Syllabus (Fourth Edition, 2023)
Physiology of the Nervous System
Pharmacology related to the Nervous System
Pharmacopeia: Neuro
Pain Physiology
Pain Pharmacology
Pharmacopeia: Pain
Nervous System Measurement
Physiology of the Nervous System
i. Describe the anatomy of cranial nerves relevant to brainstem reflexes.
ii. Explain the determinants of intra-cranial pressure.
iii. Describe the anatomy and regulation of cerebral circulation.
iv. Describe the physiology of cerebrospinal fluid.
v. Describe the major sensory and motor pathways (including anatomy) from the periphery to cortex.
vi. Explain the basic electro-physiology of neural tissue, including conduction of nerve impulses and synaptic function.
vii. Describe the major neurotransmitters and their physiological role, with particular reference to excitatory and inhibitory amino acids (including those acting on the NMDA receptor), GABA, acetylcholine, noradrenaline, dopamine and serotonin.
Pharmacology related to the Nervous System
i. Understand the pharmacology of sedating drugs.
ii. Understand the pharmacology of local anaesthetic drugs.
iii. Understand the pharmacology of anti-convulsant drugs.
iv. Understand the pharmacology of anti-depressant and anti-psychotic drugs.
Pharmacopeia: Neuro
| LEVEL 1 | LEVEL 2 | LEVEL 3 |
|---|---|---|
| Local Anaesthetics | Other | Antidepressants |
| Amides | Nimodipine | Monoamine oxidase inhibitors (MAO-i) |
| Lignocaine | Selective serotonin reuptake inhibitors (SSRIs) | |
| Bupivacaine | Serotonin-Noradrenaline reuptake inhibitors (SNRIs) | |
| Ropivacaine | Tricyclic anti-depressants (TCAs) | |
| Anticonvulsants | ||
| Midazolam | Phenytoin | Lamotrigine |
| Levetiracetam | ||
| Phenobarbitone | ||
| Sodium Valproate | ||
| Sedative / Hypnotic drugs | Antipsychotics | |
| Benzodiazepines | Barbituates | First generation antipsychotics |
| Midazolam | Thiopentone | Haloperidol |
| Diazepam | Second generation antipsychotics | |
| Other | Olanzapine | |
| Dexmedetomidine | Quetiapine | |
| Ketamine | ||
| Propofol | ||
Pain Physiology
i. Describe the physiology of pain, including peripheral nociception, conduction, receptors, mediators and pathways, spinal cord modulation and central processing of pain.
Pain Pharmacology
i. Describe the pharmacology of drugs used to treat pain.
ii. Outline the classification, structure and distribution of opioid receptors and NMDA receptors.
Pharmacopeia: Pain
| LEVEL 1 | LEVEL 2 | LEVEL 3 |
|---|---|---|
| Analgesics | ||
| Opioids | ||
| Oxycodone | Buprenorphine | |
| Fentanyl | Remifentanil | Alfentanil |
| Morphine | Hydromorphone | |
| Methadone | ||
| Tapentadol | ||
| Tramadol | ||
| Non-Opioids | ||
| Ketamine | Gabapentin / Pregabalin | Non-steroidal anti-inflammatory drugs |
| Paracetamol | ||
Nervous System Measurement
i. Describe the measurement of intracranial pressure.
SAQs
VIVAs
| 2023B | Events that lead to perception of pain following laceration to the hand CSF flow from production to absorption Pupillary light reflex, anatomical pathways |
| 2023A | NMDA receptor Opioid receptors, pharmacology |
| 2022B | GABA receptors, Anticonvulsants Pain, detection and response, Analgesics P-V relationship for ICP Cerebral blood flow: relation with PaCO2, PaO2, CPP Consequence of unexpected cut to hand |
| 2022A | How is pain sensed following a skin incision Consequence of interrupting vagal transmission at C2, PNS, Cranial nerve reflexes GABA-A receptors: structure and function GABA-A receptors: structure and function |
| 2021B | Sensory and motor pathways, pathway from periphery to cortex Phenytoin, antiepileptics, anti-depressants Opioid receptors, pharmacology Thiopentone pharmacology, why does thio have a rapid onset of action Sedatives, Propofol |
| 2021A | Opioid pharmacology, MoA Propofol pharmacology. What is in a bottle of propofol Cranial neve anatomy, pupillary reflex |
| 2020B | Opioid receptors, pharmacology GABA signalling, Propofol Cranial neve anatomy, physiology of brain stem reflexes, pupillary reflex Benzos: Midazolam, effects Cerebral blood flow, receptors Noxious stimulus: sudden sharp cut to hand |
| 2019B | Opioid pharmacology Cerebral blood flow PD of sedative drugs. Propofol 100mg: Bolus vs Slow infusion over 5 minutes |
| 2019A | P-V relationship for ICP Opioid Pharmacology, MoA Morphine Paracetamol and Toxicity |
| 2018B | CBF – flow, distribution Opioids, MoA |
| 2018A | This viva will examine nerve action potentials and neuromuscular blockade. Define pain and describe how pain is detected in response to a peripheral noxious stimulus. |
| 2017B | Neurophysiology and pharmacology. Response of the nervous system to standing on a nail. pharmacokinetics and opioids. Draw the concentration-time curve following an intravenous bolus of 100 ug fentanyl PNS, LA pharm, Femoral nerve in triangle diagram Neurophysiology and neuropharmacology. |
| 2017A | pharmacology of propofol and ketamine cerebral perfusion, its control and measurement |
| 2016B | Cerebral physio + pharm, propofol, ketamine |
| 2016A | Aging physio + pharm, oPioid pharmacology Cerebral physio + pharm, propofol, ketamine |
| 2015B | opioid pharmacology including classification and mechanism Cerebral physio+pharm, mannitol, ketamine |
| 2015A | |
| 2014B | Nerve action potentials, LA pharm Cerebral physio + pharm, Vasopressin |
| 2014A | Propofol,pharm, basic kinetics for bolus and infusions, side effects |
| 2013B | |
| 2013A | pain pathways and analgesia. Immediate response to a cut in the hand knowledge of intracranial pressure and sedating drugs |
| 2012B | Sedatives and effect on Resp and CNS, Midaz vs haloperidol, term – “neuroleptic”, EEG Cerebral blood flow, regulation, propofol |
| 2012A | Thiopentone, conc vs time curves, Vd and factors, elimination, half life Cerebral blood flow, grey vs white matter blood flow, EEG related to blood flow, factors affecting CBF |
| 2011B | |
| 2011A | ICP, CBF, control mechanisms, drugs |
| 2010B | Cerebral blood flow, relationship with PaCO2, Benzos Basic pharm, opioid drugs |
| 2010A | spinal cord anatomy, LA, pain and meds, ketamine Conc-time cure for IV bolus fentanyl, Vd, t1/2, clearance |
| 2009B | Cerebral blood flow, measurement, regulation, Opioids and their CNS effects |
| 2009A | |
| 2008B | Pharmacology of analgesic meds – Non-opioids, Opioids Cerebral blood flow, measurement, variations, Morphine |
| 2008A | Describe the physiology of pain with respect to its mediators and pathways. |
| 2007B |
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