Here are the practice questions from a recent written exam practice session at The Alfred ICU, with recommended reading from Lifeinthefastlane.com’s Critical Care Compendium:
Q1.
A 70 year-old man had coronary artery bypass surgery with 3 grafts (CAGS x3). One month later he was diagnosed with a sternal wound infection and mediastinitis requiring re-sternotomy, debridement and washout. He was admitted to ICU post-operatively with an open chest. It is now post-operative day 1 and he remains intubated, sedated and on low dose noradrenaline.
The microbiology department notifies you that his sternal wound swabs are growing an anaerobic gram positive diplococcus. You note that he has a previous history of colonisation with vancomycin-resistant enterococcus (VRE).
Outline your approach to antimicrobial therapy and sepsis management in this patient.
Learn more here:
- http://lifeinthefastlane.com/ccc/vancomycin-resistant-enterococcus-vre/
- http://lifeinthefastlane.com/ccc/initial-sepsis-management/
Q2.
Discuss the role of procalcitonin as a sepsis biomarker in intensive care.
Learn more here:
Q3.
Discuss the importance of the following components of lung ventilation strategies in patients with acute respiratory distress syndrome (ARDS):
- tidal volume (VT)
- plateau pressure (Pplat)
- positive-end expiratory pressure (PEEP)
- driving pressure (ΔP)
Learn more here:
- http://lifeinthefastlane.com/ccc/protective-lung-ventilation/
- http://lifeinthefastlane.com/ccc/open-lung-approach-to-ventilation/
- http://lifeinthefastlane.com/ccc/positive-end-expiratory-pressure-peep/
- http://lifeinthefastlane.com/ccc/high-airway-and-alveolar-pressures/
- http://lifeinthefastlane.com/ccc/driving-pressure/
You can access all the previous practice questions since 2014 here:
https://docs.google.com/document/d/1_Ta8IvVaVtc5Il7-kJwj6qKGu54OmifJGRUWCXud8dY/edit
See this link on INTENSIVE for exam resources:
https://intensiveblog.com/resources/#3