CICM Second Part Exam Practice SAQs 12042018

As prepared by Bevan Roodenburg, here are the practice written questions from a recent CICM Second Part exam practice session at The Alfred ICU, with recommended reading from Lifeinthefastlane.com’s Critical Care Compendium and other FOAM sources:

 

Q2.

A 41-year-old man is referred to ICU from the Emergency Department with severe hypercalcaemia. He is having regular episodes of non-sustained VT.

  1. List the clinical features of severe hypercalcaemia?
  2. What ECG changes occur with hypercalcaemia?
  3. Outline your specific management of his hypercalceamia and the mechanism of action for each option.

Learn more here:

http://www.derangedphysiology.com/main/required-reading/electrolytes-and-fluids/Chapter%207.4.1/hypercalcemia

Hypercalcaemia

Hypercalcaemia

Q3.

You are called to attend the emergency department to assist with preparation and management of a 20-year-old man who is on route via ambulance, unconscious. He was found submerged in an ice-water bath after a triathlon. He has a weak slow pulse. His temperature is 23 degrees.

  1. Describe your management (80% marks)
  2. What modifications to advanced life support are recommended in hypothermia? (20% marks)

Learn more here:

DROWNING (Guideline 9.3.2)

 

Hypothermia

http://www.derangedphysiology.com/main/required-reading/trauma-burns-and-drowning/Chapter%204.0.7/immersion-submersion-and-drowning

DROWNING:

  • Intubate early- mechanical ventilate, high PEEP etc..

HYPOTHERMIA:

ALS2 from March 2016 summary :

  • Check for signs of life for longer (1 minute)
  • Mechanical chest compression devices vs manual due to stiff chest wall Prolonged attempts
  • Withhold drugs until >30degrees, then double interval until >35degrees
  • Try defib 3 times but cease and retry only if temp >28degrees
  • Airway –intubate
  • Ventilation –
  • Circulation- CVC, wires VT etc.
  • Rewarming processes.

 


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

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