CICM Second Part Exam Practice SAQs 11112015

Q1.

a) A 30 year-old woman presents with abdominal pain and paraesthesia. She was diagnosed with CML 2 months previously and is being treated with chemotherapy.

These are her blood test results:

Source: http://lifeinthefastlane.com/oncology-quandary-005/

1. Describe the abnormalities and give the likely pathophysiological explanation for each. (35%)
2. What specific therapies (other than resuscitation and supportive care) are appropriate? (35%)

b) Regarding patients with haematological malignancies admitted to ICU:

1. List 3 likely reasons for an overall improvement in mortality over the past 20 years (15%)
2. List 3 important risk factors for increased mortality in this patient group (15%)

Learn more here:

• http://lifeinthefastlane.com/oncology-quandary-005/
• http://lifeinthefastlane.com/ccc/tumour-lysis-syndrome/
• http://icmcasesummaries.com/2015/08/26/outcomes-of-icu-admission-with-haematological-malignancy/

Q2.

Discuss how your approach to cardiac arrest occurring in a post-cardiac surgery patient in the ICU differs from the standard ALS approach. (100%)

Learn more here:

• http://lifeinthefastlane.com/ccc/cardiac-arrest-management-after-cardiac-surgery/
• http://lifeinthefastlane.com/ccc/advanced-life-support/

Q3.

An obtunded patient on the ward is found to have hyperammonaemia.

1. List the differential diagnosis for the underlying cause(s) of hyperammonaemia (40%)
2. List investigations that are useful for determining the underlying cause (20%)
3. Discuss the pros and cons of serum ammonia as an investigation in patients with encephalopathy (40%)

Learn more here:

• http://lifeinthefastlane.com/ccc/hyperammonaemia/