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Exam Review

Key Facts: CMMC Medicina Crítica Exam

5 Oct 2026

Next exam (Monterrey, 09:00–13:15)

CMMC call

6.0

Minimum passing grade

CMMC call

MXN 7,000 / 7,500

Certification / recertification fee

cmmcritica.org.mx

SIUC

Online registration system

cmmcritica.org.mx

5 years

Certification validity

CONACEM

The CMMC certification exam is the CONACEM-recognized critical care board exam in Mexico: a written exam offered several times a year (next: 5 October 2026, Monterrey) with a minimum passing grade of 6.0.

Sample CMMC Medicina Crítica Practice Questions

Try these sample questions to review concepts for the CMMC Medicina Crítica exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1Under the Sepsis-3 consensus definitions, which clinical parameter defines the presence of sepsis in a hospitalized adult with suspected infection?
A.An acute increase in the total Sequential Organ Failure Assessment (SOFA) score of 2 points or more
B.Presence of systemic inflammatory response syndrome (SIRS) with at least two positive physiological criteria
C.Serum lactate concentration exceeding 4.0 mmol/L regardless of blood pressure or organ dysfunction
D.Refractory hypotension requiring vasopressor administration to maintain mean arterial pressure above 70 mmHg
Explanation: Sepsis-3 defines sepsis as a life-threatening organ dysfunction caused by a dysregulated host response to infection. Clinically, organ dysfunction is identified as an acute change in total SOFA score >= 2 points consequent to the infection.
2A 62-year-old woman is admitted to the ICU with community-acquired pneumonia, blood pressure of 78/44 mmHg, and serum lactate of 4.2 mmol/L. According to the Surviving Sepsis Campaign guidelines, what is the recommended initial crystalloid resuscitation volume to be administered within the first 3 hours?
A.10 mL/kg of balanced crystalloid solution
B.30 mL/kg of balanced crystalloid solution
C.50 mL/kg of 0.9% normal saline solution
D.20 mL/kg of 5% human albumin solution
Explanation: The Surviving Sepsis Campaign recommends administering at least 30 mL/kg of intravenous crystalloids (with balanced crystalloids preferred over 0.9% saline) within the first 3 hours of resuscitation for sepsis-induced hypoperfusion or septic shock.
3Which vasoactive agent is designated as the first-line vasopressor of choice for restoring and maintaining target arterial pressure in adult septic shock?
A.Dopamine
B.Phenylephrine continuous infusion
C.Norepinephrine
D.Epinephrine
Explanation: Norepinephrine is the first-line vasopressor in septic shock due to its potent alpha-1 vasoconstriction combined with modest beta-1 inotropic activity, which effectively increases mean arterial pressure with significantly lower tachyarrhythmia rates than dopamine.
4What is the initial target Mean Arterial Pressure (MAP) recommended by international consensus guidelines during the initial resuscitation of adult patients in septic shock?
A.55 mmHg
B.75 mmHg
C.85 mmHg
D.65 mmHg
Explanation: The Surviving Sepsis Campaign strongly recommends targeting an initial MAP of 65 mmHg. Clinical trials (such as SEPSISPAM) showed that targeting higher MAP levels (80-85 mmHg) does not reduce mortality and significantly increases tachyarrhythmias, except in select elderly patients with chronic hypertension where renal replacement therapy was marginally reduced.
5A 68-year-old man in septic shock remains hypotensive with a MAP of 58 mmHg despite 30 mL/kg of crystalloid and norepinephrine titrated to 0.35 mcg/kg/min. Which is the guideline-recommended second-line vasoactive intervention to raise MAP and reduce norepinephrine requirements?
A.Add vasopressin at a fixed non-titrated infusion of 0.03 units/min
B.Add dopamine at a titratable renal-protective infusion of 2.5 mcg/kg/min
C.Substitute norepinephrine entirely with high-dose phenylephrine infusion
D.Initiate an infusion of milrinone at 0.5 mcg/kg/min without a loading dose
Explanation: Vasopressin at a fixed dose of 0.03 units/min acts on vascular V1 receptors, restoring vascular tone in relative vasopressin deficiency and exerting a catecholamine-sparing effect to achieve target MAP.
