ABIM Critical Care study guide
ABIM Critical Care · Work through your exam, one topic at a time.
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 ABIM Critical Care study guide has 12 sections and about 2,921 words.
01Respiratory Disorders and Mechanical Ventilation
Master the difference between oxygenation (reflected by PaO2/FiO2 and managed with PEEP and FiO2) and ventilation (reflected by PaCO2 and managed with rate and tidal volume). Know ARDS by the Berlin definition: onset within 1 week, bilateral opacities, not primarily cardiogenic, with PEEP ≥5 and P/F ≤300.
271 words, about 1 min02Cardiovascular Disorders and Hemodynamic Monitoring
Understand shock physiology by category: hypovolemic, cardiogenic, distributive (septic, neurogenic, anaphylactic), and obstructive (tamponade, tension pneumothorax, massive PE). Integrate physical exam, lactate, central venous oxygen saturation, and bedside ultrasound.
267 words, about 1 min03Neurologic Disorders and Neurocritical Care
Focus on the ABCs of neurocritical care: airway protection, oxygenation, and avoiding secondary injury through blood pressure and glucose control, normothermia, and seizure prophylaxis where indicated. Know the Glasgow Coma Scale and its trend value.
270 words, about 1 min04Renal, Fluid, Electrolyte, and Acid-Base Disorders
Interpret acid-base disorders systematically: calculate expected compensation, check the anion gap, and use the delta gap to detect mixed disorders. Know causes of high-anion-gap acidosis (MUDPILES) and normal-gap acidosis.
247 words, about 1 min05Infectious Diseases and Sepsis
Recognize sepsis as life-threatening organ dysfunction from infection, quantified by SOFA or bedside qSOFA, and septic shock as persistent hypotension requiring vasopressors with elevated lactate despite fluids. Emphasize the Surviving Sepsis bundle: cultures before antibiotics, early broad-spectrum antibiotics, balanced fluid resuscitation, and lactate-guided reassessment.
240 words, about 1 min06Endocrine, Nutritional, and Metabolic Disorders
Master the hyperglycemic emergencies: diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS). In DKA, treat with fluids, insulin, and potassium replacement - check potassium before insulin.
256 words, about 1 min07Gastrointestinal, Hepatic, and Hematologic Disorders
Understand GI bleeding management: resuscitation, risk stratification, PPI therapy, and urgent endoscopy. Recognize acute liver failure, hepatic encephalopathy, and the complications of cirrhosis (varices, ascites, spontaneous bacterial peritonitis, hepatorenal syndrome).
227 words, about 1 min08Trauma, Burns, and Surgical Critical Care
Apply ATLS priorities: airway with cervical spine protection, breathing, circulation, disability, exposure. Recognize life-threatening injuries: tension pneumothorax, massive hemothorax, cardiac tamponade, and airway obstruction.
245 words, about 1 min09Toxicology, Pharmacology, and Environmental Emergencies
Know the classic toxidromes: opioid (miosis, respiratory depression), sympathomimetic, anticholinergic, cholinergic, and sedative-hypnotic. Master antidotes: naloxone for opioids, flumazenil for benzodiazepines (cautiously), N-acetylcysteine for acetaminophen, sodium bicarbonate for salicylates and tricyclics, fomepizole for toxic alcohols, and hydroxocobalamin for cyanide.
213 words, about 1 min10Procedures, Monitoring, and Resuscitation
Understand indications, contraindications, and complications of common ICU procedures: central venous catheterization, arterial line placement, thoracentesis, paracentesis, lumbar puncture, intubation, and chest tube insertion. Know ultrasound guidance to improve success and reduce complications.
220 words, about 1 min11Ethics, Palliative Care, and End-of-Life Decision Making
Understand the ethical principles: autonomy, beneficence, nonmaleficence, and justice. Know surrogate decision-making standards - substituted judgment and best interests.
240 words, about 1 min12Patient Safety, Quality Improvement, and Systems-Based Practice
Understand systems-based practice: how care is delivered across teams and settings, and how errors arise from systems rather than individuals. Know quality-improvement methods (Plan-Do-Study-Act, root cause analysis, failure mode and effects analysis) and metrics (structure, process, outcome).
225 words, about 1 min