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DA(SA) Paper I Question 2 Autonomic Nervous System 2.

1 Name the main adrenergic receptors at the following sites and name one example of an agonist at each site a) Bronchi. b) Cardiac muscle. c) Vascular smooth muscle. d) Pre synaptic nerve terminals. e) Uterine Muscle. (5) 2.2 Briefly discuss diabetic autonomic neuropathy under the following two headings a) Clinical signs and/or symptoms. b) Anaesthetic implications. (10) 2.3 Briefly discuss a) The mechanism of action of digitalis. b) Name three side effects. 2.4 List 10 causes of a post-operative tachycardia. (2) (3) (5)

Coagulation 2.5 Briefly describe the mechanism involved in the normal coagulation process. (10) 2.6 What is the mechanism and / or site of action of the following drugs? a) Heparin. b) Warfarin. c) Clopidogrel. d) Tranexamic acid (Cyclokapron). e) Aspirin.

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2.7 a) What laboratory or other tests can be done to measure the activity of? i) Heparin. ii) Low molecular weight Heparin. iii) Warfarin. iv) Aspirin. v) Clopidogrel. (2.5) b) What would you use to reverse or antagonise the effects of each of these drugs prior to surgery? (2.5) 2.8 State the accepted time intervals required prior to neuraxial block in a patient given the following drug a) Unfractionated heparin. b) Low molecular weight heparin prophylaxis. c) Low molecular weight heparin treatment. d) Aspirin. e) Clopidogrel. (5) Electrolytes

2.9 Give the clinical presentation of a patient with hyponatraemia. 2.10 Briefly outline the management of a patient with hyperkalemia.

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Fluid Management 2.11 Discuss your approach to the peri-operative fluid management of a 16kg child for a laparotomy for intestinal obstruction. (10) Blood Products 2.12 Write short notes on platelet transfusion. (5)

Paediatric Cases 2.13 Discuss your general approach to the anaesthetic management of paediatric cases by writing notes under the following headings a) The modern approach to nil by mouth rules. (5) b) Detailed notes on your approach to the child with a recent upper respiratory tract infection. (10) c) Detailed notes on your approach to post-operative pain relief in children. (10) [100] Question 3 Pharmacology 3.1 Compare the pharmacokinetics and pharmacodynamics of fentanyl and meperidine (pethidine) under the following headings (you may use a table) a) Onset(when given ivi). (2) b) Potency. (2) c) Metabolism. (2) d) Cardiovascular effects on i) Heart rate. (1) ii) Myocardial contractility. (1) iii) Peripheral vascular resistance (2) Local anaesthetics 3.2 Using a diagram show components of a typical local anaesthetic molecular structure. (1.5) 3.3 What is the significance of the intermediate chain in the function of local anaesthetics? (0.5) 3.4 What is the role of pka (dissociation constant) and protein binding in the function of local anaesthetics? (3) 3.5 Using 0.5% Bupivacaine (Macaine), how many millilitres should a surgeon safely infiltrate in a surgical incision at the conclusion of a surgical procedure in a patient weighing 70kg? (2) 3.6 Name two conditions in which the use of vasocontrictive additives in local anaesthetics would be contra-indicated. (1) 3.7 Name two major differences between Ropivacaine (Naropin) and Bupivacaine (Macaine) with regards to a) Toxicity. (1) b) Differential block. (1)

Physics Temperature Disturbances 3.8 How does anaesthesia predispose to hypothermia? 3.9 Describe ways to prevent hypothermia in the surgical patients.

