A Long Week

A lot of interesting thoughts after the written exam on Tuesday. The SAQ paper is available to look at online now here.

SAQ paper

Yet again there was a proportion of this paper which could have and was predicted by various sources. I don't think it was an overly tricky exam - the hardest part of it is the time pressure you have to write each question.

1) Morbid obesity - straight from the Association of Anaesthetists Guidelines published in 2007. Enforces the need to read these guidelines in revision, as highlighted in the previous posting on sexy topics. Note the inclusion of the organisational section - requiring us to think from a managerial viewpoint, not just clinical. There has been a recent article in CEACCP October 2008 (incidentally after the paper was written) on morbid obesity.

2) Sciatic Nerve Block - standard anatomy question. I mentioned the sciatic nerve blocks (amongst others) in my anatomy posting at the beginning of September as a topic to learn.

3) GA LSCS in woman with ASD - difficult to predict this type of question. Requires knowledge of cardiac shunts and perioperative physiology/pharmacology for GA LSCS.

4) Subclavian Vein Cannulation - a surprising repeat question from October 2007 due to it being done very well last time. In fact, I suspect the reason why it came up was due to the infection component of the question - a recurring theme in this exam and something which I have touched upon in previous postings.

5) Study Design - I have no comment to make on this question.

6) PONV/Dystonic reaction - PONV is a standard question covered in Bricker and other texts. I had to delve into some past A&E experience for the dystonic reaction which was slightly random but I guess those who have seen it post-drug administration would not forget it.

7) Burns - Standard question. I must remember that 40 x 70 is not 2100 - duh!

8) Fat Embolism - at first site quite a random question, however it was a CEACCP article in October 2007 highlighting the value of reading these publications as part of the exam revision. Thanks to Dr M, one of my previous colleagues, who provided the best laugh in the pub afterwards with his explanation of minimising fat embolism by using a seatbelt!!

9) Brain Stem Death - quite crafty, not requiring the usual 'what do you test' etc. I found it quite tricky to answer, despite having looked after exactly such a patient the week before. It will be a matter of hoping that your key words match those on the marking sheet!

10) Child Abuse - more of a general exam question which could turn up in a Paeds/A&E/GP exam in almost identical format. It's inclusion was probably as a 'trendy topic' highlighting our need as anaesthetists to be aware of such issues. Luck hasn't been with me in the past taking this exam, but my participation in a Child Abuse mandatory training seminar two weeks ago has certainly scored me some points here!

11) Infection Transmission - If you had read the publication of updated guidelines on Infection Control in Anaesthesia (September 2008 edition of Anaesthesia p.1027) by the Association of Anaesthetists, you should have been laughing for this one. I posted about this topic at the end of August.

12) Rheumatoid Arthritis another standard question found in most anaesthesia exam texts. There was a CEACCP article in December 2006.

MCQ
Again, difficult to assess any sort of achievement in this section of the exam. Of note, there were 13-14 questions straight from the College guide, highlighting the importance of doing these practice papers.

Hope you've all had a good few days off - time to start thinking about some viva practice!