MCAI OSCE / VIVA NOV 2017
VIVA (Pharmocology)
1. NSAID, mode of action, COX pathway, lipoxygenase, leukotriene, asthma
2. Oral anticoagulation - warfarin , rivaroxaban, monitor , LMWH , mode of action
3. Drug preparation - slow release, oxycodon , how to prolong the effectof local anaesthetics
4. How insulin can be designed into Long acting drug , classification of insulin
5. Suxamethonium, non depolarizing neuromuscular blocking agent, why highest risk of anaphylaxis, Vecuronium versus Rocuronium
6. Vaporize, draw diagram, define SVP , plenum vaporizer, desflurane vaporizer
VIVA (Physiology)
1. Draw AP of SA, ventricular myocyte, ions movement
2. Mechanism of inspiration and expiration, lung pressure, intrapleural pressure, alveolar pressure, define compliance, draw compliance on diagram, surfactant, Law of Laplace
3. Lung volume pressure loop, hysteresis, work of breathing, factor affects delivery of oxygen , alveolar oxygen equation , oxygen flux
4. Acid base balance, what is acidosis, how body resist Ph change, buffer, respiratory compensation, physiological of acidosis and alkalosis
5. Pulse oximeter, wavelength, mechanism, draw absorbance graph, Beer-Lambert law
OSCE
1. Question sheet: CVP interpretation , cannon A wave, a, c, v, x, y reason of tall a and short y descent
2. Man station - Communication: anaesthesia awareness
3. Mannikin with 2 nurses : Resuscitation: post OGDS collapse, VF , defibrillation, 5 H , 5 T
4. Viva style - with stimulated monitoring: Tension pneumothorax , management, needle aspiration, chest drain , describe chest drain, how to diagnose tension pneumothorax without auscultation
5. Viva style - Airway : Failed intubation , Mccoy, video laryngoscopy with bougie, demo, LMA insertion , proceed with surgical airway, who invented LMA, contraindication of LMA, difference between pediatric and adult airways
6. Question sheet: Anatomy : circle of Willis , TAP block ultrasonotomy, indication for TAP block
7. Man station - History taking : placenta accreta , explain plan of anesthesia
8. Question sheet - ECG : WPW syndrome with right bundle branch block, STEMI, treatment and management, drugs to avoid in WPW
9. Question sheet - CXR : lung collapse, feature that suggest so, causes of lung collapse
10. Question sheet - Equipment : VIE, temp and pressure , N20 cylinder , pressure if full and half full, pressure regulator, soda lime, rotameter , factoring affecting the equilibrium position at low flow and high flow
11. Viva style- Hypothemia definition , source of loss of heat intra-operative, risk factor for hypothermia, type of heat loss and percentage
12. Man station : Demonstrate BP measurement with mercury sphygnomanometer, evaluate pulse, measure JVP, types of JVP pulse
13. Question sheet: Trans-esophageal doppler cardiac monitor, advantages, corrected flow time, interpret FTc 300ms and SV 47 , diagnosis ???
14. Viva stylewith simulated monitoring: Induction room AF , hypertension , cancel op, treatment for unstable AF, 4 adverse sign , dose for amiodarone
15. Question sheet: Dermatome for posterior lateral thigh, which nerve injury? dermatome back ? T10, pain over shoulder ? Suprascapularis nerve, innervation for posterior cutaneous arm