***Applied Physiology

1.How is oxygen carried in the blood? ◦What is the mechanism of binding of oxygen to haemoglobin? ◦What is this called? ◦Draw the oxygen dissociation curve? ◦What does 50% saturation mean? ◦What partial pressure does 92% saturation correspond to? ◦What partial pressure does 50% saturation correspond to? ◦What is the right shift called? (Bohr effect) ◦What are the factors determining right shift? ◦What is the physiological consequences? Why is this useful? ◦Draw the shape of the ODC for methaemoglobinaemia ◦What is the pathophysiology of methaemoglobinaemia? ◦What is the affinity ratio in methaemoglobinaemia for oxygen with respect to normal haemoglobin?

2.What is ARDS?
◦What are the defining features? What are the criteria? ◦What are the causes of ARDS? ◦What direct lung causes do you know? ◦What systemic causes of ARDS do you know? ◦How do you manage ARDS? ◦What are the ventilatory options? ◦How do you improve lung compliance? ◦How does nitric oxide work? / prostacyclin ◦How else can you treat pulmonary hypertension?

3.What muscle relaxants do you know?
◦What classes of muscle relaxants do you know? ◦How does suxamethonium work? What is it's structure? ◦How is suxamethonium metabolised at the neuromuscular junction? ◦What other cholinesterases do you know? ◦Why would you want to use a muscle relaxant? When is paralysis useful? ◦What is myasthenia gravis? ◦What is the deficiency in myasthenia gravis?

***Critical Care
1.What uses of central lines do you know?

thrombus.What options are there for pain control? ◦What is the pain ladder? ◦What routes of administration of analgesics do you know? ◦How can you give opiates? ◦What is the metabolism of morphine? ◦What is the bioavailabilty of morphine? How much is metabolised in the liver? ◦What is the problem with intermittent bolusing of opiates? ◦What is the analgesic effect of morphine? ◦Draw the graph of efficacy/potency of morphine analgesia with regards to its half life ◦What is PCA? ◦How is it delivered? ◦Is it safe? Why? ◦What do you know about epidurals? ◦What drugs are used in epidural analgesia? 3.fat. ensure tubing correct. calibrate) ◦What fluid is used for CVP transduction tubing? ◦Draw the graph for CVP change following a fluid challenge in an underfilled patient 2. septic ◦What is a pulmonary embolus? ◦What is the source of the embolus? ◦What effects would a deep venous thrombosis present with? ◦What are the features of a pulmonary embolus? ◦What are the features of arterial thrombi? ◦What are the sources of arterial emboli (Left .What is a pneumothorax? ***Pathology 1. air.◦What information can you determine from a central line? ◦How would you perform a fluid challenge? What fluid would you give? How much would you give? ◦What is the tracing of the central line waveform? ◦How is the CVP related to the right atrium? What does that mean? ◦How do you insert a CVP line? ◦What do you need to do before you use your central line (check tip.What is an embolus? ◦Give examples of embolus . amniotic fluid. nitrogen.

What is an ulcer? ◦What factors affect ulcer healing? ◦What is the pathophysiology of peptic ulcer disease? ◦What is helicobacter pylori? ◦How does it cause ulcerations in the stomach? ◦What are the ways in which helicobacter can be diagnosed? ◦Do you know of any blood tests? ◦What is the urease breath test? ◦What is the tissue pathological test? ◦What is the CLO test? ◦What does CLO stand for? ◦What infections cause ulcers? ◦What nutrient deficiency causes ulcers? ◦What skin tumours causes ulcers? ◦Name as many skin tumours as you can! 3. narrowed peripheral circulation. atheromatous diease) ◦What organs are affected and what are the clinical manifestations? ◦What is a fat embolus? ◦What is the aetiology? What are the pathophysiological theories behind fat emboli? ◦What types of patients get fat emboli? ◦What are the clinical features? ◦What are the risk factors for arterial emboli? 2.What is hyperparathyroidism? ◦How is hyperparathyroidism classified? ◦If 85% is due to a secreting adenoma.atrium/ventricle.What is a subphrenic abscess? . what is the rest due to? ◦What is secondary hyperparathyroidism? ◦What are the causes? ◦Who gets secondary hyperparathyroidism? ◦What is teritiary hyperparathyroidism? ◦What are the biochemical changes in each? ◦What is the physiogical effect of parathyroid hormone? ◦What are the effects? ***Priniciples of Surgery 1.

