Primary FRCA OSCE January 2012

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Primary FRCA OSCE-SOE exam January 201210) CXR: Again, I’m not sure what this was.11) Resus: Discussion regarding management of asystole (after being shown an ECGtrace)12) A picture of electrical connections to a patient. I really didn’t understand thepicture or the questions. One was something to do with whether the earthpotentials for the different pieces of equipment were equal. They weren’t. What isthe difference between them? What size current causes microshock. Pick 2electrical symbols and explain what they are (there were about 20 to choose from,including BF and CF equipment,13) Anatomy: Diaphragm: Lots of different things labled on a diaphragm (If I recallcorrectly it is the same picture of a diaphragm that is on Wikipedia. Unfortunatelythat was all I could recall here!) Inervation of diaphragm. Other muscles involvedin inspiration and active expiration.14) Anatomy: Spinal cross section and also lables pointing to galgia and nerves fromit. What happens in various spinal syndromes.15) Mono-auricular stethoscope- what is it? What group of patients is it used for?What resp and cardio complications can it detect? What is the characteristicmurmur of air embolism?OSCE SET 181. Interactive Resuscitation – Lady for Cat 2 LSCS, after epidural top-up,bradycardic & then asystole.2. Anatomy 1 – Basal skull (with details on trigeminal origin, facial nervedistribution).3. Communication – Lady for appendicectomy, on Methadone for previous Heroinaddiction, worried of relapse.4. Anaesthetic Hazards – Electrical safety in theatres.5. Physical Exam – CVS.6. Monitoring Equipment – Capnography.7. History 1 – Lady with RA for hand surgery.8. Resuscitation Skills – Tachycardia (AF) scenario. Talking through the algorithm& management.9. X-Ray 1 – CXR with ?enlarged thyroid/thymus.10. X-Ray 2 – CXR with ?bilateral hilar mass.11. Simulation – Tension pneumothorax (SinMan).12. Technical Skills 2 – Intraosseous on a child (indication, how to perform,contraindications, paeds fluids management).13. Measuring Equipment – O2 analyser (diagrams).14. History 2 – Laparotomy with recent 2x GI bleed.15. Anatomy 2 – Spinal Cord (very similar to the RCOA guidebook).16. Anaesthetic Equipment – Epidural Pack (what to look for at the pack which hasbeen tampered & how to prepare the epidural set before insertion).17. Technical Skills 1 – Difficult airway management during RSI (this was the teststation).Coventry collection: Many thanks to the candidates from January 2012 14Course
Primary FRCA OSCE-SOE exam January 2012OSCE set 19History - 20 yr old for tonsillectomy with IDDMHistory - 65 yr old for TURP with HTNExamination - peripheral pulses & check BPAnatomy - anatomy of the lungAnatomy - foetal circulation.Resuscitation - explain treatment of PEARadiology - lateral CXR with mid lobe collapseRadiology - AXR with kidney stonesSimulation - RSI then can't open the mouth, can't ventilate. Do needlecricothyroidotomy.Clinical - change trachy tube and questions about types of trachy tubes.Equipment - humidification equipmentCommunication - explain to mum about child having sux apnoea.Clinical - interscalene block.Simulation - obstetric arrest due to LA toxicity.Equipment - check a Bain circuitOSCE set 20OSCE:- interscaline brachial plexus block; anatomy, how to do it, risks, other nerves blockedin the process- resus station: Pregnant lady given a total spinal causing pea arrest- arterial line set up to inspect and deliberate mistakes to spot (inc air in the line,wrong fluid choice and out of date fluid!)- Resus station questions: on pea, causes, treatment- CICV simman leading to needle cricothyroidotomy- CXR lateral view of R middle lobe LRTI- AXR of large renal calculi and ask about drugs they tell you she is on (anti TB),?cause of the calculi- hygrometers to identify by pictures- 2 Histories; one young tonsillectomy (IDDM and OSA to ask about) and one elderlypt for TURP (brochiectasis and loose caps)- examine peripheral pulses and you have to use a manual sphygmomanometer- discussion with mum about sux apnoea in her son- Tracy tube change and types of Tracy tube- hilar anatomy from a lateral view- Check a baines circuit and questions on volume of gas held in outer tube, why is thisso and what happens if there is a hole in the bagOSCE set 21Sim - Anaphylaxis under GASim - Ruptured ectopic pregnancy PEA arrestRadiology: CXR w PPM and stermotomy wiresCT head:extradural haemorrhage and skull fracturesEpidural: technique and equipment usedHistory: young woman with thalassaemia and TBComm skills: Jehovahs witness for hysterectomyCoventry collection: Many thanks to the candidates from January 2012Course15
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