FCAI Written Exam 28/2/18 Review by Muhammad Amir Ayub

I knew that there was a large amount to cover for this exam, more than the membership exams. The problem was that as I focused on another topic, I forget what I had already studied previously. At the same time basic science questions could still come out, and I had no time to cover those topics at all. Hell, I only studied a core topic such as diabetes 2 hours before the exams. There was just no time.

But I knew that when it comes to these exams, there is just no shortcuts, as you don't internalize the knowledge without being mindful (woah my language!) of the topics you study. So I made a gamble to go deep whenever possible and if a topic comes out where I didn't read them at all, then it's just tough luck.

With the SAQ's, the question on the sedation spectrum was a topic that you do day in and out, but I never really "focused" and made notes on, but did do some deep reading on a long time ago; I don't think I did well on that simple topic (which makes it disappointing). The only topic that I really read up and made notes on was smoking. I presented on pre-eclampsia once, but that was like a year ago and never touched on it again. I specifically read up on opioid induced hyperalgesia and tolerance. I listened to a podcast on intra-aortic balloon pumps right before the paper (lucky me, I never read on the topic). Otherwise, I only superficially read on the other topics, once upon a time.

The SBA's were generally similar in difficulty. The theme was the same; only a bit of what I studied came out. I had notes on diabetes management, sepsis, and eye ops only (I never re-read the latter 2 topics)! I had read (once upon a time) on the SVT algorithm, cancer pain management, phrenic nerve block post BP blocks, robotic surgery, sedation spectrum, cyanotic heart disease goals, management of hypoxia on vent (daily management), sympathetic hyperreflexia, sci (incomplete notes), the DAS Extubation algorithm, peripheral nerve injuries (I think it was the median nerve). I had to just guess the answers for the rest. I just relied on my instinct of daily management for the question on daycare surgery. I read up on poisoning the night before the exams, but I was too drained by then; I could barely remember anything.

The true/false MCQ's were disappointing. I left the SAQ's early as the gap between that and the MCQ exam was just 10 minutes, and that would not be enough for me to recover. Even after snacking, I was still starving for the last paper and I just couldn't focus. There were a couple of questions where I gave a different answer than what I intended to; I'm not sure if I corrected all of them. I felt confident in answering only one question: massive transfusions. The other questions were all topics that I've read once before (or had ancient notes), but I could not completely recall the knowledge. I never covered the topics of loop recorders, changes after a heart and long transplant, diathermy. But since I could barely very poorly recall any knowledge about the other topics, there was probably no difference in the performance answering the questions that I didn't cover at all. Very disappointing.

Knowing that I had covered only so little of the topics that came up, and could only recall so little anyway, I'd be very surprised if I passed. If I passed, then good. If not, that'll just add up to the RM 40,000 that has been spent so far furthering myself. I will ban my children from this path of self-destruction. Being a quack is better to become healthier wealthier and wiser.

After the exams, I was literally starving and tired. Ate a meal, and then went to sleep. I could only wake up after more than 12 hours later.

Digital Publisher LittleThings, Dependent on Facebook, Shuts Down by Muhammad Amir Ayub

Since launching in 2014, LittleThings had amassed over 12 million Facebook followers, and its videos regularly generated thousands, if not millions, of views.

But Speiser said the recent algorithm shift, which Facebook has said was designed to tamp down content that is consumed passively – and would instead emphasize posts from people’s friends and family – took out roughly 75% of LittleThings’ organic traffic while hammering its profit margins.

Back in 2016, Speiser told The Wall Street Journal that he was highly optimistic about Facebook and its desire to help web publishers.

Now, as one source close to the company put it: “Facebook is the destroyer of worlds.”

Why anyone would depend on Facebook beats me. You gotta just dip but never submerge yourself in FB River.

Via Daring Fireball

FCAI Written Exam 28/2/18 by Muhammad Amir Ayub

I couldn't remember all of the topics that came out, but here goes what I do remember:

SAQ's (10 questions in 3 hours):

  1. sedation spectrum, mida, dissociative sedation, mac safety

  2. iabp mechanism, effects, indications, contra

  3. abd hypertension, acs, measurement, effects, management

  4. smoking, bronchospasm

  5. pe, helllp, anesthesia and o&g management 

  6. acute and chronic pain, effects of pain, opioid sparing, hyperalgesia and tolerance

  7. principles and benefits of daycare surgery

  8. RA and effects of steroids, DMARDS, anesthesia

  9. sab effects layers contraindications

SBA's (50 questions in 1 hour 40 minutes):

  1. Noac

  2. Fat emb syndrome

  3. Afe

  4. Peripheral nerve injury 

  5. Management of severe mr

  6. Das extubation

  7. Sci

  8. Sympathetic hyperreflexia

  9. Preop anemia

  10. Hyper cl met acidosis

  11. Atls

  12. Hypoxia on vent

  13. Cyanotic heart disease, r to left shunt management

  14. Neonatal hypoxia w cvs problem

  15. Tbi

  16. Anesthesia for stroke (embo)

  17. Management of anti-hpt/dm

  18. Trigeminal neuralgia

  19. Dental trauma

  20. Sepsis

  21. Sedation spectrum

  22. Complications of robotic surgery (prostate)

  23. Eye op w coad, warfarin

  24. Ra for tka (don’t think i got this one right)

  25. Phrenic nerve block post bp block

  26. Rln injury post thyroidectomy

  27. Cancer pain management

  28. Svt management (algorithm)

  29. 2 poisoning q’s: 1 on beta blocker, another tca (I think)

  30. Daycare surgery discharge criteria

True/False MCQ's (30 stems with 5 subparts each in 1 hour):

  1. Air embo diagnosis

  2. Dlt absolute indications

  3. Lvedp, stroke work, coronary perfusion

  4. Ptc

  5. Diathermy 

  6. Adverse drug reactions and allergies

  7. Trisomy 21 airway

  8. Latex allergy

  9. Thermodilution accuracy

  10. Nsaids

  11. Peds aps, morphine pk in peds

  12. Bp anatomy

  13. Sensory supply of ll

  14. Hap def and bacteriology 

  15. Caudal anat and block

  16. Herpetic neuralgia

  17. Neuropathic pain syndromes of head

  18. Pcm od

  19. Apgar score

  20. Stellate ganglion block

  21. Massive transfusion

  22. Pac’s and pcwp’s (location misinterpretation)

  23. Peribulbar block

  24. Hypothermia complications

  25. Enteral nutrition 

  26. High altitude sickness

  27. Loop recorders

  28. Changes to the cvs post heart lung transplantation

  29. Ppo values post lobectomy

I'll talk about how I did in another later post. There's enough topics here to cover a year of continuous reading.