I am very sorry I haven't been able to put more detail up
more quickly, but I'm afraid it was a dive straight back
into work. Also, it appears the del.icio.us link is not
working.
I will try to sort that later on.
Just to cover the further questions…
The remaining question in the morning was about epidural
abscess:
-Why do people get them? Predisposing factors?
Looking for usual: cleaning, asepsis, repeated attempts,
duration of catheter in situ, diabetes, pre-existing
infection
-How do you recognise it?
Signs and symptoms.
-How do you diagnose it?
-Investigations?
Make sure you get in that it is an emergency.
In the afternoon: "Here comes the science bit…"
-What is the anatomy of the pleura?
-What is the clinical significance to the anaesthetist?
-What is its function?
-What are the problems associated with eg.
pleurodesis/pleuradhesis (pick your spelling!)?
-What can accumulate in the pleura?
-How do we manage that?
-How would you manage a man with a small pneumothorax
before surgery who requires a GA? (What about RA?)
-Tell me a bit about work of breathing.
Then, next up:
-What are the functions of the placenta?
-Tell me abot diffusion. (What are the principle factors
influencing it?)
-What drugs cross the placenta?
-How?
-What other mechanisms of things crossing the placenta do
you know?
-What drugs cross by facilitated diffusion?
-Tell me about local anaesthetics and the placenta.
-What about neuromuscular blockers?
-What hormones does it produce? (Stumbled a bit over
saying beta-human chorionic
gondaotrophin/gonadotropin…!)
-What are their functions?
-Tell me about oxygen crossing the placenta. (Me: "Ah,
we're talking about the difference between fetal and
maternal/adult haemoglobin now, aren't we…so the thing
here is…." - made the examiner smile!)
Then switched examiners and had standard latex allergy
question, as per Bricker, pretty much, with a little
sideline into types of adverse drug reaction, type 1,2,3,4
allergic reactions and management of anaphylaxis, and
finally onto delivery of oxygen/medical gases to the
operating theatre. For this, make sure you know about
VIE, how it works, where it's located, why, and about N2O
cylinder manifolds and any special considerations to do
with temperature.
Reports from other sources tell me that a question
involving a certain kyphoscoliotic lady for
cholecystectomy (though elective this time) has appeared,
and also questions on management of a child with fractured
tib/fib and head injury (short case)….
Watch this space for developments.
NB: IF YOU ARE TAKING THE FINAL IN THE FUTURE, WATCH THIS
BLOG FOR MORE EXAM INTELLIGENCE RELATED ARTICLES!