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3.10 Name two intra-operative events that would alert you to the development of malignant hyperthermia (MH). (2) 3.11 How would you manage a hyperthermic patient in theatre? Arterial Line 3.12 Give 3 indications for invasive arterial blood pressure monitoring. 3.13 What is Allens test in arterial catheterisation? 3.14 Give 2 contra-indications to arterial catheterisation. 3.15 Give 3 complications of intra-arterial monitoring. (3) (1.5) (3) (1) (1.5)

3.16 What information can you derive from an arterial tracing with regards to? a) Upstroke. (1) b) Downstroke. (1) c) Variations in size during the respiratory cycle. (1) Ageing 3.17 Briefly discuss physiological changes that occur with ageing specifically pertaining to a) Cardiovascular system. (5) b) Respiratory system. (5) Physiology 3.18 Draw and label the shape of a Flow-Volume curve for a normal patient. (2) 3.19 Name ONE condition which could cause each of the following and draw the shape of the Flow-Volume curve for each a) Restrictive lung disease. (2) b) Obstructive airway disease. (2) c) Variable extra-thoracic airway obstruction. (2) d) Fixed large airway obstruction. (2) 3.20 Draw and label a normal adult oxygen-haemoglobin dissociation curve. 4) 3.21 Name 3 causes each of a left and right shift to the curve. (6)

Physics 3.22 In table form compare oxygen, nitrous oxide and air, using the following headings a) Cylinder colour. (4) b) Critical temperature. (3) c) Method of gauging cylinder content. (3)

Pharmacology 3.23 Name and state the dose of 5 agents you may use to blunt the intubation response in a hypertensive adult patient. (10) 3.24 In a suspected Malignant Hyperthermia patient, name ONE safe drug you would choose for each of the following a) Induction agent. b) Maintenance agent. c) Analgesic agent. d) Muscle relaxant. e) Anti-emetic agent. (5) 3.25 In a suspected Porphyria patient, name ONE safe drug you would choose for each of the following a) Induction agent. b) Maintenance agent. c) Analgesic agent. d) Muscle relaxant. e) Anti-emetic agent. (5) [100] Vraag 2 Outonome Senuweestelsel 2.1 Benoem die hoof adrenerge reseptore by die volgende strukture en gee een voorbeeld van n agonis by elke struktuur a) Brongi. b) Hartspier. c) Vaskulre gladdespier. d) Pre-sinaptiese senuwee-eindes. e) Uteriene spier. (5) 2.2 Bespreek kortliks diabetiese outonome neuropatie onder die volgende twee opskrifte a) Kliniese tekens en / of simptome. b) Narkose implikasies. (10) 2.3 Bespreek kortliks a) Digitalis se werkingsmeganisme. b) Noem drie newe-effekte. 2.4 Lys 10 oorsake van post-operatiewe tagikardie. (2) (3) (5)

Koagulasie 2.5 Bespreek kortliks die meganisme van die normale koagulasieproses. (10) 2.6 Wat is die meganisme en / of plek van werking van die volgende middels? a) Heparien. b) Warfarin. c) Clopidogrel.

d) Traneksaamsuur (Cyclokapron). e) Aspirien.

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2.7 a) Watter laboratorium of ander toetse kan gedoen word om die aktiwiteit van die volgende te bepaal? i) Heparien. ii) Lae-molekulre gewig Heparien. iii) Warfarin. iv) Aspirien. v) Clopidogrel. (2.5) b) Wat sal jy gebruik om die effekte van bogenoemde middels om te keer of te antagoniseer voor chirurgie? (2.5) 2.8 Noem die aanvaarde tydsinterval benodig voor n neuraksiale blok n n pasint wat die volgende middel gegee word a) Ongefraksioneerde heparien. b) Lae molekulregewig heparien profilakse. c) Lae molekulregewig heparien behandeling. d) Aspirien. e) Clopidogrel. (5) Elektroliete 2.9 Beskryf die kliniese presentering van n pasint met hiponatremie. 2.10 Gee kortliks die hantering van n pasint met hiperkalemie. (5) (5)

Voghantering 2.11 Bespreek u benadering tot die peri-operatiewe voghantering van n 16kg kind vir n laparotomie vir intestinale obstruksie. (10) Bloedprodukte 2.12 Skryf kort notas oor plaatjietransfusie. (5)

