Station 1:
Elective AAA preop assessment
Scoring
Relationship with smoking
Physics relationship as regards to rupture
Indications for op
Access and monitoring
Physiology of cross-clamping and release
Management of the above
Renal protection
Spinal cord ischemia, monitoring/prevention
Lumbar drain physiology
Anterior cord syndrome & anatomical basis
Station 2:
Assessment of patient with TBI, possible maxillofacial injury
Ideal preparation for airway management
Emergency intubation management
MILS
Interpretation of CT: EDH, gross cerebral edema. Cervical X-ray: cervical retrolisthesis
Anticipated neurological deficit
Anesthetic management for neurosurgery
BTF targets - Gases, hemodynamics
Mannitol
DI and management
Station 3:
Classification of CDH, embryology
Pathophysiology
Timing of surgery
Assessment and optimization
iNO in respiratory failure
Decision on proceeding with surgery
Ventilatory management (protective ventilation strategy)
Fluid management
Airway management for child not already intubated
Prevention of hypothermia
Concerns post reduction (atelectasis, abdominal compartment syndrome)
Tension pneumothorax
Station 4:
Perforated gastric ulcer with septic shock
Surviving sepsis campaign (SSC) definition of septic shock
Hemodynamic recommendations (fluids, vasopressors)
Physiologic basis for MAP vs SBP
Recommendations on vasopressor, inotropic choice
CO monitoring
PiCCO
Interpretation of values (supranormal CO, normal GEDVI, low SVRI, normal EVLW)
Choice of induction agent choices (etomidate, ketamine)
Choice of volatile mixture (air, nitrous) - hemodynamic, surgical implications
Refractory hypotension
Fluid challenge
Steroids - recommendations, physiology
Yeah, I passed, but I’m burned out preparing for repeated assessments while the COVID epidemic rages on. While living away from the wife and kids (and currently an inability to travel) for almost 5 years now. I felt I prepared better the last time around (despite less than ideal circumstances). This time around the “study week” (thank you roster makers) was spent more recuperating and weaning from stimulant, ehem caffeine, abuse and trying to slow down my personal struggle versus frailty (with the closure, and lack of time when it was open anyways, of the gym) as compared to studying. This is proven by the relative lack of notes written for this exam season.
Going to the exam 2 days after my second COVID vaccine jab probably didn’t help, but I don’t think it affected my handling of the exam at the end of the day.
But then again, every healthcare worker is burned out. There is no solution. Just survive it before it kills you, then medicine becomes more of a venous ooze versus arterial cut. I wonder how was the suicide rate among Western healthcare workers the past 1 year… The fuck (while looking this up):
“...residents are used “as cheap labor,” making on average $61,000 a year for working 80+ hours a week.”
I’d rather not talk about how much we earn here in comparison. But enough sad shit. Have you heard of Crossy Road Castle?