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An understanding of critical care is one of the key objectives of medical and surgical training, and viva examinations in particular remain a source of anxiety for many candidates. Surgical Critical Care Vivas follows the same format as the hugely popular General Pathology Vivas and gives candidates a means of practising some of the most common questions that they will be asked in their viva examinations. Pocket-sized, for portability, and packed with useful information in an east-to-use A-Z format, this book will help the reader to broaden their knowledge base and, by practising the vivas, gain confidence in their examination technique.
E-Book Content
Surgical Critical Care Vivas
For my wife, Pauline Cornelia O’Keeffe
Surgical Critical Care Vivas
Mazyar Kanani BSc (Hons) MBBS (Hons) MRCS (Eng) British Heart Foundation Paediatric Cardiothoracic Clinical Research Fellow Cardiac Unit Great Ormond Street Hospital London, UK
cambridge university press Cambridge, New York, Melbourne, Madrid, Cape Town, Singapore, São Paulo Cambridge University Press The Edinburgh Building, Cambridge cb2 2ru, UK Published in the United States of America by Cambridge University Press, New York www.cambridge.org Information on this title: www.cambridge.org/9780521681537 © Greenwich Medical Media Limited 2003 This publication is in copyright. Subject to statutory exception and to the provision of relevant collective licensing agreements, no reproduction of any part may take place without the written permission of Cambridge University Press. First published in print format 2005 isbn-13 isbn-10
978-0-511-14670-1 eBook (NetLibrary) 0-511-14670-1 eBook (NetLibrary)
isbn-13 isbn-10
978-0-521-68153-7 paperback 0-521-68153-7 paperback
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CONTENTS viii xi
Abdominal Trauma: Investigations Accessing the Thorax Acid-Base Acute Renal Failure (see also table in ‘Low urine output’) Acute Respiratory Distress Syndrome (ARDS) Agitation and Sedation Airway Management Analgesia Aortic Dissection Atelectasis
1 4 7 10 15 20 23 26 31 35
Blood Pressure Monitoring Blood Products Blood Transfusion Brainstem Death and Organ Donation Bronchiectasis Burns
38 42 46 51 55 57
Calcium Balance Cardiac Assessment Cardiogenic Shock Central Line Insertion Chronic Renal Failure Coagulation Defects
62 66 68 73 78 83
Disseminated Intravascular Coagulation (DIC)
86
ECG I – Basic Concepts ECG II – Rate and Rhythm Disturbances Endotracheal Intubation Enteral Nutrition Extubation and Weaning
CONTENTS
List of Abbreviations Acknowledgements
88 92 97 101 104
䉲
v
SURGICAL CRITICAL CARE VIVAS
CONTENTS vi
Fat Embolism Syndrome Flail Chest Fluid Therapy
106 111 114
Haemorrhagic Shock Head Injury I – Physiology Head Injury II – Pathophysiology Head Injury III – Principles of Management
119 124 127 130
Inotropes and Circulatory Support ITU Admission Criteria
134 139
Jugular Venous Pulse (JVP)
141
Lactic Acidosis Low Urine Output State
144 146
Magnesium Balance Mechanical Ventilatory Support Metabolic Acidosis (see also ‘Acid-base’ and and ‘Lactic acidosis’) Metabolic Alkalosis
151 153 156 159
Nutrition: Basic Concepts (see also parenteral nutrition & TPN)
161
Oxygen: Basic Physiology Oxygen Therapy
165 169
Parenteral Nutrition (TPN) Pneumonia Pneumothorax Potassium Balance