Pediatriese Gevalle 2.13 Bespreek u algemene benadering tot die narkose hantering van pediatriese gevalle deur notas te skryf onder die volgende hoofde a) Die moderne benadering tot nil per mond reels. (5) b) Omvattende notas oor u benadering tot die kind met n onlangse boonste lugweginfeksie. (10) c) Omvattende notas oor u benadering tot post-operatiewe pynverligting in kinders. (10) Vraag 3 Farmakologie 3.1 Vergelyk die farmakokinetika en farmadinamika van fentaniel en pethidien onder die volgende hoofde (mag tabuleer) a) Aanvang van werking (intraveneus toegedien). (2) b) Potensie. (2) c) Metabolisme. (2) d) Kardiovaskulre effekte op i) Harttempo. (1)

ii) Miokardiale kontraktiliteit. iii) Perifere vaskulre weerstand.

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Lokaal Verdowers 3.2 Gebruik n diagram om die komponente van die molekulre struktuur van n tipiese lokaal verdower aan te toon. (1.5) 3.3 Wat is die belang van die intermedire ketting in die funksie van lokaalverdowers? (0.5) 3.4 Wat is die rol van pka (dissosiasie konstant) en protein verbinding in die werking/funksie van lokaal verdowers? (3) 3.5 Hoeveel milliliters 0,5% bupivakaen (Macaine) kan n chirurg gebruik aan die einde van n prosedure vir wondinfiltrasie van n 70kg pasint? (2) 3.6 Noem twee toestande waar die gebruik van n vasokonstriktiewe middel, byvoeg tot lokaal verdowers, teenaangedui is. (1) 3.7 Gee twee hoof verskille tussen Ropivakaen (Naropin) en Bupivakaen (Macaine) met betrekking tot a) Toksisiteit. (1) b) Differensile blok. (1) Fisika Temperatuurversteurings 3.8 Hoe veroorsaak narkose hipotermie? 3.9 Beskryf hoe om hipotermie te voorkom in n chirugiese pasint.

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3.10 Noem twee intra-operatiewe gebeure wat jou sal waarsku tot die ontwikkeling van maligne hipertermie. (2) 3.11 Hoe sal u n hipertermiese pasint in teater hanteer? Arterile lyn 3.12 Gee 3 indikasies vir indringende arterile bloeddrukmonitering. 3.13 Wat is Allen se toets met betrekking tot arterile kanulering? 3.14 Gee 2 kontra-indikasies vir arterile kanulering. 3.15 Gee 3 komplikasies van intra-arterile monitering. 3.16 Watter inligting kan u aflei van die arterile golf met betrekking tot die a) Opwaartse been. b) Afwaartse been. c) Variasie in groote gedurende die respiratoriese siklus. (3) (1.5) (1) (1) (1.5) (1) (1) (1)

Veroudering 3.17 Bespreek kortliks die fisiologiese veranderings van veroudering met spesifieke verwysing na

a) Kardiovaskulre sisteem. b) Respiratoriese sisteem. Fisiologie 3.18 Teken en benoem die vloei-volumekurwe van n normale pasint.

