H4.i · Pain Pathways & Modulation

This VIVA will examine pain physiology and pharmacology. Describe the steps that lead to the perception of pain following a noxious stimulus?

This viva will examine pain physiology and pharmacology. Describe the events that lead to the perception of pain following a laceration to the hand.

This viva will explore your knowledge of the Autonomic Nervous System. Describe the Physiologic consequences of an unexpected cut to your hand with a sharp knife?

This viva will explore your understanding of the pain pathways and analgesic medications. Define Pain and describe how pain is detected in response to a peripheral noxious stimulus?

This viva will explore your understanding of pain pathways. How is pain sensed following a skin incision?

This viva will explore your knowledge of the body’s response to a noxious stimulus. What would happen if you have a sudden sharp cut to your hand?

This viva will examine pain pathways and analgesic pharmacology. Define pain and describe how pain is detected in response to a peripheral noxious stimulus.

This viva is on neurophysiology and pharmacology. Describe the response of the nervous system to standing on a nail.

This Viva tested knowledge of the pain pathways and analgesia. The first question asked candidates to describe what would be the immediate response to a cut to the hand.

This Viva will test knowledge of spinal cord anatomy, local anaesthetics and analgesics Draw a cross-sectional figure of the spinal cord, at the level of C3, and describe the functional anatomy and blood supply of the spinal cord at that level. Candidates were asked to draw a cross-sectional figure of the spinal cord, at the level of C3, and tested on their ability to describe the functional anatomy and blood supply of the spinal cord at that level. Candidates were also asked about local anaesthetic drugs, their mechanism of action, pain (and asked to define pain) and non-opioid analgesics, in particularly ketamine and the pharmacology of ketamine.

Candidates were expected to provide a definition for pain, discuss the pathways involved in the transmission of pain signals, and list the common mediators. Additional questions related to sensitisation (peripheral and central) and the Gate Control theory (G2c). Candidates were also asked to compare the pharmacology of local anaesthetics with particular reference to lignocaine and bupivacaine (G2b). As with any question related to pharmacology, candidates were expected to discuss factors listed under “General Pharmacology” in the syllabus: “An understanding of the pharmacology of a drug implies an understanding of the relevant pharmaceutics, pharmacokinetics (including dosage), and pharmacodynamics (including adverse effects and drug interactions).” Candidates were asked to list the different potential modes of administration of local anaesthetic agents (G2c). Candidates were also asked to describe the anatomy relevant to the insertion of a lumbar epidural catheter (G1:2j). Syllabus : G2c, G2b, G1:2j No candidates (0%) passed this question.