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Final clinical short case 51

Created: 22/3/2018
1. Discuss the anatomy of the cranial nerves.
- which cranial nerves are involved in brainstem testing, and why?
- Describe the afferent and efferent pathways.
- What are the inclusion/exclusion criteria for brainstem testing?
- Is consent required for brainstem testing?
- Who carries out this test, and what does it involve?

2. Discuss prone ventilation.
- What changes are seen with this technique (including West zones, V/Q mismatch, diaphragm)?

3. Discuss the four stages of clinical trials.
- Give an example of a phase IV trial for an analgesic.
- Discuss how double-blind, randomized, controlled trials are set up (including bias, randomisation, matched patients).
- Discuss US Food and Drug Administration (FDA) and UK Medicines and Healthcare Products Regulatory Agency (MHRA) regulations, and European standards.
- Describe the role of the local ethics committee.
- Discuss the law concerning ethics and clinical trials.

4. Discuss ECG monitoring.
- What type of filters are used?
- Describe optimal electrode placement for measuring impedance. Why is this the case?
- Compare 3 leads versus 5 leads.
- What are the uses of ECG monitoring?
- Describe the ECG changes in hyperkalaemia, and its treatment.

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