C, white count fell from 5.4 to 2.9, creatinine was roughly stable (1 to 0.7), lactate fell from 155 to 0.9, and urine output was roughly stable (325 to 275)
D. Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 102 to 118, diastolic pressure rose from 88 to 98, and heart rate rose from 74 to 78. The lowest MAP was about 72 around hour 6.0, and the lowest valid SpO2 was 84 around hour 0; respiratory rate rose as high as 18 but ended at 16. The lower-frequency data fit that summary: temperature stayed around 40.4-41.6 C, white count fell from 4.0 to 3.5, creatinine was roughly stable (1 to 0.4), lactate fell from 210 to 0.7, and urine output was roughly stable (270 to 330)

Answer: B

Viewed chronologically, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP rose from 107 to 113, diastolic pressure rose from 93 to 102, and heart rate was roughly stable (70 to 75). The lowest MAP was about 77 around hour 5.2, and the lowest valid SpO2 was 88 around hour 0.7; respiratory rate rose as high as 20 but ended at 18. The lower-frequency data fit that summary: temperature ranged from 96.7 to 98.8, white count fell from 4.8 to 3.5, creatinine was roughly stable (1 to 0.6), lactate fell from 180 to 0.8, and urine output was roughly stable (300 to 300)


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

Options:
A. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (78 to 75), diastolic pressure was roughly stable (67 to 70), and heart rate fell from 86 to 75. The lowest MAP was about 57 around hour 35.2, and the lowest valid SpO2 was 88 around hour 8.7; respiratory rate rose as high as 30 but ended at 22. The lower-frequency data fit that summary: temperature stayed around 33.3-34.7 C, white count fell from 6 to 2.8, creatinine was roughly stable (0.8 to 1), lactate was not available, and urine output was roughly stable (97 to 130)
B. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (73 to 80), diastolic pressure was roughly stable (62 to 65), and heart rate fell from 91 to 75. The lowest MAP was about 52 around hour 40.5, and the lowest valid SpO2 was 83 around hour 8.2; respiratory rate rose as high as 27 but ended at 20. The lower-frequency data fit that summary: temperature stayed around 38.5-40.0 C, white count fell from 6 to 3.7, creatinine was roughly stable (0.6 to 0.8), lactate was not available, and urine output was roughly stable (98 to 78)
C. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (75 to 78), diastolic pressure was roughly stable (64 to 67), and heart rate fell from 89 to 72. The lowest MAP was about 54 around hour 38.2, and the lowest valid SpO2 was 85 around hour 9.2; respiratory rate rose as high as 28 but ended at 21. The lower-frequency data fit that summary: temperature stayed around 36.3-37.7 C, white count fell from 6 to 3.3, creatinine was roughly stable (0.7 to 0.9), lactate was not available, and urine output was roughly stable (100 to 80)
D. Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (70 to 82), diastolic pressure stayed around 60, and heart rate fell from 89 to 72. The lowest MAP was about 57 around hour 39.2, and the lowest valid SpO2 was 85 around hour 9.2; respiratory rate rose as high as 28 but ended at 21. The lower-frequency data fit that summary: temperature stayed around 36.3-37.7 C, white count fell from 6 to 3.3, creatinine was roughly stable (0.7 to 0.9), lactate was not available, and urine output was roughly stable (100 to 80)

Answer: C

Overall, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (75 to 78), diastolic pressure was roughly stable (64 to 67), and heart rate fell from 89 to 72. The lowest MAP was about 54 around hour 38.2, and the lowest valid SpO2 was 85 around hour 9.2; respiratory rate rose as high as 28 but ended at 21. The lower-frequency data fit that summary: temperature ranged from 97.3 to 99.8, white count fell from 6 to 3.3, creatinine was roughly stable (0.7 to 0.9), lactate was not available, and urine output was roughly stable (100 to 80)


