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You are in Home >> Exams >> Primary FRCA >> OSCE and SOE

Primary OSCE 56

Created: 26/1/2011

1. Resuscitation
Demonstrate how you would respond to an anaphylaxis scenario in a simulator manikin.

2. Skills
Epidural technique and are asked follow-up questions on the spinal cord and epidurals
– changes in technique due to pregnancy, adding adrenaline, how much would you use?, etc

3. Anatomy
Describe the coronary circulation, including layers of the heart.

4. Scans
You are asked to interpret a computed tomography (CT) scan showing an extradural haematoma in the frontal right lobe.
– Discuss pupillary changes and the management of head injury.

5. History taking
Take a detailed history - both family (how his two brothers died etc) and social (how much he drinks etc) - from a patient presenting for a right hemicolectomy. The patient has a history of ischaemic heart disease and atrial fibrillation.

- How do you grade cardiac risk?
- Discuss drug interactions (e.g. between diclofenac and warfarin).

6. Scans
You are asked to interpret an intravenous urogram from a patient with chronic renal failure. There is no dye in right kidney.
- Is her stone due to a high uric acid level?

7. Anaesthetic machine check
You are asked to check a very old machine, with no breathing circuit, with various faults:

8. Equipment
You are shown an entonox cylinder and asked questions on critical and pseudocritical temperature.
- What would happen if you used it below -7 degrees C?
- What are two–stage valves?
- How does the tubing help?

9. Anatomy/nerve blocks
Demonstrate an axillary brachial plexus block.
- How would you position the patient?
- What is the angle for needle insertion?
- Describe your technique.
- Discuss the upper limb dermatomes.
- What nerve is commonly missed? Why is that not a good thing?

10. Communication skills
Counsel a woman with post-dural puncture headache, explaining the treatment options.

11. Resuscitation
Demonstrate how to defibrillate a patient who goes into ventricular fibrillation in theatre. How many shocks would you give, and what dose of amiodarone?

12. Equipment
You are asked questions about diathermy.

13. ECG
You are asked to interpret an ECG showing sinus bradycardia.
- Describe your management of severe bradycardia.

14. History taking
Take a history from a patient with a previous history of pulmonary embolism, who has experienced awareness during a previous operation

15. Examination/X-ray
You are asked to assess an airway. You are then shown a lateral c-spine X-ray and asked to interpret it. What are the abnormalities?

16. Equipment
You are asked about end-tidal gas monitoring. What would happen if you switched from isoflurane to sevoflurane?

17. Anatomy
Describe the anatomy of the spinal cord, including the ascending and descending tracts. Describe the anterior spinal cord syndrome.

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