FCA(SA)_Part_II_Past_Papers 10

8/13/2019 FCA(SA)_Part_II_Past_Papers 10

1/30

FCA(SA) Part II

THE COLLEGES OF MEDICINE OF SOUTH AFRICAIncorporated Association not for gain

Reg No 1955/000003/08

Final Examination for the Fellowship of theCollege of Anaesthetists of South Africa

31 August 2011

Paper 1 (3 hours)

All questions are to be answered. Each question to be answered in a separate book (or books if morethan one is required for the one answer)

Al die vrae moet beantwoord word. Elke vraag moet in n aparte boek (of boeke indien meer as eennodig is vir n vraag) geskryf word

1 With reference to the use of positive end-expiratory pressure (PEEP) in aventilated adult patient in the intensive care unit, discuss the ways in whichyou would titrate PEEP with reference to the items numbered (a) to (f). Givethe physiological background for your opinion concerning each item, showingthe necessary calculations and/or figures, and explain how you would use theinformation to titrate PEEPa) Total body oxygen delivery. (5)b) Information derived from arterial and mixed venous blood gases,

including applicable calculations. (40)c) Compliance of the lung. (20)d) The minimum inflexion point on the volume-pressure curve of the

ventilator. (5)e) Dead space. (20)f) Pulmonary artery pressure. (10)

[100]

1 Bespreek die maniere waarop u positiewe eind-ekspiratoriese druk(PEED) sou titreer na aanleiding van die items hieronder genommer (a) tot (f)met verwysing na die gebruik van PEED in n geventileerde volwasse pasintin die intensiewe sorgeenheid. Gee die fisiologiese agtergrond vir u opinie byelke item, wys die nodige berekeninge en/of figure en verduidelik hoe u dieinligting sal gebruik om PEED te titreera) Heelligaam-suurstoflewering. (5)b) Inligting verkry uit arterile en gemeng-veneuse bloedgasse,

insluitende toepaslikeberekeninge. (40)

c) Vervormbaarheid van die long. (20)d) Die minimum infleksiepunt op die volume-drukkurwe van die ventilator.(5)

e) Dooiespasie. (20)f) Pulmonale arteriedruk. (10)

[100]

2 You are asked to anaesthetise a twenty-five-year-old patient for athoracotomy for a pleurectomy after development of a spontaneouspneumothorax. The patient is known to have Marfans syndromea) List the expected clinical findings in this patient. (15)b) List your concerns regarding anaesthesia. (10)


2/30

c) Outline your anaesthetic plan. (60)d) List the indications for, and complications of placement of a

double lumen endotracheal tube. (15)[100]

2 U word versoek om narkose toe te dien aan n vyf-en-twintig-jarige pasint vir n torakotomie vir n pleurektomie na n spontane pneumotoraks.Die pasint is n bekendemet Marfansindrooma) Lys die verwagte kliniese bevindings in die pasint. (15)b) Lys u probleme rakende narkose. (10)c) Omskryf u narkoseplan. (60)d) Lys die indikasies en komplikasies van die plasing van n dubbellumen

endotrageale buis. (15)[100]

3 a) Discuss the use of the arterial tourniquet during surgery, under thefollowing headingsi) Pathophysiological consequences. (40)ii) Tourniquet safe times and pressures. (10)

b) Magnesium: an emerging drug in anaesthesia Write notes onmagnesium andi) Analgesia. (10)ii) Obstetrics. (10)iii) Phaeochromocytoma. (5)iv) Neuroprotection. (10)v) Cardiac arrhythmias. (10)vi) Side effects. (5)

[100]

3 a) Bespreek die gebruik van die arterile toerniket gedurende chirurgieonder die volgende hoofde

i) Patofisiologiese gevolge. (40)ii) Veilige toernikettye en drukke. (10)b) Magnesium: n Opkomende middel in narkose Skryf notas oor

magnesium eni) Analgesie. (10)ii) Obstetrie. (10)iii) Feochromositoom. (5)iv) Neurobeskerming. (10)v) Kardiale disritmie. (10)vi) Newe-effekte. (5)

