Primary FRCA SOE October 2008 - MEDICAL EDUCATION at ...

More documents

Recommendations

Info

University Hospitals Coventry & Warwickshire NHS trustClinical:30 yrs lady 34 weeks pregnant with long standing Foetal Bradycardia. She has refused anepidural and you are called to assess her for an Emergency section.Physics:Draw an arterial trace. What information can you derive from it.Whats the difference between swing in A-line trace in HF and Hypovolaemia.What are the ways in which Oxygen can be measured?Explain principal, components and working of a Oxygen Paramagnetic analyserAmbu bag. Components. Draw the of its valve. How do you test it for its working.Physiology:Define the modes in which heat is lost from the body.What causes the heat to be produced in the body.Thermoregulation in infants. Mechanism of heat production from Brown fat.Glucose metabolism. Pathways, ATP generation in each etc.What governs flow of fluids in capillaries.Starlings forces. Explain, draw diagram with values.Pharmacology:Classify IV induction agents.Tell me about Etomidate.Draw structures of- Thiopentone, Methohexitone, Propofol.Anti-HT in use in theaters.Tell me about Vasodialtors in use in theater.Nitrates : MOA, Indications, S/eMethods of drug administration.Oral route : governing principals, benefits, fall backsBioavailabilityOSCE:1> Epidural : for TKR – Level you will aim to achieve, Risks, Benefits, structures passedthrough by the epidural needle, show on patient : landmarks, corresponding spine level.2> Orbit : Identify and tell the structures passing through Optic canal & Superior orbitalfissure.Eyes blocks : Different types. Explain Retrobulbar block : Landmarks, Indications,Complications.3> ECG : SVT-Causes, treatment, indications for Cardioversion, anticoagulation.4> JVP : Show how you would measure it on a patient. Different waves and troughs,causes for the same. Causes for increased A and V waves (one cause for each), complications34
University Hospitals Coventry & Warwickshire NHS trustof central line.5> Resus: Pregnant lady with ? ectopic collapsed ----- Bradycardic6> Simulation: Failed intubation ---- Failed ventilation, method of needle cricothyrotomy.7> Anatomy: Rib. Relationship of neurovascular bundle and various muscle and nerverelations8> Communication: Postponed Inguinal Hernia Repair9> Hx taking with follow on questions: Wisdom teeth removal in a pt with PCT10> Hx taking: Asthmatic for Varicose vein surgery.11> CXR : MS with cardiomegaly12> CXR : Lateral CXR with lobar pneumonia13> Machine check: Just the machine, Rotameters, Vapouriser and the CO2 absorber14> H-electrode and Severinghaus electrode, components, label diagram. EtCO2 trace in –Rebreathing, Oseophageal intubation and COPDSet 20OSCE October 20081. SIM MAN – RSI, can’t open mouth after given sux (masseter spasm), can’t ventilate.Crico-thyroid puncture2. Resus – PEA in ectopic pregnancy woman.3. Resus – Talk through management of SVT. Straight forward questions about drugsused, energy levels, biphasic principle etc.4. CXR – mitral stenosis, pulmonary hypertension & related questions5. Lat CXR – Think it was right middle lope collapse. Not sure6. Machine check - no blanking plug/leak at vaporiser/o2 analyser not working./O2cylinder almost empty7. Anatomy – given a normal rib and first rib. Asked to explain structures crossing etc.Got it all wrong if couldn’t orientate rib ant-posteriorly. Asked to point out surfaceanatomy on actor of tracheal bifurcation, dermatome of T4, position of intercostalnerve block, rib relations of the spleen.8. Anatomy – skull. Asked to identify cribriform plate, optic foramen, superior orbitalfissure – structures passing through? What is the somatosensory supply of eyeball.What is length of socket. What structures are damaged in frontal fracture, how do youclassify, what are the signs? Demonstrate a peribulbar nerve block.9. Equipment – Tracheal intubation – 3 clinical signs of correct placement, 3 pieces ofequipment to confirm. Identify capnograph trace of Bain and Circle when 1 stconnected. Talk through management of grade 3 view.10. Equipment – Shown 2 electrode pictures – which is the pH system. Questions onelectrodes used, electrolyte, what else can be measured, what is the principle.11. Equipment – Pulse oximeter, O2 dissocation curve. Identify myoglobin curve. What isthe isobestic point, what parameter does it represent. What wavelengths are used.12. History – asthmatic, straight forward13. History follow-on – Dental extraction with history of porphyria cutanea tarda. Marksfor knowing which systems affected, enzyme abnormality involved, who wascollecting him from hospital.14. Communication – angry patient, operation cancelled due to another emergency caseslotted in.15. Examination – JVP on an actor. Questions on trace and abnormalities – causes ofraised JVP, large and absent a waves, large v waves.35
Page 1 and 2: University Hospitals Coventry & War
Page 33: University Hospitals Coventry & War

Primary FRCA SOE October 2008 - MEDICAL EDUCATION at ...

Create successful ePaper yourself

Delete template?

Save as template?