OUH

OUH1O: Pharmacology: Enzymes, receptors and local anaesthetics

Commonly examined topics:

OSCE station - LA dose calculations (yes, really, Angie’s primary had a station pretty much identical to case 2)
Viva - Enzymes
Viva - Management of LA toxicity
Viva - Local anaesthetics
Viva - COX pathway
Viva - Analgesics inc ibuprofen
Viva - Steroids and intranuclear receptors

Useful resources:

AAGBI LA toxicity guideline: https://anaesthetists.org/Home/Resources-publications/Guidelines/Management-of-severe-local-anaesthetic-toxicity
AAGBI steroid insufficiency guideline: GuidelineManagement of glucocorticoids during the peri-operative period for patients with adrenal insufficiencyGuidelineManagement of glucocorticoids during the peri-operative period for patients with adrenal insufficiencyFebruary 2020

Videos:

eLFH tutorials:

Enzymes as drug targets inc anticholinesterases: https://portal.e-lfh.org.uk/Component/Details/693268
Enzyme induction/inhibition: https://portal.e-lfh.org.uk/Component/Details/693303
Nuclear drug receptors: https://portal.e-lfh.org.uk/Component/Details/754400
Local anaesthetics: https://portal.e-lfh.org.uk/Component/Details/692088

Curriculum codes:

PR_BK_10 Nuclear receptors: Intracellular hormone receptors. e.g. cytoplasmic receptors for steroids; corticosteroids vs.

mineralocorticoid receptors

PB_BK_11 Enzymes

PR_BK_11 Enzymes as drug targets: Michaelis-Menten kinetics. Direct and allosteric mechanisms. e.g. acetylcholinesterase; cyclooxygenase; phosphodiesterase

PR_BK_08 Receptors as proteins; ion channels; transmembrane transduction and intermediate messenger systems; intracellular/nuclear receptors. Receptor regulation and tachyphylaxis

PR_BK_06 Non-specific drug actions: Physicochemical mechanisms: e.g. adsorption; chelation; neutralization

PR_BK_03 Drug chemistry: solubility, partition coefficients and movement of drugs through membranes: Lipid solubility; influence of pKa and pH; partition coefficients. Passive and active transport mechanisms

PR_BK_31 Local anaesthetic agents. Additional effects, including anti-arrhythmic effects. Mechanism of action. Clinical factors

influencing choice: operative site, patient, available agents. Toxicity syndrome; safe clinical and maximum clinical doses;

treatment of overdose

PR_BK_08 Receptors as proteins; ion channels; transmembrane transduction and intermediate messenger systems; intracellular/nuclear receptors. Receptor regulation and tachyphylaxis

PR_BK_07 Voltage-gated ion channels; membrane-bound transport pumps. Sodium, potassium and calcium channels as targets for drug action

PR_BK_09 Transduction systems as receptors: G-protein coupled receptors [GPCRs] and non-GPCR systems.

PR_BK_13 Predictable side effects of drugs: non-selective actions of drugs; action at multiple receptors; multiple anatomical locations; predictable enzyme induction-inhibition

PC_BK_06 Electrolyte solutions [also drug doses]: conversion between units e.g. molar, mg/ml, %

OUH2F: Physiology: The renal system

Commonly examined topics:

Osmolarity vs osmolality and plasma volume
TURP syndrome
Sodium handling
AKI
Blood flow to kidneys

Useful resources:

Gloucester hospitals hyponatraemia guidelines: https://www.gloshospitals.nhs.uk/media/documents/Hyponatraemia.pdf
BJA Ed article on TURP: https://academic.oup.com/bjaed/article/9/3/92/388586

Videos:

Curriculum codes:

PB_BK_12 Capillary dynamics and interstitial fluid; osmosis, filtration and convection

PB_BK_13 Osmolarity: osmolality, partition of fluids across membranes, tonicity

PB_BK_14 Lymphatic system

PB_BK_15 Special fluids especially cerebrospinal fluid: also pleural, pericardial and peritoneal fluids

PB_BK_16 Active cellular transport mechanisms

PB_BK_54 Regulation of acid-base balance

PB_BK_55 Micturition

PB_BK_56 Pathophysiology of acute renal failure

PB_BK_49 Structure and function, renal circulation

PB_BK_50 Blood flow and glomerular filtration, plasma clearance and tubulo-glomerular feedback

PB_BK_51 Tubular function and urine formation; transport processes

PB_BK_52 Assessment of renal function

PB_BK_53 Regulation of water and electrolyte [Na+, K+, Ca++, Mg++, PO4--,] balance; response to fluid loss /hypovolaemia. Role of urea and creatinine measurement.