[100]

4 A 1,9 kg premature neonate with a ventriculoseptal defect and tracheo-oesophageal fistula is scheduled for the repair of the fistulaa) Discuss the most important anaesthetic considerations in this neonate

(40)b With regard to informed consent, how would you outline the potential risk

to the parents, relevant to the surgery, anaesthetic and post-operativemanagement? (10)

c) Discuss the induction of anaesthesia and the possible strategies you mayemploy to ensure minimal stomach inflation during lung ventilation. (30)

d) Outline possible causes of intraoperative desaturation and their preventionin this patient. (20)


3/30

[100]

4 n Prematuur 1,9 kg neonaat met n ventrikuloseptale defek en trageo-esofageale fistel is geskeduleer vir herstel van die fistela) Bespreek die belangrikste narkose-oorwegings by hierdie neonaat.(40)b) Betreffende ingeligde toestemming, beskryf hoe u die potensile

risiko aan die ouers sal beskryf ten opsigte van die chirurgie,narkose en die postoperatiewe hantering? (10)

c) Bespreek die induksie van narkose en die moontlike strategiewat u kan aanwend om minimale maaginsufflasie te versekergedurende longventilasie. (30)

d) Omskryf die moontlike oorsake van intraoperatiewe desaturasie endie voorkoming daarvan in hierdie pasint. (20)

[100]


4/30

FCA(SA) Part II


Reg No 1955/000003/08


1 September 2011

Paper 2 (3 hours)



1 Describe anaesthesia for major liver resection under the following headingsa) Preoperative assessment and risk stratification. (10)b) Appropriate anaesthesia techniques including perioperative monitoring

(30)c) Fluid and transfusion management including coagulation support,

blood conservation techniques, and monitoring. (50)d) Post-operative care including analgesic options. (10)

[100]

1 Bespreek narkose vir major lewerreseksie onder die volgende hoofdea) Preoperatiewe beoordeling en risikostratifikasie. (10)b) Toepaslike narkosetegnieke, insluitend perioperatiewe monitering. (30)c) Vloeistof en transfusiehantering, insluitend stollingsondersteuning, bloedkonserveringstegnieke en monitoring. (50)d) Post-operatiewe sorg insluitend pynverligtingsopsies. (10)

[100]

2 A 48-year-old female is presented for clipping of an anterior communicatingcerebral artery aneurysm 3 days post subarachnoid haemorrhage.Discuss under the following headingsa) Pre-operative assessment of this patient with reference to

i) Classification and prognosis. (10)ii) Associated ECG abnormalities and their significance. (5)iii) Respiratory considerations. (10)

b) The risk of cerebral vasospasm and its pathogenesis and

management. (25)c) Intraoperative management with reference toi) Monitoring. (10)ii) Brain protection. (15)iii) Strategies to prevent rupture , and the anaesthetic management

of an intraoperative rupture of the aneurysm. (25)[100]

2 n 48-Jarige vrou presenteer vir klemming van n anterior kommunikerendeserebrale arterie aneurisme 3 dae na n subarachnoidale bloeding.Bespreek onder die volgende hoofdea) Pre-operatiewe beoordeling van hierdie pasint met verwysing na


5/30

i) Klassifikasie en prognose. (10)ii) Geassosieerde EKG-abnormaliteite en hul betekenis. (5)iii) Respiratoriese oorwegings. (10)

b) Die risiko van serebrale vasospasma, en die patogenese en hanteringdaarvan. (25)

c) Intraoperatiewe hantering met verwysing nai) Monitering. (10)ii) Breinbeskerming. (15)iii) Strategie om ruptuur te voorkom en die narkosehantering van

n intraoperatiewe ruptuur van die aneurisme. (25)[100]

