THE ROYAL COLLEGE OF ANAESTHETISTS
DIPLOMA OF FELLOW OF THE ROYAL COLLEGE OF ANAESTHETISTS
18th May 2000
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. A 70 year old man with chronic obstructive airways disease requires a transurethral resection of the prostate. Outline the advantages and disadvantages of intrathecal block for this patient.
2. What are the problems of monitoring anaesthetised patients in the magnetic resonance imaging unit?
3. What is the differential diagnosis of persistent headache in the puerperium of a woman who has undergone a regional anaesthetic technique? Describe the distinguishing clinical features of each cause.
4. How can jugular venous bulb oxygen saturation be measured? What factors cause its value to increase or decrease?
5. How may coagulation be assessed in the perioperative period?
6. Describe the anatomy of the coeliac plexus. What are the indications for its therapeutic blockade?
SECTION B (Book B)
7. What are the advantages and disadvantages of day case anaesthesia in patients aged more than 80 years?
8. What is the role of the laryngeal mask airway in the management of difficult intubation?
9. A patient who is HIV sero-positive is scheduled to undergo a laparotomy. Discuss the factors determining the risk of transmission to theatre staff. How can this risk be reduced?
10. Describe your procedure for cardiac life support of a child aged 5 years.
11. Outline your management of a patient with status asthmaticus who is brought into the A&E Department.
12. List, with a brief statement on the effectiveness of each one, the methods described for detecting awareness during anaesthesia.