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Exam Number : NCC
Exam Name : Certified in NeuroCritical Care (ABEM)
Vendor Name : Certification-Board
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The following are specific diseases, conditions, and clinical syndromes commonly managed by a neurointensivist:
A. Cerebrovascular Diseases
1. Infarction and ischemia
Massive hemispheric infarction
Basilar artery occlusion and stenosis
Carotid artery occlusion and stenosis
Crescendo TIAs
Occlusive vasculopathies (Moya-Moya, sickle cell)
Spinal cord infarction
2. Intracerebral hemorrhage
3. Subarachnoid hemorrhage - aneurysmal and other Vascular malformations
Arteriovenous malformations
AV fistulas
Cavernous malformations
Developmental venous anomalies
4. Dural sinus thrombosis
5. Carotid-cavernous fistulae
6. Cervical and cerebral arterial dissections
1. Traumatic brain injury
"Diffuse axonal injury"
Epidural hematoma
Subdural hematoma
Skull fracture
Contusions and lacerations
Penetrating craniocerebral injuries
Traumatic subarachnoid hemorrhage
2. Spinal cord injury
Traumatic injury (transection, contusion, concussion)
Vertebral fracture and ligamentous instability
C. Disorders, Diseases, Seizures, and Epilepsy
1 . Seizures and epilepsy
Status epilepticus (SE) Convulsive
Non-convulsive (partial-complex and "subtle" secondarily generalized SE) Myoclonic
2. Neuromuscular diseases
Myasthenia gravis
Guillain-Barre syndrome
Rhabdomyolysis and toxic myopathies
Critical illness myopathy and neuropathy
3. Infections
Encephalitis (viral, bacterial, parasitic)
Meningitis (viral, bacterial, parasitic)
Brain and spinal epidural abscess
4. Toxic-metabolic disorders
Neuroleptic malignant syndrome/malignant hyperthermia
Serotonin syndrome
Drug overdose and withdrawal (e.g., barbiturates, narcotics, alcohol, cocaine, acetaminophen).
Temperature related injuries (hyperthermia, hypothermia)
5. Inflammatory and demyelinating diseases
Multiple sclerosis (Marburg variant, transverse myelitis)
Acute disseminated encephalomyelitis (ADEM)
CNS vasculitis
Chemical or sterile meningitis (i.e. posterior fossa syndrome, NSAID induced)
Central pontine myelinolysis
6. Neuroendocrine disorders
Pituitary apoplexy
Diabetes insipidus (including triple phase response)
Thyroid storm and coma
Myxedema coma
Addisonian crisis
D. Neuro-oncology
1 . Brain tumors and metastases
2. Spinal cord tumors and metastases
3. Carcinomatous meningitis
4. Paraneoplastic syndromes
1. Eclampsia, including HELLP Syndrome
2. Hypertensive encephalopathy
3. Hepatic encephalopathy
4. Uremic encephalopathy
5. Hypoxic-ischemic and anoxic encephalopathy
F.Clinical syndromes
2. Herniation syndromes with monitoring & ICP
3. Elevated intracranial pressure and Intracranial hypotension/hypovolemia
4. Hydrocephalus detection & treatment
5. Cord compression
6. Death by neurologic criteria, end of life issues, and organ donation
7. Vegetative state
8. Dysautonomia (cardiovascular instability, central fever, hyperventilation)
9. Reversible posterior leukoencephalopathy
10. Psychiatric emergencies (psychosis)
G. Perioperative Neurosurgical Care
II. General Critical Care: Pathology, Pathophysiology, and Therapy
A. Cardiovascular Physiology, Pathology, Pathophysiology, and Therapy
1. Shock (hypotension) and its complications (vasodilatory and cardiogenic)
2. Myocardial infarction and unstable coronary syndromes
3. Neurogenic cardiac disturbances (ECG changes, stunned myocardium)
4. Cardiac rhythm and conduction disturbances; use of antiarrhythmic medications; indications for and types of pacemakers
5. Pulmonary embolism
6. Pulmonary edema: cardiogenic versus noncardiogenic (including neurogenic)