3 Discuss the paediatric patient with thermal burns under the following headingsa) The pathophysiology of acute burns. (30)b) The initial resuscitation. (20)c) The management of the child with inhalational injury. (20)d) Anaesthetic management for acute burns surgery. (20)e) Briefly discuss anaesthetic considerations for reconstructive surgery

(10)[100]

3 Bespreek die pediatriese pasint met brandwonde onder die volgende hoofdea) Die patofisiologie van akute brandwonde. (30)b) Die inisile resussitasie. (20)c) Die hantering van die kind met inhalasiebrandwonde. (20)d) Narkosehantering van akute brandwondchirurgie. (20)e) Bespreek kortliks narkose-oorwegings by rekonstruktiewe chirurgie(10)

[100]

4 a) Briefly classify cardiomyopathies and give examples in each category.(25)

b) A patient presents at 37 weeks gestation with dyspnoea and bilateral

opacification on her chest radiograph.i) How would you establish the diagnosis? (30)ii) Discuss the pre-and intra-operative management of a patient

with an established diagnosis of severe peripartumcardiomyopathy, who requires caesarean delivery. (45)

[100]

4 a) Klassifiseer kardiomiopatie kortliks en gee voorbeelde in elkekategorie. (25)

b) n Pasint presenteer teen 37 weke gestasie met dispnee en bilateraleinfiltrate op haar borskasfoto.i) Hoe sal u die diagnose bepaal? (30)ii) Bespreek die pre- en intra-operatiewe hantering van

n pasintmet n bevestigde diagnose van n erge peripartumkardiomiopatie en wat n keisersnit benodig. (45)

[100]


6/30

FCA(SA) Part II


Reg No 1955/000003/08


2 September 2011

Paper 3 Data Interpretation - Pictures (3 hours)



CANDIDATE NUMBER

Question 3 / Vraag 3


The picture below is a typical example of a somatosensory evoked potential (SSEP)obtained whilst monitoring the spinal cord during corrective spinal surgery.

Die grafiek hieronder is n tipiese voorbeeld van n somatosensoriese uitgelokte potensiaal (SSEP) wat verkry is gedurende monitering van die spinaalkoordgedurende korrektiewe spinaalchirurgie.


7/30


With reference to the x-ray belowMet verwysing na die x-foto hieronder



8/30

A routine preoperative ECG in an otherwise well 69-year-old gentleman is shownbelow

n Roetine preoperatiewe EKG van n andersins gesonde 69-jarige man wordhieronder vertoon


9/30

FCA(SA) Part II


Reg No 1955/000003/08


2 September 2011

Paper 3 Data Interpretation (3 hours)



CANDIDATE NUMBER


A 45-year-old female undergoes a transsphenoidal hypophysectomy for pituitaryadenoma. 18-hours post operatively it is noted that she is passing copious volumesof urine (400 mL per hour). The laboratory results show: Urine SG


10/30

d) What conditions other than that associated with pituitary resection may causethis abnormality? (3)d) Watter toestande mag hierdie abnormaliteit veroorsaak ander dan di

geassosieerd met hipofise-chirurgie? (3)

[10]


A 4-month-old male child is admitted to a state hospital with a history of projectilevomiting of several days duration. The surgeon requests to take him to theatreimmediately as an ICU bed has become available. The child is lethargic and themother reports that the childs nappy has been dry for more than 12 hours. Thefollowing laboratory results are obtained: pH 7.50, PaCO 2 49 mmHg, HCO 3- 37meq/L, Na + 140 meq/L, K + 2.9 meq/L, Cl - 87 meq/L

n 4-Maande-oue seuntjie word opgeneem in n staatshospitaal met n geskiedenisvan projektiele braking vir n paar dae. Die chirurg versoek om hom dadelik teatertoe te neem omdat n ISE-bed beskikbaar geword het. Die kind is letargies en diemoeder rapporteer dat die baba se doek droog is vir meer as 12 uur. Die volgendelaboratoriumresultate is verkry: pH 7.50, PaCO 2 49 mmHg, HCO 3- 37 meq/L, Na + 140 meq/L, K + 2.9 meq/L, Cl - 87 meq/L

a) What is the diagnosis? (1)a) Wat is die diagnose? (1)

b) What is the acid-base disturbance? (1)b) Wat is die suur-basisversteuring? (1)

c) What is the explanation for these abnormal results? (5)c) Wat is die verduideliking vir hierdie abnormale resultate? (5)


