THE ROYAL COLLEGE OF ANAESTHETISTS
DIPLOMA OF FELLOW OF THE ROYAL COLLEGE OF ANAESTHETISTS
29th October 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. List the three commonest causes of direct maternal deaths in the United Kingdom. What anatomical and physiological changes of pregnancy affect your ability to resuscitate a woman who has suffered cardiovascular collapse at full term?
2. What is pulmonary surfactant? Discuss its production in the lung, mechanism of action and function. What would be the effect of insufficient pulmonary surfactant?
3. Define contractility. Outline the methods available to the clinician to assess myocardial contractility in the perioperative period.
4. A 60 year old smoker requires non-laser surgery to the vocal cords. Outline the various anaesthetic techniques available, listing advantages and disadvantages of each.
5. Define pressure. List the methods available for measuring systemic arterial blood pressure. Outline the principles involved in one of the methods listed.
6. Outline the nerve pathways involved in the transmission and perception of a painful stimulus from the foot.
SECTION B (Book B - Pink)
7. What are the possible deleterious consequences of cardiopulmonary bypass when used in coronary artery surgery? How may these be reduced?
8. Summarise the perioperative anaesthetic management of a patient who requires plating of his jaw fractured in a fight?
9. What are the principles of pain relief after surgery in a drug abuser dependent on opioids?
10. What are the indications for a preoperative chest radiograph?
11. What do you understand by the term critical incident? Following a critical incident, what information should be recorded? What sequence of events should ensue?
12. Discuss the causes of muscle weakness in a critically ill patient. How would you investigate them?