Primary FRCA exam January 2010

Primary FRCA exam January 2010repeated, doses of intralipid, need for section). All straightforward - other candidates said thatexaminer didn't hide his disappointment well when they didn't know the dose of intralipid,apparnetly asked one if he'd every administered local anaesthetics!)6 Hazards - electrical safety showing very confusing diagram of patient connected to CVPline and ECG monitoring, types of earth, differences in earth potentials. Really hard to followwhat was wanted. Finished with a grid of about 20 symbols and asked to pick two and namethem.7 Equpiment - capnography - information provided, what happens at each stage in acapnograph trace, causes of abnormal traces8 Critical incident - managing a narrow complex tachycardia, doses of adenosine, action ifadenosine fails, energy used for cardioversion, doses of adrenaline,9 History taking - patient for interval lap chole.10 Resus - recently inserted trache falls out on AICU, nurse bagging without O2. difficult tobag, better with two person technique, sats not improving markedly, reinsertion fails, unableto intubate from top. Options now.11 Radiology - Child sudden breathless at birthday paty. X ray shows almost completewhiteout on left with mediastinal shift to left (i.e. collapse). Straightforward questions thetheme being is it aspiration or foreign body and collapse12 Difficult intubation - identify this laryngoscopic grade, techniques to improve it, clinicaland objective signs of oesophageal vs tracheal intubation. Identify 3 capnograph traces fromchoice of 4 - oseophageal intubation, tracheal intubation in a Bain and in a circle.Set 12SOE Pharmacology and physiologyPharmacology1. Antibiotics; Fluclocaxillin and other penicillins difference and indications for use, movedonto gentamicin with reference to indications for use and therapeutic index and finished upwith antibiotic resistance and penicillinsReceptors- classification and types and moved on to g protein coupled receptorsLocal anaesthetics- what affects speed of onset of local anaesthetics pka, lipid solubility andprotein binding, moved onto pKa of lignocaine, bupivicaine and toxicity and treatment andIVRa and why prilocaine is used.PhysiologyShunt and V/q mismatch and V/q ratio of upper lung to lower lung west zones and howanaesthesia affects V/QComponents of blood and the pH of blood, HB WCC platelets - speaking to other candidatesthey moved on to buffers which I did not17