11/30

d) Would you agree with the surgeon that the patient be taken to theatre

immediately, and give a reason? (1)d) Stem u saam met die chirurg dat die pasint dadelik teater toe geneem moetword, en gee n rede? (1)

e) What would be your course of action from presentation until the surgery? (3)e) Wat sal u aksieplan wees vanaf presentering tot chirurgie? (3)

[10]


A 42-year-old previously healthy male patient presents with chest pain which ismade worse by movement. An early diastolic murmur is noted in the aortic region.

n 42-Jarige, voorheen gesonde man presenteer met borskaspyn wat vererger metbeweging. n Vroe diastoliese geruis word gehoor oor die aorta-area.

a) Describe the ECG. (4)a) Beskryf die EKG. (4)

b) What is the ECG diagnosis? (1)b) Wat is die EKG diagnose? (1)

c) What are the possible aetiologies in this patient? (5)c) Wat is die moontlike etiologie in hierdie pasint? (5)


12/30

[10]


A patient presents to hospital with the following scenario n Pasint presenteer by die hospitaal met die volgende beeldi) 60-Years of age with a history of binge alcohol consumption.i) 60-Jaar-oud met n geskiedenis van episodiese oormatige alkoholmisbruik.ii) Acute central abdominal pain, radiating to the back.ii) Akute, sentrale abdominale pyn wat versprei na die rug.iii) Serum values:iii) Serumwaardes:

Na + = 143 meq/LK+ = 5.1 meq/LCl- = 98 meq/L

Urea = 4.8 mmol/LCreatinine = 100 mol/L Amylase = 1200 U/LCalcium = 2.1 mmol/LGlucose = 15.2 mmol/L

iv) Full blood countiv) Volbloedtelling

Hb = 14 g/dLWCC = 14,000/mLPlatelet count = 115 10 9/L

v) Liver Enzyme Analysisv) Lewerensiemanalise

AST = 130 IU/L ALT = 100 IU/LLDH = 1500 IU/L


13/30

a) What is the likely diagnosis? (1)a) Wat is waarskynlike diagnose? (1)

b) Which of these factors indicates severe disease? (3)b) Watter van hierdie faktore dui op ernstige siekte?

At 48 hours after admission the following is noted48-Uur na opname word die volgende genoteer

The patient has required 5 litres of Ringers Lactate, 1500 mL of hydroxyethyl starch and

has received 2800 mL of other fluids with medication and parenteral nutrition. His urineoutput is 0.5 mL/kg/hour.

Die pasint het 5 liters Ringerslaktaat benodig, 1500 mL hidroksie-etielstysel en het 2800mL ander vloeistowwe ontvang saam met medikasie en parentrale voeding. Syurienuitskeiding is 0,5 mL/kg/uur.

Serum valuesSerumwaardes

Na + = 135 meq/LK+ = 4.8 meq/LCl- = 108 meq/LUrea = 7.6 mmol/LCreatinine = 160 mol/L

Amylase = 800 U/LCalcium = 1.7 mmol/L

Full blood countVolbloedtelling

Hb = 8 g/dL (no blood transfused)WCC = 15,000/mLPlatelet count = 100 10 9/L

Liver Enzyme AnalysisLewerensiemanalise

AST = 132 IU/L ALT = 103 IU/LLDH = 1505

c) Which factors are suggestive of severe disease at this time? (4)c) Watter faktore is op hierdie tydstip suggestief van ernstige siekte? (4)


