Reading

Reading1F: Physiology: Acid base balance and immunity

Commonly examined topics:

OSCE - pH, pCo2, pO2 measurements
OSCE - Measurement of CO2 production
Viva - pH and acid base balance
Viva - Sepsis
Viva - Physiological changes in the elderly
Viva - Anaphylaxis
Viva - Hypersensitivity
Viva - Inflammation

Useful resources

NAP 6 on perioperative anaphylaxis: https://www.nationalauditprojects.org.uk/NAP6home
AAGBI guideline on anaphylaxis: 3-1 Anaphylaxis (UPDATED April 2022)
AAGBI guideline on sepsis: 3-14 Sepsis
AAGBI guideline on people with dementia: GuidelinePeri-operative care of people with dementiaGuidelinePeri-operative care of people with dementiaFebruary 2019

Videos:

E-LFH tutorials:

Acid base balance: https://portal.e-lfh.org.uk/Component/Details/561647
Immunity: https://portal.e-lfh.org.uk/Component/Details/561642
Allergy and inflammatory response: https://portal.e-lfh.org.uk/Component/Details/561752
Regulation of body fluid pH: https://portal.e-lfh.org.uk/Component/Details/561782
Acid base chemistry: https://portal.e-lfh.org.uk/Component/Details/417917
Logarithms and pH: https://portal.e-lfh.org.uk/Component/Details/417822
Anaesthesia in the elderly: https://portal.e-lfh.org.uk/Component/Details/464111

Curriculum codes:

PB_BK_01 Organization of the human body and control of internal environment

PB_BK_02b Changes with advancing age

PB_BK_03 Cells; components and organelles

PB_BK_04 Function of cells; genes and their expression

PB_BK_05 Cell membrane characteristics; cell junctions, receptors

PB_BK_06 Protective mechanisms of the body

PB_BK_07 Definition of pH. Strong and weak acids.

PB_BK_08 Acid base balance. Includes buffers, Henderson-Hasselbalch equation and anion gap

PB_BK_09 Ions e.g. Na+, K+, Ca++, Mg++, Cl-, HCO3

PB_BK_10 Cellular metabolism; aerobic vs anaerobic

PB_BK_25 White blood cells: types, origins, characteristics, turnover

PB_BK_26 The inflammatory response, systemic inflammatory responses, hypersensitivity reactions

PB_BK_27 Immunity and allergy; innate vs acquired, non-specific vs specific, humoral vs cellular

PB_BK_28 Immunodeficiency – congenital and acquired

PC_BK_79 Measurement of pH, PCO2, PO2, electrolytes

PC_BK_80 Derived blood gas variables, e.g. HCO3a, HCO3s, BE. Siggaard-Andersen nomogram

PC_BK_81 Measurement of CO2 production, oxygen consumption, respiratory quotient

PC_BK_03 Logarithms

Reading2F: Physics and equipment: Heat and temperature

Common things that come out in the primary:

OSCE:

Machine check +/- faults
Circle system
Bain system
Soda lime
Cylinders
Temperature measurement

Viva questions:

Heat and temperature
Scavenging and pollution
Soda lime
Gas laws
Patient warming
Heat transfer

Useful resources to use/refer to:

AAGBI machine check: https://anaesthetists.org/Home/Resources-publications/Guidelines/Checking-Anaesthetic-Equipment

Videos: The Gas Laws

Curriculum codes:

PC_BK_10 Heat: including temperature, absolute zero

PC_BK_11 Heat transfer and loss: conduction, convection, radiation, evaporation

PC_BK_12 Temperature measurement: including Hg, alcohol, infrared, thermistor, thermocouple, Bourdon gauge, liquid crystal.

