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 LITF.com’s Critical Care Compendium and other FOAM sources:
Q1.
See these questions on DerangedPhysiology.com:
- http://www.derangedphysiology.com/main/cicm-fellowship-exam/past-papers/2016-paper-1-saqs/question-26.1
- http://www.derangedphysiology.com/main/cicm-fellowship-exam/past-papers/2016-paper-1-saqs/question-26.2
- http://www.derangedphysiology.com/main/cicm-fellowship-exam/past-papers/2016-paper-1-saqs/clone-question-26.2
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.
- List the clinical features of severe hypercalcaemia?
- What ECG changes occur with hypercalcaemia?
- Outline your specific management of his hypercalceamia and the mechanism of action for each option.
Learn more here:
https://lifeinthefastlane.com/ccc/hypercalcaemia/
https://lifeinthefastlane.com/ecg-library/basics/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.
- Describe your management (80% marks)
- What modifications to advanced life support are recommended in hypothermia? (20% marks)
Learn more here:
https://resus.org.au/glossary/drowning-guideline-9-3-2/
https://lifeinthefastlane.com/ccc/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