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CICM First Part interactive diagrams

73 interactive teaching figures mapped to 53 CICM First Part learning objectives. Each diagram opens inside the matching note in Primex.

Section b

Pharmacokinetic compartment models (Part 1)
  • PK compartment models — Explain the single and multiple compartment pharmacokinetic models.
Drug metabolism — phase I and phase II reactions
  • PK compartment models — Describe the distribution of drugs and factors that influence this.
Context-sensitive half-time
Pharmacokinetic compartment models (Part 2)
  • PK compartment models — Explain the kinetics of an intravenous bolus dose and intermittent dosing regimen compared with an infusion.
Dose-response curves and receptor theory
  • Dose-response curves — Define and explain dose-effect relationships of drugs, including dose-response curves, with reference to: graded and quantal response therapeutic index and therapeutic window intrinsic activity, potency and efficacy and …

Section c

Lung compliance, elastic recoil and time constants
Airway resistance and pressure-flow dynamics
Lung volumes and capacities — FRC, closing capacity and spirometry
V/Q mismatch and hypoxaemia (Part 1)
  • V/Q distribution (West / Riley) — Describe the concepts of global and regional ventilation and perfusion and: describe the factors that affect these concepts describe the West's zones of the lung and explain the mechanisms responsible for them, explain V…
  • V/Q distribution (West / Riley) + Oxygen cascade — atmosphere to mitochondrion — Explain the concept of shunt and: the physiological effects of shunt, how shunt may be measured.
  • V/Q distribution (West / Riley) — Define venous admixture and describe its relationship to shunt and V/Q mismatch.
Oxygen delivery and consumption / Oxygen-haemoglobin dissociation curve
Oxygen delivery and consumption
PEEP — physiological effects / Control of breathing
  • Mechanical ventilation modes — Describe the physiological consequences of intermittent positive pressure ventilation and positive end-expiratory pressure.

Section d

Cardiac action potentials (Part 1)
  • Cardiac action potential — Describe the structure of the excitatory elements of the heart including: Sino-atrial node, Atrio-ventricular node, Bundle of His, Purkinje Fibres, anatomical course of conduction.
Cardiac action potentials (Part 2)
  • Cardiac action potential — Explain the ionic basis and processes involved in the following: automaticity of the cardiac pacemaker cells excitation and relaxation of cardiac pacemaker cells excitation and relaxation of cardiac muscle cells
  • Wiggers diagram — cardiac cycle (animated) + Cardiac action potential — Correlate the mechanical events of the cardiac cycle with the electrical and ionic events.
Cardiac output and its determinants (Part 1)
Cardiac output and its determinants (Part 2)
  • Frank-Starling curve — Explain the Frank-Starling mechanism and its relationship to excitation-contraction coupling.
Peripheral circulation and shock
  • Starling capillary forces — Describe the features of the capillary microcirculation, including mechanisms of fluid exchange and its regulatory controls.
Physiological changes of pregnancy / PEEP — physiological effects
  • Mechanical ventilation modes — Explain the physiological consequences of the following on the cardiovascular system: intermittent positive pressure ventilation, positive end-expiratory pressure, Valsalva manoeuvre.
ECG principles — waveforms, intervals and axis
  • ECG mean QRS axis determination — Describe the principles and interpretation of the electrocardiogram (ECG) including: method of measurement including the components of the ECG, limitations and potential sources of error and artefact including the need f…
Anti-hypertensive drugs / Anti-arrhythmic drugs

Section e

Renal tubular physiology (Part 1)
  • Nephron + diuretic sites — Outline the anatomy of the kidneys with particular focus on the anatomy of the functional unit, the nephron.
Acute kidney injury — pathophysiology (Part 1)
Renal tubular physiology (Part 2)
Acute kidney injury — pathophysiology (Part 2)
Renal replacement therapy — principles

Section f

Hyponatraemia — causes and management
  • Renin-angiotensin-aldosterone system — Describe the distribution, regulation and physiological importance of the following ions; sodium, chloride, potassium, magnesium, calcium, phosphate.

Section g

Acid-base disorders — physiology, pH regulation and buffer mechanisms

Section h

Lumbar puncture anatomy and technique
Cerebral autoregulation
Intracranial pressure monitoring / Sedation and analgesia in ICU
  • Monro-Kellie intracranial volume + ICP curve — Describe the measurement and interpretation of intracranial pressure including: methods of measurement, limitations and potential sources of error, methods used to minimise error and artefact including the need for calib…

Section i_sec

Skeletal muscle physiology (Part 1)
  • Cardiac action potential — Describe the physiology of skeletal, smooth and cardiac muscle including excitation-contraction coupling.
Neuromuscular blocking agents in ICU

Section l

Insulin and glucose homeostasis in ICU (Part 1)
  • Glucose homeostasis — Describe the endocrine secretions of the pancreas including their regulation and function.
  • Glucose homeostasis — Describe the control of blood glucose including effects of fasting and response to a glucose load.
Calcium and phosphate homeostasis
Adrenal axis — critical illness-related corticosteroid insufficiency
Insulin and glucose homeostasis in ICU (Part 2)
  • Glucose homeostasis — Understand the pharmacology of hypoglycaemic drugs.
  • Glucose homeostasis — Understand the pharmacology of glucagon.

Section n

Coagulation cascade and fibrinolysis (Part 1)
  • Coagulation cascade — Describe the process and regulation of haemostasis, coagulation, and fibrinolysis.
Coagulation cascade and fibrinolysis (Part 2)
  • Coagulation cascade — Describe the methods for assessing coagulation, including viscoelastic assays.
Platelet function and DIC / Coagulation cascade and fibrinolysis
  • Coagulation cascade — Understand the pharmacology of drugs that affect coagulation including: anti-coagulants and their reversal agents where relevant, anti-platelet drugs, fibrinolytic drugs, anti-fibrinolytic drugs.

Section p

Fetal and neonatal circulation — transition at birth (Part 2)

Section q

Toxicology — toxicokinetic principles, antidote mechanisms and key overdose agents in ICU
  • Glucose homeostasis — Understand the pharmacology of miscellaneous and specific antidotes not listed elsewhere (e.g. fomepizole/ethanol for toxic alcohols, deferoxamine for iron, dimercaprol/DMSA/DMPS for heavy metals, Prussian blue for thall…
Beta-blocker and calcium-channel-blocker overdose
  • Glucose homeostasis — Understand the management of beta-blocker and calcium-channel-blocker overdose — escalating therapy from IV calcium and glucagon through high-dose insulin euglycaemia (1 unit/kg/h titrated up to 10 units/kg/h), vasopress…

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