2011 First Sitting VIVAs

This Viva will examine your knowledge of the pharmacology of common resuscitation fluids. Q 1. What is the composition of Hartmann’s Solution? As this viva developed it sought an understanding of “balanced solutions”, difference, adverse effects of intravenous solutions and difference between crystalloids and colloids and distribution of common intravenous solutions within the body. Candidates mostly had difficulty defining and differentiating a colloid from a crystalloid. A colloid is defined as a substance dispersed evenly throughout another substance. The hydrocolloids consist of colloid particles dispersed in water and as such the solid particles may be unable to pass through a semi-permeable membrane, thus exerting a colloid osmotic force and preferentially expanding the intravascular volume.

This Viva will examine your knowledge about temperature and drugs that may affect temperature Q 1. Outline the mechanisms by which the body controls temperature The majority of candidates did well on this viva. Candidates were expected to know physiological mechanisms associated with defending against temperature fluctuations, sites of measurement of temperature, differences between sites, how NSAIDs reduced a fever and mechanisms of adverse effects associated with NSAIDs. Areas of weakness were failure to mention diurnal variation, thermoneutral zone and differences associated with neonates, newborns and children.

This Viva will explore your knowledge of basic pharmacology and poisoning. Q 1. Describe the factors that affect ORAL drug absorption This viva explored basic pharmacology, dose response curves and poisoning as it related to paracetamol, aspirin and organophosphates. Areas of weakness included the depth of knowledge regarding basic pharmacology as it related to concepts such as clearance and bioavailability and first pass metabolism.

This Viva will test your knowledge about intracranial pressure and cerebral blood flow. Q 1. What are the determinants of intracranial pressure? This viva explored basic and highly relevant area of CNS physiology. Candidates are expected to draw, interpret and explain the relationship between intracranial pressure, cerebral blood flow and variety of chemical and physiologic control mechanisms as they may be illustrated within graphs. Basic pharmacologic pharmacologic principles of ICP control were also discussed. Lack of knowledge depth and conceptual understanding were areas that need further attention.

This Viva will examine your knowledge of respiratory physiology Q1: Draw the flow volume loop of the lung of a young adult male. Include tidal volume and submaximal efforts Dynamic tests of forced vital capacity are one of the most common types of respiratory function test that trainees will be exposed to. Candidates were expected to accurately label and discuss features of the flow volume loop including accurate axes, peak flow and its determinants and the effort dependent and independent parts of the loop. Pressures and flow characteristics in the airway during quiet expiration and forced expiration were sought. An adequate description of dynamic airways compression resulting in forced expiratory gas flow limitation was also required. Also asked were expiratory gas flow characteristics and lung volumes in chronic obstructive and restrictive lung disease. Finally the viva briefly explored knowledge of equipment that measures gas flow. Most candidates performed poorly in this viva. The main area of weakness was a lack of understanding of how pressure and flow change in the lungs during quiet and forced expiration. Also most candidates did not appreciate the importance of alveolar (lung) elastic recoil pressure in determining the pressure gradient for gas flow during quiet and forced expiration and how this depends on lung volume.

This Viva will examine your knowledge of the physiology of glucose regulation and hypoglycaemic drugs as well as the physiology of the Thyroid gland Q 1. Describe the physiology of Insulin This viva began with a discussion on the physiology of insulin, physiological consequences of insulin deficiency, oral hypoglycaemic drugs and the thyroid gland. Generally candidates performed well in this viva. The role of insulin beyond metabolism of glucose, fat and protein was not well understood. The differences in the pharmacology between T4 and T3 was another area of weakness.

This Viva will test your knowledge of renal physiology and potassium regulation Q 1. Briefly outline the functions of the kidney? This viva tested, briefly, knowledge of renal function, as well as covering hyperkalaemia in some depth. Candidates had a general knowledge related to hyperkalaemia, but struggled to explain the cardiac consequences as they related to the cardiac action potential and as they reflected upon the ECG.

This Viva will discuss the pharmacology and the physiology of the peripheral circulation During the reading time, candidates were also shown a figure of SNP, and were asked if they recognised it. The viva then went on to discuss the pharmacology of SNP. This was generally well done. For the latter half of the viva,