Final FRCA: 300 SBAs Kariem El-Boghdadly, Imran Ahmad
INDEX
A
Abciximab 342
Abdominal compartment syndrome 5657, 6667
management 67
risk factors 67
Abdominal perfusion pressure (APP) 56
Abdominal trauma, fluid resuscitation in 62
Absolute risk reduction (ARR) 201
Accidental dural puncture (ADP) 30
Activated clotting time (ACT) 76, 154
Activated partial thromboplastin time (aPTT) 17
Acupuncture, in pain management 150151
Acute kidney injury (AKI) 28, 387
diagnosis 387, 388
principles of management of 29
RIFLE criteria 28, 28
risk factors 387
stage 1 388
Acute renal failure (ARF) 278
Acute respiratory distress syndrome (ARDS) 25, 228
Berlin definition 228
causes of 228
classification of severity 25
extracoporeal membrane oxygenation in 230
general management 229
high frequency oscillation ventilation in 230
inhaled nitric oxide in 230
mechanical ventilation in 229
pathophysiology of 228229
pharmacological management 230
prone positioning in 229230
severe, management of 2526
Adductor canal block 321324
Adjustable gastric band (AGB) 379
Adrenaline
in anaphylaxis management 79
in hypotension with bradyarrhythmia 382
Adrenoceptor blocking agents 285
Aerobic gram negative bacilli (AGNB) 29
After action review (AAR) 134
Airway management, in children 193, 194
Airway surgery, anaesthesia for 376377
Alcoholic chronic liver disease 145146
Alcohol use, and rhabdomyolysis 119
Allodynia 117
Alpha-1 antitrypsin 200
Amiodarone 156
in atrial flutter 14
Amitriptyline
in fibromyalgia 115
in neuropathic pain 36
overdose, management of 2627
Amniotic fluid embolism (AFE) 192
Anaemia, preoperative 362
Anaesthesia
for airway surgery 376377
anaphylaxis during 149150
in remote locations 267
for urgent surgery in pregnant patient 113
Anaphylactoid reactions 220
Anaphylaxis 149150, 219220
triggers for 220
Aneurysm coiling, general anaesthesia for 344345
Anion gap metabolic acidosis 106
Ankle blocks 384385
Anorexia nervosa 244
Anterior interosseous nerve 269, 270
Anticonvulsants, in post surgical pain 34
Anticubital fossa 269, 270
Anti-diuretic hormone (ADH) 131, 144
Anti-embolism stockings 17
Antimicrobial prophylaxis, in surgery 14
Aortic aneurysm repair, and renal impairment 199
Aortic cross-clamping 39, 118119
Aortic dissection
with aortic regurgitation 217, 217218
classification systems 217
management of 217218
risk factors for 217
Apnoea/hypopnea index (AHI) 148, 284
Apnoea testing 303
ARDSNet ventilator strategy 26
Arrhythmias 39
direct current cardioversion in 3940
Arterial blood gas (ABG) analysis
burns patients 378
fat embolism syndrome 6061
Arytenoid dislocation 381
Ascorbic acid deficiency 120
Aspiration pneumonia 382
Aspirin 342
Asthma 67, 187188
in children 235
management of 6869
preoperative evaluation and preparation 235
severity of 68
Atelectasis 402403
characteristic of lobe involved 403
chest X-ray in 403
non-obstructive 402
obstructive 402
Atosiban 69
Atrial fibrillation (AF) 188
risk factors 188
treatment 189
Atrial flutter 13
DC cardioversion in 1314
management 1314
risk factors 13
Atrial pacing 14
Automated external defibrillator (AED) 132
Awake fibre-optic intubation 137
Axillary block 139
B
Back pain 281, 318, 363
lower 282, 396
Bacterial tracheitis 132133
Bariatric surgery 311312
Bazett’s formula, for corrected QT interval 156
Bier’s block anaesthesia 267269
Bilateral vocal cord paralysis 218
Bilevel positive airway pressure (BPAP) 262
Bisphosphonates, in cancer induced bone pain 359360
Bleeding, maxillary down-fracture and 18
Brachial plexopathy, and chest wall pain 34
Brachial plexus 140, 141 see also Brachial plexus blocks
branches of cords 142
cords 140
divisions 140
roots 140
supraclavicular branches 141
terminal branches 140141
trunks 140
Brachial plexus blocks 138142, 184
axillary 139, 184185
infraclavicular 139, 184
interscalene 138139, 184
supraclavicular 139, 184
Brain injury see also Traumatic brain injury (TBI)
safe transfer of patients with 272273
severe, and brainstem death 273
Brain natriuretic peptide (BNP) 54
