Intensive care and emergency: The most important topics to be read for your EDAIC examination.

Intensive care and emergency are among the most dreaded topics, feared by almost every aspirant. However, questions concerning the topic are frequently asked in both parts of the EDAIC examinations. Fortunately, the questions revolve around limited topics and specific blocks that are not very difficult to memorise and retain, provided you know where to concentrate your efforts. This list includes the most common exam questions that you are likely to be asked in the EDAIC examination. Although the examiner is at liberty to test or ask anything, there are all-time favourites that you must know.

To make the challenging terrain a little less painful, we have tried to compile a list of the most important topics to be read from these systems, a bare minimum yet essential topics’ compilation.

Targetedaic recommends: What to read in intensive care and emergency

1. Calculate lean and predicted body weight
2. 24-hour nutrition requirements in ICU patients in general, burn patient, postop case, sepsis
3. Micronutrient defeciencies
4. Aspiration prophylaxis
5. Gut decontamination
6. Critical illness neuropathy/myopathy. Diagnosis and prevention
7. Ventilatory modes
8. NIV. Indications, precautions and contraindications. Comparison with invasive ventilation.
9. Ventilator bundles
10. Management of burns patient
11. Weaning
12. Tracheostomy. Early and late tracheostomy.
13. Percutaneous tracheostomy. Indications and contraindications.
14. VAP. Diagnosis, prevention, treatment.
15. Hospital-acquired infections
16. Bedsore. Management.
17. Sepsis
18. ARDS
19. GB syndrome
20. Myasthenia
21. Status asthmaticus
22. Status epilepticus
23. ICU scores
    NYHA, Golman, Lee’s, Child-Pugh, World Federation Neurosurgeons, SOFA, APACHE II, RASS, CAM-ICU, ARDS
24. Acute pancreatitis
25. Role of steroids in critical care
26. Stroke
27. Flail chest. Pain management.
28. ICD drainage system. Diagram and working.
29. MI
30. PCM toxicity
31. Acute hepatic failure
32. Fluid balance in ICU
33. Antibiotics. Common groups, indications, side-effects and contraindications and doses.
34. Abdominal compartment
35. Clostridium deficile
36. Tissue oxygenation and oxygen delivery
37. Sedation in ICU
38. Delirium. Diagnosis and management. – ICS Guidelines/CAM ICU. Causes, prevention, detection and management.
39. Traumatic brain injury. Management. Goals.
40. Transfer of a critically ill patient.
41. Postoperative pulmonary complications*
42. Starvation, carbohydrate loading, and outcome after major surgery
43. SIRS. Management.
44. Analgesia and sedation in critical care
45. NIV in perioperative period*
46. Dexmedetomidine: its use in intensive care medicine and anaesthesia
47. HF oxygen therapy*
48. Anaphylaxis
49. N-acetylcysteine. Non-PCM uses.
50. Management of hypertensive emergency
51. Oxygen toxicity. Safe FiO2.
52. COVID presentation, differential diagnosis, management and complications. What are the staff precautions while handling the case?
53. Acute aortic dissection
54. ACLS, PALS, ATLS
55. Intracranial haemorrhage. Differentiation between SDH and EDH.
56. Effects of chronic alcohol consumption. Signs and symptoms and treatment of acute withdrawal?
57. Poisonings
    i. PCM
    ii. Alcohol
    iii. TCA
    iv. Sedative overdose
    v. Oral hypoglycaemics
    vi. CO
    vii. SNP
    viii. Thiocyanate
58. CASE SCENARIO:
    i. What criteria would you use to define brainstem death in a potential donor admitted in ICU under your care?. WJat pathophysiological changes do you think would be present in a patient? How will you manage the patient till organ harvesting is undertaken?
    ii. How is acute pancreatitis diagnosed? How will you manage the patient in ICU? What scoring systems are used for the severity grading? Can you name some complications of the disease?
    iii. What are the indications for renal replacement therapy (RRT) in the intensive care setting? List the types of RRT available in intensive care. Outline the principle mechanisms of solute and water removal by filtration and dialysis during RRT.
    iv. You are asked to review a 30-year-old male who is a known epileptic in convulsive status epilepticus. Can you define status epilepticus? Outline your initial management of this patient, including the use of emergency antiepileptic drug therapy. Sixty minutes after your initial management, the patient continues to be in status epilepticus. What would be your further management? What are the complications associated with refractory convulsive status epilepticus?
    v. A 30-year-old man is brought to the emergency department after being rescued from drowning. What are the relevant questions you would ask the rescue team? He has a Glasgow Coma Score of 13 but an arterial oxygen partial pressure of 6kPa (45mmHg) breathing 4L of oxygen via a variable performance mask. Outline your initial management of this patient.
    vi. A 47-year-old man has a significant hemorrhage following trauma and is admitted to your emergency department. There is no sign or history of head injury. Can you define major hemorrhage and elaborate on the principles of management? What complications might follow a massive blood transfusion?
    vii. Define critical illness weakness and list the types that may occur. (3 marks) b) List the risk factors for the development of weakness on the ICU. (6 marks) c) What are the clinical features of CIW? (4 marks) d) How may nerve conduction studies determine the type of CIW? (4 marks) e) What are the options for the management of CIW? (2 marks).
    viii. You are called in to assess a 44-year-old patient in the Emergency Department with traumatic brain injury. Her CT scan reveals only cerebral oedema. What is a secondary brain injury, and when is it likely to occur? Outline the primary physiological and cellular changes associated with secondary brain injury. How will you minimize the chances of secondary brain injury in this patient?
    ix. What are the indications for and possible contraindications to elective percutaneous tracheostomy (PCT)? List the potential early and late patient complications of PCT.
    x. You are asked to assess a 25-year-old male admitted to the Emergency Department with 30% burns from a house fire. What signs in the patients would suggest significant inhalational injury? How will you assess or investigate the case (concerning the severity of the inhalational injury), and what are the likely findings in severe injury? List the indications for early tracheal intubation to secure the airway. How do burn injuries influence the use of suxamethonium?
    xi. Calculate the nutritional requirements of a 70kg critically ill patient. Can you calculate the total volume of water required? What other components would you like to add? What are the investigations deemed necessary in the patient? How can TPN be administered? What are the likely complications?
    xii. Ten days post-admission in ICU, a patient developed diarrhoea with abdominal distension. What are the likely diagnosis and your management?

FOR MUST-READ TOPICS IN THE RESPIRATORY SYSTEMS, CLICK HERE.

FOR MUST-READ TOPICS IN THE NERVOUS SYSTEM, CLICK HERE.

FOR MUST-READ TOPICS IN THE  ENDOCRINE, METABOLIC AND NEUROMUSCULAR SYSTEMS, CLICK HERE.

FOR MUST-READ TOPICS IN THE PAIN AND REGIONAL ANAESTHESIA, CLICK HERE.

FOR MUST-READ TOPICS IN THE PHARMACOLOGY, CLICK HERE.