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3.19 Noem EEN toestand wat elk van die volgende mag veroorsaak en teken die vorm van elke vloei-volume kurwe a) Restriktiewe longsiekte. (2) b) Obstruktiewe lugwegsiekte. (2) c) Veranderbare ekstra-torakale lugwegobstruksie. (2) d) Gefikseerde groot lugwegobstruksie. (2) 3.20 Teken en benoem die suurstof-hemoglobiendissosiasiekurwe van n normale volwassene. (4) 3.21 Noem 3 oorsake elk vir n verskuiwing van die kurwe na links en na regs.(6) Fisika 3.22 Vergelyk suurstof, laggas en lug in tabelvorm onder die volgende hoofde a) Kleur van silinder. (4) b) Kritiese temperatuur. (3) c) Metode om silinder inhoud te meet. (3) Farmakologie 3.23 Noem 5 middels met die dosering wat u kan gebruik om die intubasierespons te demp in n volwasse pasient met hipertensie. (10) 3.24 Noem EEN veilige middel wat u sal kies onder elk van die volgende hoofde vir n pasint met vermoedelike maligne hipertermie-gevoeligheid a) Induksiemiddel. b) Instandhoudingsmiddel. c) Analgetikum. d) Spierverslapper. e) Anti-emetiese middel. (5) 3.25 Noem EEN veilige middel wat u sal kies onder elk van die volgende hoofde vir n pasint met vermoedelike porfirie a) Induksiemiddel. b) Instandhoudingsmiddel. c) Analgetikum. d) Spierverslapper. e) Anti-emetiese middel. (5) [100] Paper II Question 2 Adrenalin

2.1 List 4 indications for use in the peri-operative period. 2.2 Name the receptor(s) stimulated. 2.3 List 3 possible complications with use.

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2.4 Which volatile anaesthetic would you avoid co-administering and why? (1) Post Dural Puncture Headache 2.5 How would a patient with this headache most likely describe it? 2.6 What is believed to be its pathogenesis? 2.7 What patient population is most likely to be affected? 2.8 How would you manage the patient? TURP Syndrome 2.9 Which 2 major organ systems are mostly involved? 2.10 Give 2 presenting signs that you may find for each system. (2) (2) (2) (4) (1) (2)

2.11 What surgical technique factors may predispose a patient to developing the syndrome? (3) 2.12 What would be your immediate clinical management? Diabetes Mellitus 2.13 Name 4 longterm complications of diabetes mellitus. (4) (2)

2.14 Which 3 blood investigations would you request to establish the level of optimisation of the metabolic state? (3) 2.15 Which blood test gives an indication of long term control? (1)

2.16 What airway management problems may you encounter during a general anaesthetic in a diabetic patient? What are the pathological changes in diabetes that result in the problems you mentioned? (4) Propofol 2.17 What is the intravenous induction dose in mg/kg body weight? 2.18 What is the intravenous maintenance infusion rate? (0.5) (0.5)

2.19 What drug can be used to reduce the pain often associated with the injection? Give name of drug and the dose used. (1) 2.20 List 3 other side effects or complications of Propofol. 2.21 What other useful effects does it have in the peri-operative period? (3) (2)

2.22 Name 3 of the clinical problems that may be seen in a patient with Propofol Infusion Syndrome. (3) 2.23 A patient is booked for a redo hip replacement and has a Hct of 45% a) Write down your complete plan for intra-operative fluid management. (5)

b) This patient is at risk for massive blood loss. What blood conservation steps can you take? (5) 2.24 A patient known with ischemic heart disease is booked for an inguinal hernia repair. a) Concerning the premed in the IHD patient, what is your approach? (3) b) What anaesthetic goals would you set for this patient? (5) c) What drugs can be considered to reduce post-op mortality. (2) 2.25 A healthy patient received Rapifen, Thiopentone and Scoline for a caesarean section. After 1hour she doesnt respond when trying to wake her. a) Tabulate your differential diagnosis for delayed awakening. (3) b) What is the most likely reason? (1) c) How can you confirm your diagnosis? (2) d) What is your management for this problem? (2) e) In retrospect, briefly state an alternative approach to your anaesthesia induction, including drug choice. (2) 2.26 After a brachial plexus block a 50kg patient starts complaining of feeling strange. What follows is the typical sequelae of local anaesthetic toxicity a) Describe in sequence how this syndrome presents? (4) b) Which agent is lifesaving and how does it work? (2) c) What else should be done in a scenario like this? (2) d) Work out the volume of 0.5% Marcaine that can be given safely. (2) 2.27 One of the purposes of the premed is to carefully evaluate the airway a) What tests can be done when doing your evaluation?(0.5 marks) b) What other factors predicts a difficult airway? (0.5 marks) c) Draw pictures of the Cormack & Lehane classification. d) Which single test predicts a difficult intubation best and why? (3) (3) (2) (2) [100]

