As prepared by Chris Nickson, here are the practice written questions from this week’s 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 chloride-rich crystalloid solutions (e.g. normal saline) for fluid therapy in the critically ill.
Learn more here:
http://lifeinthefastlane.com/ccc/chloride-in-critical-illness/
Q2.
Regarding infectious endocarditis:
- List 8 findings on physical examination (20%)
- Discuss the role of echocardiography in making the diagnosis (40%)
- Outline the specific therapies required for successful treatment (40%)
Learn more here:
http://lifeinthefastlane.com/ccc/infective-endocarditis/
http://lifeinthefastlane.com/ccc/infective-endocarditis-echocardiography/
Q3.
You have been referred a patient from the emergency department. He is a 35-year-old man who has presented unconscious (GCS 3) with fixed dilated pupils after drinking ‘homemade moonshine’ the previous day.
His initial arterial blood gas (FiO2 0.3) shows:
| pH 6.8 PaCO2 40 mmHg PaO2 80 mmHg HCO3 6 mmol/L |
Na 138 mmol/L K 5.5 mmol/L Cl 105 mmol/L Glucose 12 mmol/L Lactate 7 mmol/L |
He has been intubated and is haemodynamically stable (HR 90/min, BP 110/70 mmHg, no vasopressors).
Outline your management over the first 24 hours.
Learn more here:
http://lifeinthefastlane.com/ccc/methanol-toxicity/
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