MCAI OSCE & SOE Nov 2018
Physiology
1. What is anaemia? Normal Hb range. What is haemoglobin. How does haemoglobin bind O2. How anaemia affects ODC and oxygen content.
2. Cardiac output. Frank starling law, stroke volume. How to measure CO - thermodilution and Ficks principle. What changes happen in 1L blood loss intra op.
3. Pain pathways. What happen when you cut your finger. How analgesic drugs act on the pathway.
4. Fetal vs maternal haemoglobin. Double Bohr and Haldane effect. What is the difference between fetal and adult liver.
5. EEG waveforms and indications for BIS?
Pharmacology
1. Local anaesthetics
- esters vs amides.
-lignocaine vs bupivacaine
- how isomerism affects side effects and potency of LA.
-management of LA toxicity. ABC + intralipid dose
2. Pharmacokinetics
- Volume of distribution, clearance, CSHT.
-Determining factors of the above with examples.
3. Antiemetics
-Receptors involved and where located.
-Factors determining whether you would give antiemetic for pt undergoing surgery.
-Examples of drugs, mode of action, side effects of maxolon and ondansetron.
4. Diuretics
-Mode of action and side effects of every drug acting on the nephron.
5. Physics - CO2 measurement. Why measure EtCo2. Infrared wavelength. Mainstream vs sidestream.
OSCE
1. Counsel pt for ankle block. Pt ask can she drive home postop.
2. Peripheral nerve stimulator - uses, definition of single twitch, PTC.
3. CXR - left pleural effusion. Causes and further investigations.
4. MRI - how it works, indications, problems, magnetic field 1 tesla means what?
5. Communication - postdural puncture headache after LSCS
6. ACLS - CPR post cardiac arrest
7. ECG - p pulmonale, right axis deviation, t inversion lateral leads - diagnosis? What anticipated problems if undergoing major op.
8. Laparoscopic surgery - pros and cons. What can happen in trendelenburg and reverse trendelenburg?
9. Critical incident - Anaphylaxis
10. Interpret various capnography waveforms - spinal surgery pt in prone position.
11. Difficult airway in fetal brady pt. What is nerve supply of larynx? Contraindications of FONA.
12. Ultrasound (define wavelength, amplitude, frequency, period). Identify type of probe, what is piezoelectric??
13. Larynx anatomy - steps how to do FONA
14. Examination of the eye