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

Options:
A. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (109 to 107), MAP was roughly stable (78 to 81), and heart rate fell from 86 to 75. SpO2 started at 97, ended at 100, and fell as low as 88 around hour 8.7; respiratory rate ranged 14-30. For labs and output, white count fell from 6 to 3.8, creatinine was roughly stable (0.8 to 1), lactate was not available, and urine output was roughly stable (97 to 83)
B. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure stayed around 104, MAP rose from 75 to 81, and heart rate fell from 89 to 72. SpO2 started at 100, ended at 98, and fell as low as 84 around hour 9.2; respiratory rate ranged 12-28. For labs and output, white count fell from 6 to 3.3, creatinine was roughly stable (0.7 to 0.9), lactate was not available, and urine output was roughly stable (100 to 80)
C. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (110 to 106), MAP was roughly stable (79 to 82), and heart rate fell from 85 to 75. SpO2 started at 96, ended at 100, and fell as low as 89 around hour 8.6; respiratory rate ranged 14-30. For labs and output, white count fell from 5 to 2.5, creatinine was roughly stable (0.8 to 0.8), lactate was not available, and urine output was roughly stable (96 to 84)
D. For handoff, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure was roughly stable (106 to 110), MAP was roughly stable (75 to 78), and heart rate fell from 89 to 72. SpO2 started at 100, ended at 98, and fell as low as 85 around hour 9.2; respiratory rate ranged 12-28. For labs and output, white count fell from 6 to 3.3, creatinine was roughly stable (0.7 to 0.9), lactate was not available, and urine output was roughly stable (100 to 80)

Answer: D


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

Options:
A. Over the available measurements, the heart rate fell from 89 to 72, MAP was roughly stable (75 to 78), and diastolic pressure moved from 64 to 67. Systolic pressure ranged 86-124 and ended at 110, and SpO2 recovered to 98 after a low of 85 around hour 9.2. Respiratory rate ended at 21; the available labs showed white count fell from 6 to 3.3, creatinine was roughly stable (0.7 to 0.9), lactate was not available, and urine output was roughly stable (100 to 80)
B. Over the available measurements, the heart rate fell from 87 to 74, MAP rose from 73 to 81, and diastolic pressure moved from 66 to 65. Systolic pressure ranged 84-109 and ended at 106, and SpO2 recovered to 100 after a low of 83 around hour 10.2. Respiratory rate ended at 22; the available labs showed white count fell from 6 to 2.9, creatinine was roughly stable (0.8 to 0.8), lactate was not available, and urine output was roughly stable (98 to 82)
C. Over the available measurements, the heart rate fell from 93 to 75, MAP was roughly stable (79 to 82), and diastolic pressure moved from 60 to 64. Systolic pressure ranged 90-149 and ended at 114, and SpO2 recovered to 94 after a low of 89 around hour 9.8. Respiratory rate ended at 19; the available labs showed white count fell from 7 to 3.9, creatinine was roughly stable (0.6 to 1.0), lactate was not available, and urine output was roughly stable (96 to 76)
D. Over the available measurements, the heart rate fell from 84 to 76, MAP was roughly stable (70 to 74), and diastolic pressure moved from 68 to 62. Systolic pressure ranged 82-94 and ended at 106, and SpO2 recovered to 100 after a low of 84 around hour 8.4. Respiratory rate ended at 23; the available labs showed white count fell from 5 to 2.5, creatinine was roughly stable (0.8 to 0.8), lactate was not available, and urine output was roughly stable (150 to 84)

Answer: A


Question:
Which summary best captures the overall course shown by the serial data?

Options:
A. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (90 to 86), diastolic pressure rose from 69 to 76, and heart rate fell from 109 to 100. The lowest MAP was about 59 around hour 2.8, and the lowest valid SpO2 was 88 around hour 1.4; respiratory rate rose as high as 28 but ended at 18. The lower-frequency data fit that summary: temperature stayed around 32.9-34.2 C, white count was 20.1 on its only check, creatinine was 0.4 on its only check, lactate was not available, and urine output fell from 1280 to 280.
B. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (85 to 91), diastolic pressure rose from 64 to 77, and heart rate fell from 114 to 96. The lowest MAP was about 54 around hour 2.0, and the lowest valid SpO2 was 83 around hour 1.8; respiratory rate rose as high as 28 but ended at 15. The lower-frequency data fit that summary: temperature stayed around 38.1-39.5 C, white count was 17.5 on its only check, creatinine was 0.6 on its only check, lactate was not available, and urine output fell from 1140 to 310.
C. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (91 to 85), diastolic pressure rose from 70 to 83, and heart rate fell from 108 to 101. The lowest MAP was about 60 around hour 1.6, and the lowest valid SpO2 was 89 around hour 0.6; respiratory rate rose as high as 28 but ended at 18. The lower-frequency data fit that summary: temperature stayed around 32.1-33.5 C, white count was 20.5 on its only check, creatinine was 0.4 on its only check, lactate was not available, and urine output fell from 1300 to 285.
D. Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (87 to 89), diastolic pressure rose from 66 to 79, and heart rate fell from 112 to 98. The lowest MAP was about 56 around hour 1.8, and the lowest valid SpO2 was 85 around hour 1.6; respiratory rate rose as high as 26 but ended at 16. The lower-frequency data fit that summary: temperature stayed around 35.9-37.2 C, white count was 18.6 on its only check, creatinine was 0.5 on its only check, lactate was not available, and urine output fell from 1200 to 260.

