Exam Intelligence

This is the final day of Final FRCA vivas, and EI hopes
many people have passed the exam. For those of you who
have yet to sit the exam this coming Autumn, all the best
of luck.

The last question we can tell you about, as intelligence
received has run thin in the last 24 hours, was a
pharmacology question which came up about the use of
NSAIDs, including the pathway and enzymes they act on and
the implications of their use and the controversy of COX-2
selective inhibitors and why increased cardiovascular
deaths occurred.

EI is going to take a (quite frankly well deserved) break
for a few days, before starting to home in on further
tips, tricks and techniques for studying, learning,
remembering and most importantly passing the Final
Examination.

Please keep visiting, as there is something new on the
horizon which is going to be developed behind the scenes,
and will initially be released in bits and pieces before
coming together in one fell swoop.

Congratulations to all those who passed, and our
comiserations for those of you that didn’t. Stick with EI
and we will try to bring you information to maximise your
chances of success.

EI has heard about some more exam questions that have come up in the vivas this week, so here we go:

-Describe the pathophysiology of ARDS
-Describe your management of a patient with ARDS
-How do you optimise PEEP?
-How do you optimise PEEP if you don’t have fancy ventilators(!)?

-Draw a saggital section of the eye.
-Describe the anatomy.
-Mark the insertion of the conjunctiva into the sclera.
-Why is the anatomy of the eye important to anaesthetists?

A physics/measurement question on CPX and examining a CPX test result came up.

Future Sounds…
Keep an eye on this blog for some well researched answers to the questions that have come up in this last Final FRCA Exam.
Also, as the next sitting approaches, EI will bring together more resources, and simplified explanations of topics that might come up. Hopefully we can help others achieve the same success we have, by sharing some of our revision tips and tricks, and some of the cunning ploys we adopted.
We welcome any suggestions and questions, please feel free to comment or contact EI on the email link in the right-hand column.

If you have a topic you struggle with, ask us, and we will try to help.

If you are still waiting to take your viva tomorrow: GOOD LUCK!

Firstly, E.I. hears that the questions today included THAT
kyphoscoliotic lady for cholecystectomy, a head injured
child with fractured tib and fib, a question about
categorisation of Emergency LSCS, and a question about
heart blocks. More detailed information than that has not
really yet come this way.

Secondly, for those doing the Final FRCA in the
future….the grapevine has told us that The Clinical
Anaesthesia Viva book is going to reach us in a second
incarnation sometime soon, so keep your eyes peeled for
that one….

If you have any information you want to share, please pass
it on to examintelligence”AT”googlemail.com .

Good luck to anyone still awaiting their viva!

I was never any good at anatomy when I was at medical
school, though I learned and remembered enough of it to
pass the exams. When I actually started working, that’s
when I learned clinically relevant anatomy to what I was
doing, and much more in depth at the same time.
For example as an orthopaedic SHO it’s quite useful to
know the anatomy of the rotator cuff, which tendons and
nerves are likely to be severed if someone flies with arm
outstretched through a sheet of plate glass, and which
ones you can use to replace Tendo Achilles if necessary.
As an anaesthetist there are certain areas which one
needs to pay attention to as well. Actually, seeing as we
are (as someone put it on a forum recently), the “last
true generalists” we probably need to know most anatomy,
but that’s beside the point for the purposes of this blog.

The areas of particular interest are cranial nerves,
sympathetic and parasympathetic nervous system, triangles
of the neck, epidural and spinal anatomy, paravertebral,
costal/intercostal/diaphragmatic anatomy, anatomy of the
airway including lungs, femoral triangle, cervical, lumbar
and sacral nerve plexi (or should that be plexuses?),
anywhere where a nerve runs that we can stick a needle,
and of course vascular anatomy…

Erm…quite a lot then.

Quite frankly I personally can’t be bothered to go back to
the anatomy books to start from scratch about learning all
this stuff, but we have discovered a former urology
surgeon who now teaches anatomy at Cambridge has
co-authored a book which some of you may have seen at
college. Instant anatomy is a fantastic little book, full of simple
diagrams and lists. Even better than this, though, is the
website, which is cheaper (read free), but also provides
the opportunity to buy a CD-ROM, a snip at £17.99. Full of diagrams, podcasts
and PowerPoint presentations, we’ve found it an invaluable
aid in our…revision (ahem). Simply pop it in your
computer, get out your popcorn/pizza/wild boar and venison
sausages and chianti/Tamatar Dal (that’s Dal with
tomatoes, apparently best done with Urad Dal, which I
haven’t tried) and salad, click, sit back and relax as you
absorb the information in your own personal lecture.

PS: Sadly I get no commission for encouraging anyone to
buy it, but it really is a good CD…

Well, I think that anyone doing Final FRCA ought to be looking out for at least some of the following:

Questions on anaesthesia and obesity (New AAGBI guidelines)

Local Anaesthetic Toxicity (New AAGBI guideline incorporating Intralipid (Lipidrescue))

CEMACH (new report at the end of last year) - something always comes up the following exam

Intrapartum analgesia (NICE guideline in 2007 and two articles to do with epidurals in CEACCP in last 12 months)

Malignant Hyperthermia (revised AAGBI guideline and another perennial favourite)

Thyroid surgery (CEACCP article in April 2007, perennial favourite and something about it in every SAQ book I’ve got)

Coagulation questions (At least two articles in CEACCP over the last 12 months, it’s another topic open for discussion, and there’s the whole “cell-based model” to consider. Maybe something on Novo7, and also Fondaparinux/ways of preventing DVT/VTE)

So there’s some things that I think MIGHT come up.