14/30

d) What other test is strongly indicated to assess severity, and what results wouldsuggest severe disease on this test? (2)

d) Watter ander toets is sterk aangedui om die ernstigheidsgraad te beoordeel, en watterbevindinge sal op ernstige siekte dui met hierdie toets? (2)

[10]


a) Place the following signs of a fulminant malignant hyperthermia episode under generalanaesthesia, in the time sequence in which they are likely to appear (5)

a) Plaas die volgende tekens van n fulminerende maligne hipertermie episodetydens algemene narkose in die temporale volgorde waarin dit waarskynlik sal voorkom

(5)

- Rapid temperature rise.Vinnige temperatuurstyging.

- Falling end-tidal oxygen content.Dalende endgety-suurstofinhoud.

- Rising end-tidal CO 2 content.Stygende endgety-CO 2 inhoud.

- Rapid rise in the temperature of the sodalime.Vinnige styging van die natronkalktemperatuur.

- Sinus tachycardia.Sinustagikardie.

- Ventricular arrhythmias.Ventrikulre disritmie.

- Base excess > - 8 meq/L.Basisoormaat > -8 meq/L

1234567

b) List the differential diagnosis of this constellation of signs. (5)b) Lys die differensile diagnose van hierdie groep tekens. (5)


15/30

[10]


What are the causes of pulseless electrical activity in a cardiac arrest situation? [10]Wat is die oorsake van polslose elektriese aktiwiteit tydens n kardiale arres? [10]


16/30


The following results are obtained from a thirty-year-old woman presenting for a laparoscopyfor pelvic pain, complaining of tiredness and muscle weakness. The only other abnormalityis a blood pressure of 195/120.

Die volgende resultate is verkry van n dertigjarige vrou wat presenteer vir laparoskopie vir lae-

abdominale pyn. Sy kla van moegheid en spierswakheid. Die enigste ander abnormaliteit is nbloeddruk van 195/120.

Na + 137 meq/L, K + 2.6 meq/L, urea 4.2 mmol/L, creatinine 99 mol/L, Hb 10 g/dL, plateletcount 150 x 10 9 /mL.

a) What is the likely diagnosis? (1)a) Wat is waarskynlike diagnose? (1)

b) What is the underlying mechanism of this condition? (2)b) Wat is die onderliggende meganisme van hierdie toestand? (2)

c) What are the anaesthestic implications of this condition? (3)c) Wat is die narkose-implikasies van hierdie toestand? (3)

d) What is characteristic about the replacement of the deficient electrolyte? (1)d) Wat is die tipies van die vervanging van die elektroliet wat tekort is? (1)

e) What conditions may be associated with secondary hyperaldosteronism? (3)e) Wat toestande mag geassosieer wees met sekondre hiperaldosteronisme? (3)

[10]


17/30


The following results are obtained from a forty-year-old woman presenting for placement ofbilateral nephrostomy catheters. She is known to suffer from stage 3 cervical carcinoma. Herblood pressure is 180/100, for which she receives a calcium antagonist:Na + 130 meq/L, K + 4.9 meq/L, urea 51 mmol/L, creatinine 532 mol/L, Hb 6.5 g/dL

Die volgende resultate word verkry van n veertigjarige dame wat presenteer vir plasing vanbilaterale nefrostomiekateters. Sy is bekend met stadium 3 servikskarsinoom. Haar bloeddrukis 180/100 waarvoor sy n kalsiumantagonis neem:Na + 130 meq/L, K + 4.9 meq/L, urea 51 mmol/L, creatinine 532 mol/L, Hb 6.5 g/dL

a) What is the likely diagnosis? (1)a) Wat is die waarskynlike diagnose? (1)

b) What are the anaesthetic implications of this condition? (5)b) Wat is die narkose-implikasies van hierdie toestand? (5)

c) What are the anaesthetic implications of positioning of this patient for the procedure?(4)

c) Wat is die narkose-implikasies van die posisionering van hierdie pasint vir die proseduur? (4)

