Saturday, March 17, 2007

Final FRCA questions

Final FRCA, 28/06/05

Final FRCA Exam Questions:
(my friend had these questions for his exam).
Long case
36y male with neurofibromatosis presents with convulsions he also hadright sided homonymous hemianopia for last few weeks.
He is a smoker andalcoholic.
O/E consious, appropriate, no focal neurology other than the eye sight.PR 56/min BP 140/90mmHg.
ECG- Right axis deviation, Up slurring of ST in V4&V5.
CXR-RUL collapse consolidation and a well circumscribed mass in the midzone.
FBC Unremarkable except MCV89
BioChem Unremarkable except high
ALPCT posterior cranial fossa tumour looks malignant.
Nerosurgens want todo a craniotomy
Questions
1.Summarise
2. Planned/ Emergency
3.Differential diagnosis Lung mets/ Nerofibromatosis
4.what is the % of Nerofibromatosis becoming malignant
5.What is R/homonymous hemianopia6.Alcohol intake what is the recommendation
How much is a unit of alcohol
7.ECG description
8.CXR description
9.Why MCV high/ Causes of high MCV
10.Why ALP high in this Pt normal billirubin
11.What other investigation you need
12. Will you proceed with the case
13. Principal of neurosurgery
14.What is the position for this surgery


Short Cases

74yRuptured aortic aneurysm while in the ward
What will you do now?How do you resuscitate circulation?
What will you do?
How much blood will you requestHow much will you resuscitate?How do you proceed?
Where will you anaesthetise?Take me through the process?
What induction agent will you use?Difference between Ketamine and Etomidate?What monitoring will you use
Do you need arterial line to start the caseHow do you monitor clotting

What is the principal of thrombo elastogram
When do you expect problems
How do you treat intra operative hypertension

26y Thoraxoscopic
Sympathectomy for hyperhydrosis
What do you see in the CXR- Pneumothorax
What else do you see- Subcutaneous emphysema
How to detect pneumothorax on the tableWhat do you do immediatelyHow do you insert chest drainWhere do you insert
Do you apply suction

25yMytonica Dystrophica

What are featuresMode of inheritanceOnsetWhat are the problems for anaesthetists
What is the principal of anaesthetic managementWhat is pathology associated

Basic science viva
Physics
Define Laminar flow/ Turbulant flow
Hagen Poiseulle’s formulae
Factors affecting turbulent flow & howWhat is the relevance to anaesthetistReynaulds number
Variable orifice flow meterPrinciple and relevance

Anatomy
Nerve supply of the foot Femoral nerve root valueRelation ship of those nerve to the ankle Ankle block performanceMaximum dose CalculationComplication

Pharmacology

Benzodiazepine action how do they actGABA recetor MidazolamEffects/ Side effects Uses
Continuos infusion
Context sensitive half life define
Normal half life of midazolam

Physiology

Draw clotting cascadeWhat is the role of the plateletsWhat is the importance of tissue factor
Fibrinolytic system

My viva questions, Dec 06
long case
middle aged Downs man for cataract, very anxious, has ASD, loud P2, XRC with prominent pulmonary veins, ECG with RAd and Rt sided strain, patient SOB.
questions
1. summary
2.how would you proceed
3.how would cardiologist treat (diuretics)
4. how would you manage GA?

Short clinical scenarios
1. Failed needle toracocentesis for tention pneumothorax XRC
diagnosis, reasons for failure, what would you do next?

2. IVDU for operation- all routine questions from exam books
3. Prone position- all routine questions

Clinical science viva
1. Physiscs- everything about cautery
2. physiology/pharmac- ICT/ how different anaesthetic agents affect ICT?
3. Organ donation issues, neonates?



2 comments:

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