Applied Physiology
- How is oxygen carried in the blood?
- What is the mechanism of binding of oxygen to haemoglobin?
- What is this called?
- Draw the oxygen dissociation curve?
- What does 50% saturation mean?
- What partial pressure does 92% saturation correspond to?
- What partial pressure does 50% saturation correspond to?
- What is the right shift called? (Bohr effect)
- What are the factors determining right shift?
- What is the physiological consequences? Why is this useful?
- Draw the shape of the ODC for methaemoglobinaemia
- What is the pathophysiology of methaemoglobinaemia?
- What is the affinity ratio in methaemoglobinaemia for oxygen with respect to normal haemoglobin?
- What is ARDS?
- What are the defining features? What are the criteria?
- What are the causes of ARDS?
- What direct lung causes do you know?
- What systemic causes of ARDS do you know?
- How do you manage ARDS?
- What are the ventilatory options?
- How do you improve lung compliance?
- How does nitric oxide work? / prostacyclin
- How else can you treat pulmonary hypertension?
- What muscle relaxants do you know?
- What classes of muscle relaxants do you know?
- How does suxamethonium work? What is it's structure?
- How is suxamethonium metabolised at the neuromuscular junction?
- What other cholinesterases do you know?
- Why would you want to use a muscle relaxant? When is paralysis useful?
- What is myasthenia gravis?
- What is the deficiency in myasthenia gravis?
Critical Care
- What uses of central lines do you know?
- What information can you determine from a central line?
- How would you perform a fluid challenge? What fluid would you give? How much would you give?
- What is the tracing of the central line waveform?
- How is the CVP related to the right atrium? What does that mean?
- How do you insert a CVP line?
- What do you need to do before you use your central line (check tip, ensure tubing correct, calibrate)
- What fluid is used for CVP transduction tubing?
- Draw the graph for CVP change following a fluid challenge in an underfilled patient
- What options are there for pain control?
- What is the pain ladder?
- What routes of administration of analgesics do you know?
- How can you give opiates?
- What is the metabolism of morphine?
- What is the bioavailabilty of morphine? How much is metabolised in the liver?
- What is the problem with intermittent bolusing of opiates?
- What is the analgesic effect of morphine?
- Draw the graph of efficacy/potency of morphine analgesia with regards to its half life
- What is PCA?
- How is it delivered?
- Is it safe? Why?
- What do you know about epidurals?
- What drugs are used in epidural analgesia?
- What is a pneumothorax?
Pathology
- What is an embolus?
- Give examples of embolus - fat, thrombus, amniotic fluid, air, nitrogen, septic
- What is a pulmonary embolus?
- What is the source of the embolus?
- What effects would a deep venous thrombosis present with?
- What are the features of a pulmonary embolus?
- What are the features of arterial thrombi?
- What are the sources of arterial emboli (Left atrium/ventricle, narrowed peripheral circulation, atheromatous diease)
- What organs are affected and what are the clinical manifestations?
- What is a fat embolus?
- What is the aetiology? What are the pathophysiological theories behind fat emboli?
- What types of patients get fat emboli?
- What are the clinical features?
- What are the risk factors for arterial emboli?
- What is an ulcer?
- What factors affect ulcer healing?
- What is the pathophysiology of peptic ulcer disease?
- What is helicobacter pylori?
- How does it cause ulcerations in the stomach?
- What are the ways in which helicobacter can be diagnosed?
- Do you know of any blood tests?
- What is the urease breath test?
- What is the tissue pathological test?
- What is the CLO test?
- What does CLO stand for?
- What infections cause ulcers?
- What nutrient deficiency causes ulcers?
- What skin tumours causes ulcers?
- Name as many skin tumours as you can!
- What is hyperparathyroidism?
- How is hyperparathyroidism classified?
- If 85% is due to a secreting adenoma, what is the rest due to?
- What is secondary hyperparathyroidism?
- What are the causes?
- Who gets secondary hyperparathyroidism?
- What is teritiary hyperparathyroidism?
- What are the biochemical changes in each?
