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Primary FRCA OSCE January 2012

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<strong>Primary</strong> <strong>FRCA</strong> <strong>OSCE</strong>-SOE exam <strong>January</strong> <strong>2012</strong>times. Asked dose of adrenaline. Asked to demonstrate intubation when I said I wouldintubate (Grade 1 no worries). Differentials (total spinal, AFE, etc). What if continuedresus unsuccessful (C-section within 5 minutes). How to treat total spinal (I saidsupportive treatment etc, but she kept asking for more, not sure what else she wasexpecting). What symptoms/signs of high spinal.10. Cranial nerves. Trigeminal nerve - how many nuclei, where are they situated.What branches. Where does V1, V2, V3 exit and point on skull. What do theyinnervate. What about motor component of V3. How do you test facial nerve. Whatelse does facial nerve innervate (I said taste for ant 2/3 tongue, chorda tympani, but hewanted more). Which nerve innervates posterior 1/3 of tongue (IX).11. History taking. Lady due for some hand surgery. Bad arthritis affecting lung,kidneys. On Methotrexate & Prednisolone. Lots to ask re. various systems affected.12. Electrical safety. Shown diagram of patient on operating table which was earthed.Connected to ECG, which was earthed. Also connected to ?arterial line which wasearthed. Asked re. microshock, and various questions about earth and equipotentialstuff which I had no idea about. Then shown a bunch of pictures of various electricalsymbols. Pick 2 and tell me what they represent. Bad station, most candidates I spoketo had no idea what was going on.13. Capnography. Shown picture of capnograph, what 3 parameters can be derivedfrom this (etCO2, fiCO2, rate). Principle of capnography. What do different phasesrepresent. What if there's upward slope of plateau. Name 3 critical incidents that acapnograph can show.14. Communication skills. Ex-IVDU for appendicectomy. On methadone, concernedre. pain relief and relapse if given morphine. Very short station, gave a lot ofreassurance and found had a lot of time left. I went into history etc. to kill time, wasstopped by examiner who said it was not necessary.15. Shown ECG of fast AF (looked regular but only after drawing those lines onblank piece of paper found that it was not). Name one investigation that will help youdetermine cause. What energy levels and how many shocks will you deliver forDCCV. Contraindications for DCCV. Name drugs to slow rate. How is amiodaronegiven. How else will you manage this patient if he was stable but not responding tochemical cardioversion.16. Questions re. difficult airway. Shown diagram of Grade 3 laryngoscopy - what isit (wanted Grade 3 Cormack-Lehane). What would you do now. Still can't intubate,next step. Now can't ventilate, LMA. Can't ventilate via LMA. Describe differenttechniques of crico (needle vs surgical). Jet ventilator, how do you use it.<strong>OSCE</strong> set 31) Simulation Station: CT1 just intubated young male with life-threatening acuteasthma, so far given nebulised salbutamol & iv steroids. You as SpR called by CT1for help as pt starts desaturating, tachycardic. DD: tension pneumothorax. Asked toactually do needle thoracocentesis on SimMan, then describe chest drain insertion.Coventry collection: Many thanks to the candidates from <strong>January</strong> <strong>2012</strong>Course3

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