CICM Second Part Exam Practice SAQs 20072016

As prepared by Chris Nickson, here are the practice questions from today’s written exam practice session at The Alfred ICU, with recommended reading from LITF.com’s Critical Care Compendium and other FOAM sources:

Q1.

Regarding clinical trial outcomes:

  1. Explain the difference between primary and secondary outcomes (20%)
  2. What are composite endpoints, and describe their disadvantages (20%)
  3. What are surrogate outcomes, and why they might be used in a clinical trial (40%)
  4. Explain why a trial might use “ventilator free days” as an outcome instead of “duration of mechanical ventilation” (20%)

Learn more here:

SMRs and the ins and outs of good and bad outcomes

 

Q2. (CICM SAQ 2013.1 Q7)

Regarding external ventricular drains (EVDs):

  1. Identify the 4 components indicated by the arrows below (20%)
  2. Where should the arterial transducer be placed if a patient has an EVD placed for ICP management? (30%)
  3. Outline your approach to an EVD that has stopped draining CSF (50%)

Learn more here:

Own the EVD!

Q3.

A 50-year-old man is referred for ICU admission with neutropenic septic shock following chemotherapy for acute myeloid leukaemia.

  1. Discuss the prognostic factors that are important in predicting his survival from this acute critical illness (50%)
  2. What is your approach to ICU admission if the referring and team and the patient both want ICU admission despite a poor prognosis? (50%)

Learn more here:

Patients and families that want “everything” done

Neutropaenic Sepsis

 

  1. In general, the prognosis for acute illness (e.g. hospital survival) of cancer patients depends on their pre-existing performance levels and number of organ failures. The specifics of the cancer diagnosis, stage and therapies is generally less important (though there are exceptions to every rule). I’m hoping to write a LITFL CCC article on this soon!
  2. Part b) should involve consideration of: i) what if the patient is moribund and imminently dying – changing the geography of imminent death is rarely helpful (b) exploration of the patient’s values and goals, if they want ‘everything’ we need to find out what this means, and (c) consideration of admission with a ‘time trial’ and appropriate limits to therapy.


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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