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

Primary OSCE 4

Created: 7/9/2004

1. Lateral chest X-ray
You are shown the lateral chest X-ray which shows diaphragmatic hernia and pleural effusion. The patient has a history of vocal cord carcinoma for rigid endoscopy.
- Is the patient suitable for laryngeal mask airway?
- Is an AP\PA view needed?
- Is a cricoid needed?
- Is there air above diaphragm?

2. Statistics
You are shown a negatively skewed distribution:
- Is it normally distributed?
- Label the mode, median and mean
- Would the Mann Whitney U test be suitable for these data ?
- Are the data parametric?
- If these vaues were to be squared, would this produce a a normal distribution?
- Would plotting the log of these values give a normal distribution?

3. You are shown a trace of jugular venous pressure (JVP), which has been taken with the patientnot at an inclination of 45 degrees, and wearing a shirt:
- Is it normal?
- What is the cause of large a-waves?
- What is the cause of large v-waves?
- What is the cause of an absent a-wave?
- how do valvular disorders affect the JVP

4. Take a preoperative history from a 54-year-old asthmatic presenting with varicose veins
- Patient has aspirin-sensitive asthma
- Patient is allergic to propanolol

6. Diathermy
- Which is the earth electrode?
- paediatric suitable for 40 yo?
- Should unipolar or bipolar electrodes be used?
- You are shown a selection of sine waves: are they for cutting or coagulation?
- What are the associated risks?
- What is current density?
- What is frequency for cutting?
- Why does this not cause ventricular fibrillation?
- You are shown two circuits, with circuit A isolated: which is safer for
   i) the patient?
   ii) staff?

7. Supraclavicular block
- Show the landmarks on an actor
- Describe the block: needle size, depth, amount of local anaesthetic (LA), type of LA, strength of LA, etc.
- What are the risks of supraclavicular block?
- Show the interscalene groove
- What are the risks associated with interscalene block?

8. Bain circuit check
- What happens if it is disconnected at the patient/bag/at fresh gas flow (FGF)?
- What is the volume of the outer tubing?
- What FGF is needed for normocapnoea in a 100 kg patient (spontaneous ventilation & intermittent positive pressure ventilation)?
- What is the effect of shortening the tubing?
- What is the effect of lengthening the tubing?

9. You are shown a vitalograph trace
- Is it calibrated for body temperature, pressure and saturation (BTPS)?
- FEV1 greater than 200
- FVC greater than 250
- Normal FEV1/FVC ratio
- Obstructive pattern
- No risk associated with spinal
- Would the patient be suitable for upper airway surgery?
- What might be the cause of this type of lung disease?

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