7. Acute aortic and peripheral vascular disorders (dissection, pseudoaneurysm)
8. Recognition, evaluation and management of hypertensive emergencies and urgencies
9. Calculation of derived cardiovascular parameters, including systemic and pulmonary vascular resistance, alveolararterial gradients, oxygen transport and consumption
B.Respiratory Physiology, Pathology, Pathophysiology and Therapy
1.Acute respiratory failure
Hypoxemic respiratory failure (including ARDS)
Hypercapnic respiratory failure
Neuromuscular respiratory failure
2. Aspiration
3. Bronchopulmonary infections
4. Upper airway obstruction
5. COPD and status asthmaticus, including bronchodilator therapy
6. Neurogenic breathing patterns (central hyperventilation, Cheyne-Stokes respirations)
7. Mechanical ventilation
Positive pressure ventilation (BIPAP)
PEEP, CPAP, inverse ratio ventilation, pressure support ventilation, pressure control, and non- invasive ventilation
Negative pressure ventilation
Barotrauma, airway pressures (including permissive hypercapnia)
Criteria for weaning and weaning techniques
8. Pleural Diseases
Massive effusion
9. Pulmonary hemorrhage and massive hemoptysis
10. Chest X-ray interpretation
11. End tidal C02 monitoring
12. Sleep apnea
13. Control of breathing
C. Renal Physiology,Pathology, Pathophysiology and Therapy
1.Renal regulation of fluid and water balance and electrolytes
2.Renal failure: Prerenal, renal, and postrenal
3.Derangements secondary to alterations in osmolality and electrolytes
4. Acid-base disorders and their management
5.Principles of renal replacement therapy
6. Evaluation of oliguria and polyuria
7.Drug dosing in renal failure
8. Management of rhabdomyolysis
9. Neurogenic disorders of sodium and water regulation (cerebral salt wasting and SIADH).
D. Metabolic and Endocrine Effects of Critical Illness
1. Enteral and parenteral nutrition
2. Endocrinology
Disorders of thyroid function (thyroid storm, myxedema coma, sick euthyroid syndrome)
Adrenal crisis
Diabetes mellitus
Ketotic and hyperglycemic hyperosmolar coma Hypoglycemia
3. Disorders of calcium and magnesium balance
4. Systemic Inflammatory Response Syndrome (SIRS)
5. Fever, thermoregulation, and cooling techniques
E.Infectious Disease Physiology, Pathology, Pathophysiology and Therapy
1. Antibiotics
Antibacterial agents
Antifungal agents
Antituberculosis agents
Antiviral agents
Antiparasitic agents
2. Infection control for special care units
Development of antibiotic resistance
Universal precautions
Isolation and reverse isolation
3. Tetanus and botulism
4. Hospital acquired and opportunistic infections in the critically ill
5. Acquired Immune Deficiency Syndrome (AIDS)
6. Evaluation of fever in the ICU patient
7. Central fever
8. Interpretation of antibiotic concentrations, sensitivities
F.Physiology, Pathology, Pathophysiology and therapy of Acute Hematologic Disorders
1 . Acute defects in hemostasis
Thrombocytopenia, thrombocytopathy
Disseminated intravascular coagulation
Acute hemorrhage (GI hemorrhage, retroperitoneal hematoma)
Iatrogenic coagulopathies (warfarin and heparin induced)
2. Anticoagulation and fibrinolytic therapy
3. Principles of blood component therapy (blood, platelets, FFP)
4. Hemostatic therapy (vitamin K, aminocaproic acid, protamine, factor VIla)
5. Prophylaxis against thromboembolic disease
6. Prothrombotic states
G. Physiology, Pathology, Pathophysiology and Therapy of Acute Gastrointestinal (GI) and Genitourinary (GU)
1. Upper and lower gastrointestinal bleeding
2. Acute and fulminant hepatic failure (including drug dosing)
3. Ileus and toxic megacolon
4. Acute perforations of the gastrointestinal tract
5. Acute vascular disorders of the intestine, including mesenteric infarction