Brainstem death (BSD) testing 143, 223, 297, 303
Brainstem herniation 59
Bronchial blockers 174, 174, 175
Bronchiolitis 133
Bronchopleural fistula 339340
Bupivacaine 269
Buprenorphine 357
Burns
‘Breathing’ assessment in 231
in children 3233
cyanide poisoning in 198199
enteral nutrition in 38
fluid resuscitation after 105, 118, 232
intubation for 105, 225226, 361
management in 3839, 118, 231233, 361
pain in 397398
referral criteria in 105, 233, 233, 283
rule of 9s, for body surface area (BSA) estimation 232, 232
C
Campylobacter jejuni 27
Cancer pain 3638, 37, 359360
Carbamazepine, in trigeminal neuralgia 3334, 151
Carboprost 69
Cardiac arrest
after cardiac surgery 173
management after 138
targeted temperature management after 386387
Cardiac disease, in pregnancy 191
Cardiac output monitoring 106109
Cardiac patients, and non-cardiac surgery 5354
Cardiac risk index (Lee Index) 53
Cardiac surgery, and coagulation defects 258260, 259, 260
Cardiopulmonary exercise testing (CPET) 135
anaerobic threshold 136137
cardiac output 136
measurements and results 136
performing test 135
safety 136
Carotid endarterectomy (CEA) 361362
Carotid surgery, anaesthesia for 321
Caudal epidural analgesia 345346
Cell salvage 76
Central neuraxial block (CNB), and epidural abscess 2021
Central post-stroke pain 152
Central retinal artery occlusion (CRAO) 383
Central venous catheters 24
Centre for Maternal and Child Enquiries (CMACE) report, on maternal deaths 192
Cerebral blood flow (CBF) autoregulation 337, 337
volatile anaesthetics and 92, 9293, 93
Cerebral oedema 114
Cerebral perfusion pressure (CPP) 337
Cerebral reperfusion syndrome 361362
Cerebral salt-wasting syndrome (CSWS) 131132, 186, 187
Cervical ultrasound 222
Child abuse 395
Child, uncooperative 185186, 236, 271272
Chi squared test 363
Chloroprocaine 269
Chronic lower back pain (LBP) 282
Chronic obstructive pulmonary disease (COPD)
protocolised weaning in 276
ventilatory management in 275276
weaning failure in 276
Chronic post surgical pain (CPSP) 116117, 117, 238
Clinical Negligence Scheme for Trust (CNST) regulations 134
Clinical Pulmonary Infection Score (CPIS) 29
Clinical risk management 133134
assessment 134
awareness 134
identification 134
management 134
re-evaluation 134135
Clonidine, as anaesthesia for middle ear surgery 178
Clopidogrel 342
Coagulopathy in cardiac surgery patients, management of 227228
Coarctation of the aorta 3132
Codeine, in neonates 197
Codeine phosphate 398
Coeliac plexus block 195196
in chronic upper gastrointestinal malignancy 152153
Cognitive behavior therapy (CBT) 282
Complex regional pain syndrome (CRPS) 34, 117, 240241
Budapest criteria 34, 35
diagnosis 3435
treatment 35, 3536
Computed tomography (CT)
burns patients 378
neck infections 222
Confusion Assessment Method in the intensive care unit (CAM-ICU) 354
Continuous positive airway pressure (CPAP) 139, 262
Coronary artery bypass grafting (CABG) 13
care after 274275
Coronary artery dominance 77
Crawford classification, of aortic thoracoabdominal aneurysms (TAAA) 399
Creatinine kinase (CK) 119
Cricoid pressure, use of, for rapid sequence induction 307
Croup 133
CT pulmonary angiography (CTPA) 110111
Cyanide poisoning 198199
Cyproheptadine 237
D
Dabigatran 18, 342
Danaparoid 17
Dantrolene, in malignant hyperthermia 379
Da Vinci system 264265
Day case surgery, selection criteria for 341, 341
Death, criteria 303
Delayed cerebral ischaemia 214215
Delirium, in critically ill patients 353, 353354
assessment methods 354
management of 354
risk factors associated with 353
types of 353354
Dexametomidate, in delirium 354
Diabetes inspidus (DI) 144
Diabetic ketoacidosis (DKA) 65, 106
in children with diabetes 114
management of 6566
Diabetic patient, and surgery 96
insulin regimens 96
Dobutamine, in septic shock 308
Double lumen tubes 174, 175
and bronchial blockers 174, 174
malpositioning 95, 9596
Dual antiplatelet therapy (DAPT) 343
Duke Activity Index 135
Duke’s criteria, for infective endocarditis 324325