[10]


18/30


The following results are obtained form a fifty six year old female patient, presenting forexploration of a neck mass:

Die volgende resultate word verkry van n ses-en-vyftigjarige dame wat presenteer vir dieeksplorasie van n nekmassa:Na + 139 meq/L, K + 4.8 meq/L, urea 7 mmol/L, creatinine 98 mol/L, Hb 13 g/dL,calcium 3.25 mmol/L, phosphate 0.70 meq/L.

a) What is the likely diagnosis? (1)a) Wat is die waarskynlike diagnose? (1)

b) What are the anaesthetic implications of this condition? (6)b) Wat is die narkose-implikasies van hierdie toestand? (6)

c) What complications might you need to address in the immediate post operative period?(3)

c) Watter komplikasies mag u aandag benodig in die onmiddelike postoperatiewe periode? (3)

[10]


a) What part of the spinal cord does SSEP monitor? (1)a) Watter deel van die spinaalkoord word gemonitor deur SSEP? (1)


19/30

b) How would the trace change with significant spinal cord ischaemia? (2)b) Hoe sal die grafiek verander tydens betekenisvolle spinaalkoordisgemie? (2)

c) What other factors can influence the SSEP during surgery? (4)c) Watter ander faktore kan die SSEP gedurende chirurgie benvloed? (4)

d) Which additional evoked potential can be used to monitor the spinal cord optimally? (1)

d) Watter addisionele uitgelokte potensiaal kan gebruik word om die spinaalkoord optimaalte monitor? (1)

e) How would this alter your anaesthetic technique? (2)e) Hoe sal dit u narkosetegniek wysig? (2)

[10]



20/30

A 50-year-old patient is scheduled for removal of a floor of mouth tumour. He is otherwise welland asymptomatic. His blood results show a serum sodium of 120 meq/L.

n 50-Jarige pasint is geskeduleer vir die verwydering van n mondvloertumor. Hy is andersinsgesond en asimptomaties. Sy bloedresultate toon n serumnatrium van 120 meq/L.

a) What is the most likely cause of the hyponatraemia? (1)a) Wat is die waarskynlikste oorsaak van die hiponatremie? (1)

b) How would you manage this hyponatraemia? (2)b) Hoe sal u hierdie hiponatremie hanteer? (2)

c) What is Tumour Lysis Syndrome? (4)c) Wat is Tumorlise-sindroom? (4)

d) List 3 other paraneoplastic disturbances. (3)

d) Lys 3 ander paraneoplastiese versteurings. (3)


21/30

[10]


Concerning porphyriaBetreffende porfirie

a) Indicate the positions of the enzyme defects in Acute Intermittent Porphyria (AIP)

and Variegate Porphyria (VP) on the pathway below. (2)a) Dui die posisies van die ensiemdefekte aan op die biosintetiese pad hieronder vir Akuut

Intermitterende Porfirie (AIP) en Porfirie Variegata (VP). (2)

b) What are the characteristic biochemical findings in AIP and VP? (2)b) Wat is die karakteristieke biochemiese bevindinge in AIP en VP? (2)


22/30

c) How may AIP and VP differ in their clinical presentation? (1)c) Hoe kan AIP en VP verskil in hul kliniese beeld? (1)

d) List in point form the key elements of management of an acute porphyric crisis. (5)d) Lys puntsgewys die sleutelelemente in die hantering van n acute porfiriekrisis. (5)

[10]


With reference to the meta-analysis result below, which pertains to the incidence of sternalsepsis after cardiac surgery

Met verwysing na die meta-analiseresultate hieronder wat handel oor die insidensie vansternale sepsis na kardiale chirurgie

(Please note: DM = diabetes mellitus; NDM = non-diabetes mellitus)


23/30


24/30

[10]


Complete the table which compares the NYHA classification for exercise tolerance with moreobjective determinants of exercise tolerance. Give the value (or minimum and maximum)which would be equivalent to the NHA class.

