ABIM Critical Care case studies
ABIM Critical Care · Put your knowledge to work in context.
The ABIM Critical Care Medicine Certification Examination is the American Board of Internal Medicine's certifying assessment for physicians who have completed accredited critical care fellowship training and wish to be recognized as board certified in critical care medicine. It is aimed at intensivists practicing in medical, surgical, cardiac, and neurologic intensive care units, and it is generally taken alongside or after initial internal medicine certification. The exam samples the full breadth of adult critical care: respiratory failure and mechanical ventilation, shock and hemodynamic monitoring, neurocritical care, renal and acid-base physiology, sepsis and infection, endocrine and metabolic derangements, gastrointestinal, hepatic, and hematologic problems, trauma and burns, toxicology, procedures and resuscitation, and the ethics, palliative care, quality, and systems topics that surround ICU practice. Items are single-best-answer multiple choice and reward applied clinical reasoning over isolated recall, often presenting a deteriorating patient and asking for the next best step. The ABIM Critical Care case studies are 5 cases and about 1,898 words.
1Weaning Failure in a Patient with COPD and Auto-PEEP
A 68-year-old man with GOLD stage 3 COPD is on day 4 of mechanical ventilation for a COPD exacerbation. He is sedated with propofol 30 mcg/kg/min, awake and following commands, afebrile, with clear secretions.
431 words, about 2 min2Fluid Resuscitation Strategy in Septic Shock with Cardiac Dysfunction
A 74-year-old woman presents with septic shock from cholangitis. She is intubated and on norepinephrine 0.35 mcg/kg/min.
386 words, about 2 min3Hyponatremia and Seizure in a Postoperative Neurosurgical Patient
A 52-year-old woman is 6 days post transsphenoidal resection of a pituitary macroadenoma. She develops confusion and a witnessed generalized tonic-clonic seizure.
337 words, about 2 min4Sedation and Neurologic Prognostication After Cardiac Arrest
A 61-year-old man with no known comorbidities had an out-of-hospital cardiac arrest with bystander CPR and return of spontaneous circulation after 22 minutes. He is comatose on day 3 in the ICU, intubated and mechanically ventilated, on propofol 40 mcg/kg/min and fentanyl.
381 words, about 2 min5Massive Transfusion and the Lethal Triad in Trauma
A 29-year-old man is brought in after a high-speed motorcycle crash. He is hypotensive (BP 78/40), tachycardic (HR 138), and has a distended abdomen and unstable pelvis on exam.
363 words, about 2 min