THE ROYAL COLLEGE OF ANAESTHETISTS
DIPLOMA OF FELLOW OF THE ROYAL COLLEGE OF ANAESTHETISTS
18th May 1999
9.30am to 12.30pm
CANDIDATES ARE REQUIRED TO ANSWER ALL TWELVE QUESTIONS:
Questions numbered ONE TO SIX must be answered in Book A.
Questions numbered SEVEN TO TWELVE must be answered in Book B.
Candidates must attempt all twelve questions or they will fail 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. Candidates are advised to spend approximately the same amount of time on each question and ensure that the important issues are included in their answers
SECTION A (Book A)
1. Outline your perioperative management of a patient with a ruptured abdominal aortic aneurysm.
2. What are the physical principles of the capnograph? Discuss the applications of capnography in anaesthetic practice.
3. A General Practitioner has contacted you for advice about a patient who may be susceptible to malignant hyperthermia. Write a letter to the General Practitioner explaining the significance of this condition for the patient and the relatives.
4. Outline the possible complications of anaesthesia with a patient in the prone position.
5. What is the normal glucocorticoid response to surgery? Outline, with reasons, your perioperative corticosteroid regimens in patients:
a) taking steroids at the time of surgery;
b) who have stopped taking steroids several months previously.
6. How do you confirm that a double-lumen endobronchial tube has been placed correctly? Outline the possible complications associated with the use of this equipment.
SECTION B (Book B)
7. What are the principles of cancer pain management?
8. Outline your technique for percutaneous tracheostomy, with particular reference to the anatomy involved. List the possible complications of this procedure.
9. A surgeon is attempting an inguinal herniorrhaphy in a fit obese young man under local anaesthetic infiltration that is proving inadequate and asks for your help. What anaesthetic strategies are available for managing this situation?
10 What are the principles of adult cardio-pulmonary bypass? What are the common complications of this procedure?
11. What are the risks for patients associated with the administration of general anaesthesia in dental surgery? How may these risks be reduced?
12. Write short notes, with reasons, on your anaesthetic management of emergency Caesarean section for cord prolapse in a fit 21 year old primagravida.