Dural puncture, and post-dural puncture headache 103104
Dysaesthesia 117
E
Echocardiography 222
Electroconvulsive therapy (ECT) 19
anaesthesia for 1920, 179
and biphasic physiological response 19
Electroencephalogram (EEG), for diagnosis of death 223
Emergence delirium (ED) 70
Endobronchial intubation 5556
Endotracheal tube (ETT) 55
Epidural abscess, diagnosis and management of 2021, 363
Epidural analgesia 281
Epidural blood patch (EBP) 355
Epiglottitis 133
Ergometrine 69
Erythropoiesis 362
European Society of Cardiology (ESC) guidelines, for assessment of cardiac patients for non-cardiac surgery 5354
Exercise therapy 282
Extracorporeal membrane oxygenation (ECMO) 26, 230, 350351
Extra-vascular lung water (EVLW) 107, 108
Extra-ventricular drain (EVD) 6364
Eye injury, penetrating 153154
F
Fascia liaca block, in hip fractures 7273
Fat embolism syndrome 6061
Femoral catheter 282
Femoral nerve (FN) 321322, 322
fascia iliaca block 323
3-in-1 nerve block 322323
nerve stimulator guided nerve block 322
ultrasound guided block 323
Fentanyl 176, 272, 357
in poly-trauma patient 234
Fentanyl PCA, in sickle cell crises 399
Fibromyalgia 115, 396397
Filtration gradient (FG) 57
FLACC (Face, Legs, Arms, Cry, Consolability) scale 71, 71
Flexible bronchoscopy, in smoke inhalational injuries 377378
Flow-volume loops 58, 59
Fluid resuscitation
burns injury 32, 39, 105
paediatric trauma 142
septic shock 144145
Fluid trials 190, 191
Fondaparinux 17, 18, 343
Foot, nerves of 384, 384
deep peroneal nerve 385
saphenous nerve 385
superficial peroneal nerve 385
sural nerve 385
tibial nerve 384
Foreign body aspiration 340341, 356
Frailty phenotype 200
Fulminant liver disease, paracetamol overdose and 109110
G
Gabapentin
post-herpetic neuralgia 7374
post surgical pain 34, 114115
Gas embolism 98
detection 98
incidence 98
pathophysiology 98
treatment 9899
Gas flow within respiratory tract 266
Gastric volume, in injured patient 70
Gate theory of pain 36, 36
Genital tract sepsis 234235
Gentamicin 14
Gestational thrombocytopenia 356
Glasgow coma scale (GCS) 189
paediatric 7879
Glaucoma 285
Global end-diastolic volume (GEDV) 107, 108
Glucose control, in non-diabetic patient 348349
Glycerol gangliolysis 151
Glycopyrrolate 137
Guanethidine 240
Guillain–Barré syndrome 2728, 131
H
Haematoma, after thyroid surgery 219
Haemochromatosis 200
Haemorrhage 376
Haemorrhagic shock, classes of 62, 62
Haloperidol, in delirium 354
Head and neck infections, imaging studies for 221222
Head injuries
in children 316
patient transfer in 215216
Heart failure, management of 389390
Helium 265266, 266
Heparin-induced thrombocytopenia (HIT) 17, 18, 312313
diagnosis of 312313, 313
4T score for 313, 313
type 1 312
type 2 312
Heparins 298, 342
High frequency jet ventilation 99100, 100, 377
High frequency oscillation ventilation (HFOV), in ARDS 230
High impact intervention care bundle, for ventilation-associated pneumonia prevention 2930
Hip fractures 7273, 223
anaemia and transfusion 224
echocardiography 223224
postoperative pain relief 150
preoperative pain management 239240
timing of surgery and delays 223
Hip replacement surgery, pain management in 282
HIV testing 111112
Horner’s syndrome 139, 321
Hydroxocobalamin, for cyanide poisoning in burns patients 198
Hyperalgesia 117
Hyperbaric bupivacaine 176
Hyperbaric prilocaine 2% 176
Hypercarbia, during rigid bronchoscopy 341
Hyperpathia 117
Hypocalcaemia, after thyroid surgery 218219
Hypoglossal nerve 344
Hyponatraemia 131132
in brain injury 186187, 187
Hypotension following aortic cross-clamping 39
Hypothermia
effects of, on coagulation cascade 154
perioperative 280281
Hypoxaemia 95
Hypoxia, during rigid bronchoscopy 340341
Hysterectomy surgery, analgesia in 300301
I
Implantable cardioverter-defibrillator (ICD) 132
Infant, anaesthesia for surgery in 113114
Infantile pyloric stenosis 192
Infective endocarditis 324325
Inferior alveolar nerve 344
Infraclavicular block 139
Inhalational injury 225226
Intensive Care Delirium Screening Checklist (ICDSC) 354
