This is a list of all the Physics related SAQs in the Final SAQ paper back to the year 2000.
Note that some of these questions are repeated word for word, or, with very slight modifications.
Question 1 (Blue Book) REPEATED
- a) What are the indications for renal replacement therapy (RRT) in the intensive care setting? (8 marks)
- b) List the types of RRT available in intensive care. (6 marks)
- c) Outline the principle mechanisms of solute and water removal by filtration (3 marks) and dialysis (3 marks) during RRT.
Pass rate 84.9%
Question 3 REPEATED
- a) Outline the basic physical principles involved in formation of an ultrasound image. (6 marks)
- b) What patient factors (3 marks) and acoustic artefacts (4 marks) may influence the ultrasound image quality?
- c) Which two needling techniques are commonly used in ultrasound guided nerve blocks? (2 marks). List the advantages and disadvantages of one of these techniques. (5 marks)
Pass rate 58.9%
Question 4 REPEATED (from 2010)
- a) What is meant by counter pulsation in the context of an intra-aortic balloon pump (IABP)? (1 mark)
- b) Briefly explain the effect of counter pulsation from an IABP on coronary blood flow and the left ventricle. (4 marks)
- c) What are the indications for (6 marks) and contraindications to (3 marks) the use of an IABP in an adult?
- d) List possible complications of an IABP. (6 marks)
Pass rate 58.7%
Question 12 (Grey Book)
You are asked to transfer an intubated intensive care patient for a magnetic resonance imaging (MRI) scan.
- a) What is meant by the terms magnetic resonance (MR) safe, and MR conditional, in relation to equipment used in the MRI scanner room? (2 marks)
- b) What precautions can be taken to prevent burns caused by monitoring equipment used in an MRI scanner? (6 marks)
- c) List other precautions you would take to minimise the risks associated with MRI. (7 marks)
- d) What are the contraindications to an MRI scan? (5 marks)
Pass rate 45.8%
Question 12 (Grey Book)
- a) What are the factors associated with an increased risk of accidental awareness under general anaesthesia (AAGA)? (14 marks)
- b) What monitoring devices can be used to help reduce the incidence of AAGA? (2 marks)
- c) What are the possible consequences to the patient of an episode of AAGA? (4 marks)
Pass rate 57.1%
Question 4 (Pink Book)
- a) How should you manage the perioperative opioid requirements of a patient who is having elective surgery and who takes regular opioids for non-malignant pain? (8 marks)
- b) Give the conversion factors for oral tramadol, codeine and oxycodone to the equianalgesic oral morphine dose. (3 marks)
- c) What are the perioperative implications of an existing spinal cord stimulator? (6 marks)
- d) What additional perioperative precautions should be taken if the patient has an intrathecal drug delivery system fitted? (3 marks)
Pass rate 25.0%
Question 9 (Orange Book)
- a) Outline the basic principles of ultrasound signal and image generation. (6 marks)
- b) How may physical factors influence the image quality of an ultrasound device? (6 marks)
- c) Which two needling techniques are commonly used in ultrasound guided nerve blocks and what are the advantages and disadvantages of each? (8 marks)
Pass Rate 5.7%
- a) What are the indications for insertion of an implantable cardiac defibrillator (ICD)? (20%)
- b) How might surgical diathermy affect the ICD? (20%)
- c) A patient with an ICD is listed for elective surgery; what preparations are necessary preoperatively, intra-operatively and postoperatively? (45%)
- d) How does the management differ if this patient requires emergency surgery? (15%)
Pass Rate 67.1%
- a) What are the indications for arterial cannulation? (35%)
- b) How may an invasive arterial pressure measuring system be calibrated? (20%)
- c) Outline the sources of error when measuring invasive arterial pressure. (45%)
35.8% pass rate.
- a) What are the indications for renal replacement therapy (RRT) in the Intensive Care setting? (40%)
- b) List the types of RRT available on Intensive Care. (30%)
- c) Outline the principle mechanisms of solute and water removal by RRT. (30%)
59.1% pass rate.
A 34-year-old man is scheduled for a posterior fossa tumour excision.
- a) List patient positions that might be employed for this operation. (10%)
- b) What potential intraoperative problems are associated with posterior fossa craniotomy? (25%)
- c) What monitoring techniques can specifically detect the presence of venous air embolism during surgery and for each method used, give the features that would indicate the diagnosis? (40%)
- d) How would you manage a significant venous air embolism in this patient? (25%)
48.4% pass rate.
- a) What are the complications of continuous epidural analgesia (CEA) in the ward setting? (40%)
- b) How should patients be monitored throughout the period of CEA? (25%)
- c) Outline the safety features that relate to equipment used for CEA. (35%)
70.4% Pass rate.
- a) What are the important safety features incorporated into the design of a medical gas cylinder and valve? (45%)
- b) How would you normally identify the content of a gas cylinder? (25%)
- c) What information does the pressure gauge on a nitrous oxide cylinder provide and how would you establish the amount of nitrous oxide remaining in a cylinder? (20%)
- a) Why can touching a piece of faulty domestic electrical apparatus cause ventricular fibrillation? (25%)
- b) What is microshock and how does thiscause ventricular fibrillation? (15%)
- c) List the factors which make an anaesthetised patient in the operating room at particular risk from electrical hazards. (10%)
- d) What precautions are taken to reduce electrical hazards in the operating room? (40%)
- a) How are implantable cardiac pacemakers and implantable cardioverter defibrillators classified? (25%)
- b) What information should be sought relating to these devices preoperatively? (30%)
- c) What precautions should you take perioperatively when anaesthetising patients with these devices, where the use of surgical diathermy / electrocautery is anticipated? (35%)
- a) What non-invasive methods can be used to measure blood pressure? (30%)
- b) How do most automated non-invasive cuff techniques measure blood pressure? (40%)
- c) What are the causes of errors commonly encountered in non-invasive blood pressure measurement systems? (20%)
- a) What information is available from a thermodilution pulmonary artery catheter? (35%)
- b) How can this information be used in the management of a critically ill, hypotensive patient following laparotomy for faecal peritonitis? (55%)
- a) What methods are used to measure blood pressure non-invasively? (35%)
- b) How do most automated non-invasive cuff techniques measure blood pressure? (45%)
- c) What are the common errors encountered in non-invasive blood pressure measurement systems? (20%)
- Define capnography.
- Draw and label a normal capnograph trace.
- Why is capnography useful during general anaesthesia ?
- Give examples of abnormal traces and their causes.
- What procedures are associated with venous gas embolism ?
- How can it be detected?
- What are the effects of a large venous gas embolus? Describe its management.
- Describe how and why a vaporiser delivering desflurane is different from one delivering isoflurane
- List the patterns of peripheral nerve stimulation that may be used to monitor non-depolarising neuro-muscular blockade during anaesthesia.
- How is each used in clinical practice?
- Define pressure.
- List the methods available for measuring systemic arterial blood pressure.
- Outline the principles involved in one of the methods listed
- Describe the principles involved in pulse oximetry.
- What are its limitations in clinical practice?
- Describe the features of the anaesthetic machine which are intended to prevent the delivery of a hypoxic mixture to the patient.
- Outline the methods of estimation of arterial pCO2 and their limitations.
- How does a rotameter flowmeter work?
- Describe its advantages and limitations.
- What safety features should be incorporated into an intravenous patient controlled analgesia (PCA) system and what is the purpose of each?
- What instructions would you give to the nursing staff, having set up the PCA?
- What are the problems of monitoring anaesthetised patients in the magnetic resonance imaging unit?
- List, with a brief statement on the effectiveness of each one, the methods described for detecting awareness during anaesthesia.