6. Acute intestinal obstruction, volvulus
7. Pancreatitis
8. Obstructive uropathy, acute urinary retention
9. Urinary tract bleeding
H. Immunology and Transplantation
1. Principles of transplantation (brain death, organ donation, procurement, maintenance of organ donors, implantation)
2. Immunosuppression, especially the neurotoxicity of these agents
I. General Trauma and Burns
1. Initial approach to the management of multisystem trauma
2. Skeletal trauma including the spine and pelvis
3. Chest and abdominal trauma - blunt and penetrating
4. Burns and electrical injury
J. Monitoring
1. Neuromonitoring
2. Prognostic, disease severity and therapeutic intervention scores
3. Principles of electrocardiographic monitoring
4. Invasive hemodynamic monitoring
5. Noninvasive hemodynamic monitoring
6. Respiratory monitoring (airway pressure, intrathoracic pressure, tidal volume, pulse oximetry, dead space, compliance, resistance, capnography)
7. Metabolic monitoring (oxygen consumption, carbon dioxide production, respiratory quotient)
8. Use of computers in critical care units for multimodality monitoring
K. Administrative and Management Principles and Techniques
1. Organization and staffing of critical care units
2. Collaborative practice principles, including multidisciplinary rounds and management
3. Emergency medical systems in prehospital care
4. Performance improvement, principles and practices
5. Principles of triage and resource allocation, bed management
6. Medical economics: health care reimbursement, budget development
L. Ethical and Legal Aspects of Critical Care Medicine
1. Death and dying
2. Forgoing life-sustaining treatment and orders not to resuscitate
3. Rights of patients, the right to refuse treatment
4. Living wills, advance directives; durable power of attorney
5. Terminal extubation and palliative care
6. Rationing and cost containment
7. Emotional management of patients, families and caregivers
8. Futility of care and the family in denial
M. Principles of Research in Critical Care
1. Study design
2. Biostatistics
3. Grant funding and protocol writing
4. Manuscript preparation
5. Presentation preparation and skills
6. Institutional Review Boards and HIPAA
Ill. Procedural Skills
A. General Neuro-Critical Care
1 . Central venous catheter placement; dialysis catheter placement
2. Pulmonary artery catheterization
3. Management of mechanical ventilation, including CPAP/BiPAP ventilation
4. Administration of vasoactive medications (hemodynamic augmentation and hypertension lysis)
5. Maintenance airway and ventilation in nonintubated, unconscious patients
6. Interpretation and performance of bedside pulmonary function tests
7. Direct laryngoscopy
8. Endotracheal intubation
9. Shunt and ventricular drain tap for CSF sampling
10. Performance and interpretation of transcranial Doppler
11. Administration of analgosedative medications, including conscious sedation and barbiturate anesthesia
12. Interpretation of continuous EEG monitoring
13. Interpretation and management of ICP and CPP data
14. Jugular venous bulb catheterization
15. Interpretation of Sjv02 and Pbt02 data
16. Management of external ventricular drains
I 7. Management of plasmapheresis and IVIG
18. Administration of intravenous and intraventricular thrombolysis
19. Interpretation of CT and MR standard neuroimaging and perfusion studies and biplane contrast neuraxial angiography
20. Perioperative and postoperative clinical evaluation of neurosurgical and interventional neuroradiology patients
21. Performance of lumbar puncture and interpretation of cerebrospinal fluid results
22. Induction and maintenance of therapeutic coma and hypothermia

