Bucks

Science Curriculum for each session:

Bucks1F: Anatomy: Respiratory and cardiovascular

Commonly examined topics: 

• OSCE station - diaphragm anatomy for labelling

• OSCE station - chest drain anatomy of safe triangle

• OSCE station - anatomy of larynx particularly muscles and nerves

• OSCE station - thoracic inlet anatomy including first rib

• OSCE station - coronary anatomy

• OSCE station - CXR interpretation

• OSCE station - ECG interpretation

• Viva - CXR interpretation, ECG interpretation, difficult airway, anaesthetic emergencies e.g. pneumothorax and perioperative MI

Useful resources:

• AAGBI QRH: Cardiac arrest (2-1) and cardiac ischaemia (3-12): https://anaesthetists.org/Home/Resources-publications/Safety-alerts/Anaesthesia-emergencies/Quick-Reference-Handbook-QRH/PDF-version

• European society of cardiology guidelines on cardiac risk in non-cardiac surgery (https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/ESC-Guidelines-on-non-cardiac-surgery-cardiovascular-assessment-and-managem)

• DAS guidelines awake tracheal intubation: https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/anae.14904

• DAS guidelines CICO: https://das.uk.com/files/das2015intubation_guidelines.pdf

Videos:

Upper airway: https://vimeo.com/431186933

CXR Interpretation for OSCEs

Chest and respiratory: https://vimeo.com/424283386

Curriculum codes:

AN_BK_01 Mouth, nose, pharynx, larynx, trachea, main bronchi, segmental bronchi, structure of the bronchial tree; age-related changes from the neonate to the adult

AN_BK_02 Airway / respiratory tract blood supply and innervation

AN_BK_03 Pleura [including surface anatomy], mediastinum and its contents

AN_BK_04 Lungs; lobes and microstructure of lungs

AN_BK_05 Diaphragm, other muscles of respiration including innervation

AN_BK_06 The thoracic inlet and 1st rib

AN_BK_07 Interpretation of the normal adult chest x-ray

AN_BK_08 Heart - chambers, valves, conducting system and pericardium; blood supply and innervation

AN_ BK_27 Innervation of the pharynx and larynx

AN_BK_42 Landmarks for performance of cricoid pressure and surgical airway procedures

AN_BK_43 Landmarks for insertion of intercostal drainage catheters

Bucks2O: Pharmacology: Induction agents and respiratory drugs

Commonly examined topics 

• OSCE - Acute bronchospasm

• OSCE - MH

• Viva - Hypoxia

• Viva - Volatiles + OG partition coefficients

• Viva - Induction agents

• Viva - Isomers

• Viva - MH

Useful resources:

AAGBI QRH

• 2-2 Hypoxia desaturation cyanosis

• 2-3 Increased Airway Pressure

• 3-8 Malignant hyperthermia crisis (UPDATED January 2021)

• 3-4 Bronchospasm (UPDATED January 2019)

Videos:

• Inhalational Anaesthetic Agents

• Isomers

• Malignant Hyperthermia

• Paediatric anaesthesia introduction

Curriculum codes

PR_BK_27 Volatile and gaseous anaesthetic agents: Structure of available agents. MAC. Clinical effects: CNS [including ICP], CVS, RS. Unwanted effects of individual agents. MH susceptibility; hepatitis risks. Factors affecting onset and offset time. Oil/gas partition coefficient

PR_BK_01 Organic chemistry: drugs as organic molecules: types of intermolecular bonds; interactions between molecules; organic compared with inorganic compounds; bond strength; important atomic constituents: C, N, O, P, S and halides

PR_BK_28 Intravenous anaesthetic agents: Chemical classes. Properties of an ideal induction agent. Adverse effects on CNS [including effects on ICP], CVS, RS; pharmacokinetics including metabolism

PR_BK_29 Mechanisms of general anaesthetic action

PR_BK_04 Isomers: structural and stereoisomers: classification systems; clinical relevance

PR_BK_53 Respiratory system: general: Classes of drugs acting on the respiratory tract including bronchodilators; oxygen; surfactant; mucolytics; pulmonary vasodilators. Methods of administration; indications for use; mechanisms of action; adverse effects

PR_BK_54 Respiratory system: drugs used in acute severe asthma and chronic asthma; volatile agents. Mechanisms of action

PR_BK_65 RS stimulants including theophyllines, doxapram

Bucks3F: Physics and equipment: Flow and gases

Commonly examined topics

• Vaporisers (including drawing/labelling)

• VIE (including drawing/labelling)

• Cylinders and manifold

• Pressure gauges (including real photos and maths questions)

• Venturi mask/bernoulli’s principle

• Gas measurement (including real photos of fuel cells!)