6A 54-year-old man in septic shock due to fecal peritonitis requires norepinephrine at 0.45 mcg/kg/min and vasopressin at 0.03 units/min to maintain a MAP of 62 mmHg. Under Surviving Sepsis Campaign guidelines, what is the indicated corticosteroid regimen?
A.Dexamethasone 10 mg IV every 6 hours for 14 days
B.Intravenous hydrocortisone at a dose of 200 mg per day
C.Methylprednisolone 1 g IV daily pulsed for 3 days
D.Oral fludrocortisone 0.5 mg daily without glucocorticoid
Explanation: In adults with septic shock and ongoing vasopressor requirements (norepinephrine or epinephrine >= 0.25 mcg/kg/min for at least 4 hours), the guidelines recommend intravenous hydrocortisone at 200 mg/day (administered as 50 mg IV every 6 hours or as a continuous infusion).
7A 70-year-old patient with septic shock has achieved a MAP of 66 mmHg on norepinephrine. However, central venous oxygen saturation (ScvO2) remains 52%, serum lactate continues to rise, and bedside echocardiography demonstrates severe left ventricular hypokinesia. Which pharmacologic intervention is recommended?
A.Increase norepinephrine infusion to target a MAP of 85 mmHg
B.Administer an additional 30 mL/kg crystalloid bolus challenge
C.Add dobutamine infusion or switch to epinephrine
D.Initiate intravenous esmolol to reduce myocardial oxygen demand
Explanation: When myocardial dysfunction persists with evidence of ongoing hypoperfusion (low ScvO2, worsening hyperlactatemia) despite adequate intravascular volume and MAP, the Surviving Sepsis Campaign recommends adding an inotrope, such as dobutamine, or adding epinephrine.
8Which combination of clinical conditions is strictly required for arterial Pulse Pressure Variation (PPV) to reliably predict fluid responsiveness?
A.Spontaneous breathing efforts, tidal volume of 6 mL/kg, and presence of atrial fibrillation
B.High positive end-expiratory pressure (> 15 cmH2O), severely impaired lung compliance, and sustained sinus tachycardia
C.Closed chest, spontaneous breathing on pressure support, and tidal volume of 8 mL/kg
D.Absence of spontaneous breathing efforts, regular sinus rhythm, and tidal volume >= 8 mL/kg PBW
Explanation: Pulse Pressure Variation (PPV) relies on predictable heart-lung interactions during positive-pressure ventilation. Validity requires full mechanical ventilation without spontaneous triggering, absence of cardiac arrhythmias (regular sinus rhythm), and tidal volumes of at least 8 mL/kg of predicted body weight with normal chest wall compliance.
9What is the primary hemodynamic mechanism that makes the Passive Leg Raising (PLR) maneuver an accurate dynamic test of fluid responsiveness?
A.It transfers approximately 300 mL of autologous venous blood as a reversible preload challenge
B.It induces reflex baroreceptor-mediated arteriolar vasoconstriction to transiently elevate systemic vascular resistance
C.It lowers intrathoracic pressure to selectively reduce left ventricular afterload during mechanical ventilation
D.It activates intrinsic stretch receptors in the coronary sinus to augment baseline myocardial inotropy
Explanation: The PLR maneuver shifts approximately 300 to 500 mL of venous blood from the lower limbs and splanchnic reservoir into the central circulation. This acts as an endogenous, completely reversible volume challenge. An increase in cardiac output or stroke volume >= 10-15% measured in real time demonstrates that the patient is operating on the ascending limb of the Frank-Starling curve.
10During critical care echocardiography, which calculation provides the most accurate bedside estimate of stroke volume (SV)?
A.Left ventricular end-diastolic internal dimension multiplied by fractional shortening measured on standard linear M-mode echocardiography
B.Left ventricular outflow tract (LVOT) cross-sectional area multiplied by the LVOT pulsed-wave Doppler velocity time integral (VTI)
C.Peak continuous-wave Doppler aortic jet velocity divided by the total indexed left ventricular end-systolic volume calculation
D.Simpson biplane ejection fraction percentage multiplied by the invasive central venous pressure measurement
Explanation: Stroke volume is calculated by multiplying the cross-sectional area of the LVOT (Area = pi * [diameter / 2]^2) by the velocity time integral (VTI) of blood flow through the LVOT obtained via pulsed-wave Doppler in the apical 5-chamber view. A normal LVOT VTI is typically 18 to 22 cm.