Intercostal nerve (ICN) block 400401, 401
International Association for the Study of Pain (IASP), definition of pain 117
International normalised ratio (INR) 17
Interscalene blocks 138139
Intra-abdominal hypertension 56
Intra-abdominal pressure (IAP) 56, 67
elevated 5657
and intra-abdominal hypertension 67
measurement of 6667
normal 56, 67
Intra-aortic balloon pump (IABP) counterpulsation 94, 94
aim of 94
contraindications and cautions 95
haemodynamic effects of 94
indications for 9495
Intracranial haematoma 297298
Intracranial pressure (ICP) 337338
Intracranial pressure (ICP) bolt 51, 52
Intracranial pressure (ICP) waveform 51, 51, 6263, 63
Lundberg A waves 51, 52
Lundberg B waves 5152
Lundberg C waves 52
in non-compliant brain 51, 52
peaks 51
Intralipid 71
Intraocular pressure (IOP) 75, 153154, 285
Intra-thoracic blood volume (ITBV) 107, 108
Intravenous access, in children 396
Intravenous regional anaesthesia (IVRA) 267 see also Bier’s block anaesthesia
Intubation for transfer, indications for 272273
Invasive arterial pressure monitoring, in trans-sphenoidal surgery 375
Iron deficiency 120
Ischaemic optic neuropathy (ION) 383
Isovolumetric contraction (IVC) 94
J
Jayneway lesions 325
Jehovah’s Witnesses (JW), strategies for 303304
cell salvage 305
drugs/blood fractions/recombinant factors 305
haemodilution 304305
perioperative 304
preoperative 304
K
Kayser-Fleischer rings 199200
Ketamine 272
middle ear surgery 178
perioperative pain management 193
poly-trauma patient 234
L
Lamotrigine, in post-stroke pain 152
Landmark technique, for TAP block 306, 307
Laryngeal mask airway (LMA) 55, 343344
Laser-resistant endotracheal tubes 96
Laser technology, and airway fire 96
Le Fort classification, of mid-facial injury 299, 299
Le Fort I osteotomy, and complications 1819
Left anterior descending artery (LAD) 77, 77
Left circumflex artery (LCX) 77, 77
Left coronary artery (LCA) 77, 77
Lepirudin 17, 313
Levobunolol 285
Levobupivacaine 269
Lignocaine 137, 176
in Bier’s block 267269
Linear array probes 6162
Lingual nerve 343344
Liver failure, fluid management in 190, 191
Liver transplantation, in paracetamol overdose 110
Local anaesthetic (LA) toxicity 7071, 300
Lower limb surgery 180 see also Sciatic nerve block
Lower segment Caesarean section (LSCS)
airway management and 112113
under general anaesthesia 394
Low frequency jet ventilation 377
Low-molecular-weight heparin (LMWH) 17, 283284, 342
Ludwig’s angina 221222
Lumbar sympathetic plexus block 153
Lung isolation, difficult airway and 174, 174175, 175
M
Macrocytic anaemia 362
Magnesium, as anaesthesia for middle ear surgery 178179
Magnesium sulphate, in pre-eclampsia 31
Magnetic resonance imaging (MRI) 12, 12, 222
anaesthesia for, safety considerations in 101
contraindications to 13
for epidural abscess diagnosis 2021
equipment safety in MR settings 1213
whole spine 363
MAGPIE Trial 31
Major adverse cardiac events (MACE), risk factors for 241
Malignant hyperthermia (MH) 236237, 379
Malignant hyperthermia susceptibility (MHS) 236
Mandibular repositioning devices 262
Masseter spasm 302
Maxillofacial trauma, airway management in 299300
McGill pain questionnaire 238239
Mean arterial pressure (MAP) 56
Mechanical ventilation 226
weaning from 226227
Median nerve block 269270
Meningiomas 297298
Meta-analysis 403404
Metaraminol 298
Methadone 357, 358359
Methicillin-resistant Staphylococcus aureus (MRSA) 29
and antibiotic regimens in surgery 14
Methicillin sensitive Staphylococcus aureus (MSSA), and ventilator associated pneumonia 2930
Microcytic anaemia 362
Microlaryngeal tube 377
Midazolam 137, 272
in poly-trauma patient 234
Middle ear surgery, anaesthesia for 178179
Minimally invasive cardiac output monitors 106109, 107, 108
Misoprostol 69, 191
Mivacurium 179
Mobitz II atrioventricular (AV) block 260
Morphine
for pain in neonate 197, 398
in porphyria 75
for postoperative pain 70
Morphine allergy 357
Morphine patient controlled analgesia (PCA) 358359
Motor evoked potentials (MEPs) 303, 383