OUH3O: Anatomy: Brain and spinal cord

Commonly examined topics

OSCE station: Cranial nerve foramina on base of skull - labelling
OSCE station: ATLS guidelines for trauma
OSCE station: Neurological examination including cranial nerve examination
OSCE station: Anatomy of vertebrae - labelling
Viva: Head injury/Intracranial pressure management
Viva: Major trauma

Useful resources to use/refer to:

RCEM C spine injury: https://www.rcemlearning.co.uk/reference/cervical-spine-injury/
ATLS guidelines

Videos:

Curriculum codes:

AN_BK_11 Brain and its subdivisions; blood supply

AN_BK_12 Spinal cord, structure of spinal cord, major ascending and descending pathways; blood supply

AN_BK_15 Spinal meninges, subarachnoid and extradural space; contents of extradural space

AN_BK_28 Eye and orbit

PB_BK_67 The brain: functional divisions

PB_BK_68 Brain stem; organization, interconnections

PB_BK_69 Intracranial pressure: cerebrospinal fluid, blood flow

AN_BK_33 Cervical, thoracic and lumbar vertebrae

AN_BK_16 Anatomy of CSF system

AN_BK_26 Cranial nerves

PB_BK_76 Spinal cord: anatomy and blood supply, effects of spinal cord section

OUH4F: Physiology: Obstetrics and gynaecology

Commonly examined topics

Useful resources:

Videos: TBC

Curriculum Codes:

AN_BK_14 Pain pathways relevant to the stages of obstetric labour and delivery

AN_BK_35 Ligaments of vertebral column

AN_BK_36 Surface anatomy of vertebral spaces; length of spinal cord and subarachnoid space; age-related differences from the neonate to the adult

AN_BK_34 Sacrum, sacral hiatus

PB_BK_02a Changes at birth and in early life

PB_BK_97 Physiological changes associated with pregnancy

PB_BK_98 Materno-fetal, fetal and neonatal circulation

PB_BK_99 Function of placenta; placental transfer

PB_BK_100 Fetus; physiological changes at birth

PB_BK_101 Lactation

OUH5F: Pharmacology: Pre-op drugs

Commonly examined topics

Useful resources:

Videos: TBC

Curriculum Codes:

PR_BK_14 Idiosyncratic side effects of drugs: e.g. blood and bone-marrow dyscrasias; pulmonary fibrosis; anti-platelet effects.

Anaphylactic and anaphylactoid reactions: comparison; treatment; identification of responsible drug; risks with polypharmacy

PR_BK_16 Drug interactions: Types of interaction: synergism, additivity, antagonism; isobolograms. Classification of mechanisms of drug interaction

PR_BK_58 CNS: antiepileptic agents: Mechanisms of action; unwanted side effects

PR_BK_59 CNS: antidepressants: Classes of drug: anaesthetic relevance

PR_BK_60 Therapy for diabetes mellitus: Drugs used in type 1 and type 2 diabetes: Insulins: classification of types available; routes of administration; perioperative management. Unwanted effects and risks and therapy of hypo- or hyperglyaemia

PR_BK_61 Hormones: corticosteroids: Indications for use; clinical effects; long-term complications of glucocorticoid use

PR_BK_63 Hormones: treatment of thyroid disorders: Synthesis and release of thyroid hormones. Preparations used in hyper- and hypothyroidism

PR_BK_64 CNS stimulants; classes, mechanisms of action, uses in anaesthesia

PR_BK_67 Effects of drugs on the eye and vision; includes intra-ocular pressure

PR_BK_66 Antimicrobial agents: general classification: Types of antimicrobial agents: antiviral; antibacterial; antifungal; bacteriostatic and bacteriocidal. Mechanism of action. Indications for use of different classes of antibiotics. Bacterial resistance

OUH6F: Statistics and data handling

Commonly examined topics

Useful resources:

Videos: TBC

Curriculum Codes:

SM_BK_01 Recalls the simple aspects of study design

SM_BK_02 Explains the outcomes measures and the uncertainty in their definition

SM_BK_03 Explains the basis of meta-analysis and evidence based medicine

SM_BK_04 Recalls the types of data and their representation

SM_BK_05 Explains the normal distribution as an example of parametric distribution

SM_BK_06 Explains indices of central tendency and variability

SM_BK_07 Recalls simple probability theory and the relationship to confidence values

SM_BK_08 Explains the null hypothesis

SM_BK_09 Explains the choices for simple statistical tests for different types of data

SM_BK_10 Recalls type I and type II errors

OUH7O: Pharmacology: Neuromuscular blockade

Commonly examined topics

Useful resources:

Videos: TBC

Curriculum Codes:

PR_BK_36 Muscle relaxants. Classification. Sites of action. Properties of an ideal muscle relaxant. Dantrolene and management of MH

PR_BK_37 Depolarizing muscle relaxants: Structure, mechanism of action. Organophosphate poisoning. Adverse effects and

contraindications

PR_BK_38 Non-depolarizing muscle relaxants: Structural classification; sub-classification according to onset-time and duration of action. General comparison of aminosteroids and bisbenzyisoquinoliniums. Comparison of individual agents; metabolism and active metabolites. Unwanted effects.

PR_BK_39 Reversal of neuromuscular blockade: Indications for use; mechanisms of action; clinically unwanted effects of reversal of neuromuscular blockade

PR_BK_21 Non-enzymatic drug elimination: Hofmann degradation

PR_BK_12 Anticholinesterases: Classification of drugs that inhibit acetylcholinesterase and plasma cholinesterase including

Organophosphates

PR_BK_02 Organic chemistry: ionization of molecules: type of groups that ionize: amides, hydroxyl, carboxyl. Oxidation and reduction. Permanently charged [quaternary ammonium] drugs.

PR_BK_18 Administration and absorption: routes of administration; first-pass metabolism and bioavailability. Selection of appropriate route. Drug delivery systems: e.g. sustained release, enteric coated, transdermal patch and iontophoretic systems

PR_BK_19 Oral administration: Time-course for systemic appearance; factors e.g. pKa, lipid solubility, active transport. Bioavailability of drugs given orally and its measurement

PC_BK_84 Assessment of neuromuscular blockade

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