CICM Second Part Exam Practice SAQs 17052017

Q1.

A 23-year-old man was the front-seat passenger in a motor vehicle crash. He was intubated for agitation with a GCS 13 in ED and the massive transfusion protocol was activated (total 10 x PRBC, 6 x FFP, 3 x platelets, and 5 x cryoprecipitate). “Pan-scan” CT revealed pelvic fractures with contrast extravasation and he was transferred to the angiography suite. There were other injuries identified on imaging. Following angioembolisation of bleeding pelvic vessels he was admitted to ICU while awaiting external fixation of his pelvis. You review him soon after admission, he is intubated and sedated with HR 120/min and decreasing BP of 85/50 mmHg.

Outline your approach to the initial assessment and management of this case.

Learn more here:

http://lifeinthefastlane.com/ccc/initial-trauma-assessment/

http://lifeinthefastlane.com/ccc/pelvic-trauma/

https://lifeinthefastlane.com/ccc/shock-ddx/

http://lifeinthefastlane.com/ccc/haemostatic-resuscitation/

http://lifeinthefastlane.com/ccc/angiography-and-embolisation-in-pelvic-trauma/

http://lifeinthefastlane.com/ccc/pre-peritoneal-packing/

http://lifeinthefastlane.com/ccc/pelvic-arterial-injury/

Q2.

Compare and contrast pressure-controlled ventilation with volume-controlled ventilation.

Include relevant flow/pressure/ volume versus time curves in your answer.

Learn more here:

http://www.derangedphysiology.com/main/core-topics-intensive-care/mechanical-ventilation-0/Chapter%203.1.1/control-variables-volume-and-pressure

Q3.

Discuss the issues regarding the timing of renal replacement therapy initiation in a patient with sepsis and acute kidney injury.

Learn more here:

https://lifeinthefastlane.com/ccc/indications-timing-and-patient-selection-for-rrt/