Muscle relaxants 179
Myasthenia gravis (MG) 170, 401402
Osserman classification 170
requirement for post op ventilation 170171
Myocardial infarction (MI) 76
coronary circulation and 7677, 77
ECG changes 7778, 78
Myoglobinuria 119
N
N-acetyl cysteine (NAC) 109
N-acetyl-p-benzoquinone imine (NAPQI) 109
Naloxone 149
Nasal endotracheal tube 19
Neonatal apnoea, postoperative 113114
Neonatal pain, analgesia for 398
Neonatal resuscitation 314315, 315
Neonates, analgesia for 197
local anaesthetics 197
non steroidal anti-inflammatory drugs 197
opiates 197
paracetamol 197
Neonates, critically ill, evaluation and management of 3132
Nerve block needles 2122, 22
cutting tip needle 21, 22
pencil point needles 22, 22
Nerve fibres 154156, 155, 155
Nerve stimulators 101103
Neurapraxia 343
Neurogenic shock 376
Neuron 154, 155
Neuropathic pain 117
Nimodipine, in delayed cerebral ischaemia prevention 215
Nitrous oxide, as anaesthesia for middle ear surgery 178
Nociception 117
Non heart-beating organ donation (NHBOD) 309310
Non-invasive ventilation (NIV) 275
Normocytic anaemia 362
Number needed to treat (NNT) 201
Numeric rating scale 239
Nutritional support, in critically ill patients 390391
O
Obese patients, perioperative management of 263264
Obesity 311
in pregnancy 147148
and weight loss surgery 379381
Obstetrics, management of difficult and failed intubation in 112113
Obstructive hydrocephalus 6364
Obstructive sleep apnoea (OSA) 284
in children 148
Obstructive sleep apnoea/hypopnoea syndrome (OSAHS) 262263
Oculocardiac reflex 241
Oculomotor nerve palsy 314
Oesophageal Doppler 171, 171173, 325326
afterload and 172
peak velocity and 172
stroke distance/stroke volume and 172
Oesophageal perforation 381
Olanzapine, in delirium 354
Opioid-induced hyperalgesia 38, 74
Opioid rotation 38
Opioids
after hip replacement surgery 282
in cancer-related pain 3738
for pain management 358
Opioid toxicity 237
Opioid withdrawal 237, 358
Oral intubation 299
Organ donation 309310
Oxcarbazepine, in trigeminal neuralgia 3334
P
Pacemakers
indications for insertion of 260, 261
NAPSE/BPEG coding system 261
summary of pacing modes 261
Paediatric trauma 142
Pain
assessment of, in children 71, 7172, 72
in cancer 3638, 37
control of, strategies for 37
definition of 117
gate theory of 36, 36
Pain scales 238239
Paracetamol
intravenous, in children 115116, 116
in neonates 197
overdose, and fulminant liver failure 109110
Paraesthesia 117
Paravertebral block 338339
Parkland formula, for resuscitation fluid volumes 32, 39, 105, 118, 232
Patent ductus arteriosus (PDA) 32
Patient-controlled analgesia (PCA) 149, 282283
Patient Safety Incident (PSI) 134
Peripheral nerve blocks, needles for 2122, 22
Peripheral nerve fibres 155, 155
Peripheral nerve stimulator 101103
Pethidine 357, 399
Phaechromocytomas 221
Phantom limb pain 193, 195
Phenylephrine 137
PiCCO monitoring 106109, 107, 108
Pituitary tumours 375
Placenta praevia 279
Polymorphic ventricular tachycardia (VT) 156
Porphyria 7475, 75
Post-dural puncture headache (PDPH) 103104, 319320, 320, 355
Posterior femoral cutaneous nerve (PFCN) 180
Post-herpetic neuralgia (PHN) 7374, 317
Post-mastectomy pain 34
Postoperative nausea and vomiting (PONV), strabismus surgery and 241
Post partum haemorrhage (PPH) 69
Pre-eclampsia 31, 281
Pregnancy
anaesthesia for non-obstetric surgery during 113
anaesthesia for parturients 355356
cardiac disease in 191
obesity in 147148
painless vaginal bleeding in 279
pre-eclampsia in 31
Preoperative fasting, in patients 280, 315316
Prilocaine 268
Primary biliary cirrhosis 200
Primary sclerosing cholangitis 200
Prolonged QT 156
Propofol 179
in poly-trauma patient 234
Prostin intravenous infusion, in critically ill neonate 3132
Pulmonary artery catheter (PAC) 106
Pulmonary aspiration of gastric contents 242
bronchopulmonary segments and 242244, 243
Pulmonary embolism (PE) 110111, 376
CT angiography in 157158
diagnosis and management of 157158
Pulmonary Embolism Severity Index (PESI) 157
