Structured oral examination practice for the final FRCA PDF
Preview Structured oral examination practice for the final FRCA
OXFORD SPECIALTY TRAINING Structured Oral Examination Practice for the Final FRCA This page intentionally left blank OXFORD SPECIALTY TRAINING Structured Oral Examination Practice for the Final FRCA EDITED BY Rakesh Tandon Consultant Anaesthetist, Addenbrooke’s Hospital, Cambridge University Hospitals, Cambridge, UK 1 1 Great Clarendon Street, Oxford OX2 6DP Oxford University Press is a department of the University of Oxford. It furthers the University’s objective of excellence in research, scholarship, and education by publishing worldwide in Oxford New York Auckland Cape Town Dar es Salaam Hong Kong Karachi Kuala Lumpur Madrid Melbourne Mexico City Nairobi New Delhi Shanghai Taipei Toronto With offi ces in Argentina Austria Brazil Chile Czech Republic France Greece Guatemala Hungary Italy Japan Poland Portugal Singapore South Korea Switzerland Thailand Turkey Ukraine Vietnam Oxford is a registered trade mark of Oxford University Press in the UK and in certain other countries Published in the United States by Oxford University Press Inc., New York © Oxford University Press, 2012 The moral rights of the author have been asserted Database right Oxford University Press (maker) First published 2012 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, without the prior permission in writing of Oxford University Press, or as expressly permitted by law, or under terms agreed with the appropriate reprographics rights organization. Enquiries concerning reproduction outside the scope of the above should be sent to the Rights Department, Oxford University Press, at the address above You must not circulate this book in any other binding or cover and you must impose the same condition on any acquirer British Library Cataloguing in Publication Data Data available Library of Congress Cataloging in Publication Data Data available Typeset in GillSans by Cenveo, Bangalore, India Printed in Great Britain on acid-free paper by CPI Group (UK) Ltd, Croydon, CR0 4YY ISBN 978–0–19–958401–7 10 9 8 7 6 5 4 3 2 1 Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always check the product information and clinical procedures with the most up-to-date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. The authors and publishers do not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work. Except where otherwise stated, drug dosages and recommendations are for the non-pregnant adult who is not breastfeeding. Contents List of abbreviations ix List of contributors xiii Introduction xv Chapter 1 1 Clinical anaesthesia 3 Long case: A case for craniotomy 3 Short cases 8 Questions 8 Answers 9 Clinical science 19 Questions 19 Answers 20 Chapter 2 29 Clinical anaesthesia 31 Long case: A case for total thyroidectomy 31 Short cases 35 Questions 35 Answers 37 Clinical science 41 Questions 41 Answers 42 Chapter 3 47 Clinical anaesthesia 49 Long case: A case for elective colectomy 49 Short cases 54 Questions 54 Answers 56 Clinical science 60 Questions 60 Answers 61 Chapter 4 67 Clinical anaesthesia 69 Long case: A patient with carcinoma of the sigmoid colon 69 Short cases 73 v Contents Questions 73 Answers 75 Clinical science 80 Questions 80 Answers 81 Chapter 5 87 Clinical anaesthesia 89 Long case: A patient for total hip replacement 89 Short cases 95 Questions 95 Answers 97 Clinical science 103 Questions 103 Answers 104 Chapter 6 111 Clinical anaesthesia 113 Long case: A patient with spinal stenosis 113 Short cases 119 Questions 119 Answers 121 Clinical science 126 Questions 126 Answers 127 Chapter 7 135 Clinical anaesthesia 137 Long case: A case of hiatus hernia 137 Short cases 142 Questions 142 Answers 144 Clinical science 150 Questions 150 Answers 151 Chapter 8 161 Clinical anaesthesia 163 Long case: A young boy with Guillain–Barré syndrome 163 Short cases 168 Questions 168 Answers 169 vi Contents Clinical science 176 Questions 176 Answers 177 Chapter 9 185 Clinical anaesthesia 187 Long case: A patient for elective open AAA repair 187 Short cases 192 Questions 192 Answers 193 Clinical science 200 Questions 200 Answers 201 Chapter 10 211 Clinical anaesthesia 213 Long case: A patient in Accident and Emergency 213 Short cases 219 Questions 219 Answers 220 Clinical science 225 Questions 225 Answers 226 Chapter 11 233 Clinical anaesthesia 235 Long case: A patient with multiple medical issues 235 Short cases 240 Questions 240 Answers 241 Clinical science 245 Questions 245 Answers 246 Chapter 12 253 Clinical anaesthesia 255 Long case: A patient for dental clearance as day-case procedure 255 Short cases 261 Questions 261 Answers 263 vii Contents Clinical science 269 Questions 269 Answers 270 Chapter 13 279 Clinical anaesthesia 281 Long case: A patient for major cancer surgery 281 Short cases 287 Questions 287 Answers 288 Clinical science 295 Questions 295 Answers 296 Chapter 14 305 Clinical anaesthesia 307 Long case: A patient with epilepsy on emergency operating list 307 Short cases 313 Questions 313 Answers 314 Clinical science 319 Questions 319 Answers 320 Chapter 15 327 A child with upper respiratory tract infection 329 Anaesthetic management of a patient with severe sepsis 331 Smoking and drinking alcohol and anaesthesia 334 Fast tracking in anaesthesia 336 What is ziconotide? 337 What is dabigatran? 338 What is sugammadex? 339 Applications of transdermal drug delivery 340 Role of cell salvage in anaesthesia 342 Sedation in children and young people: current recommendations 344 Failed spinal anaesthesia: mechanisms, management, and prevention 347 Ultrasound-guided or peripheral nerve stimulation for peripheral nerve blocks 349 Rapid sequence induction and intubation: current controversy 351 The current fi ndings of The Centre for Maternal and Child Enquiries (CMACE) 354 viii List of abbreviations A&E accident and emergency AAA abdominal aortic aneurysm AAGBI Association of Anaesthetists of Great Britain & Ireland ABC airway, breathing, circulation ABCDE airway, breathing, circulation, disability, exposure ABG arterial blood gas ACE angiotensin-converting enzyme ACh acetylcholine ACTH adrenocorticotropic hormone AF atrial fi brillation AL axial length ALI acute lung injury ALP alkaline phosphatase APH antepartum haemorrhage aPTT activated partial thromboplastin time ARDS acute respiratory distress syndrome ARF acute renal failure ASA American Society of Anesthesiologists ATP adenosine triphosphate AVB atrioventricular conduction block AVPU alert, voice, pain, unresponsive (scale) AVPU atrioventricular BAL bronchoalveolar lavage BP blood pressure BTS British Thoracic Society cAMP cyclic adenosine monophosphate CBF cerebral blood fl ow CHB complete heart block CMACE Centre for Maternal and Child Enquiries CMRO cerebral metabolic requirement of O 2 2 CN cranial nerve CNS central nervous system CO carbon monoxide CO carbon dioxide 2 COHb carboxyhaemoglobin COPD chronic obstructive pulmonary disease CPAP continuous positive airway pressure CPP cerebral perfusion pressure CPR cardiopulmonary resuscitation CRP C-reactive protein CSA central sleep apnoea CSF cerebrospinal fl uid CT computed tomography CVP central venous pressure CVS cardiovascular system ix
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