- What is the physiogical effect of parathyroid hormone?
- What are the effects?
Priniciples of Surgery
- What is a subphrenic abscess?
- Have you seen one before?
- What are the causes?
- What are the clinical features of a subphrenic abscess?
- What are the nerve supplies to the diaphragm seeing as you brought it up...?
- What are the biochemical changes?
- Do you always get pain?
- What features would you see on a chest x-ray?
- What other imaging would you do apart from ultrasound?
- How would you treat this?
- What is the principle in treatment of an abscess?
- What drainage options are there for subphrenic abscesses?
- What is mediastinitis?
- What are the defining features?
- How do you get mediastinitis?
- What is rupture of the oesophagus known as (Boerhaave's phenomena)
- What imaging modalities would you do?
- What can you see on a chest x-ray (surgical emphysema)
- What are the principles of treatment?
- What would you treat? When would you treat? How would you treat?
- What is your approach to scrotal pain?
- What are the causes of scrotal pain?
- What is the nerve supply to the testicle?
- How does it enter the scrotum?
- What are the causes of testicular inflammation?
- What is testicular torsion?
- Who gets testicular torsion?
- Why do patients have abdominal pain?
Applied Surgical Anatomy
- Shown a right femur
- What is this?
- What type of joint is the hip joint?
- What six movements are possible at the hip joint?
- What biochemical property of the femur allows it to be so mobile?
- What is the blood supply to the head of the femur?
- How does it get to the head of the femur?
- What are the ligaments of the femur?
- Which of these is the strongest?
- Illustrate the attachments of the femoral capsule? Why is it important to know this?
- What is the significance of the foveal blood supply?
- When is the blood supply via the ligamentum teres important?
- Shown a saggital section of the pelvis
- What is this? What type of scan is it? What kind of section is it?
- What are the structures that you can see?
- What are the limits of the peritoneal markings?
- How far exactly does the peritoneum extend inferiorly?
- How much of the bladder is covered by peritoneum?
- How much of the uterus is covered by peritoneum? What is the broad ligament?
- What is the space behind the uterus called?
- Shown the facial nerve
- What is this?
- What is this gland (the parotid)?
- How many branches of the facial nerve are there?
- Name them
- How can you test the facial nerve? What muscles in particular can you test?
- What's this (submandibular gland)?
- What is the nerve supply to the submandibular gland?
- If the cervical branch of the facial nerve is injured, what deficits would you expect to see?
- Shown the Sigmoid colon on a cadaver
- What is this?
- How do you know?
- How can you tell large bowel apart from small bowel?
Operative Surgery
- A patient presents with a dorsally angulated distal radius fracture in casualty.
- What is your approach?
- How would you examine the patient?
- What features would you look for?
- What analgesia would you give?
- How would you perform a haematoma block?
- What anaesthetic do you use?
- What is the appropriate dose of lignocaine?
- What are the features of local anaesthetic toxicity?
- Would you use anything else with the local anaesthetic (adrenaline)
- Why would adrenaline help?
- In what circumstances would you not use adrenaline?
- What other local anaesthetics do you know?
- What is special about bupivacaine? Under what circumstances have you used it?
- What is special about marcaine? What is it's specific gravity? Why is that important to anaesthetists
- How do you manipulate a fracture?
- What is Newton's third law?
- How would you manipulate a distal radius fracture?
- What are you doing to the fracture when you increase the tilt?
- Why are you doing this?
- What is dis-impaction?
- How would you apply the plaster? How many layers of plaster?
- Where would you plaster from and to? Why? (immobilise joint above and below) What physical property are you using?
- What follow up would you do for this patient?
- How long does an upper limb fracture take to heal?
- What is a gastrostomy?
- When would you use it?
- What type of patients require it?
- What methods of insertion do you know of?
Other people on the day got asked:
- Surface anatomy of the foot
- Formation of ileostomy
- Function of the pancreas and cellular / biochemical effects
- Management of supracondylar fractures
- Appendicitis and appendicectomy
- Bones of the foot
- Structures around medial malleolus of the foot