As we approach the fellowship exam, it was time that I put together my Top 30 again for this year. Usually in the past the success rate in terms of my predictions has been about 30% - 50%, depending on the exam What's my recommendation on how you use this list? I recommend that you keep studying the way you're studying but you pay a little bit of extra attention to these particular topics. They should in fact be the topics that you are studying anyway.
Here we go:
ECG of a Mobitz block
ECG of a wide complex rhythm, whether this be an actual tachycardia ie. >120 and a VT or whether this is a slower than 120 wide complex rhythm.
Ischemic ECG. This may be a differentiation between ischemia and pericarditis.
ABG a triple abnormality.
Blood gas related to an iron overdose, which may show a metabolic acidosis specifically in a child.
Traumatic cardiac arrest.
Massive transfusion protocol. This should include not only the ratios at which you use it but an understanding of what factors make a difference and what factors don't make a difference, as well as understanding when you might have to start this protocol. The other thing to also consider is an understanding of the newer thinking which involves type-specific platelets.
Head injury, both adults and children.
Pelvic injury management.
Major chest injury. This will potentially also include a chest x-ray.
Penetrating neck injury.
DKA in kids plus the resuscitation. Here you will be expected to know how to give the fluids, to know the causes of cerebral oedema and to demonstrate that your management of the patient will not produce cerebral oedema.
Seizures in kids.
Meningococcemia or meningococcal infection.
Calcium abnormalities. You should consider these in terms of their effect on cardiac function, not only on cardiac wall motion etc. also on their effect on the ECG.
Sepsis management such as ascending cholangitis.
Pulmonary embolism and pneumonia management at home. This is a disposition approach.
The ischemic gut.
Paracetamol overdose. This is important given the new guidelines that have come out recently so be aware of those. There is a summary of those that was given out in the first face-to-face. There is also a summary on the resus.com.au blog.
Cardiac drug overdose. So this will include beta blockers and especially understanding the difference between the lipophilic propranolol and metoprolol.
An attempted hanging.
Injury to the eye. So this might include globe rupture, globe penetration, hyphaema's because these have all been very, very popular in the past.
Sodium channel blockers or sodium channel overdose. This is important particularly in terms of the ECG and management and they have been asked in the past. They are a very popular question.