Fellowship - ICU

Question 1

Outline the major considerations for organ donation after circulatory death (DCD).

Question 2

Discuss the advantages and disadvantages of the use of neuromuscular blocking drugs in a patient admitted to the intensive care unit

Question 3

Outline the physiological implications of brainstem death following subarachnoid haemorrhage in a patient listed for organ donation.

Question 4

In regard to total parenteral nutrition:1. What are the indications? (30%)2. What are the complications? (70%)

Question 5

“Identify the points labelled A to F on this intra-aortic balloon pump (IABP) pressure-time trace at the commencement of 1:2 augmentation (30%). Outline the aims of IABP placement and discuss the underlying physiological principles (70%).
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Question 6

Describe the features you require of a transport ventilator for a patient with severe ventilator-dependent acute respiratory distress syndrome.

Question 7

List the indications for hyperbaric oxygen therapy. (30%) Discuss the problems with providing this treatment. (70%)

Question 8

Intensive care patients may be at risk of ventilator-associated pneumonia (VAP). a. Describe the likely aetiology of, and risk factors for, VAP. (50%) b. Outline prevention strategies that reduce the incidence of VAP. (50%)

Question 9

Discuss the advantages and disadvantages of non-invasive ventilation methods in the intensive care unit (22.9%)

Question 10

a. List the methods of assessing intracranial pressure (ICP) (30%)b. Evaluate the role of ICP monitoring in the setting of traumatic brain injury (70%)

Question 11

You are covering ICU in your local district hospital when a 14-year-old boy presents to your ED obtunded and hypotensive with a rash suggestive of meningococcal sepsis. Describe your resuscitation

Question 12

“The electrolyte results below were taken from a 38 year old woman found obtunded 30 hours after abdominal hysterectomy. She had no intercurrent llnesses prior tosurgery. Explain how these electrolyte abnormalities are most likely to have arisen and describe how you would correct them.
Result mmol/L Normal range mmol/L
Sodium 110 135-145
Potassium 3 3.0-5.0
Chloride 80 95-105
Bicarbonate 25 20-32
Glucose 5.0 3.0-5.5
Urea 3.0 3.0-8.0
Creatinine 0.06 0.06-0.12
Measured Osmolality 225 mosmol/kg 280-295mosmol/kg”

Question 13

Define circulatory shock. Categorise the causes of circulatory shock and give an example in each category.

Question 14

A 25 year old, 65kg woman with acute severe asthma requires intubation and ventilation. Explain the problems associated with initiating ventilatory support in this patient and describe how you would overcome them.

Question 15

What are the principles of ventilatory management of patients with acute respiratory distress syndrome (ARDS)?

Question 16

Discuss the usefulness of the continuous measurement of mixed venous oxygen saturation in the intensive care patient?

Question 17

Outline the steps necessary to diagnose brain death in a 38 year old woman who is comatose following a subarachnoid haemorrhage.