Today is the closing date for applications.
If you have left it this late and you have equipment problems be creative. Take a photo of your application and email it to Moira Besterwitch. Mail it by registered post! Find a way of time/date stamping that application even if it doesn’t actually get to ANZCA house until next week.
Outline the clinical laboratory assessment of liver function
Many of our drugs are metabolised by the liver, and many of our procedures rely on normal coagulation status.
An elevation in AST is related to zone 1 damage TRUE/FALSE
Hypoalbuminaemia is seen within 48 hours of a hepatic insult TRUE/FALSE
There will be hyperglycaemia in severe hepatic insufficiency TRUE/FALSE
Urea will be low in severe hepatic insufficiency TRUE/FALSE
Biliary obstruction can cause a high INR TRUE/FALSE
Outline the physiological effects of the adrenal hormones aldosterone and cortisol. (Do NOT describe synthesis or metabolism).
Sometimes we administer steroids… Sometimes we withhold them…
Aldosterone works on the distal tubules and collecting ducts TRUE/FALSE
Aldosterone increases the reabsorption of potassium TRUE/FALSE
Cortisol increases blood glucose TRUE/FALSE
Cortisol has mineralocorticoid activity TRUE/FALSE
Both have slow onsets of action TRUE/FALSE
Describe how the large daily volume of glomerular filtrate is altered by the kidney to form a relatively low volume of concentrated urine.
BT_PO 1.64 BT_PO 1.67
This question just asks for some basic functions of the kidney
Approximately 80% of the glomerular filtrate is absorbed TRUE/FALSE
The medulla is hyperosmotic due to salt and urea TRUE/FALSE
ADH plays an important role TRUE/FALSE
Urea is actively secreted TRUE/FALSE
The counter-current mechanism creates a hypo-osmotic medulla TRUE/FALSE
Discuss the physiological consequences of total spinal anaesthesia caused by intrathecal administration of 20ml of 2% lignocaine at the L3/4 level. (Do not include management)
A great question to demonstrate understanding of the physiological consequences of neuraxial blockade. The effects can all be deduced from your knowledge of physiology and pharmacology. However there is a most excellent article in AIC(1974) in which TI Evans, a Victorian anaesthetist, administered 30-40ml of 1% lignocaine intrathecally at the lumbar level in 100 patients. He proceeded to tilt the table 10 to 15 degrees head down and administer oxygen until vocal cord paralysis and unconsciousness developed and he intubated them. There were excellent conditions for abdominal surgery. The curious can access this work online through the college library, as a bonus the same issue (2) has quite a nice article on electrical safety as well.
This will cause bradycardia TRUE/FALSE
The patient will have dilated gut TRUE/FALSE
The patient will become hyperthermic TRUE/FALSE
The patient will have dilated pupils TRUE/FALSE
The patient will be unconscious TRUE/FALSE
Submitting an exam application on the closing date demonstrates commitment to a career in anaesthesia TRUE/FALSE
The above is facetious but many candidates do apply on the final day that applications are open. One of my candidates missed the application date once, it was heartbreaking, not only did she have to study for another 6 months she also lost her spot on the training program and had to find a new job for a year.
It is now a month until applications close, if you are studying as if you will sit in August, then you should apply as if you will sit in August. The college does not deduct the funds from your credit card until after the closing date. Don’t take the risk of missing the application closing date because of personal circumstances or equipment failure.
Draw an expiratory flow volume curve obtained from a maximal expiratory effort after a vital capacity breath, for a person with:
A. normal lungs
B. restrictive lung disease
C. obstructive lung disease
Explain how and why these curves (and the derived parameters) are different in each disease state (15 marks)
We see a lot of patients with pulmonary function tests, their associated curves and parameters. Understanding the physiology, aids interpretation of the results.
A vital capacity breath is from expiratory reserve volume (ERV) to total lung capacity (TLC) TRUE/FALSE
The effort independent component is due to dynamic airways closure TRUE/FALSE
The TLC is increased in obstructive lung disease TRUE/FALSE
The effort independent component is steeper in restrictive lung disease TRUE/FALSE
A normal peak expiratory flow rate would be 10 L/min TRUE/FALSE
I’m skipping over SAQ 9 as I covered it on December 5 last year.
Draw both aortic root and a radial artery pressure wave forms on the same axes. Explain the differences between them.
It’s important to realise that the vessels of the circulation are not just a passive conduit – systemic pressure waveforms are produced by an interaction of the left ventricle, arterial physical properties and characteristics of the blood
Tapering contributes to the higher peak pressure seen in the radial artery TRUE/FALSE
Reflection contributes to the diastolic hump seen in the radial artery TRUE/FALSE
Stiff vessels will transmit reflected pressure waves faster TRUE/FALSE
Mean pressure is higher in the radial artery TRUE/FALSE
The Bernoulli effect created by a slower flow rate when the aortic valve closes creates the incisura TRUE/FALSE
Compare and contrast low-molecular-weight heparin (LMWH) and unfractionated heparin (UFH).
These are drugs that are commonly administered to our patients pre-operatively and can impact upon our procedural decisions.
LMWH only inhibits factor XI TRUE/FALSE
High dose UFH can inhibit platelet aggregation TRUE/FALSE
Only UFH can be administered IV TRUE/FALSE
Only UFH prolongs APTT TRUE/FALSE
LMWH has less predictable pharmacokinetics TRUE/FALSE
Discuss the factors affecting duration of action of a local anaesthetic block to a major peripheral nerve.
Lot of patient interest out there in you knowing this.
Less lipid soluble drugs have a longer duration of action TRUE/FALSE
Low protein binding causes a longer duration of action TRUE/FALSE
Large molecules have a longer duration of action TRUE/FALSE
Less vascular areas have a longer duration of action TRUE/FALSE
In an elderly patient there will be a longer duration of action TRUE/FALSE