Primary FRCA OSCE-SOE exam January 2012 Coventry collection ...

Primary FRCA OSCE-SOE exam January 2012
Post op – on extubation, she developed laryngospasm; how would I manage this, how
would I diagnose laryngospasm, who is more prone to it and what are the causes.
Physics
Humidity – why is it important in anaesthetics – prevent drying of gases, prevent heat
loss, prevent static build up. Define absolute and relative humidity. How can you
measure humidity – explain how they work.
Pressure reducing valves – where are they found on an anaesthetic machine –
cylinder to machine, Ritchie whistle. How they work – (the diagram was in front of
you so you didn’t have to draw it) but an in depth explanation was needed.
Force/energy – What is force? What is it measured in? Relationship to other derived
SI units (I think they were getting onto force, pressure, area relationship). What is
energy, different types of energy (electrical, mechanical (potential, kinetic), thermal).
Explain about these and how you can change one form into another. Transducers
were mentioned then I was asked how does a generator or a motor work – I think they
were trying to get me to explain a bit more about how it can change one form of
energy into another.
SOE set 2
Pharmacology viva
- Differences between Fentanyl and Alfentanil; lipid solubility, pKa, Ionisation,
dose/potency hence concentration gradient, volume of distribution and clearance
Gastric acid secretion; drugs that work on that, PPIs, H2 antagonists, Antimuscarinics,
moved on to antiemetics, prokinetics
- Population variability in drug metabolism: I started off by talking about where drugs
are metabolised (liver, kidneys, lung, plasma, gut) and pharmacokinetics. I said that
what the body does to the drug (pharmacokinetics) can be split into Absorbtion,
Distribution, Metabolism, Excretion and then went on to discuss each factor
mentioning the following: genetic variability (Ea:Ea Dibucaine, acetylation, phase 1
and phase 2 metabolism), lifestyle factors such as smoking and alcohol, physiological
factors such as old age, neonates, pregnancy and pathological factors such as sepsis,
renal failure, coealiacs, ileus, liver failure.
Physiology
- Oxygen- Hb dissociation curve; p50, what makes it go left and right, what is 2-
3DPG, why is it sigmoid, Bohr shift, Haldane effect, Hamburger effect
-How is CO2 stored in the body? Bicarb, carbamino compounds, dissolved
- Left ventricular pressure trace and draw the aortic pressure trace. How does the
aortic pressure trace change with aortic stenosis? how can you work out the mean
arterial pressure from the trace?
Coventry collection: Many thanks to the candidates from January 2012
Course
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