Syllabus (Fourth Edition, 2023)
F1. Anatomy of the Respiratory System
i. Describe the structure and function of the upper airway, lower airway, and alveolus.
ii. Describe the structure of the chest wall and diaphragm and relate this to respiratory mechanics.
iii. Outline the anatomy of the pulmonary and bronchial circulations.
F2. Control of Ventilation
i. Describe the control of breathing.
F3. Mechanics of Breathing
i. Describe the inspiratory and expiratory processes involving the chest wall, diaphragm, pleura, and lung parenchyma.
ii. Understand compliance (static, dynamic, and specific) and its measurement.
iii. Relate compliance to the elastic properties of the respiratory system.
iv. Describe the pressure volume relationships in the respiratory system.
v. Explain the concept of time constants.
vi. Explain the significance of the vertical gradient of pleural pressure and the effect of positioning.
vii. Describe the pressure-flow and flow-volume relationships of the lung.
viii. Describe the factors affecting airway resistance and its measurement.
ix. Explain the relationship between resistance and respiratory gas flow.
x. Describe the production, properties, and role of surfactant.
xi. Describe the work of breathing and its components.
F4. Pulmonary Gas Volumes
i. State the normal values of lung volumes and capacities.
ii. Explain the factors that influence lung volumes and capacities.
iii. Explain the measurement of lung volumes and capacities.
iv. Define closing capacity, describe the factors that alter closing capacity, its clinical significance and measurement.
F5. Pulmonary Circulation
i. Describe the anatomical and physiological features of the pulmonary circulation.
ii. Understand pulmonary vascular resistance and the factors that affect this.
iii. Understand the differences between the pulmonary and systemic circulation.
F6. Ventilation-Perfusion Relationships
i. Describe the concepts of global and regional ventilation and perfusion and the factors that affect these.
ii. Describe West’s zones of the lung and explain the mechanisms responsible for them.
iii. Explain ventilation-perfusion matching and mismatching. Explain the effect of ventilation-perfusion mismatch on oxygen transfer and carbon dioxide elimination.
iv. Define dead space and its components. Explain how these may be measured and describe the physiological impact of increased dead space.
v. Explain the concept of shunt, its physiological effects, and its measurement.
vi. Explain venous admixture, its relationship to shunt and ventilation-perfusion (V/Q) mismatch.
F7. Diffusive Transfer of Respiratory Gases
i. Describe and explain the oxygen cascade.
ii. Describe the movement of carbon dioxide from the cell to the atmosphere.
iii. Explain perfusion-limited and diffusion-limited transfer of gases.
iv. Define diffusing capacity and its measurement.
v. Describe the role of endogenous nitric oxide in ventilation and perfusion.
F8. Gas Transport in the Blood
i. Describe the carriage of oxygen in blood.
ii. Explain the oxyhaemoglobin dissociation curve and factors that may alter it.
iii. Describe the carriage of carbon dioxide in blood.
iv. Explain the carbon dioxide dissociation curve.
v. Describe the oxygen and carbon dioxide stores in the body.
vi. Describe the physiology of foetal haemoglobin
F9. Pulmonary Function Tests and Equations
i. Describe the measurement and interpretation of pulmonary function tests.
ii. Describe the carbon dioxide and oxygen response curves and how these may be used to assess the control of breathing.
iii. Understand respiratory equations that describe ventilation, perfusion, blood flow and respiratory mechanics.
F10. Applied Respiratory Physiology
i. Describe the physiological consequences of intermittent positive pressure ventilation and positive end-expiratory pressure.
ii. Explain the physiological effects of hyperoxia, hypoxaemia, hypercapnia and hypocapnia.
iii. Explain the effect of changes in posture on ventilatory function.
iv. Define humidification, outline the mechanisms of humidification and its importance.
v. Explain the pathways and importance of the cough reflex.
vi. Outline the non-ventilatory functions of the lungs.
F11. Respiratory Pharmacology and Therapeutic Gases
i. Describe the pharmacology of oxygen.
ii. Describe the pharmacology of anti-asthma drugs.
iii. Outline the pharmacology of drugs used to treat acute pulmonary hypertension.
i. Describe the pharmacology of oxygen.
ii. Describe the pharmacology of anti-asthma drugs.
iii. Outline the pharmacology of drugs used to treat acute pulmonary hypertension.