Anatomical sites used for measurement

PC_BK_13 Latent heats, triple point of water

PC_BK_14 Patient warming systems: principles

PC_BK_15 Warming equipment for intravenous fluids: principles

PC_BK_16 Laws of thermodynamics; mechanical equivalent of heat

PC_BK_01 Mathematical concepts: relationships and graphs

PC_BK_66 Plenum systems: warming blankets, theatre and anaesthetic room ventilation

PC_BK_86 Environmental monitoring: contamination by anaesthetic gases and vapours

PC_BK_26 Scavenging devices

PC_BK_19 Physics of gases. Gas Laws: kinetic theory of gases, Boyles, Henry’s, Dalton, Charles, Gay-Lussac

PC_BK_20 Critical temperature, critical pressure

PC_BK_25 Suction devices

PC_BK_70 CO2 absorption: chemistry, complications

Reading3F: Pharmacology: Analgesics, premeds and social drugs

Common things that come out in the primary: TBC

Useful resources to use/refer to: TBC

Videos: TBC

Curriculum codes:

PR_BK_15 Tachyphylaxis and tolerance: Examples of drugs demonstrating tachyphylaxis; proposed mechanisms. Opioid dependence and tolerance

PR_BK_32 Analgesics. Simple analgesics, NSAIDs and opioids. Available routes of administration; peri-operative prescribing; chronic compared with acute pain prescribing

PR_BK_33 Aspirin and paracetamol. Comparison of structures; indications and contraindications; mechanisms of action. Bioavailability; metabolism; toxicity

PR_BK_34 Non-steroidal anti-inflammatory analgesics: Classification. Mechanism of action. Clinical effects and uses; unwanted effects, contraindications

PR_BK_35 Opioid analgesics: Receptor classification. Mechanism of action. Inhibitory effects, sites of action on pain pathways.

Unwanted effects. Full and partial agonists and partial agonists. Routes of administration

PR_BK_68 Social drugs including tobacco, alcohol and non-legal drugs: anaesthetic relevance

PR_BK_30 Benzodiazepines: classification of action. Clinical actions. Synergism with anaesthetic agents. Antidote in overdose

PR_BK_55 Gastrointestinal system: general: antisialogogues; drugs reducing gastric acidity; drug effects on the GI tract including gastric and bowel motility

PR_BK_56 Antiemetics: Anatomical sites for antiemetic action; central and peripheral inputs to vomiting centre; use of dexamethasone

PR_BK_05 Mechanisms of drug action: physicochemical; pharmacodynamic; pharmacokinetic: drug-receptor interactions; dose response and log[dose]-response curves; agonists, partial agonists, antagonists. Reversible and irreversible antagonism.

Potency and efficacy

Reading4O: Physics and equipment: Lasers, ultrasounds and cleaning

Common things that come out in the primary: TBC

Useful resources to use/refer to: TBC

Videos: TBC

Curriculum codes:

PC_BK_55 Processing, storage, display of physiological measurements

PC_BK_56 Transducers and strain gauges

PC_BK_57 Lasers: basic principles and safety

PC_BK_58 Ultrasound: basic principles of ultrasound

PC_BK_59 Demonstrates knowledge of the physics relevant to optical fibres

PC_BK_60 Doppler effect, principle and clinical application

PC_BK_90 Principles of hygiene, including cleaning and sterilisation of equipment

PC_BK_18 Colligative properties: osmolarity, osmolality, osmometry, diffusion

Reading5O: Physiology: Cardiovascular system

Common things that come out in the primary: TBC

Useful resources to use/refer to: TBC

Videos: TBC

Curriculum codes:

PB_BK_38 Cardiac muscle contraction

PB_BK_39 The cardiac cycle: pressure volume relationships, work and power

PB_BK_40 Rhythmicity of the heart; cardiac impulse generation

PB_BK_41 Regulation of cardiac function; general and cellular

PB_BK_42 Control of cardiac output [including Starling relationship]

PB_BK_43 Fluid challenge and heart failure, types of shock

PB_BK_44 Electrocardiogram and arrhythmias, origin of ECG, effects of temperature, ischaemia, infarction and electrolyte imbalance

PB_BK_45

Neurological and humoral control of systemic blood pressures, blood volume and blood flow [at rest and during physiological

disturbances e.g. exercise, haemorrhage and Valsalva manoeuvre]

PB_BK_46 Peripheral circulation: capillaries, vascular endothelium and arteriolar smooth muscle

PB_BK_47 Functions of endothelium

PB_BK_48 Characteristics of special circulations including: pulmonary, coronary, cerebral, renal, portal, transitional and fetal

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