Primary FRCA OSCE January 2012

Primary FRCA OSCE-SOE exam January 20122. Resus station – a pregnant lady has just had an epidural sited prior to C-section, andhas arrested. PEA on monitor – start CPR, lateral tilt, paramedic available to help you,deliver baby. Then questions on 2 most likely causes (spinal block, intravascularinjection) and intralipid dosing.3. Questions on the lung hilum – name the labeled structures (bronchus, pulmonaryarteries and veins, groove for aorta).4. Electricity questions – currents required to cause VF in microshock, what would1mA feel like, name any 2 symbols on this page of about 20 symbols (they were allcompletely obscure – I have no idea where they find them)5. Communication station – suxamethonium apnoea, explain to the mother of thechild what had happened.6. Humidity – what is absolute and relative humidity? Which of these diagrams showsa Wet and Dry bulb hygrometer – how does it work? Which of these diagrams showsa Regnault’s hygrometer, which shows a hair hygrometer? Would gas at 50% relativehumidity have higher absolute humidity at 30 or 37°C?7. Examination of the arterial and venous systems (not cardiovascular), includingtaking a manual blood pressure using a sphygmomanometer.8. History station – rambling old man, wouldn’t let you get a word in. Had to keepcutting him off to keep the history going – ask an open question at your peril. HadCOPD, crowns, didn’t want a spinal as his daughter had a bad experience.9. Check a Bain circuit - perforated outer tube. Followed by questions on the Baincircuit (flows for spontaneously and manually ventilated patients, volume of the outertube, what would happen if the bag was disconnected)10. X ray station – lateral chest XR showing a middle lobe pneumonia11. X ray station – abdominal XR (which seemed to be normal) and questions on aclinical scenario.12. Difficult airway station – following DAS guidelines for an RSI, including needlecricothyrotomy13. Describe and demonstrate the steps in changing a tracheostomy tube on a ICUpatient.14. History station – 20 yr old man for tonsillectomy, who also had type 1 diabetes.Seemed to be a straight forward anaesthetic history (DM history and control, tonsilscaused snoring, no recent tonsillitis, patient had crowns).15. Diagram of lung fissures – name the horizontal fissure, the oblique fissure, what isthe surface anatomy?16. A diagram of the foetal circulation – name the umbilical veins, arteries, foramenovale, ductus arterious. What is the Hb saturation in the umbilical veins and arteries?What does the DA become in the adult? What causes the FO and DA to close at birth?Coventry collection: Many thanks to the candidates from January 2012 17Course