Question 3 3.1 a) Illustrate and label the components of a Mapleson A (Magill) circuit. (3) b) What are the required fresh gas flows for spontaneous and controlled ventilation, respectively for this circuit? (2) Nasal Airways 3.2 a) In which patients are they relatively contra-indicated? b) Name one situation in which they are preferred. c) How is the chosen length estimated? (3) (1) (1)

3.3 a) Name 3 nerve blocks commonly used to facilitate an awake intubation. (3) b) What is an important disadvantage of these blocks? (1) c) What can be used as an alternative to above mentioned blocks? (1) 3.4 a) Why is lead II commonly used for intra-operative ECG monitoring? b) How can lead V5 be monitored using only 3 leads (2) (3)

3.5 Name 5 possible complications of the controlled hypotension anaesthetic technique. (5) 3.6 Name 5 major factors affecting stroke volume. (5)

3.7 List 5 anatomical features of the paediatric airway that make neonates and infants often difficult to intubate. (5) 3.8 a) What is normal PR time? b) Name 2 causes of a short PR time. c) How can the above causes be differentiated from one another? (1) (2) (2)

3.9 Name the types of non-haemolytic immune reactions following blood transfusions. (5) 3.10 Which ECG changes are commonly associated with hypokalemia? (5)

3.11 a) What is the partial pressure of inspired oxygen for a patient breathing room air at sea level? (1) b) Write out the equation for alveolar partial pressure of oxygen (PAO2) in words. (2) c) Define the term dead space, and give an approximate value for normal dead space. (2) 3.12 a) Describe the waveforms seen in the jugular venous pressure trace. (4) b) What causes cannon waves to be seen in the jugular venous pressure trace? (1) 3.13 a) What is contained in cylinders painted orange? b) What kind of vapouriser is a copper kettle? c) List 3 disadvantages of using ether as a volatile agent 3.14 Draw and label a diagram of a spirogram, showing all lung volumes. (1) (1) (3) (5)

3.15 a) Outline the anatomical landmarks used when inserting a central venous pressure line into the internal jugular vein. (2) b) List 3 complications of central line insertion. (3) 3.16 a) Write down Boyles Law. b) Give one example of the application of this law in anaesthesia. c) Explain the use of a bimetallic strip in a vapouriser. (2) (1) (2)

3.17 Draw and label a diagram of the structures see on laryngoscopy of a patient with a Mallampati score of 1. (5) 3.18 a) What clotting factor is missing in a patient with haemophilia A? (1) b) What blood test is abnormal in a patient with haemophilia A? (1) c) Briefly describe your management of a patient with a clotting disorder.3) 3.19 a) What does PEEP stand for? (0.5) b) Define asthma. (0.5) c) Describe the ventilator settings you would use to ventilate a patient with severe bronchospasm. (4) 3.20 a) List the complications associated with the Trendelenberg position. (3)

b) Which nerve injury is associated with the lithotomy position? c) How should the patient be supported in the prone position? Vraag 2 Adrenalien 2.1 Lys 4 indikasies vir perioperatiewe gebruik hiervan. 2.2 Noem die reseptor(e) wat dit stimuleer. 2.3 Lys 3 moontlike komplikasies met gebruik.