Voltooi die tabel wat die NYHA-klassifikasie vir oefeningstoleransie vergelyk met meerobjektiewe bepalers van oefeningstoleransie. Gee die waarde (of minimum en maksimum) watekwivalent sal wees met die NYHA-klas.

NYHA VO 2max METS EF

1

2


25/30

VO2max = maximum oxygen uptake (mL/kg/min);METS = metabolic equivalents;EF = ejection fraction. [10]


a) What is the diagnosis?a) Wat is die diagnose?

b) Note the reason(s) for your opinion.b) Gee die rede(s) vir u opinie.

[10]


a) Draw the left ventricular pressure volume curve for a patient with clinically significantmitral regurgitation. (6)

a) Teken die linkerventrikel druk-volumekurwe vir n pasint met klinies betekenisvollemitraalregurgitasie. (6)

3

4


26/30

b) List the reasons for potential improvement of the symptoms of mitral regurgitation inpregnancy. (4)

b) Lys die redes vir die potensile verbetering van mitraalregurgitasie-simptome tydensswangerskap. (4)

[10]


An adopted 12-year-old girl of African origin presents for cholecystectomy due to repeatepisodes of gallstone colic. She appears well, but gives a history of repeated hospitalisationwith abdominal pain, and had an abdominal organ removed 2 years previously, although herfoster parents do not know why. Her full blood count and liver function tests are as follows

n Aangenome, 12-jarige meisie van Afrika-oorsprong presenteer vir n cholesistektomievanwe herhalende galsteenkoliek. Sy kom gesond voor maar gee n geskiedenis vanherhalende hospitalisasies vir abdominale pyn en n abdominale orgaan is verwyder 2 jaartevore, maar haar voogouers weet nie wat die rede was nie. Haar volbloedtelling enlewerfunksies is soos volg

Hb 9.8 g/dL, MCV 82 fL, MCHC 27 g/dL, WBC 11.6 10 9/L, platelet count 468 10 9/L,reticulocyte count 12%, ALT 32 IU/L, alkaline phosphatase 67 IU/L, AST 41 IU/L, albumin 49g/L, bilirubin (total) 53 mol/L.


27/30

a) What do these results show? (2)a) Wat wys hierdie resultate? (2)

b) What is the underlying diagnosis? (1)

b) Wat is die onderliggende diagnose? (1)

c) How might the diagnosis be confirmed? (1)c) Hoe kan die diagnose bevestig word? (1)

d) Which abdominal organ was removed 2 years previously, and why? (2)d) Watter abdominale orgaan is 2 jaar tevore verwyder, en waarom? (2)

e) What are the most important anaesthetic considerations for the planned surgery? (4)e) Wat is die belangrikste narkose-oorwegings vir die beplande chirurgie? (4)

[10]


Tabulate the differences between starches and gelatins. [10]Tabuleer die verskille tussen die stysels en die gelatiene. [10]


28/30


a) Write down the Henderson-Hasselbalch equation. (2)a) Skryf die Henderson-Hasselbachvergelyking neer. (2)

b) Define Stewarts Strong Ion Difference. (3)b) Definieer Stewart se Sterk Ioonverskil (Strong Ion Difference). (3)


29/30

c) Define the anion gap and its clinical use. (2)c) Definieer die anioongaping en sy kliniese gebruik. (2)

d) Briefly discuss the clinical relevance of a hyperchloraemic metabolic acidosis. (3)d) Bespreek kortliks die kliniese relevansie van n hiperchloremiese, metaboliese

asidose.(3)

[10]


a) What is the abnormality? (3)a) Wat is die abnormaliteit? (3)


30/30

b) What are the causes of axis deviation on an ECG? (7)b) Wat is die oorsake van as-deviasie op n EKG? (7)

[10]

Date post:	04-Jun-2018
Category:	Documents
Upload:	matenten
View:	235 times
Download:	0 times

FCA(SA)_Part_II_Past_Papers 10

Documents