Examination Anaesthesia: A Guide to the Final FANZCA Examination(2e)

Name: Examination Anaesthesia: A Guide to the Final FANZCA Examination

Edition: 2nd

Author: Christopher Thomas, Christopher Butler

Subject: Anaesthesia

Language: English

Publisher: Elsevier

Examination Anaesthesia-A Guide to the Final FANZCA Examination-2e

Brief Introduction

The concept of a guide to approaching a fellowship examination in a medical specialty is not a new one. For as long as examinations have existed, tips and tricks have been passed down from one generation of candidates to the next. The Australian and New Zealand College of Anaesthetists’ final fellowship examination is no exception, and much of the inspiration for this book comes from others who have attempted to ease the pain of past examination candidates, most notably Dr Gabriel Marfan, whose remembered preparation and exam experiences from the late 1990s formed the ‘Gabe Files’, still accessible online. Many other skilled mentors throughout Australasia and the Pacific region have provided invaluable guidance and encouragement for each new generation of anaesthetists approaching the last major hurdle that leads to the FANZCA finish line.

Examination Intensive Care and Anaesthesia was written in 2006, and contained the first incarnation of the volume you now hold. It was the brainchild of Carole Foot and Nikki Blackwell of intensive care fame, who co-opted one of the current authors to provide chapters and information relevant to anaesthesia. The preface of that book contained the prophetic statement: ‘As intensive care continues to develop its own identity … the concept of a combined guide to the examination process for intensivists and anaesthetists will become outmoded.’ On 1 January 2010 the College of Intensive Care Medicine was established as an independent entity. By the time this book has been published, Examination Intensive Care will also be in production.

Contents

Chapter 1 Overview of the FANZCA final examination 1

  • FANZCA training scheme 1
  • Format of the final examination 2
  • Timing and location 2
  • The written examination 3
  • The clinical examination 5
  • Marking components of the final examination 7

Chapter 2 Preparation for the final examination 9

  • Resources 9
  • The college website 9
  • Textbooks 12
  • Journals 16
  • Resuscitation guidelines 17
  • Courses 17
  • Preparation strategies 19
  • Philosophy 19
  • Timing 20
  • Study groups 20
  • Looking after yourself 21
  • Coping with failure 21

Chapter 3 The written examination 23

  • Overview 23
  • Performance strategies 23
  • Multiple choice questions (MCQ) 24
  • Short answer questions (SAQ) 25
  • Written examination topics 26
  • Airway management 26
  • Ambulatory anaesthesia 26
  • Anaesthetic equipment 27
  • Applied anatomy 27
  • Applied physiology and pharmacology 28
  • Crisis management 28
  • Intensive care topics 29
  • Monitoring 29
  • Neuroanaesthesia 30
  • Obstetric anaesthesia 30
  • Paediatric and neonatal anaesthesia 30
  • Pain management 31
  • Perioperative medicine 31
  • Regional anaesthesia 32
  • Remote location anaesthesia 33
  • Statistics and research 33
  • Transfusion medicine 33
  • Trauma anaesthesia 33
  • Vascular anaesthesia 34
  • Welfare, consent and quality assurance issues 34

Chapter 4 The medical vivas 35

Overview 35
Performance strategies 35
Patient assessment stations 37

  • The patient with aortic valve stenosis 37
  • The patient with ischaemic heart disease 39
  • The patient with hypertension 41
  • The patient with a permanent pacemaker/implantable defibrillator 43
  • The patient with peripheral vascular disease 46
  • The patient with chronic obstructive pulmonary disease 48
  • The patient with pulmonary fibrosis 50
  • The patient with diabetes 52
  • The patient with thyroid disease 54
  • The patient with pituitary disease 55
  • The patient with morbid obesity/obstructive sleep apnoea 57
  • The patient with a spinal injury 59
  • The patient with muscular dystrophy 61
  • The patient with multiple sclerosis 63
  • The patient with myasthenia gravis 64
  • The patient with chronic renal impairment 65
  • The patient with chronic liver disease 67
  • The patient with an organ transplant 69
  • The patient with rheumatoid arthritis 71
  • The patient with ankylosing spondylitis 73
  • The patient with trisomy 21 74

Chapter 5 The anaesthesia vivas 77

  • Overview 77
  • Performance strategies 77
  • The viva 78
  • Anaesthesia viva topics 82
  • Airway 82
  • Blood transfusion/coagulation 83
  • Burns 84
  • Cardiothoracic anaesthesia 84
  • Co-existing disease 84
  • Complications of anaesthesia 87
  • Data interpretation 87
  • Emergency/crisis situations 88
  • ENT/maxillofacial/thyroid surgery 89
  • Contents xi
  • Equipment/environment 90
  • General surgery 90
  • Intensive care 90
  • Neurosurgical anaesthesia 90
  • Obstetrics and gynaecology 91
  • Orthopaedics 93
  • Paediatric anaesthesia 94
  • Pain management 95
  • Regional anaesthesia 96
  • Remote locations 96
  • Trauma 97
  • Vascular surgery 98
  • Welfare and professional issues 98

Chapter 6 Data interpretation for the final examination 100

  • Electrocardiography 101
  • Chest radiography 119
  • Neck radiography 138
  • Computed tomography (CT) 144
  • Magnetic resonance imaging (MRI) 151
  • Echocardiography 156
  • Arterial blood gas analysis 167
  • Coagulation studies 170
  • Full blood count examination 176
  • Urea and electrolytes 179
  • Respiratory function tests 183
  • Sleep studies 188

Chapter 7 Useful reference and review articles 199

  • Overview 199
  • Airway management and spinal injury 199
  • Allergy and anaphylaxis 201
  • Anaesthesia and co-existing disease 201
  • Anaesthesia and specific situations 207
  • Cardiac anaesthesia 207
  • Cardiovascular risk and myocardial protection in anaesthesia 208
  • Coagulation and anaesthesia 211
  • Complications and consent in anaesthesia 212
  • Endocrine disease and anaesthesia 216
  • Intensive care topics 217
  • Monitoring and equipment in anaesthesia 218
  • Muscle disorders and anaesthesia 220
  • Neuroanaesthesia 220
  • Obstetric anaesthesia 221
  • Ophthalmic anaesthesia 223
  • Orthopaedic anaesthesia 223
  • Paediatric anaesthesia 224
  • Pain management 226
  • Pharmacology and anaesthesia 227
  • Regional anaesthesia 229
  • Remote locations and anaesthesia 231
  • Thoracic anaesthesia 232
  • Transfusion medicine 232
  • Vascular anaesthesia 233

Excerpts

The medical vivas take place the day after the written examination, and consist of two 18-minute examination stations involving a clinical encounter with a real patient. The medical vivas evaluate candidates’ ability to perform an appropriate preoperative assessment. Candidates must take a relevant history, perform a focused examination eliciting physical signs and review investigation results, allowing them to enter into a discussion of the pathophysiology and functional reserve of the patient in relation to the risks of anaesthesia.Marks in this component of the exam are allocated for the appropriateness of the history-taking and whether key symptoms are elicited. Candidates are expected to listen to the patient and also respond to their non-verbal cues. In the examination stage, candidates are marked on an examination technique which is sequential and logical, and which elicits key signs. Professionalism is also judged, and candidates are expected to show patients respect, with concern for their comfort and modesty. Finally, an organised and efficient presentation of findings is expected; candidates must show good knowledge of the medical condition present and its implications for anaesthesia.

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