(0.5) (1.5) TOTAL 100

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2.4 Watter inhalasie narkosemiddel se toediening sal u vermy daarmee saam en hoekom? (1) Postdurale Punksie Hoofpyn 2.5 Hoe sal n pasint met hierdie hoofpyn dit heel moontlik beskrywe? 2.6 Wat is die patogenese hiervan geglo om te wees? 2.7 Watter populasie pasinte word mees waarskynlik affekteer? 2.8 Hoe sal u die pasint hanteer? Die TURP-sindroom 2.9 Watter 2 hoof orgaanstelsels is meestal betrek? 2.10 Gee 2 aanvangstekens wat u mag vind by elke sisteem. (2) (2) (2) (4) (1) (2)

2.11 Watter sjirurgiese tekniek faktore mag n pasint predisponeer tot die ontwikkeling van die sindroom? (3) 2.12 Wat sal u onmiddellike kliniese hantering wees? Diabetes Mellitus 2.13 Noem 4 langtermyn komplikasies van diabetes mellitus. (4) (2)

2.14 Watter 3 bloedondersoeke sou u aanvra om die optimaliseringsvlak van die metaboliese staat te bepaal? (3) 2.15 Watter bloedtoets gee n aanduiding van langtermyn beheer? (1)

2.16 Watter lugweghanterings probleme mag u ervaar tydens algemene narkose in n diabeet? Wat is die patologiese veranderinge in diabetes wat tot hierdie genoemde probleme lei? (4) Propofol 2.17 Wat is die intraveneuse induksie dosering in mg/kg liggaamsgewig? 2.18 Wat is die intraveneuse instandhoudings infusiespoed? () ()

2.19 Watter middel kan gebruik word om die pyn geassosieerd met toediening te verminder? a) Gee die naam en dosis van die middel. (1) 2.20 Lys 3 ander newe-effekte of komplikasies van Propofol. (3)

2.21 Watter ander bruikbare effekte het dit in die perioperatiewe tydperk?

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2.22 Noem 3 kliniese probleme wat gesien mag word in n pasint met die Propofol infusiesindroom. (3) 2.23 n Pasient word geboek vir n herhaal heupvervanging met n Hct 45%. a) Skryf neer jou volledige plan vir intra-operatiewe vogtoediening. (5) b) Die pasint loop n risiko vir massiewe bloedverlies. Watterbloedkonserverings stappe kan jy neem? (5) 2.24 n Pasint bekend met isgemiese hartsieke word geboek vir n liesbreuk herstel a) Aangaande die premed in n pasient met isgemiese hartsiekte, wat is jou benadering? (3) b) Watter narkose doelwitte sal jy nastreef vir hierdie pasint? (5) c) Watter middels kan jy oorweeg om post-operatiewe mortaliteit te verlaag? (2) 2.25 n Gesonde pasient ontvang Rapifen, Thiopentone en Scoline vir n keiser. n Uur en na die operasie is daar steeds nie n teken dat die pasint asemhaal nie. a) Tabelleer jou differensiele diagnose vir vertraagde ontwaking. (3) b) Wat is die waarskynlikste diagnose? (1) c) Hoe kan jy die diagnose bevestig? (2) d) Wat is u hantering vir die probleem? (2) e) Gee retrospektiewelik n alternatiewe benadering tot u induksie van narkose, insluitend keuse van middels. (2) 2.26 n 50kg Pasint begin kla dat hy snaaks voel nadat n bragiaalpleksus blok uitgevoer is. Hierna volg die tipiese simptome en tekens van lokale verdowing toksisiteit. a) Beskryf in volgorde hoe die sindroom presenteer? (4) b) Watter middel is lewensreddend en hoe werk dit? (2) c) Wat moet verder in n senario soos hierdie gedoen word? (2) d) Bereken die volume 0.5% Marcaine wat met veiligheid gegee kan word? (2) 2.27 Tydens die premed moet die lugweg sorgvuldig ge-evalueer word. a) Watter toetse kan gedoen word om die lugweg te ondersoek? (1/2 punte) (3) b) Watter ander faktore voorspel n moelike lugweg? (1/2 punte) (3) c) Teken prentjies van die Cormack & Lehane klassifikasie. (2) d) Watter enkele toets voorspel n moeilike lugweg die beste en hoekom s jy so? (2) 3 3.1 a) Teken en benoem die komponente van n Mapleson A (Magill) narkosebaan. (3) b) Hoeveel varsgasvloei word benodig vir spontane en gekontroleerde ventilasie, onderskeidelik vir bogenoemde baan? (2) 3.2 Betreffende nasale lugwe

a) In watter pasinte is hulle gebruik relatief gekontra-indikeerd? b) Noem n situasie waar dit verkies word. c) Hoe word die lengte van die lugweg geskat?