simplified PESI (sPESI) 157
Pulmonary oedema 389
Pulseless ventricular tachycardia (VT) cardiac arrest 7071
Pulse oximetry 378
Pyloric stenosis 192
Q
QT interval 156
Qualitative data 363
Quantitative data 363
Quetiapine, in delirium 354
R
Radial nerve block 270271
Radiography 222
Radiotherapy, for bone pain 360
Rapid response teams, anaesthetists in 104105
Rapid sequence induction (RSI)
cricoid pressure for 307
in head injury 385
unanticipated difficult intubation during 5455, 55
Recombinant erythropoietin (EPO) 304, 362
Rectal examination, in liver disease 145146
Recurrent laryngeal nerve 344
Refeeding syndrome 245
Regional anaesthesia
peripheral nerve stimulator use in 101103
use of ultrasound in 224225, 225
Remifentanil 138
in maxillofacial surgery 19
in middle ear surgery 178
Remifentanil patient-controlled analgesia (PCA) 316317
Renal impairment, aortic aneurysm repair and 199
Renal replacement therapy, in acute kidney injury 278, 308309, 351
clot formation, prevention of 352353
indications for 351352
types of 352
Resuscitation and maintenance fluid, in burns 32
Retromolar space 299
Retropharyngeal abscess 133
Reynolds number (Re) 266
Rhabdomyolysis 119
Right coronary artery (RCA) 7677, 77
Rigid bronchoscope 377
Rigid bronchoscopy, for foreign body removal 340341
Rivaroxaban 18, 342343
Robotic surgery 264265
Rocuronium 219220
in poly-trauma patient 234
Root cause analysis (RCA) 134
Ropivacaine 269
Roux-en-Y gastric bypass 380
Royal College of Anaesthetists (RCoA) guidelines, on anaesthesia in non theatre settings 267
S
Sacral plexus 180
Sciatic nerve 180
Sciatic nerve block 180
Beck’s anterior approach 182, 182
Guardini’s subtrochanteric approach 182, 183
Labat’s transgluteal approach 181, 181
Mansour’s parasacral block 180, 181
popliteal approach 182183, 183
Raj approach 181, 182
Sedation 347
in intensive care 349350
levels of 347
monitoring 347
pre-assessment 347
principles and drugs 347348
Sensory evoked potentials (SEPs) 303
Sepsis 6465
intra-abdominal 234235
Septic shock, fluid resuscitation in 144145
Serotonin Release Assay (SRA) 312
Serotonin syndrome 237238
Serum osmolality 131
Sevoflurane 9293, 356
Shingles 73
Shoulder surgery, anaesthesia for 318319, 319
Sickle cell crises 399
Sickle cell disease 316
Smoke inhalation injury 377378
Sodium chloride 145
Somatosensory evoked potentials (SSEPs) 383
Sphenopalatine ganglion block 153
Spinal anaesthesia, in day surgery 175176
Spinal catheter 30
Spinal cord compression, and pain 318
Spinal cord stimulation, in complex regional pain syndrome 240241
Spinal infection, epidural drug delivery and 2021
Spinal shock 376
Spinal surgery 382384
eye and visual complication 383
prone position 383
spinal cord monitoring 383
Spontaneous breathing trial (SBT) 226227, 275
Staphylococcus aureus 14, 133
Staphylococcus epidermidis 14
Starch solutions 145
Statistical tests 363364, 364
Status epilepticus 53
STOP-BANG questionnaire 263264, 284
Storz ventilating bronchoscope 340
Strabismus surgery 241
Stroke volume index (SVI) 308
Subarachnoid haemorrhage (SAH) 214, 214, 391393
delayed cerebral ischaemia in 214215
imaging for diagnosis of 392
management of 393
presentation of 392
spontaneous 392
World Federation of Neurological Surgeons Scale (WFNSS) 392
Subdural haematoma 385
Submasseteric abscess 302
Submental intubation 300
Sub-Tenon’s blocks 320321
Superior hypogastric plexus block 153
Supraclavicular block 139
Surgical tracheostomy 299300
Surviving Sepsis Guidelines 6465
Sympathetic block 152
contraindications to 153
indications for 152
types of 153
Sympathomimetic agents 285
Syndrome of inappropriate antidiuretic hormone secretion (SIADH) 131132, 186, 187
Syntocinon 69, 191
Systemic vascular resistance index (SVRI) 108
T
Temporary transvenous cardiac pacing, insertion of 146147
Temporomandibular joint 302, 302
Tension pneumothorax 376
Therapeutic hypothermia, in post-cardiac arrest patients 138
Thiopentone, in poly-trauma patient 234
Thoracic epidural anaesthesia 346347
