Malaysia Anesthesia Parallel Pathway Post FCAI Assessment, Part 3 of 6, Clinical Review

What a lengthy title….

Anyways, I passed this with distinction despite the odds: Broken computer a few months back, lack of any time in another month, and lastly my son is down with bronchiolitis, currently being taken care by my non-doctor wife at home. He’s improving, but I barely studied anything 3 days prior to the exam and drove to KL from Melaka only when “happy enough” the morning of the exam with little sleep. But that’s beside the point. I want to share the topics discussed that you, the reader, can reference for your own study topics.

Examiner 1:
Preggy elective breech ppm sick sinus syndrome
All about obs preoperative review, ppm classification n management
ECG review; pacemaker (ventricular pacing) dependence
Anesthetic technique (decided for CSE), needs during LSCS
Blood on aspirating epidural
Tachyarrhythmia post buzzing

Examiner 2:
Cardiac assessment non cardiac surgery
RCRI
Non invasive tests
Elective BKA for patient on warfarin
Bridging & Chads2vasc
Fast AF intraop; stable tachyarrhythmia algorithm
Guillain barre syndrome coming for tracheostomy
What is GBS and anesthetic concerns
Airway emergency post tracheostomy
Concerns with new tracheostomy

Examiner 3:
Neonatal vs preterm definitions
CVS changes of infants vs adults
Common surgical procedures in the age groups
Preparation for neonate/preterm surgery
2 week post 35 weeks premmie for herniotomy; concerns
Anesthetic technique in full
Postop considerations

Examiner 4:
SAH presentation
CT scan interpretation
SAH classification and implications
Myocardial injury post sah
Differentiation with MI?
Deferral of op?
Anesthetic aims, technique, TIVA vs inhalational
Monitoring (considerations for neuromonitoring/CO monitoring)
Temporary clipping n complications
Transmural pressure and implications
Management of rupture (burst suppression, flow arrest)

Many of the topics here were not specifically covered during my preparations. Probably around 30%-50% of the topics have been made into notes the past, but I only reread a minimal amount of them. Personally I wasn’t happy with my performance during the 2nd and 4th sessions. Will probably have to go deeper into these topics next time. If you followed this blog, you’d know that none of my new notes actually made it into this particular exam.

Based on my own personal review, I don’t think I need to drastically change my approach to studying yet. Don’t fix what is not broken.

Epilepsy & Other Related Stuff + Other Thoughts

Just finished scanning another set of long notes. Had a lot of trouble scanning these notes.

1. I always add some water to my fountain pens to prevent them drying out in the Malaysian climate. It seems that I’ve added too much water as the brown and grey colors become too light when scanned. Sorry for that.

2. I’ve finally installed MacOS Big Sur on my working laptop (my previous Retina 2012 MacBook Pro, acting as a home server, can’t have it installed). Since I’m on the Developer Program, it’s on the 11.1 version. However, there are still some significant bugs. It seems that the drivers for my dedicated scanner, the many years old HP Deskjet 46460 (that produces the best scans I’ve seen), has gotten screwed. All shading from fountain pen inks become lost as my writing become something like pastel ink. In the same line a green ink suddenly becomes black. Apparently many also have the same problem, on both HP and Apple forums; I don’t know who is responsible. As a workaround, I used my “server” laptop to scan the new set of notes.

3. It’s the time of year again when I get my email notifying that Squarespace is going to charge me again for hosting this website. This website has been running at a loss since its beginning. As much as those occasional thanks and compliments motivate me, this website has not been financially sustainable, and I’ve always searched for ways to make some money to pay off at least the bills for hosting this. Recently Squarespace has introduced Member Areas, and is along many measures I’m thinking about. Maybe an ad-free site for a fee? In the meantime, I’ve added a PayPal link if you’re interested in giving donations. Much thanks.

Regarding Getting the Masters Copy

It’s been soooo long since I last updated this blog, and that disappoints me. I wonder if it’s worth keeping it online as it takes money, money I need. But I’ve already paid for another year…So yeah.

Anyways, I’d like to take a moment and address reader feedback (yay). So this reader from India asked if he can get a PDF compilation of my notes. I asked him to download the JPEG from the site instead, and there’s a few reasons for this.

1. My modern handwritten notes are scanned at very high resolution, higher than what a human retina can process: 600 dpi. Kinda like music masters. Thus the filesizes are huge for the relatively small content. My full stash of notes currently sits at…5 GB

2. The JPEG’s have been processed to 220 dpi on the site, and it is JPEG’s that this site uses to render the images and not PDF pages. This is the around the same value as the DPI of a Retina MacBook. It’s smaller than the DPI’s of say the top smartphones, but I think this is a good compromise. I have actually been trying to downsize the scans to 460 (ala top smartphones), but PDFPen broke what was a working feature related to this, and I’ve given up since. Maybe in the future I’ll just scan at 460 dpi.

Now if someone wants to pay me for my stuff, that’s a different issue altogether! This site is more in the red than a non-profit!