FCAI SOE April 2023
SOE 1 Preoperative medicine, optimisation, data interpretation
1. DM with subcutaneous insulin continuous pump
Insulin - function and in it’s absence
Acute and chronic complication of DM
Components of subcutaneous insulin pump
How to manage patient on insulin continuous pump pre operatively
2. Scleroderma
What is scleroderma
How would u manage
3. COPD
Lobectomy and lung resection
FEV1 90 FVC 94 DLCO 55
Calculate PpoDLCO
Lobes and segments
Right upper lobe resection
Implications of knowing FEV and DLCO
CXR - Phrenic nerve palsy
4. Prehabilitation
Medical optimisation
Nutrition
Stress response to surgery
5. MET
How to calculate
Physiological stress to major surgery
6. Kidney CKD
CKD stages
GFR <15ml/min
Blood investigation associated with CKD
Urgent indication for dialysis
Anaesthesia for AVF creation
SOE 2 General anaesthesia and pain
1. Gunshot wound. Cervical
What would be your Prehospital management
ED management
X-ray and CT scan
Spinal cord injury classification
Spinal cord perfusion pressure
2 Paraumbilical hernia. Rectus sheath block.
Anatomy, levels to block.
Unilateral vs bilateral block.
Surgeon vs ultrasound. Which would you prefer?
3. Pregnancy 38/52 primigravida come for ELLSCS with rheumatic hearts disease with MS
Pathophysiology
Implications of MS and pregnancy
How do u classify heart failure in this case?
Mode of anaesthesia
Anticoagulant
4. 10yo Autism spectrum disorder
Challenges
Patient is aggressive, management
5. Pedicle Free flap surgery. Infected Prothesis
DM HTN IHD Hb 11 preop.
Will u proceed with the surgery?
Physics
6. Inguinal hernia repair. Chronic radiculopathy with spinal cord stimulator
Components of spinal cord stimulator
Indications for spinal cord stimulator
Implications during operation
Mode of anaesthesia
SOE 3 Intensive care and advanced science
1. Workplace incident, bilateral crush injury-
Interpret abg with hyperK, metabolic acidosis. High urea, high CK
Rhabdomyolysis and AKI
Management?
Going for surgery
Mode of anaesthesia
2. ARDS.
Ventilation strategy.
Mechanisms of VILI.
Prone
ECMO
3. Intraosseus route on 50 yo
How you perform?
What device will you use?
Complication ?
what drugs are contraindicated for intraoosseus route ?
What drugs to avoid?
How to give fluids ? use pump
Whats the difference between the blood drawn. Abg interpretation
What’s the implication in peadiatrics ?
4. 72 yo NOF. Allergy morphine - pruritus. Mode of anaesthesia. Adjuncts in spinal.
Mechanism of action in listed drugs.
Clonidine vs opiods advantages and disadvantages.
5. What’s the urgent indication for dialysis
How many types of CRRT available.
CVVH. CVVHD. CVVHDF. What’s the differences. Mode of action.
What factors that will affect the passing of the solute through the semipermeable membrane?
What drugs can be added to the circuit for anticoagulation ? In which patient we use clexane ?
How will you design an ideal filter and solution?
6. Laparoscopic cholecystectomy. 3 years post heart transplantation.
Anaesthetic implications
Drugs to avoid