Intensive Care at EDAIC Part I: The Key Topics from Paper B

Intensive care carries a significant weight in Paper B of the EDAIC Part I exam. It is a vast field, but the questions cluster around a few recurring themes. Here is a map of the topics worth mastering.

1. Respiratory failure and ARDS

• The Berlin definition of ARDS and the severity criteria (the PaO₂/FiO₂ ratio).
• The principles of protective ventilation: low tidal volume (6 ml/kg ideal body weight), limited plateau pressures, optimal PEEP.
• Adjunctive manoeuvres: prone positioning, neuromuscular blockade, ECMO as a rescue option.

2. Sepsis and septic shock

• The Sepsis-3 definitions and the SOFA score.
• The "hour-1" bundle: cultures, lactate, early antibiotics, fluid resuscitation.
• Vasopressors: noradrenaline as first line, mean arterial pressure targets.

Keep in mind: sepsis questions frequently test the sequence and timing of interventions, not just the doses. Understand the "why" behind each step.

3. Acute kidney injury and renal replacement therapy

• The KDIGO criteria for acute kidney injury.
• The indications for renal replacement therapy (RRT): refractory hyperkalaemia, severe acidosis, fluid overload, symptomatic uraemia.
• The differences between continuous and intermittent modalities.

4. Acid-base balance

An exam classic. Practise the systematic interpretation of arterial blood gases:

1. pH — acidosis or alkalosis?
2. Respiratory vs. metabolic component.
3. Calculate the anion gap and the expected compensation.

5. Nutrition, sedation and delirium

• The principles of score-guided sedation (RASS) and sedation holds.
• Delirium screening (CAM-ICU).
• The timing and route of nutrition in the critically ill patient.

How to approach these topics

Intensive care rewards integrated thinking: a question rarely tests a single isolated fact. Build mental frameworks that link pathophysiology to clinical intervention, and practise on MTF questions that simulate real scenarios.

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