CICM First Part Exam Practice Vivas 04032016

Here are the practice questions from the viva practice session on Friday 4th March 2016 at The Alfred ICU, with recommended reading from LITF.com’s Critical Care Compendium and other sources.

Viva 1

Q1: Briefly describe the pharmacology of propofol 

Q2: Please draw the structure of propofol

Q3: Explain the multi-compartment model of distribution and elimination

Q4: What is context-sensitive half-time?

Q5: Please draw the context-sensitive half-times of the following drugs: Midazolam, Remifentanil, Propofol & Fentanyl.

Q6: Please explain the term “decrement time”.

Learn more here:

Life In The Fast Lane – Propofol

ICU Primary Prep – Basic Pharmacology

Hill, S. A. (2004). Pharmacokinetics of drug infusions. Continuing Education in Anaesthesia. http://doi.org/10.1093/bjaceaccp/mkh021

Pharmacology for Anaesthesia and Intensive Care, 4th Ed. TE Peck & SA Hill. Cambridge University Press, 2014.

Viva 2

Q1: What is this molecule?

Sodium-nitroprusside-2D

Q2: Outline side effects of this medication.

Q3: Outline the available antidotes for acute cyanide toxicity.

Q4: What are the functions of the vascular endothelium?

Q5: What are some common tests of coagulation that you are aware of?

Q6: When should the International Normalised Ratio (INR) be used to assess a patient’s coagulation status?

Q7: Please describe how the thromboelastogram measures coagulation status.

Q8: Describe the key components of the thromboelastograph.

Q9: If the thromboelastograph from a bleeding patient demonstrated fibrinloysis which blood products would you consider administering? 

Q10: Describe the pharmacology of tranexamic acid.

Learn more here:

LITFL – Sodium Nitroprusside

LITFL – Cyanide Poisoning

Galley, H. F., & Webster, N. R. (2004). Physiology of the endothelium. British Journal of Anaesthesia, 93(1), 105–113. http://doi.org/10.1093/bja/aeh163

LITFL – Coagulation Profile

icuprimaryprep.com – Haematology Physiology 1

Uptodate.com – Clinical use of coagulation tests

LITFL – Thromboelastogram/TEG

Tranexamic Acid

Basic Physiology for Anaesthetists. C. Huang, D. Chambers, G Matthews. Cambridge University Press, 2014

You can access all the previous practice questions since 2015 here:
https://docs.google.com/document/d/1r8JTbV6lEzMg7I0R5fCwPMaIY3elNobgcQy-bCt7F4M/edit?usp=sharing
See this link on INTENSIVE for exam resources:
https://intensiveblog.com/resources/#3

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