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.
A 62-year-old male is admitted to the ICU post-operatively having undergone a transthoracic oesophagectomy for squamous cell carcinoma of the oesophagus. The patient was extubated at the end of the operation but requires re-intubation two days post-surgery due to respiratory failure.
- List the likely underlying causes of respiratory failure specific to this clinical situation (30%)
- List the pros and cons of non-invasive ventilation in this clinical situation (30%)
- Briefly outline the principles of management of an anastomotic leak in this patient (40%)
Learn more here:
https://lifeinthefastlane.com/cicm-saq-2014-1-q22/
Q2.
A 45-year-old woman received a tracheostomy while she recovered from a cerebellar haemorrhage. She has made good progress and is deemed ready for decannulation.
1. What are your criteria for determining readiness for tracheostomy decannulation? (50%)
She develops laryngospasm immediately after decannulation.
2. Outline your approach to the management of this situation. (50%)
Learn more here:
https://lifeinthefastlane.com/ccc/tracheostomy-decannulation-hot-case/
https://lifeinthefastlane.com/ccc/laryngospasm/
Q3.
You are called to the Emergency Department to assist in the management of a 45-year-old man with respiratory distress. He is a known HIV patient with Pneumocystis jiroveci pneumonia and an allergy to sulphonamides.
On examination:
- Temperature 38.8 C
- Mucous membranes appear cyanotic Respiratory rate 35/min
- Heart rate 125/min
- Blood pressure 90/50 mmHg
- SpO2 82% on 8L/min oxygen via Hudson mask
Initial arterial blood gas analysis (ABG) is as follows:
- Interpret the ABG report. (20%)
- What is the likely diagnosis? (10%)
- Outline your management of this patient (70%)
Learn more here:
https://lifeinthefastlane.com/cicm-saq-2012-2-q29/
https://lifeinthefastlane.com/ccc/pneumocystis-jiroveci-pneumonia/
https://lifeinthefastlane.com/ccc/haemolytic-anaemia/
https://lifeinthefastlane.com/ccc/methaemoglobinaemia/
https://lifeinthefastlane.com/ccc/methylene-blue/
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