As prepared by Chris Nickson, here are the practice questions from the last written exam practice session at The Alfred ICU, with recommended reading from LITF.com’s Critical Care Compendium and other FOAM sources:
Q1.
An 80kg male with an isolated traumatic brain injury has developed acute kidney injury following a CTPA, which was negative for pulmonary embolus.
You decided to commence continuous renal replacement therapy.
- Outline the factors you consider when determining the best site for vascath insertion (50%)
- Provide a renal replacement therapy prescription, with appropriate explanation (50%)
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Q2.
Regarding rhabdomyolysis:
- Describe how you make the diagnosis (10%)
- List the potential causes (40%)
- Outline your approach to the management (50%)
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Q3. (from CICM SAQ 2009.1 Q15)
A 60 year old patient has been admitted to the ICU for 5 days with severe sepsis secondary to a perforated sigmoid colon. He had a sigmoid colectomy and washout of his peritoneum, and appropriate antibiotic therapy. His initial course was complicated by severe septic shock that is now resolving and acute renal failure for which he is still receiving continuous renal replacement therapy. He is currently still ventilated via an oral endotracheal tube, on SIMV with a rate of 16, TV of 700, PEEP of 5 and FiO2 of 0.45.
He is receiving a small dose of fentanyl and propofol, but is awake and co-operative although he has generalised weakness.
His arterial blood gases are shown below:
pH 7.32
PaO2 85 mmHg (11.3 Kpa)
PaCO2 45 mmHg (6 Kpa)
HCO3 18 mmol/L
BE -4.9 mmol/L
What criteria will you use to determine whether the patient is ready to be extubated?
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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:
https://intensiveblog.com/resources/#3