Thoraco-abdominal aortic aneurysm 399400
Thoracotomy pain, analgesic options for 195, 196
Thromboelastograph (TEG) tests 259, 259260, 260
Thromboembolic deterrent stockings (TEDS) 17
Thyroidectomy, and hypocalcaemia 218219
Tic douloureux see Trigeminal neuralgia (TN)
Tirofiban 342
Tocolytic therapy, in uterine inversion 279280
Torsade de pointes 156
Total intravenous anaesthesia (TIVA) 377
Total knee replacement (TKR), adductor canal block in 323324
Total spinal block 313314
Tracheal necrosis 219
Tracheal rupture 381
Tracheomalacia 219
Tracheostomy airway emergencies, management of 15, 1516
Tramadol 237, 357
Tranexamic acid 76, 305
Transcutaneous electrical nerve stimulation (TENS) 36, 36, 282, 317, 396
Transfusion-related acute lung injury (TRALI) 191
Transport of critically ill adult, planning before 2425
Trans-sphenoidal pituitary surgery 375
Transurethral resection of the prostate (TURP) 176
Transversus abdominis plane (TAP) block 306307
Trauma anaesthesia 233234
Trauma, paediatric 142, 394
Traumatic brain injury (TBI) 22
airway/ventilation 23
drugs, use of 24
haemodynamics 23
hyponatraemia in 186187, 187
initial assessment and resuscitation 22
intracranial pressure (ICP), management of 2324
intubation prior to transfer in 215216
Tricyclic antidepressants (TCA) 26
overdose, management of 2627
Trigeminal neuralgia (TN) 3334, 151
Trigeminocardiac reflex 19
Trismus 301
TURP syndrome 176
glycine in 177
plasma sodium and osmolality in, changes in 177
volume in, changes in 177
U
Ulnar nerve block 271
Ultrasound-guided nerve block 224225, 225
in-plane approach 225
long-axis view 225
out-of-plane technique 225
short-axis view 224
Ultrasound probe 6162
curved array probes 61
hockey stick footprint probes 61
linear array probes 61, 62
phased array probes 61
Unanticipated difficult intubation, management of 5455, 55
Uncooperative child patient, anaesthesia for 185, 236, 271272
consent 185
drug treatments 272
holding/restraint 185, 272
provision of safe sedation 185186
risk factors for induction distress 271
Unfractionated heparin 17
Upper airway obstructions 58
extrathoracic 58
flow-volume loops 58, 59
intrathoracic 58
Upper limb peripheral nerve blocks 269
median nerve block 269270
radial nerve block 270271
ulnar nerve block 271
Upper limb surgery, anaesthesia for 184
Uterine inversion 279280
Uterotonics 191
Uvular necrosis 381
Uvulopalatopharyngoplasty (UPPP) 263
V
Vaccination at time of anaesthesia 357
Vallergan (trimeprazine) 272
Vancomycin 14
Vancomycin resistant enterococci (VRE) 29
Varicella zoster virus (VZV) 73
Vasopressin 59, 273
Venous air embolism (VAE) 9899, 258 see also Gas embolism
during head and neck surgery 19
Venous thromboembolism (VTE)
prevention of 1718
risk of, after day surgery 16
Ventilator associated infection (VAI)
causative organisms 29
definition 29
diagnosis 29
prevention and management 2930
Ventilator-associated pneumonia (VAP) 276
diagnosis 277
risk factors 276277
Ventricular fibrillation (VF) 132
Verbal descriptor scale 239
Violence/aggression in visitors, management of 104105
Visual analogue scale (VAS) 71, 239
Vitamin A deficiency 40, 120
Vitamin B1/thiamine deficiency 120
Vitamin C deficiency 120
Vocal cord damage, after thyroid surgery 218
Volatile anaesthetics, and cerebral blood flow autoregulation 92, 9293, 93
W
Warfarin 17, 342
Weaning from ventilator 226227
Weight loss surgery 379
malabsorptive 380
operative factors 380
preoperative assessment 380
restrictive 379
Wilcoxon signed rank test 363364, 364
Wilson’s disease 199200
Wong–Baker FACES scale 72, 239
Z
Zygomatic arch fractures 302303
×
Chapter Notes

Save Clear


iiiFinal FRCA
300 SBAs
Kariem El-Boghdadly MBBS BSc (Hons) FRCA Specialist Registrar in Anaesthesia, South East School of Anaesthesia, London, UK Imran Ahmad MBBS FRCA Consultant Anaesthetist, Guy’s and St Thomas’ NHS Foundation Trust, London, UK Honorary Senior Lecturer, King’s College, London, UK Training Programme Director Anaesthesia South London (ASL), London, UK
iv© 2015 JP Medical Ltd.
