THE ROYAL COLLEGE OF ANAESTHETISTS
DIPLOMA OF FELLOW OF THE ROYAL COLLEGE OF ANAESTHETISTS
31st October 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. Outline the key points in the management of a patient with massive haemorrhage.
2. What diagnostic features would lead you to identify malignant hyperthermia during and immediately after anaesthesia of an adolescent presenting for appendicectomy?
3. Write brief notes on the physiological responses that constitute the stress response to surgery.
4. How does a rotameter work? Describe its advantages and limitations.
5. What safety features should be incorporated into an intravenous patient controlled analgesia (PCA) system and what is the purpose of each? What instructions would you give the nursing staff, having set up the PCA?
A ten week old male infant weighing 3.5 kg is scheduled for inguinal hernia repair. He was delivered prematurely at thirty-four weeks. List the risk factors and state how these can be minimised.
SECTION B (Book B)
7. You anaesthetised a sixty-four year old man for removal of a protruding disc C4/5. The patient was found to be quadriplegic in recovery. Discuss the likelihood of this being a consequence of you anaesthetic.
8. Discuss the perioperative management of the blood pressure of a patient undergoing removal of a phaeochromocytoma.
9. What are the main point that you would include in a patient information leaflet that you would submit to support an application to your local ethics committee to study a new non-depolarising muscle relaxant?
10. Describe the diagnosis and immediate assessment of a patient with smoke inhalation injury.
11. Describe the anatomy of the nerves involved for neural conduction blockade at the ankle.
12. A sixty-five year old diabetic female is to undergo a total abdominal hysterectomy. She is normally controlled by oral hypoglycaemic drugs. Describe your perioperative management of her blood sugar.