Answer: D

Taken together, this reads as a mixed hemodynamic course, not just an isolated respiratory issue: MAP was roughly stable (87 to 89), diastolic pressure rose from 66 to 79, and heart rate fell from 112 to 98. The lowest MAP was about 56 around hour 1.8, and the lowest valid SpO2 was 85 around hour 1.6; respiratory rate rose as high as 26 but ended at 16. The lower-frequency data fit that summary: temperature ranged from 96.6 to 98.9, white count was 18.6 on its only check, creatinine was 0.5 on its only check, lactate was not available, and urine output fell from 1200 to 260.


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

Options:
A. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 131 to 121, MAP was roughly stable (87 to 89), and heart rate fell from 112 to 98. SpO2 started at 100, ended at 97, and fell as low as 85 around hour 1.6; respiratory rate ranged 14-26. For labs and output, white count was 18.6 on its only check, creatinine was 0.5 on its only check, lactate was not available, and urine output fell from 1200 to 260.
B. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 135 to 115, MAP was roughly stable (85 to 87), and heart rate fell from 114 to 96. SpO2 started at 98, ended at 95, and fell as low as 83 around hour 1.8; respiratory rate ranged 13-27. For labs and output, white count was 19.7 on its only check, creatinine was 0.4 on its only check, lactate was not available, and urine output fell from 1140 to 275.
C. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 156 to 117, MAP was roughly stable (91 to 92), and heart rate fell from 108 to 100. SpO2 started at 96, ended at 100, and fell as low as 84 around hour 1.4; respiratory rate ranged 16-24. For labs and output, white count was 16.7 on its only check, creatinine was 0.6 on its only check, lactate was not available, and urine output fell from 1300 to 235.
D. Across the recorded window, the main signal is labile hemodynamics with a brief oxygenation drop: systolic pressure fell from 101 to 81, MAP was roughly stable (82 to 84), and heart rate fell from 116 to 101. SpO2 started at 96, ended at 92, and fell as low as 80 around hour 1.9; respiratory rate ranged 12-28. For labs and output, white count was 20.9 on its only check, creatinine was 0.3 on its only check, lactate was not available, and urine output fell from 1080 to 290.

Answer: A


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

Options:
A. Viewed chronologically, the heart rate fell from 115 to 95, MAP was roughly stable (90 to 92), and diastolic pressure moved from 63 to 82. Systolic pressure ranged 89-151 and ended at 117, and SpO2 recovered to 94 after a low of 88 around hour 2.6. Respiratory rate ended at 14; the available labs showed white count was 20.1 on its only check, creatinine was 0.6 on its only check, lactate was not available, and urine output fell from 1120 to 280.
B. Viewed chronologically, the heart rate fell from 112 to 98, MAP was roughly stable (87 to 89), and diastolic pressure moved from 66 to 79. Systolic pressure ranged 86-131 and ended at 121, and SpO2 recovered to 97 after a low of 85 around hour 1.6. Respiratory rate ended at 16; the available labs showed white count was 18.6 on its only check, creatinine was 0.5 on its only check, lactate was not available, and urine output fell from 1200 to 260.
C. Viewed chronologically, the heart rate fell from 116 to 94, MAP was roughly stable (91 to 93), and diastolic pressure moved from 62 to 83. Systolic pressure ranged 90-156 and ended at 146, and SpO2 recovered to 93 after a low of 84 around hour 1.9. Respiratory rate ended at 14; the available labs showed white count was 20.5 on its only check, creatinine was 0.6 on its only check, lactate was not available, and urine output fell from 1250 to 285.
D. Viewed chronologically, the heart rate fell from 108 to 101, MAP was roughly stable (82 to 84), and diastolic pressure moved from 70 to 76. Systolic pressure ranged 82-101 and ended at 91, and SpO2 recovered to 100 after a low of 80 around hour 1.3. Respiratory rate ended at 18; the available labs showed white count was 16.4 on its only check, creatinine was 0.3 on its only check, lactate was not available, and urine output fell from 1320 to 230.

