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    The Colleges of Medicine of South Africa

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    The document is an exam for a Subspecialty Certificate in Critical Care from the College of Anaesthetists of South Africa. It contains 4 questions regarding the management of patients in intensive care. Question 1 involves the management of a 15-year-old patient admitted to the ICU after a motor vehicle accident with an isolated closed head injury. Question 2 is about the management of liver disease, including defining hepatic encephalopathy and discussing interventions for it. Question 3 asks about current concepts in peri-operative fluid management, specifically discussing capillary permeability, the endothelium, Starling's principle, and the role of lymphatics in edema. Question 4 asks about the pathophysiology of edema as it relates to capillary perf

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    The Colleges of Medicine of South Africa

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    matenten
    59 views2 pages
    The document is an exam for a Subspecialty Certificate in Critical Care from the College of Anaesthetists of South Africa. It contains 4 questions regarding the management of patients in intensive care. Question 1 involves the management of a 15-year-old patient admitted to the ICU after a motor vehicle accident with an isolated closed head injury. Question 2 is about the management of liver disease, including defining hepatic encephalopathy and discussing interventions for it. Question 3 asks about current concepts in peri-operative fluid management, specifically discussing capillary permeability, the endothelium, Starling's principle, and the role of lymphatics in edema. Question 4 asks about the pathophysiology of edema as it relates to capillary perf

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    Cert_Critical_Care(SA)_Anaes

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    Cert_Critical_Care(SA)_Anaes_Past_Papers 6

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    The document is an exam for a Subspecialty Certificate in Critical Care from the College of Anaesthetists of South Africa. It contains 4 questions regarding the management of patients in intensive care. Question 1 involves the management of a 15-year-old patient admitted to the ICU after a motor vehicle accident with an isolated closed head injury. Question 2 is about the management of liver disease, including defining hepatic encephalopathy and discussing interventions for it. Question 3 asks about current concepts in peri-operative fluid management, specifically discussing capillary permeability, the endothelium, Starling's principle, and the role of lymphatics in edema. Question 4 asks about the pathophysiology of edema as it relates to capillary perf

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    59 views2 pages

    The Colleges of Medicine of South Africa

    Uploaded by

    matenten
    The document is an exam for a Subspecialty Certificate in Critical Care from the College of Anaesthetists of South Africa. It contains 4 questions regarding the management of patients in intensive care. Question 1 involves the management of a 15-year-old patient admitted to the ICU after a motor vehicle accident with an isolated closed head injury. Question 2 is about the management of liver disease, including defining hepatic encephalopathy and discussing interventions for it. Question 3 asks about current concepts in peri-operative fluid management, specifically discussing capillary permeability, the endothelium, Starling's principle, and the role of lymphatics in edema. Question 4 asks about the pathophysiology of edema as it relates to capillary perf

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    Cert Critical Care(SA) Anaes

    THE COLLEGES OF MEDICINE OF SOUTH AFRICA


    Incorporated Association not for gain Reg No 1955/000003/08

    Examination for the Subspecialty Certificate in Critical Care of the College of Anaesthetists of South Africa 23 August 2012 Paper 1 (3 hours)
    All questions to be answered. Each question to be answered in a separate book (or books if more than one is required for the one answer)

    1 2

    Discuss the management of the patient with refractory hypoxaemia Include in your answer relevant specific studies (100) A 15 year old male patient is admitted to your ICU after a motor vehicle accident. The trauma primary survey prior to ICU admission shows that he has an isolated closed head injury. Outline your management of this patient under the following headings: a) Diagnostic investigations (20) b) General supportive treatment measures (20) c) Management of intracranial pressure (20) d) Mechanical ventilator therapy (10) e) The role of steroids, anticonvulsants and free radical scavengers (10) f) Hypothermia in Traumatic Brain Injury (20) [100] With respect to the management of liver disease a) Define hepatic encephalopathy and briefly describe its pathophysiology. (10) b) What are the precipitating factors for the development of hepatic encephalopathy? (8) c) Discuss management interventions directed specifically at hepatic encephalopathy that may be utilized. Indicate their relative efficacy and evidence for benefit. (20) d) What would you recommend in terms of nutrition for the patient with hepatic encephalopathy? (6) e) What pulmonary complications are described in end stage liver disease? Indicate the pathophysiology and therapies available for their management. (40) f) Define the hepato-renal syndrome and indicate how it may be best managed. (16) [100] With reference to the current concepts on peri-operative fluid management, discuss: a) The pathogenesis of oedema Include in your answer a discussion on the following i) capillary permeability. ii) the endothelium and the endothelial surface complex. iii) the validity of Starlings principle. iv) the role and function of lymphatics in oedema.

    (50)

    b)

    The pathophysiology of oedema

    Include in your answer a discussion on the following i) capillary perfusion pressure or flow. ii) DO2. iii) Is hypoxia deleterious to the patient? iv) capillary density.

    (50) [100]

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