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Final basic sciences short case 29

Created: 13/6/2014
1. Describe the liver macroscopicallyand microscopically (portal tract etc)
- What are the functions of the liver, and where within the liver do the various functions take place?
- How do we test for liver function?
- Where does the hepatic artery arise from?
- What does bile do?
- Describe bilirubin metabolism
- Describe the effects of anaesthetic agents on the liver

2. Discuss the physiological effects of anaesthetising a patient with a C6 fracture. Include discussion of:
- The airway
- Reduced functional residual capacity
- Autonomic instability
- Pressure sores and positioning
- Poor nutrition
- Use (or not) of suxamethonium
- Where patient should be cared for postoperatively.

3. Describe the contents of an ampoule of bupivicaine
- Isomers (briefly discuss)
- Discuss the toxicity of local anaesthetics
- How do local anaesthetics work?
- How is bupivicaine metabolised?
- How are other local anaesthetics metabolised? (e.g. esters)
- How does bupivicaine compare with lidocaine, in terms of onset and duration of action?

4. Discuss the scavenging, Control of Substances Hazardous to Health (COSHH) regulations and time-weighted average.
- Discuss pollution in theatres - where does it occur?
- Discuss the optimal design of a new theatre
- What is laminar flow?
- How many air changes should there be per hour in the operating theatre?

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