As prepared by Chris Nickson, 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.
Critically evaluate the use of vasopressin in septic shock (100%)
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Q2.
a) Outline the factors that affecting the performance of complex tasks in crisis situations (50%)
b) List the key principles of crisis resource management (50%)
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Q3.
A 24 year-old woman presents to the emergency department (ED) after waking with generalised weakness.
Her VBG shows:
| pH | 7.14 |
| pCO2 (mmHg) | 40 |
| pO2 (mmHg) | 20 |
| Bicarbonate (mmol/L) | 13 |
| Hb (g/L) | 157 |
| Na (mmol/L) | 141 |
| K (mmol/L) | 1.4 |
| Cl (mmol/L) | 116 |
| Glucose (mmol/L) | 7.0 |
| Lactate (mmol/L) | 1.2 |
| iCa (mmol/L) | 1.20 |
a) Interpret the VBG findings (40%)
This is her urine pH and electrolytes:
| Urine pH and electrolytes | |
| pH | 7 |
| Na (mmol/L) | 20 |
| K (mmol/L) | 18 |
| Cl (mmol/L) | 35 |
| Ca (mmol/L) | 1.46 |
b) Interpret the urine pH and electrolytes (30%)
c) What is the likely diagnosis? (10%)
d) What is the specific therapy for this diagnosis? (20%)
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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:
//intensiveblog.com/resources/#3