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You are in Home >> Exams >> Primary FRCA >> OSCE and SOE

Primary OSCE 9

Created: 7/9/2004
1. Examination
- Patient with a head injury and cervical collar
- Demonstrate how you assess the GCS and  perform a neurological examination.

2. Ankle block anatomy
What nerves supply the ankle?
- What are the anatomical relationships between deep peroneal and tibial nerves?
- Describe the course of the saphenous nerve

3. Data
You are asked questions on coagulation/ liver function in a patient who has had a recent stroke (1 month ago) and has atrial fibrillation. He has an International Normalised Ratio of 3.5, a thrombin time of 12 seconds, a kaolin clotting time of 60 seconds and a platelet count of 350 x 109/L

- Can you give this patient spinal anaesthesia?
- Does he have a liver problem?
- Is he on warfarin?
- Would you delay operation for 6 months?
- Can you give suxamethonium (hemiplegia)?
- Would you attempt to cardiovert him?

4. Pulmonary artery flotation catheter 
You are shown a trace and asked some questions

5. Statistics
- You are asked questions about 
- You are asked questions about a graph of weight versus height

6. Chest X-ray
You are shown a lateral chest X-ray, showing a massive hiatus hernia
- Do you need to obtain a postero-anterior X-ray?
The patient is presenting for vocal cord examination because of vocal cord paralysis
- Can you perform cricoid pressure?
- Are H2 blockers needed?

7. Paediatric resuscitation (non-traumatic)
- What are the causes of electromechanical dissociation, and what immediate treatment should you give?

8. Lasers
You are shown a steel laser endotracheal tube (ETT) and a normal ETT; answer some questions on:
- the relevance of the two cuffs
- Safety in theatre
- Risks
- Laser physics
- Eye protection
– Why are goggles only suitable for the CO2 laser?
- What are lasers used for?

9. Circle check
Carry out a check on a circle breathing system

10. Oscillotonometry
- How does this work?
- You are shown an oscillation trace: what are the associated safety issues/risks?

11. Capnography
- You are shown a trace and asked to describe it
- You are asked questions on respiratory physiology
- What are the causes of the changes in the trace?
- You are shown a trace showing a high FiCO2 and asked to comment on it

12. Safe use of defibrillator
- Treatment
- Abnormal rhythm

13. History taking
Take a history with regard to analgesia in labour

14. History taking
Take an anaesthetic history of a patient about to undergo an ear, nose and throat operation

15. Anatomy
 You are shown a diagram of of the cross-section of a spinal cord and asked questions about it

16. Communication
Speak to an anxious woman presenting for a gynaecological operation with stable angina/hypertension who has mask phobia due to a dental experience as a child

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