About the CMMC Medicina Crítica Exam

Independent CMMC critical care certification study practice by OpenExamPrep. The Consejo Mexicano de Medicina Crítica, A.C., recognized by CONACEM, certifies intensivists through a written knowledge exam offered at several sessions each year. The next is on 5 October 2026 in Monterrey, 09:00–13:15, with a minimum passing grade of 6.0. Fees are MXN 7,000 for certification and MXN 7,500 for recertification, and registration is through the SIUC. The official exam is in Spanish; this bank is an independent English-language MCQ study adaptation based on the CMMC recommended bibliography and current international guidelines (Surviving Sepsis Campaign, ARDS, KDIGO, PADIS). It is not an official translation or simulation.

Exam sponsor: Consejo Mexicano de Medicina Crítica, A.C. (CMMC). The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Assessment

Written multiple-choice knowledge exam offered at several sessions each year, frequently alongside critical care congresses; the 5 October 2026 session in Monterrey runs from 09:00 to 13:15, and the minimum passing grade is 6.0. Registration is through the council's SIUC system. This bank groups practice into shock and hemodynamics, mechanical ventilation, neurocritical care, renal and acid-base disorders, and infection, nutrition and post-arrest care (an OpenExamPrep study grouping, not an official blueprint).

Time Limit

About 4 hours 15 minutes (09:00–13:15)

Passing Score

Minimum grade 6.0

Exam / Certification Fees

MXN 7,000 certification / MXN 7,500 recertification

Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Official sources

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

Core section (weight not published)

Choque, Monitoreo Hemodinámico y Reanimación

Surviving Sepsis Campaign bundle guidelines, fluid responsiveness assessment (PPV, PLR, echocardiographic VTI), vasoactive agent selection (norepinephrine, vasopressin, epinephrine, dobutamine), septic vs cardiogenic vs hypovolemic vs obstructive shock

Core section (weight not published)

Ventilación Mecánica y Falla Respiratoria Aguda

Berlin definition of ARDS, lung-protective ventilation (tidal volumes 4-8 mL/kg PBW, driving pressure < 14 cmH2O, plateau pressure < 30 cmH2O), prone positioning, neuromuscular blockade, patient-ventilator asynchronies, non-invasive ventilation, and weaning criteria

Core section (weight not published)

Neurointensivismo, Sedación, Analgesia y Delirium

Severe traumatic brain injury management, Monro-Kellie doctrine, target CPP 60-70 mmHg, hyperosmolar therapy (mannitol vs 3% hypertonic saline), refractory status epilepticus algorithms, PADIS guidelines (pain-first, RASS, CAM-ICU), and spontaneous awakening trials

Core section (weight not published)

Falla Renal Aguda, Trastornos Ácido-Base y Electrolíticos

KDIGO criteria for AKI staging, continuous renal replacement therapy (CRRT: CVVH, CVVHD, effluent dose 20-25 mL/kg/h, regional citrate anticoagulation), Stewart physicochemical acid-base interpretation (SID, ATOT), life-threatening hyperkalemia, and dysnatremias

Core section (weight not published)

Infecciones Graves en UCI, Nutrición y Cuidados Post-Paro

Ventilator-associated pneumonia prevention bundles, catheter-related bloodstream infections, antimicrobial stewardship for multidrug-resistant pathogens, early enteral nutrition protocols, targeted temperature management (TTM 32-36 C), and brain death determination