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3.3 a) Noem 3 senuweeblokke wat algemeen gebruik word om n wakker intubasie te fasiliteer. (3) b) Wat is n belangrike nadeel van hierdie senuweeblokke? (1) c) Watter metode kan gebruik word as alternatief tot bogenoemde blokke? (1) 3.4 a) Waarom word afleiding II algemeen gebruik vir intraoperatiewe EKG monitering? (2) b) Hoe kan afleiding V5 gemoniteer word met net 3 afleidings? (3)

3.5 Noem 5 moontlike komplikasies van die gekontrolleerde hipotensie narkosetegniek. (5) 3.6 Noem 5 belangrike faktore wat slagvolume bepaal. (5)

3.7 Lys 5 anatomiese kenmerke van die pediatriese lugweg wat neonate en babas dikwels moeilik intubeerbaar maak. (5) 3.8 a) Wat is normale PR tyd? b) Noem 2 oorsake van n kort PR tyd. c) Hoe kan bogenoemde oorsake van mekaar onderskei word? (1) (2) (2)

3.9 Noem die tipes non-hemolitiese immuunreaksies na transfusie van bloed. (5) 3.10 Watter EKG veranderinge word algemeen met hipokalemie geassosier? (5) 3.11 a) Wat is die parsile druk van ingeasemde suurstof vir n pasint wat kamerlug asem by seevlak? (1) b) Skryf die formule vir alveolre parsile druk van suurstof (PAO2) in woorde neer. (2) c) Definieer die term dooiespasie en gee n benaderde waarde vir normale dooiespasie. (2) 3.12 a) Beskryf die golfvorms van die jugulre veneusedruk patroon. (4) b) Wat veroorsaak dat kanongolwe in die jugulre veneusedruk patroon gesien word? (1) 3.13 a) Wat word bevat in oranje gassilinders? b) Watter soort verdamper is n koperketel? c) Lys 3 nadele van die gebruik van eter as inhalasiemiddel. (1) (1) (3)

3.14 Teken en benoem n diagram van n spirogram; met aanduiding van alle longvolumes. (5) 3.15 a) Beskryf kortliks die anatomiese landmerke wat gebruik word met die insit van n sentrale veneuse lyn in die interne jugulre vena. (2) b) Lys 3 komplikasies van sentralelyn plasing. (3)

3.16 a) Skryf Boyle se Wet neer. b) Gee een voorbeeld van die toepassing van hierdie wet in narkose. c) Verduidelik die gebruik van die bi-metaliese strook in n verdamper. 3.17 Teken en benoem n diagram van die strukture wat gesien word met laringoskopie van n pasint met n Mallampati telling van 1. 3.18. i) Watter stollingsfaktor is gebrekkig in n pasint met hemofilie A. ii) Watter bloedtoets is abnormal in n pasint met Hemofilie A. iii) Beskryf kortliks u hantering van n pasint met n stollingsafwyking.

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3.19. i) Waarvoor staan PEED? () ii) Definieer Asma () iii) Beskryf die ventilatorstellings u sou gebruik om n pasint met erge brongospasma te ventileer. (4) 3.20. i) Lys die komplikasies geassosieerd met die Trendelenburg posisie. (3) ii) Watter senuweebesering word assosieer met die lithotomy posisie? () iii) Hoe moet n pasint in die maagliggende posisie ondersteun word? (1) TOTAL 100