Acute Respiratory Failure MCQ Quiz | Critical Care

Welcome to this specialized quiz on Acute Respiratory Failure, a critical topic for every MBBS student venturing into critical care and emergency medicine. This quiz is designed to test your understanding of the pathophysiology, classification, diagnosis, and management principles of this life-threatening condition. Covering both Type I (Hypoxemic) and Type II (Hypercapnic) failure, along with key concepts like ARDS, V/Q mismatch, and ventilatory support, these 25 questions will challenge your clinical knowledge. After completing the quiz, submit your answers to see your score and review the correct responses. For your future reference and study, you can download all the questions along with their correct answers in a convenient PDF format.

1. What is the primary pathophysiological mechanism in Type I (Hypoxemic) Acute Respiratory Failure?

2. A patient presents with acute dyspnea. Arterial Blood Gas (ABG) analysis shows PaO2 55 mmHg, PaCO2 65 mmHg, and pH 7.25 on room air. What type of respiratory failure is this?

3. According to the Berlin definition, which of the following is NOT a criterion for diagnosing Acute Respiratory Distress Syndrome (ARDS)?

4. Which of the following conditions is a common cause of Type II respiratory failure due to “pump failure”?

5. The A-a gradient (Alveolar-arterial oxygen gradient) is typically normal in which cause of hypoxemia?

6. In a patient with hypoxemia due to an intrapulmonary shunt, how does the PaO2 respond to supplemental 100% oxygen?

7. Which of the following is a primary goal of mechanical ventilation in ARDS?

8. A patient with a severe COPD exacerbation is in Type II respiratory failure. Which intervention is often considered first-line to avoid intubation?

9. The term “permissive hypercapnia” in the context of mechanical ventilation for ARDS refers to:

10. What is the defining ABG characteristic of Type II respiratory failure?

11. A classic sign of severe hypercapnia on physical examination is:

12. Which parameter on a mechanical ventilator is most directly adjusted to control a patient’s PaCO2?

13. In a patient with status asthmaticus leading to respiratory failure, the primary problem is:

14. What is the main purpose of using PEEP in a patient with ARDS?

15. A patient on mechanical ventilation for ARDS has a plateau pressure of 35 cmH2O. What is the most appropriate next step?

16. Type IV respiratory failure is associated with:

17. Which of the following is a potential complication of prolonged high FiO2 (>0.6)?

18. The “baby lung” concept in ARDS describes:

19. Which of the following is an absolute contraindication for Non-Invasive Positive Pressure Ventilation (NIPPV)?

20. What is the role of prone positioning in severe ARDS?

21. In a patient with acute respiratory failure, rapid shallow breathing (high respiratory rate, low tidal volume) is an indicator of:

22. The driving pressure (Plateau Pressure – PEEP) on a ventilator is a key indicator of:

23. Which of these conditions typically presents as Type I (Hypoxemic) respiratory failure?

24. What is a major risk of using high tidal volumes (e.g., > 8 mL/kg of predicted body weight) in a patient with ARDS?

25. A patient with severe pancreatitis develops acute respiratory failure with bilateral infiltrates on chest X-ray and a PaO2/FiO2 ratio of 150. What is the most likely diagnosis?