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Medical knowledge and practice change constantly. This book is designed to provide accurate, authoritative information about the subject matter in question. However readers are advised to check the most current information available on procedures included and check information from the manufacturer of each product to be administered, to verify the recommended dose, formula, method and duration of administration, adverse effects and contraindications. It is the responsibility of the practitioner to take all appropriate safety precautions. Neither the publisher nor the editors assume any liability for any injury and/or damage to persons or property arising from or related to use of material in this book.
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vPreface
Recent pass rates for the Final FRCA written examination have fallen by around 25%, a significant drop that suggests candidates require more practice ahead of the exam. There are few single best answer (SBA) revision books or past papers currently available for the Final FRCA. Recognising this problem and following on from our experience of writing Primary FRCA: 450 MTFs and SBAs, we decided to write this book of 300 practice SBAs.
The written element of the Final FRCA consists of a 3-hour short answer question (SAQ) section of 12 compulsory questions and a multiple choice question (MCQ) section. This comprises 90 MCQs to be completed in 3 hours; 60 multiple-true-false (MTF) questions and 30 SBA questions (the latter introduced in September 2010). The content of the exam is aligned to the intermediate training CCT curriculum, with variable weighting applied to different aspects of the curriculum. The 30 question SBA section generally includes 20 questions in clinical anaesthesia, 5 in intensive care medicine and 5 in pain management. The SBAs are often seen as the most challenging section of the MCQ paper, because they test the application of knowledge in the clinical setting, as opposed to the MTFs which test factual recall.
Each SBA question consists of a clinical scenario (the ‘stem’), and a direct ‘lead-in’ question, followed by five answer options. One of these is the ideal response, although all options are possible solutions. Four marks are awarded for each correct answer and no marks are lost for an incorrect answer, therefore a total of 120 marks is possible. Due to the heavy relative weighting of the SBAs, they are an important aspect of the written examination, and it is crucial that candidates practise as much possible in order to answer them correctly.
The 10 papers of 30 SBAs in this book cover every aspect of the Final FRCA syllabus. We have included 20 clinical anaesthesia, 5 intensive care medicine and 5 pain management questions in each paper to reflect the exam. Each question is up-to-date at the time of writing and reflects the standard and type of question that candidates will encounter.
Failing to pass the Final FRCA is both expensive and upsetting, so it is prudent to be well prepared. It requires candidates to have an in-depth knowledge spanning the syllabus, and to have practised their examination technique. We believe this book provides candidates with both the knowledge and the technique, and that it will help candidates succeed in the Final FRCA SBA exam.
Kariem El-Boghdadly
Imran Ahmad
January 2015
  • Chapter 1 Mock Paper 1
    • Questions
    • Answers
  • Chapter 2 Mock Paper 2
    • Questions
    • Answers
  • Chapter 3 Mock Paper 3
    • Questions
    • Answers
  • Chapter 4 Mock Paper 4
    • Questions
    • Answers
  • Chapter 5 Mock Paper 5
    • Questions
    • Answers
  • Chapter 6 Mock Paper 6
    • Questions
    • Answers
  • Chapter 7 Mock Paper 7
    • Questions
    • Answers
  • Chapter 8 Mock Paper 8
    • Questions
    • Answers
  • Chapter 9 Mock Paper 9
    • Questions
    • Answers
  • Chapter 10 Mock Paper 10
    • Questions
    • Answers
  • Index
ixContributors