Preparing for the CMMC Medicina Crítica Exam

What You Need to Know

  • Passing score: Minimum grade 6.0
  • Assessment: Written multiple-choice knowledge exam offered at several sessions each year, frequently alongside critical care congresses; the 5 October 2026 session in Monterrey runs from 09:00 to 13:15, and the minimum passing grade is 6.0. Registration is through the council's SIUC system. This bank groups practice into shock and hemodynamics, mechanical ventilation, neurocritical care, renal and acid-base disorders, and infection, nutrition and post-arrest care (an OpenExamPrep study grouping, not an official blueprint).
  • Time limit: About 4 hours 15 minutes (09:00–13:15)
  • Exam / certification fees: MXN 7,000 certification / MXN 7,500 recertification Official sources

Using Our Practice Resources

  • Work through all 100 available questions
  • Review every answer and explanation
  • Track weak areas and revisit them
  • Use our AI tutor for tough concepts

CMMC Medicina Crítica: Suggested Study Strategy

1Master the Surviving Sepsis Campaign 2021 recommendations: 30 mL/kg balanced crystalloid within 3 hours for hypoperfusion, norepinephrine first with a MAP target of 65 mmHg, vasopressin at norepinephrine 0.25–0.5 mcg/kg/min, and hydrocortisone 200 mg/day for ongoing vasopressor need.
2Understand dynamic indicators of volume responsiveness: passive leg raise (PLR) with real-time cardiac output or VTI monitoring, and pulse pressure variation (PPV) in sinus rhythm on mandatory mechanical ventilation with tidal volume >= 8 mL/kg.
3Review ARDS management protocols rigorously: target tidal volume 4-8 mL/kg predicted body weight (PBW), plateau pressure < 30 cmH2O, driving pressure < 14 cmH2O, prone positioning for at least 16 consecutive hours in severe ARDS (P/F < 150), and early neuromuscular blockade.
4Know neurocritical algorithms: target cerebral perfusion pressure (CPP) between 60 and 70 mmHg, ICP threshold >= 22 mmHg for intervention, tiered management of intracranial hypertension, hyperosmolar therapy (mannitol vs 3% hypertonic saline), and EEG-guided status epilepticus management.
5Consolidate CRRT principles and acid-base mechanics: KDIGO AKI criteria, continuous venovenous hemodiafiltration (CVVHDF), effluent dosing target 20-25 mL/kg/h, regional citrate anticoagulation with systemic calcium titration, and Stewart's strong ion difference (SID).

Frequently Asked Questions

What is the CMMC certification examination?

The Examen de Certificación en Medicina Crítica is administered by the Consejo Mexicano de Medicina Crítica, A.C. (CMMC), the council recognized by CONACEM for the specialty. Certification is valid for 5 years and is renewed through recertification.

When is the examination held and how do candidates register?

The CMMC runs several exam sessions each year, often alongside critical care congresses. 2026 sessions included 16 January (CDMX), 22 July and 8 August, and the next is on 5 October 2026 at the Escenario GNP Seguros in Monterrey (09:00–13:15). Candidates register through the SIUC on cmmcritica.org.mx.

What are the fees, question count, and passing score?

Fees are MXN 7,000 for certification and MXN 7,500 for recertification. The 2026 call sets a minimum passing grade of 6.0; the number of items is not published.

What content and clinical domains are tested?

The CMMC publishes a recommended bibliography rather than a weighted blueprint. Practice here covers shock and resuscitation, mechanical ventilation and ARDS, neurocritical care, renal replacement therapy and acid-base physiology, ICU infections, nutrition, and post-cardiac-arrest care.

Does this practice bank cover the whole certification process?

No. This bank practises the written knowledge component with English-language multiple-choice questions. It does not reproduce official items or any documentary or practical requirements the council applies.

Why is this question bank provided in English?

The official CMMC exam is administered in Spanish. This bank is an independent English-language MCQ study adaptation built from the international literature and guidelines behind modern intensive care. It is not an official translation or simulation.