Time yourself

I've not posted for a while due to a hectic ICU schedule and also because I've been trying to do some serious work.
Many thanks to Dr Booker who runs the infamous Booker Course up in Liverpool, who mentioned this website as a useful source of information for Finals revision. I went on this course last March and, apart from scaring the hell out of me, it really dragged me up to the level required to pass the SAQ section of the written paper. More than anything, it gave me a method and structure which provided me with confidence to tackle and complete the paper within the allotted time-frame.
I thought I would follow up my last posting about sexy topics with an equally sexy mock-exam to try. You will recognise some of the questions, some are topical, and some I have written myself - apologies if they are poorly worded. Of vital importance is that you have a clear 3 hour period to attempt the exam, and stick to the timings for each question. Hopefully by now you should have some idea of your preferred method for answering the SAQs and should have practiced some timed questions. Try this one seriously as if it were the paper.

Question 1
a) Describe the factors that may lead to i) venous air embolism (20%) and ii) arterial air embolism (20%)
b) What is paradoxical air embolism and how does it occur? (20%)
c) Explain the physiological basis for the use of capnography in the detection of venous air embolism. (30%)

Question 2
A 4 year old (20 kg) is admitted with acute appendicitis and is scheduled for urgent surgery. She has been vomiting for 2 days, is pyrexial, has a tachycardia of 170 bpm and prolonged capillary refill.
a) Describe the perioperative fluid management of this case using intravenous crystalloids. (60%)
b) Outline the complications that can occur with inappropriate intravenous crystalloid therapy. (30%)

Question 3
a) What are the important considerations in the preoperative assessment of a hypertensive patient presenting for elective surgery? (50%)
b) Outline the perioperative risks associated with hypertension and their management. (40%)

Question 4
a) Briefly describe your technique for performing a deep cervical plexus block for carotid
endarterectomy under local anaesthesia. (35%)
b) List the complications of a deep cervical plexus block. (35%)
c) List the advantages and disadvantages of performing a carotid endarterectomy under regional
anaesthesia. (30%)

Question 5
a) How is ventilator-associated pneumonia (VAP) diagnosed? (20%)
b) Explain the i) physical (50%) ii) positional (15%) and iii) pharmacological (15%) strategies that have been advocated for its prevention?

Question 6
a) List the specific problems and risks associated with a twin pregnancy. (45%)
b) What are the important considerations and options when planning the anaesthetic management for the delivery of twins around term? (45%)

Question 7
a) If neuromuscular block has been achieved during general anaesthesia using rocuronium explain the mechanism of spontaneous recovery from neuromuscular blockade. (15%)
b) What classes of drugs could be used to accelerate the recovery from rocuronium? (10%)
c) How do the classes of drugs in part (b) work? (15%)
d) What are the advantages and disadvantages of the classes of drugs identified in part (b)? (50%)

Question 8
a) List the complications arising from anaesthesia in the prone position (60%)
b) How may these be avoided? (40%)

Question 9
You are performing an axillary nerve block for a 54 year old man pre-hand surgury. After injecting 15mls 0.375% bupivacaine, the man develops an acute tonic-clonic seizure quickly followed by loss of consciousness and ventricular fibrillation on the ECG monitor.
a) Describe your immediate management and resuscitation (30%)
b) Assuming this man has developed LA toxicity, outline your further treatment (70%)

Question 10
a) What are the current clinical indications for perioperative blood transfusion? (40%)
b) Outline methods of reducing perioperative autologous blood transfusion (60%)

Question 11
a) Describe the pharmacology of gabapentin (60%)
b) List it's current clinical uses. (40%)

Question 12
(a) Define explicit and implicit awareness during general anaesthesia. (10%)
(b) What may increase the likelihood of awareness? (40%)
(c) List the techniques used to assess depth of anaesthesia and comment on their value. (40%)

Now get a couple of consultants/registrars to mark your questions - Good Luck!!