FRCA Things to Know

Question 1

Steroid Equivalent Doses

Answer 1

Hydrocortisone 20mg
Dexamethasone 0.75mg
Prednisolone 5mg
Methylprednisolone 4mg

Question 2

Clarke (polarographic) sensor principle?

Answer 2

Reduction

Question 3

What does Body Plethysmography measure and how?

Answer 3

Lung volumes (including FRC) through using Boyle’s Law in a sealed environment

Question 4

What is contained within the Child-Pugh classification?

Answer 4

Albumin
Bilirubin
INR
Ascities
Encephalopathy

Question 5

What does the Stefan-Boltzmann law state?

Answer 5

The total emissive power of a black body is proportional to the fourth power of its absolute temperature.

Question 6

What are the contraindications/sources of error in LiDCO monitoring?

Answer 6

First trimester pregnancy
AR
IABP
Lithium
<40kg
Muscle relaxants (positive ammonia ion)

Question 7

What current is the ‘let-go’ threshold?

Answer 7

10-15mA

Question 8

What is the most sensitive and specific test used for the identification of absolute iron deficiency?

Answer 8

Serum ferritin (less than 30 µg/L)

Question 9

Which method of decontamination is the most effective in destroying prions harboured in surgical instruments?

Answer 9

Autoclave at 121°C for 30 minutes with 1N NaOH

Question 10

Which GABAA receptor subunit is particularly important for the interaction with volatile anaesthetic agents?

Answer 10

Alpha

Question 11

Which laser type is most suitable for photocoagulation in retinal surgery due to its absorption by haemoglobin and melanin?

Answer 11

Argon

Question 12

Which measurement is the most sensitive indicator of mild obstructive airway disease?

Answer 12

FEF 25-75%

Question 13

How many litres of blood are filtered daily by the kidneys?

Answer 13

180L

Question 14

Which parts of the body receive the most blood flow at rest?

Answer 14

Carotid body- 2000 ml/minute/100 g
Thyroid 560
Kidneys 420

Question 15

Which parts of the body have the highest oxygen consumption at rest?

Answer 15

Heart 11ml/minute/100g
Kidney 6.8
Brain 3.7

Question 16

Raised Anion Gap

Answer 16

Methanol
Uraemia
DKA
Paracetamol/Propylene Glycol
Infection/iron/isoniazid
Lactic acidosis
Ethylene glycol/ethanol
Salicylates

Question 17

Normal Anion Gap

Answer 17

Addisons
Bicard losses (GI/Renal)
Chloride excess
Diuretics (Acetazolamide)

Question 18

Describe the findings in Brown Sequard Syndrome

Answer 18

Loss of fine touch, proprioception, vibration and motor weakness on ipisilateral side
Loss of pain and temperature on contralateral side

Question 19

How does Botulism Toxin work?

Answer 19

BLOCKS
-Pre-synaptic acetylcholine release
-Intrafusal muscle units with a reduction in afferent I/IIa signals reducing tone
-Efferent autonomic fibres

Question 20

DKA Resolution Criteria

Answer 20

BG <14mmol/L
Ketones <0.6mmol/L
pH >7.3

Question 21

Normal RAP

Answer 21

0-8mmHg

Question 22

Normal RVP

Answer 22

0-8 (Diastole)
15-30 (Systole)

Question 23

Normal PAP

Answer 23

5-15 (Diastole)
15-30 (Systole)

Question 24

Normal PCWP

Answer 24

4-12

Question 25

Normal LAP

Answer 25

4-12

Question 26

Normal LVP

Answer 26

0-12 (Diastole) 90-140 (Systole)

Question 27

What stimulates renin release?

Answer 27

Low BP Low Na Sympathetic stimulation

Question 28

What is Eaton Lambert Syndrome?

Answer 28

Autoimmune NMJ disorder causing muscle weakness. Attacks VGCC on pre-synaptic membrane

Question 29

What is Myasthenia Gravis?

Answer 29

Chronic NMJ disorder causing muscle weakness with ocular and bulbar symptoms. Attacks AChRs on post-synaptic membrane

Question 30

How do organophosphate poinsons work?

Answer 30

Acetylcholinesterase inhibitors- excess Ach causes nicotinic and muscarinic stimulation. Results in fasciculations/weakness, cramp and paralysis

Question 31

What does hypercarbia do to myocardial contractility, and peripheral/cerbral circulations?

Answer 31

Inhibit it, resulting in vasodilation of circulations

Question 32

Partial pressure of O2 in umbilical vein

Answer 32

4.7kPa

Question 33

Pathophysiology of sickle cell

Answer 33

Change in amino acid sequence of haemoglobin from glutamate to valine

Question 34

What is the role of Hepcidin?

Answer 34

Peptide hormone produced in the liver that inhibits iron absorption and transport by binding to ferroportin channels in the basolateral membrane of enterocytes

Question 35

Codeine PKA and enzyme

Answer 35

8.2 CYP2D6

Question 36

Normal CSF Contents

Answer 36

Protein 0.2 to 0.4g/l (some quote 1.5-4.5g/dl) WCC 0-5 HCO3- 22-28 Cl- 120 Na 140 K 3 Ca 1.2 Mg higher than plasma Glucose 4 pH 7.3

Question 37

What filter size is used in cell salvage?

Answer 37

150micron

Question 38

What is the gold standard of sterilsation?

Answer 38

Steam (autoclave)

Question 39

Haemoglobin structure (HbA1, HbA2, HbF)

Answer 39

HbA1 2 alpha 2 beta (98% total) HbA2 2 alpha 2 delta HbF 2 alpha 2 gamma

Question 40

How do you calculate compliance?

Answer 40

1/total compliance = 1/chest wall compliance + 1/lung compliance.

Question 41

Normal lung compliance

Answer 41

200ml/cmH20

Question 42

What is the Pasteur point?

Answer 42

0.3kPa

Question 43

During exercise what is the blood flow to the skeletal muscles and heart?

Answer 43

Muscles 50-100ml/100g/min (1-4 at rest) Heart- Can exceed 30L/min in athletes (but muscle has the greatest % increase)

Question 44

Resting membrane potentials

Answer 44

Nerve cells: -70mV Skeletal/cardiac muscle: -90mV

Question 45

Threshold potential

Answer 45

Nerve -55mV Cardiac -65mV Pacemaker -40mV