Shown a right femur ◦What is this? ◦What type of joint is the hip joint? ◦What six movements are possible at the hip joint? ◦What biochemical property of the femur allows it to be so mobile? ◦What is the blood supply to the head of the femur? .? ◦What are the biochemical changes? ◦Do you always get pain? ◦What features would you see on a chest x-ray? ◦What other imaging would you do apart from ultrasound? ◦How would you treat this? ◦What is the principle in treatment of an abscess? ◦What drainage options are there for subphrenic abscesses? 2.◦Have you seen one before? ◦What are the causes? ◦What are the clinical features of a subphrenic abscess? ◦What are the nerve supplies to the diaphragm seeing as you brought it up...What is mediastinitis? ◦What are the defining features? ◦How do you get mediastinitis? ◦What is rupture of the oesophagus known as (Boerhaave's phenomena) ◦What imaging modalities would you do? ◦What can you see on a chest x-ray (surgical emphysema) ◦What are the principles of treatment? ◦What would you treat? When would you treat? How would you treat? 3.What is your approach to scrotal pain? ◦What are the causes of scrotal pain? ◦What is the nerve supply to the testicle? ◦How does it enter the scrotum? ◦What are the causes of testicular inflammation? ◦What is testicular torsion? ◦Who gets testicular torsion? ◦Why do patients have abdominal pain? ***Applied Surgical Anatomy 1.

Shown the facial nerve ◦What is this? ◦What is this gland (the parotid)? ◦How many branches of the facial nerve are there? ◦Name them ◦How can you test the facial nerve? What muscles in particular can you test? ◦What's this (submandibular gland)? ◦What is the nerve supply to the submandibular gland? ◦If the cervical branch of the facial nerve is injured.◦How does it get to the head of the femur? ◦What are the ligaments of the femur? ◦Which of these is the strongest? ◦Illustrate the attachments of the femoral capsule? Why is it important to know this? ◦What is the significance of the foveal blood supply? ◦When is the blood supply via the ligamentum teres important? 2. what deficits would you expect to see? 4.A patient presents with a dorsally angulated distal radius fracture in casualty. .Shown the Sigmoid colon on a cadaver ◦What is this? ◦How do you know? ◦How can you tell large bowel apart from small bowel? ***Operative Surgery 1.Shown a saggital section of the pelvis ◦What is this? What type of scan is it? What kind of section is it? ◦What are the structures that you can see? ◦What are the limits of the peritoneal markings? ◦How far exactly does the peritoneum extend inferiorly? ◦How much of the bladder is covered by peritoneum? ◦How much of the uterus is covered by peritoneum? What is the broad ligament? ◦What is the space behind the uterus called? 3.

How do you manipulate a fracture? ◦What is Newton's third law? ◦How would you manipulate a distal radius fracture? ◦What are you doing to the fracture when you increase the tilt? ◦Why are you doing this? ◦What is dis-impaction? ◦How would you apply the plaster? How many layers of plaster? ◦Where would you plaster from and to? Why? (immobilise joint above and below) What physical property are you using? ◦What follow up would you do for this patient? ◦How long does an upper limb fracture take to heal? 3.◦What is your approach? ◦How would you examine the patient? ◦What features would you look for? ◦What analgesia would you give? ◦How would you perform a haematoma block? ◦What anaesthetic do you use? ◦What is the appropriate dose of lignocaine? ◦What are the features of local anaesthetic toxicity? ◦Would you use anything else with the local anaesthetic (adrenaline) ◦Why would adrenaline help? ◦In what circumstances would you not use adrenaline? ◦What other local anaesthetics do you know? ◦What is special about bupivacaine? Under what circumstances have you used it? ◦What is special about marcaine? What is it's specific gravity? Why is that important to anaesthetists 2.What is a gastrostomy? ◦When would you use it? ◦What type of patients require it? ◦What methods of insertion do you know of? .

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