• Hagen-Poiseuille and flow

• Spirometry

• Safety mechanisms

Useful resources: 

• VIE: https://www.frca.co.uk/article.aspx?articleid=100342

• Videos:

  • Pressure & Flow

  • Flow

  • Physics of vapours

Curriculum codes

PC_BK_22 Pressure: absolute and relative pressure; gauge pressure

PC_BK_23 Manufacture and storage of gases and vapours, safety

PC_BK_24 Cylinders and pipelines, Bourdon gauge

PC_BK_21 Physics of vapours

PC_BK_33 Vapour pressure: saturated vapour pressure

PC_BK_34 Vaporisation: process of vaporisation

PC_BK_35 Vaporisers: principles, including plenum and draw-over, temperature compensation, concentration

PC_BK_36 Principles of surface tension

PC_BK_78 Measurement of gas and vapour concentrations: e.g. infra-red, paramagnetic, fuel cell, oxygen electrode, mass spectrometry

PC_BK_27 Measurement of lung volumes and diffusion

PC_BK_28 Density and viscosity of gases

PC_BK_29 Laminar and turbulent flow: Hagen-Poiseuille equation, Reynold’s number, examples including helium

PC_BK_30 Measurement of volume and flow in gases and liquids, including pneumotachograph and other respirometers

PC_BK_31 Bernoulli principle

PC_BK_32 Venturi effect and entrainment devices

Bucks4O: Physiology: Nerves and muscles

Commonly examined topics in the primary: TBC

Useful resources to use/refer to: TBC

Curriculum codes: 

PB_BK_29 Action potential generation and its transmission

PB_BK_30 Neuromuscular junction and transmission, motor end-plate

PB_BK_31 Disturbances of neuromuscular transmission

PB_BK_32 Myopathies – congenital and acquired

PB_BK_33 Muscle contracture – malignant hyperthermia, myoclonus, burns

PB_BK_34 Muscle types; skeletal, smooth, cardiac

PB_BK_35 Skeletal muscle excitation-contraction coupling

PB_BK_36 Smooth muscle contraction: sphincters

PB_BK_37 Motor unit concept

PB_BK_65 Neuronal structure and function

PB_BK_66 Resting membrane potential, action potentials, conduction, synaptic mechanisms, actions of neurotransmitters

PB_BK_70 Maintenance of posture

PB_BK_71 Autonomic nervous system; organization, ganglia, adrenergic vs cholinergic

PB_BK_72 Neurological reflexes: monosynaptic, polysynaptic, stretch, inhibition

PB_BK_73 Motor function: basal ganglia, spinal and peripheral

PB_BK_74 Sense: receptors, nociception, proprioception, sight, taste, smell, hearing, balance, touch, temperature

Bucks5F: Physiology: Endocrine and stress response

Commonly examined topics: TBC

Useful resources to use/refer to:

Curriculum codes: 

AN_BK_22 Anatomical organisation of the autonomic nervous system.

AN_BK_23 Sympathetic innervation, sympathetic chain, ganglia and plexuses

AN_BK_24 Parasympathetic innervation; cranial and sacral outflow

AN_BK_25 Stellate ganglion

AN_BK_29 Functional anatomy of the hypothalamic/pituitary system

AN_BK_30 Functional anatomy of the adrenal gland

AN_BK_31 Functional anatomy of the thyroid and parathyroid glands

AN_BK_32 Anatomical organisation of the endocrine pancreas

PB_BK_89 Body temperature and its regulation, [including differences at extremes of age]

PB_BK_90 Hormones; types, receptors, heirarchy, extracellular signalling

PB_BK_91 Mechanisms of hormonal control; feedback mechanisms, effects on membrane and intracellular receptors

PB_BK_92 Hypothalamic and pituitary function

PB_BK_93 Adrenocortical hormones

PB_BK_94 Adrenal medulla; adrenaline and noradrenaline

PB_BK_95 Pancreas; insulin, glucagons and exocrine function

PB_BK_96 Thyroid and parathyroid hormones and calcium homeostasis