Wind-down

Thank you to all the messages you have all left. I hope those who passed are enjoying a bit of freedom. To those who weren't successful, I appreciate how you are feeling having been through it myself.

This time around, I managed to get 2's in all sections of the exam which I was really chuffed about (I seriously thought I was on a 1+ for the Science Viva!). Below is a summary of my exam:

Long Case
"The one with the malignant melanoma on her back" Straight from Mills, Maguire, & Barker Clinical Viva Book p.167.
-COPD (obstructuve PFTs, RLL pneumonia), HTN (mild renal failure, LVH/strain on ECG). On enalapril - still hypertensive.
-Preoptimisation, antihypertensives, pathophys of malignant melanoma (I said more common in gingers - they loved that!), prone position + complications. Anaesthesia. HDU/ICU

Short Cases

1) Obese man for knee arthroscopy, cardiac stent one year ago, only on statin and ACE-i. ECG Qwaves inf, TWi anterolat. Preoptimisation, stents, ?regional + NOT day case!

2) Dural Tap straight from Bricker SAQ book! What do you do? They steered me towards spinal catheter and it's management +doses + pathophysiology of PDPH.

3) 8yo boy RTA #tib/fib GCS 8/15. Straightforward airway management in trauma case. They placed a lot of emphasis on C-spine protection.

Science

Anatomy - 'Where can the phrenic nerve be damaged?'. Causes of damage + course of nerve.

Physiology - Renal replacement therapy in ICU including drawing of CVVHF/CVVHDF circuits + Rx of life-threatening hyperkalaemia.

Physics - Humidification - different methods. HME filters. Pathophysiology of damage to airways by not humidifying gases

Pharmacology - 'You have given 8mg vecuronium and at the end of a 1hr operation there is no response to peripheral nerve stimulation.' Discuss possibilities. Moved on discussion of NMJ. Don't forget simple things like machine failure.

Hope this helps.