Syllabus · Historical · V4 (2023) · Renal System
H4 · Renal Measurement
H4.ii · Renal Measurement
Describe the utility of biochemical estimates of renal function (including but not limited to the measurement of serum creatinine, cystatin C and estimates of Creatinine Clearance such as eGFR).
Written examination
SAQ history
Creatinine & Renal Function
3 exam appearances
Write notes comparing the use of serum creatinine and creatinine clearance in the assessment of renal function in the critically ill.
11%
Describe the relationship between creatinine clearance and serum creatinine. (60% of marks) What are the limitations in using serum creatinine to assess renal function in the critically ill? (40% of marks)
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Describe the relationship between creatinine clearance and serum creatinine concentrations. What are the potential pitfalls in using serum creatinine concentrations to assess renal function in a critically ill patient in ICU?
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Oral examination
VIVA history
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2016A · Day 2 · VIVA 4
This viva tested knowledge of renal physiology and the pharmacology of diuretics. It discussed the functions of the kidney, GFR and factors that influence plasma creatinine.
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2010B · VIVA 4
This station will explore the pharmacology of opioid drugs. An elderly man has been admitted after an emergency laparotomy. He is on an infusion of morphine at 5 mg/hr. His serum creatinine has doubled overnight and he is oliguric. What are the pharmacological effects of morphine in this patient and how are they brought about? Similarly in this viva, candidates struggled with an applied knowledge of basic pharmacological principles relating to commonly used drugs. Mechanisms of action of opioids was also an area of weakness.
Sources: objective text from the relevant CICM syllabus; historical SAQ and VIVA wording from CICM examiner reports.