Answer: B


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

Options:
A. Viewed chronologically, the heart rate rose from 68 to 93, while MAP rose from 71 to 97. Systolic pressure was labile, ranging 87-113, with the lowest value around hour 1.6. SpO2 briefly dipped to 86 around hour 44.5 before recovering to 93, while respiratory rate peaked at 42 and later settled at 36. The associated labs and urine output showed that white count rose from 8.9 to 18.1, creatinine rose from 1.4 to 1.6, lactate was checked once at 2.1, and urine output fell from 320 to 140, with recorded outputs ranging 22-380.
B. Viewed chronologically, the heart rate rose from 63 to 98, while MAP rose from 66 to 97. Systolic pressure was labile, ranging 85-148, with the lowest value around hour 1.2. SpO2 briefly dipped to 83 around hour 42.5 before recovering to 98, while respiratory rate peaked at 38 and later settled at 31. The associated labs and urine output showed that white count rose from 11.5 to 15.5, creatinine rose from 1.0 to 1.5, lactate was checked once at 1.8, and urine output fell from 285 to 110, with recorded outputs ranging 19-415.
C. Viewed chronologically, the heart rate rose from 69 to 92, while MAP rose from 72 to 98. Systolic pressure was labile, ranging 79-108, with the lowest value around hour 1.6. SpO2 briefly dipped to 89 around hour 45.2 before recovering to 92, while respiratory rate peaked at 44 and later settled at 37. The associated labs and urine output showed that white count rose from 8.5 to 15.8, creatinine rose from 1.4 to 1.5, lactate was checked once at 2.1, and urine output fell from 325 to 135, with recorded outputs ranging 70-375.
D. Viewed chronologically, the heart rate rose from 65 to 96, while MAP rose from 68 to 94. Systolic pressure was labile, ranging 83-133, with the lowest value around hour 1.4. SpO2 briefly dipped to 85 around hour 41.5 before recovering to 96, while respiratory rate peaked at 40 and later settled at 33. The associated labs and urine output showed that white count rose from 10.4 to 16.6, creatinine rose from 1.2 to 1.4, lactate was checked once at 1.9, and urine output fell from 300 to 160, with recorded outputs ranging 20-400.

Answer: D


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

Options:
A. In broad terms, the heart rate stayed around 97, MAP fell from 102 to 54, and diastolic pressure moved from 87 to 39. Systolic pressure ranged 72-185 and ended at 86, and SpO2 recovered to 54 after a low of 54 around hour 136.7. Respiratory rate ended at 10; the available labs showed white count rose from 6.5 to 9.4, creatinine rose from 1.4 to 5.4, lactate fell from 4.2 to 0.9, and urine output was roughly stable (60 to 100)
B. In broad terms, the heart rate stayed around 95, MAP fell from 104 to 57, and diastolic pressure moved from 85 to 41. Systolic pressure ranged 70-200 and ended at 82, and SpO2 recovered to 52 after a low of 56 around hour 136. Respiratory rate ended at 9; the available labs showed white count rose from 6.9 to 9.0, creatinine rose from 1.2 to 5.8, lactate fell from 3.8 to 0.8, and urine output was roughly stable (62 to 98)
C. In broad terms, the heart rate stayed around 100, MAP fell from 98 to 58, and diastolic pressure moved from 91 to 35. Systolic pressure ranged 76-160 and ended at 82, and SpO2 recovered to 58 after a low of 53 around hour 161.7. Respiratory rate ended at 12; the available labs showed white count rose from 5.9 to 8.6, creatinine rose from 1.6 to 4.8, lactate fell from 4.8 to 1.0, and urine output was roughly stable (110 to 96)
D. In broad terms, the heart rate was roughly stable (92 to 100), MAP fell from 102 to 54, and diastolic pressure moved from 87 to 36. Systolic pressure ranged 72-185 and ended at 86, and SpO2 recovered to 58 after a low of 54 around hour 136.7. Respiratory rate ended at 10; the available labs showed white count rose from 6.5 to 9.4, creatinine rose from 1.4 to 5.4, lactate fell from 4.2 to 0.9, and urine output was roughly stable (60 to 100)

Answer: A