Hepatobiliary, Haematology, Ophthalmology, ENT, and more: The most important topics to be read for your EDAIC examination.

This list covers the frequently asked questions from Hepatobiliary, Haematology, Ophthalmology, ENT and other miscellaneous topics. Case scenarios and questions based on these are likely to be asked during MCQ or viva examinations.

To make the challenging terrain a little less painful, we have tried to compile a list of the most important areas to be covered from these systems, a bare minimum yet essential topics’ compilation.

Targetedaic recommends: What to read in the Hepatobiliary, Haematology, Ophthalmology, ENT, and micellaneous other topics.

HEPATOBILIARY SYSTEM

• Liver function.
• Liver metabolism, pathophysiology of hepatectomy
• Hepatectomy physiological methods to reduce blood loss
• Moderate liver failure with left hemicolectomy – pathophysiology, management, post op plan, epidural, intercostal block vs epidural in this case, intercostal block indication/ contraindication, complications
• Cirrhotic patient for bowel resection.
• Delayed recovery in hepatic patient.
•  Postoperative pain management hepatic failure patient
• Consequence of portal hypertension.
• Anesthetic consideration for patient with liver cirrhosis
• Clinical case: old patient with moderate liver cirrhosis for hemicolectomy surgery because of ca. Discussion about coagulation. Discussion about electrolyte disturbance in a cirrhotic patient

MEASUREMENTS AND PHYSICS

• Clark’s electrode.
• severnghuas electrode
• pH electrode
• Arterial wave form, dampened and undampened waveforms. causes of dampening
• CVP waveform. waveforms in different diseases. significance. relation to cardiac cycle
• Spirometery. Draw the graph, label, what will the effect of restyrictive/ obstructive disease
• P-V loop of the left and righ heart, frank-starling graph, effect of failing ventricle
• Diathermy. Different waveforms. Precautions and contraindications
• Fire safety
• Temperature and humidity measurement principles.
• Capnography
• Pharmacokinetic models
• Anaesthetic gas monitoring.
• Neuromuscular monitoring. Draw TOF in depolarising and non-depolarising block
• Blood flow measureemnt (CO, hepatic blood flow, brain blood flow)
• BIS, EEG, awareness monitoring
• awareness under anaesthesia
• consent
• Physics laser, oxygen analyzer paramagnetic analyze
• Problems with pulse oximetry and sources of error
• Cardiac output monitoring
• Arterial line, cvp line
• Pulmonary artey catheter, insertion and graph
• Measurement of gas concentrations, especially oxygen, carbon dioxide, nitrogen, nitrous oxide, volatile anaesthetic agents
• Basic concepts of electricity and magnetism. Capacitance, inductance and impedance. Amplifiers. Band width, filters. Amplification of biological potentials: ECG, EMG, EEG. Sources of electrical interference. Draw capacitors and inductors
• Draw defibrillator circuit
• Draw a normal distribution curve

HEMATOLOGY AND COAGULATION

• Mechanism of clot
• Platelet structure and function in detail. Drugs affecting platelet function.
• Thromboelastogram. Shape and relation to coagulation cascade factors/events. Factors that alter the shape. You must be able to draw and label a TEG and its variations
• Coagulation cascade. You should be able to draw common and alternate pathways with labelled catalysts/ cofactors when involved. Different tests
• Von Willebrand disease
• PT/INR/aPTT
• DIC
• Anaphylactoid reactions
• Erythropoietin: what do you know? Uses, route, adverse effects and illegal use! Discussion may go to blood salvage techniques
• Coagulation pathway.
• Heparin and warfarin details. Antidotes.
• Heparin. Mechanism of action; side effects, reversal, uses Anti-coagulants (perioperative management)
• ASRA guidelines for neuraxial block
• Von-Willebrand disease*** (types, preoperative assessment and preparation, desmopressin and dose. What is the most common cardiac problem with those patients?)
• Jehovah’s witness
• List the Polycythemia types and how would you diagnose them.
• Physiological implication of an adult/ child/ geriatric patient losing 1liter of blood and your management.
• Physiological changes after bleeding
• Clinical Case: 5-year-old boy with suspected bleeding 6 hours after tonsillectomy. Earlier, the patient had told his mother that he felt sick. The nurse was sure that was no bleeding in PACU. BP 90/50 HR 126 RR 24/min. How to manage? Discuss your assessment and management in detail.
• Polycythemia Rubra vera: define, is there any bleeding tendency and what are the measures to prevent perioperative venous thrombosis and PE.

• Blood products
  • Types, storage, indications and doses
  • PRBC
  • Platelets
  • Cryoprecipitate/ Fibrinogen indications and dose
  • FFP
  • additives used for PRBCs, shelf life, what sort of PRBCs are given in transplanted patients.
  • Which products do not require to be  crossmatched
  • Complications
  • How to salvage blood
  • Alternatives to transfusion
  • Massive transfusion.
  • Incompatible blood transfusion reaction Management.

OPHTHALMOLOGY AND ENT

• Anaesthesia of child posted for strabismus surgery
• Ocular blocks***
• Describe nerve supply of the eye – neurology behind pupillary light reflex.
• Clinical Case: Options for anaesthesia in old age coming for cataract, advantages and disadvantages of each option
• Anaesthesia for eye surgery
• Ophthalmic blocks
• Post tonsillectomy bleeding
• Management of open vs closed eye injury
• Airway fire.
• Vocal cord nodule. Microlaryngectomy tubes.
• Precautions during use of laser
• Blocks for cleft palate and lip
• Drugs contraindicated in glaucoma

General anaesthesia and miscellaneous

• Inherited disease associated with problems in anaesthesia.
• Aldrete score or when can I transfer a patient from an HDU or recovery room to standard wards
• One-day or daycare surgery. Which surgeries and which patients are suitable for this approach. When to keep them overnight?
• Postoperative delirium
• Delayed recovery
• Geriatric patient
• DC shock. Draw a primary defib circuit and explain the functioning. Doses in adults and children. Contraindications?
• What happens during induction of anaesthesia and alveolar gas equation.
•  Low flow anaesthesia. Definition. Advantages.
• Fire safety
• Management of an inadvertent needle prick injury (discussion went on to HIV positive patient and Prophylaxis)
• How to measure gas flow in anaesthesia (equipment names and bobbin flowmeter and ultrasound flowmeter in details)
• Types of LMA

FOR MUST-READ TOPICS IN THE RESPIRATORY SYSTEMS, CLICK HERE.

FOR MUST-READ TOPICS IN THE NERVOUS SYSTEM, CLICK HERE.

FOR MUST-READ TOPICS IN THE  ENDOCRINE, METABOLIC AND NEUROMUSCULAR SYSTEMS, CLICK HERE.

FOR MUST-READ TOPICS IN THE PAIN AND REGIONAL ANAESTHESIA, CLICK HERE.

FOR MUST-READ TOPICS IN THE PHARMACOLOGY, CLICK HERE.

FOR MUST-READ TOPICS IN THE CRITICAL CARE AND EMERGENCY, CLICK HERE.

FOR MUST-READ TOPICS IN THE PREGNANCY, OBSTETRICS AND PAEDIATRICS CLICK HERE.

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