THE ROYAL COLLEGE OF ANAESTHETISTS
DIPLOMA OF FELLOW OF THE ROYAL COLLEGE OF ANAESTHETISTS
Tuesday 30th April 2002
9.30am to 12.30pm
CANDIDATES ARE REQUIRED TO ANSWER ALL TWELVE QUESTIONS:
Questions numbered ONE TO SIX must be answered in Book A. (Blue)
Questions numbered SEVEN TO TWELVE must be answered in Book B. (Pink)
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 - Blue)
1. Draw a diagram of the lumbar plexus. Outline the anatomical basis of a ‘3 in 1’ block. Explain why the block may fail to provide reliable analgesia for hip surgery.
2. Describe the principles involved in pulse oximetry. What are its limitations in clinical practice?
3. What aims and strategies are emphasised in a "Pain Management Programme"?
4. Discuss methods of applying non-invasive ventilation. What are its uses and benefits?
5. What is meta-analysis? Outline the methodology. How are the results usually presented?
6. A 78 year old male heavy smoker is admitted for laparotomy for his rectal cancer. He is treated with bendrofluazide and atenolol for hypertension (160/90 mmHg on admission). What specific actions would you take to improve the chances of a successful outcome.
SECTION B (Book B - Pink)
7. Describe the anaesthetic management of a penetrating eye injury in a screaming 5 year old child.
8. Discuss the reasons for and against the use of nitrous oxide in anaesthetic practice.
9. What is disseminated intravascular coagulation. Discuss its management in the critically ill patient.
10. Write a guideline for reducing and treating postoperative nausea and vomiting.
11. Discuss the principles underlying the anaesthetic management of carotid endarterectomy.
12. List the key clinical features, and commonest causative agents, of severe anaphylaxis occurring during general anaesthesia. Outline its management.