Y01. Pharmacopeia: Resp
LEVEL 1 | LEVEL 2 | LEVEL 3 |
---|---|---|
Oxygen | Bronchodilators | Corticosteroids |
Anti-muscarinic agents – ipratropium, theophylline (aminophylline) | – Inhaled – Intravenous – Oral | |
Beta agonists – Salbutamol | Exogenous Surfactant | |
Pulmonary Vasodilators | ||
Nitric Oxide | ||
Prostacyclin |
F12. Respiratory Measurement
i. Describe the principles of pulse and tissue oximetry, co-oximetry including calibration, sources of errors and limitations.
ii. Describe the principles of capnography, including calibration, sources of errors limitations.
iii. Describe the methods of measurement of oxygen and carbon dioxide tension in blood.
iv. Describe the principles of measuring oxygen concentration.
SAQs
VIVAs
2023B | Regional variability in V&Q in lung Oxygen delivery systems and measurement Work of breathing and determinants |
2023A | Oxygen measurement, sodium channel physiology View of larynx during intubation Work of breathing and components, diagram |
2022B | Regional variability in V&Q throughout upright lung Oxygen cascade Work of breathing and components, diagram |
2022A | FRC change with preoxygenation (100% O2 in supine) O2 physiology and pharmacology. Calculate total O2 content when sats 90 to 95% and pO2 from 60 to 75mmHg) PO2 changes in oxygen cascade V/Q ratios in erect |
2021B | Components of Work of breathing PaCO2 vs PETCO2, pulmonary vasculature Closing capacity, measurement |
2021A | Compliance Measurement: Concentration of oxygen in inspired gas Oxygen cascade: Steps and values Oxygen delivery devices CO2 carriage, physiology |
2020B | Elderly: gas exchange, physiology, pharmacology Factors that affect respiratory rate Oxygen content, transport Oxygen cascade Compliance |
2019B | Monro-Kellie doctrine Spirometry |
2019A | Estimate ABG values for sats 85% on fiO2 0.5 Spirometry View of larynx during intubation |
2018B | Oxygen Cascade FRC Neonatal Physiology, Airway vs adult Spirometry |
2018A | respiratory changes in pregnancy. Explain why pregnant patients desaturate so quickly. “High Flow” Oxygen Therapy – diagram In relation to respiration, describe the central chemoreceptors, and explain their role in the control of ventilation. lung volumes and capacities – Why does the lung not “collapse” at the end of expiration? |
2017B | CO2 physiology – relationship of PCO2 and CO2 conc respiratory physiology, oxygen cascade, and the renal handling of sodium physiology and pharmacology of work of breathing, graph structure and function of the respiratory system and inhaled drug delivery role of oxygen in the body |
2017A | physiological reasons for an increased respiratory rate and the mechanism understanding of the gas laws understanding of lung volumes CO2, Capnograph Oxygen cascade |
2016B | Respiratory physio, obesity, LES, gastric emptying, Metoclopramide |
2016A | Resp physio, Abdominal pressure, splanchnic blood flow, terlipressin |
2015B | Resp physio, Oxygen cascade, humidity |
2015A | respiratory physiology, capnography |
2014B | Resp physio and measurement, Capnography, dead space |
2014A | oxygen, measurement of oxygen and principles around humidity Resp physio, effects of obesity |
2013B | Respiratory physiology, measurement, oxygen delivery, shunt, deadspace, O2 measurement |
2013A | knowledge of oxygen administration and oxygen measurement Resp physiology, Dynamic pulmonary compliance (PV loop), Expiratory flow curve |
2012B | Hypoxia vs hypoxaemia, clark electrode, physiological mechanisms of hypoxaemia, asthma, bronchodilators |
2012A | Hb saturation of newborn breathing air, Fetal Hb diss cureve, fetal/newboen circulation, changes at birth, normal values of newborn vital signs Vascular anatomy of blood flow in lungs, venous admixture, shunts, systemic vs pum circ, drugs to treat pulm HTN |
2011B | Treatment of Asthma, pharmacology Normal pulmonary arterial pressure, drugs, NO, measurement, Pulmonary vascular resistance |
2011A | Resp – flow volume loop, dynamic airways compression, alveolar elastic recoil pressire |
2010B | Arterial oxygen tension, resp physio and oxygen measurement |
2010A | ABG, H-H equation, Hypoxaemia, shunt, pulse oximetry |
2009B | Curve – Pulmonary compliance, Surfactant, Ventilator waveforms |
2009A | Patient with PE. Calculate the A-a gradient. |
2008B | Draw Capnograph tracing Collapse Lt Lung – processes contributing to hypoxia – V/Q, shunt, PVR, Pulse oximetry |
2007B | Asthma in extremis – NMJ, NMJ blocking drugs How would you measure gas flow Causes of low PaO2 Ventilator graphs – P,V waveform |
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