Surgical Critical Care
Core concepts
Understand shock types (hypovolemic, cardiogenic, distributive, obstructive) and their hemodynamic profiles. Master sepsis and septic shock management, including early antibiotics and fluid resuscitation. Know respiratory failure and mechanical ventilation principles, acute respiratory distress syndrome, and ventilator-associated pneumonia. Understand acute kidney injury, electrolyte disorders, and nutrition in the critically ill. Know sedation, delirium, and prevention of complications such as VTE and pressure injury. Understand brain death and end-of-life care in the ICU.
Traps in questions
Questions often test fluid responsiveness versus overload, and when to use vasopressors. Distinguish sepsis from systemic inflammatory response syndrome without infection. Another trap is the timing of antibiotics in septic shock; delay worsens outcomes. Watch for questions about permissive hypercapnia and lung-protective ventilation.
Worked rule of thumb
In septic shock, give broad-spectrum antibiotics early, resuscitate with crystalloid, and add vasopressors if hypotension persists despite fluids. Reassess perfusion with lactate clearance and urine output.
Exam strategy
Use hemodynamic profiles to classify shock. Low preload suggests hypovolemia; high preload with low output suggests cardiogenic; low systemic vascular resistance suggests distributive.