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

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.

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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