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Cork training and practising Board publish “strategic plan for 2022-2026” | NCC Study Guide and test dumps

28 November 2021By Tom Collinstom@TheCork.ie

The Taoiseach Micheál Martin, T.D. referred to Cork schooling and practising Board – C ETB – have established themselves as “deeply rooted individuals of the neighborhood in Cork” and paid tribute to their “adaptability, resilience and dedication to supporting novices” as he launched their new strategy commentary for 2022-2026 and Learner showcase on Friday morning.

The method commentary outlines and defines the strategic path that Cork schooling and working towards Board will take over the subsequent 5 years and addresses 5 primary pillars of precedence, which encompass:

  • getting to know and instructing
  • crew and organisation
  • communicating and Connecting
  • aiding Equality, diversity and Inclusion
  • Infrastructure
  • The Taoiseach paid tribute to the interior Cork training and practicing Board crew and Board of directors, schools, schools, centres and capabilities for supporting novices during the pandemic.

    He delivered that commitments made in Cork training and practising Board’s old approach statement from 2017-2021 to enable for the provision of enhanced use of ICT to raise the accessibility of educational opportunities had proved “prescient” and become “a fine benefit” when faraway and blended getting to know was vital.

    Mr. Martin advised these current at the virtual launch that Cork education and practicing Board and its predecessors had contributed enormously through the years to “addressing the numerous challenges facing communities within the metropolis and county of Cork” – and added he become joyful to see an extensive session process in the back of the formation of the new strategic plan.

    He stated: “i'm heartened to know Cork ETB consulted largely when drawing up this strategy – you have got based yourselves as a deeply rooted member of the community in Cork and your dedication to session ensures that you will continue to be so.

    “Your imaginative and prescient of featuring a pathway for every learner suggests a clear imaginative and prescient that education and practicing have to have relevance to the individual learner and the world by which they reside,” he brought.

    “this is a vital, amazing piece of labor and i am looking forward to seeing the a hit beginning of the commitments contained inside it within the coming years,” the Taoiseach concluded.

    2026 imaginative and prescient: Pictured (l to r), for the launch of Cork schooling and working towards Board’s new approach observation for 2022-2026 and Learner exhibit, were Chief government, Denis Leamy and Director of provider guide and building, Suzanne Mullins. The 2nd of its form for the training entitiy, the method is part of an ongoing effort devised through a really considered system involving internal and exterior stakeholders, with the learner on the core during. photograph: Jim Coughlan.

    Chief government of Cork training and working towards Board, Denis Leamy additionally addressed those current on the digital launch and paid tribute to workforce and stakeholders.

    He pointed out: “right through the pandemic we've validated that they are an enterprise that is committed to supplying brilliant functions and one which is able to adapting and innovating: even in the most difficult of circumstances.

    we now have shown commitment and bravery and we've at all times positioned the needs of their beginners and their group of workers on the forefront of all their concerns. regardless of the entertaining calls for that the Covid pandemic has positioned on us, they now have persevered to be a leader in training, searching for out new alternatives for building and boom.”

    He introduced that Cork training and practicing Board became now “getting into a duration of appreciable trade” and that the method plan turned into devised through “a extremely considered procedure that involved interior and external stakeholders, guaranteeing all views had been taken into consideration.”

    Mr Leamy pointed out the new strategic plan would deliver Cork education and practising Board with the direction and impetus required to ensure that Cork education and training Board remained “a pivotal drive in the start of education services in Cork city and County.”

    He introduced: “The method includes 5 simple pillars. all over the lifetime of the plan, it's their intention to focal point on the construction and enhancement of these pillars. The tough work of implementing this method now starts off. Underlying all their strategic goals is a very true determination to make sure excellence in all that they do. whereas their Strategic Plan is ambitious, it's available.”

    Mr Leamy concluded: “large work is already taking place throughout numerous areas of Cork training and training Board on the course of the delivery of these desires and aims. This strategy is a method – a part of an ongoing effort by means of the employer as an entire. Working collectively, they can achieve it. i'm assured that this approach commentary is a useful step ahead within the future of Cork education and training Board.”

    For extra suggestions on Cork training and practising Board, its new approach commentary for 2022-2026 and Learner exhibit, see www.corketb.ie

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