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CICM First Part interactive diagrams

99 interactive teaching figures mapped to 69 CICM First Part learning objectives. Each diagram opens inside the matching note in Primex.

Section b

Pharmacokinetic compartment models and drug absorption
Drug distribution, metabolism and clearance
Effect-site concentration and context-sensitive half-time
Infusion kinetics and therapeutic drug monitoring
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 …
Adverse drug reactions and interaction mechanisms

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, dead space and shunt
  • 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 carriage and the oxyhaemoglobin dissociation curve
Carbon dioxide carriage and dissociation curve
IPPV, PEEP and the physiological effects of altered oxygen and carbon dioxide
  • Mechanical ventilation modes — Describe the physiological consequences of intermittent positive pressure ventilation and positive end-expiratory pressure.
Blood gas and exhaled carbon dioxide measurement
  • Capnography waveform interpreter — Describe the measure of exhaled carbon dioxide including: methods of measurement; qualitative and quantitative capnography limitations and potential sources of error of each methods used to minimize error and artefact in…

Section d

Cardiac and coronary circulation anatomy
Cardiac conduction system anatomy
  • 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 and excitation-contraction coupling
  • 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 cycle pressures and determinants of cardiac output
Cardiac reflexes and the Frank-Starling mechanism
  • Frank-Starling curve — Explain the Frank-Starling mechanism and its relationship to excitation-contraction coupling.
Ventricular pressure-volume loops and central venous oxygen saturation
Peripheral vascular resistance and coronary circulation regulation
Peripheral circulation and shock
  • Starling capillary forces — Describe the features of the capillary microcirculation, including mechanisms of fluid exchange and its regulatory controls.
Cardiovascular compensatory responses and effects of positive pressure ventilation
  • 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 and blood pressure monitoring
Vasopressors — noradrenaline, vasopressin, adrenaline
Anti-hypertensive and anti-arrhythmic drugs

Section e

Renal anatomy and overview of kidney functions
  • Nephron + diuretic sites — Outline the anatomy of the kidneys with particular focus on the anatomy of the functional unit, the nephron.
Renal blood flow and its regulation
Glomerular filtration and tubular function
Measurement of renal function and diuretic pharmacology
Renal replacement fluid pharmacology

Section f

Fluid compartments and distribution
Plasma osmolality regulation and lymphatic system
Hyponatraemia — causes and management
Intravenous fluids — crystalloids and colloids pharmacology

Section g

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

Section h

Lumbar puncture anatomy and intracranial pressure determinants
Cerebral autoregulation
Intracranial pressure monitoring and sedative pharmacology
  • 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

Muscle anatomy and excitation-contraction coupling
  • Cardiac action potential — Describe the physiology of skeletal, smooth and cardiac muscle including excitation-contraction coupling.
Neuromuscular blocking agents in ICU

Section l

Pancreatic hormones and blood glucose control
  • 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.
Renal and adrenal hormones and calcium control
Adrenal axis — critical illness-related corticosteroid insufficiency
Hypoglycaemic drugs and glucagon
  • Glucose homeostasis — Understand the pharmacology of hypoglycaemic drugs.
  • Glucose homeostasis — Understand the pharmacology of glucagon.

Section n

Haemostasis, coagulation and natural anticoagulants
  • Coagulation cascade — Describe the process and regulation of haemostasis, coagulation, and fibrinolysis.
Inflammation, immunity and host defences
Anaphylaxis and hypersensitivity reactions
Coagulation and platelet function testing
  • Coagulation cascade — Describe the methods for assessing coagulation, including viscoelastic assays.
Anticoagulant, antiplatelet and fibrinolytic drugs
  • 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

Placental transfer and neonatal circulatory transition

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…
Organophosphate poisoning — atropine and pralidoxime
  • Toxidrome discriminator grid — Understand organophosphate and carbamate poisoning — SLUDGE/DUMBELS toxidrome, nicotinic features, irreversible acetylcholinesterase inhibition and the 'ageing' window, titrated doubling-dose atropine to atropinisation, …

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