THE ROYAL COLLEGE OF ANAESTHETISTS
DIPLOMA OF FELLOW OF THE ROYAL COLLEGE OF ANAESTHETISTS
19th May 1998
9.30am to 12.30pm
Candidates are required to answer all twelve questions. Questions numbered 1 - 6 must be answered in Book A and questions numbered 7 - 12 must be answered in Book B. Candidates who fail to answer all twelve questions will not pass the Examination.
Candidates are informed that one of the Examiners is present during the time allowed for the paper, for consultation in case any question should not appear clear.
SECTION A (Book A)
1. Describe your procedure for cardiac life support in a child aged five years.
2. What methods are available for therapeutic nerve blockade? Explain the mechanism of action for each method.
3. You are asked to anaesthetise an 87 year old lady for diathermy of her bladder tumour on a day case basis. What are the potential problems of this case and how would you manage them?
4. What are the disadvantages of nitrous oxide in clinical practice?
5. How does a rotameter flowmeter work? Describe its advantages and limitations.
6. Describe in detail how you would accurately measure a patient’s peak expiratory flow rate. What factors may give rise to erroneous readings?
SECTION B (Book B)
7. Draw a labelled diagram of the anatomy of the anterior aspect of the wrist. How may this knowledge be used in anaesthetic practice?
8. List the factors associated with central venous catheter infections and suggest methods to limit such infections.
9. A patient with a history of obstructive sleep apnoea presents for an elective cholecystectomy. How would you assess the fitness for anaesthesia? What precautions would you take with your anaesthetic management of this patient?
10 A 60 year old man presents for a hemicolectomy. How may choice of pain management influence recovery from surgery?
11. Explain the importance of a high airway pressure alarm system during general anaesthesia.
12. List the pathophysiological and clinical features of HELLP syndrome. What are the diagnostic laboratory findings and the priorities in management?