Primary FRCA OSCE January 2012

Primary FRCA OSCE-SOE exam January 2012CXR: coarct aorta (i think, by the q's asked, but have to admit the rib notching wasnot entirely obvious to me)CXR: mitral regurg, cardiomegaly etctension pneumothorax recognition and managementexamine resp system and inerpret spirometrymonaural stehtoscopeelec safety q with diagram which i just didn't understand.check equipment for rsiOSCE set 91. DAS guidelines on failed intubation. Shown a picture of Gd 3 Cormack & Lehane– how can I improve view, what equipment I want. Then moved through steps forfailed intubation in RSI2. Resuscitation – pregnant lady epidural top up for cat 1 delivery – PEA,management of arrest – if you gave adrenaline as soon as you noticed it was aPEA, the following cycle she has a pulse (if you didn’t give adrenaline, thescenario went on until you did)3. Anatomy – trigeminal and facial nerves. Which foramen the ophth & mandibularbranches emerge from. What they supply. Facial nerve, what it supplies and howyou test.4. Communication – pt for appendicectomy on methadone – worried about painespecially about relapse if has morphine5. Electrical safety – shown a diagram of equipment with different earthconnections, asked how microshock is prevented in this diagram, what are thepotential differences of the earth wires. Shown a sheet of about 15-20 symbols,pick 2 and state what they mean (most of them were not ones I have seenanywhere)! – Hoping this was a test station – everyone found it ridiculously hard!6. History – pt with RA, on steroids and methotrexate, PONV, poor exercisetolerance – likely due to fibrosis.7. Examination – CVS. Radial, neck and precordium only. Explain your methodsand what else you would do.8. How you would treat pt in AF – both if shocked and not shocked9. CXR – pt for removal thyroid nodule. CXR had tracheal deviation and stenosis –is tracheomalacia likely, should you induce with cannula in a foot, is thoracotomyroutine, should calcium be checked for following 2 weeks.10. CXR – asthmatic pt, RR 33. Classical batwing appearance on CXR andmanagement of pt was asked.11. SIM man – asthmatic – high PAW, ended up with pneumothorax, had todecompress and explain how you would insert ICD12. IO needle and child – indications, contraindications, show how you insert, how toestimate weight of child, bolus dose, circulating volume of blood13. History – pt for Ca colon to be removed. Extensive cardiac history – MI, AF onwarfarin, angina, HTN. GI bleed recently. Previous Gas OK, ex smoker14. Oxygen analysers – shown diagram of 3 with labels missing – which ispolarographic – name all labelled parts, which equation shows reaction at thecathode. Which were the other 2 diagrams showing (fuel cell and paramagnetic)15. CO2 analysis – capnography, what it tells you. Differences between arterial andETCO2. Shown a capnograph trace – explain what is happening at each place;Coventry collection: Many thanks to the candidates from January 2012 8Course