Arab Board OSCE, Clinical & Oral Exams Exam Page Nov. 2010 1-4 April 2011 5-9 Dec. 2011 10-19 April 2012 20-27 | Nov. 2012 28-35 April 2013 36-44 | Nov. 2013 45-49 March 2014 50-51 April 2015 52 Nov. 2015 53-58 April 2016 59-61 Nov. 2016 62-65 April 2017 66-71 March 2018 72-75 Nov. 2018 76-79 Jan. 2019 80-82 April 2019 83-86 Dec. 2019 87-91 April 2021 92-97 Collected by: Dr/Tamer Gamal AbdelhamiaCOsce 14/2040) - Sets Stimulator». Henkean [ite ov Gohoe Con epee to Blo 2, Care OT Qa. Tk &. ured enty (S- alelicl muscle Crbiaclen = CL Te bing. Cals le Acalgbelolee mabibéz lait. — 2 > DYfereacaa hekoean aolall J Pralicliie anise ptonten (y)-—— BDugam af Slow vetume... drops. 2. (prt orienkd Yotumet ~ ~ ~~ ee _. page 10). gn oS 7 4.) APGAR Sane =. you ate gien Ihe dd of anzaskeon y Cleabile —- ) TURE. jnigakoa Buick? rn 5 CLERP. ivvigaken 1 ackanl, haacanlege cach DEC Daskiys cn. syealace ne beucl pre WDvferences bebrean LV frilare S ventWiculor intercepenules Lvéov 7 ? kGroteta table). 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Gy he > JE Cork ? : a Heclinlars ve Vb. > Cimmant me, Biven 4 olefoie bevels of heart. ae —Cemmant on COG F Cokibrakion shat clo you expect ? wheal to mosnt by Stiain & — Chin ischemia. © cesy tn nermaf) Oprenctien ? & howd 7 — Gemment on AGG: given , hat ia Larens F hy 7 - ~CTG potters tn oletabe Jishat clees each ane mean ? — What bo your anacothale oleecsem ? —Qhet in meant by WELLP BP fo — What b Ke ehiference be sean rcliggenic &) nen Crcligenie Pulmenory eotoma 7 - — het clgs wae sou. propo Inc Has hee 2, ~ Shek is hetikol ? rake of BY of blockers 2? Fal ~ oftar clubs sin.dan you. protic Sor Suryery ? haber & cher 5S kK TE, ohet clrys are prebresead & why F ‘ (BZ) Eqdiementa (6) Sued O- Breoliiny theirs clarsWiation 2 chal in Ayre’s Tpriece 4 dru it 8 obyan mochficed Jackson Reet d hat o> the FF in Contvellend G Spenlenoxo ventlalion 7 bb Gpnegraphy principle , Weve bongth , brad olevia._, Daven S-merk imopiralion heap. d het” Gpeo of pres?! ? 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OPAP had te be jer afr Gers, infdion Ikan expiry Hh CPAP ~Durhy one deny ventilation het bo [Bs bert. Poston’ » “Supine or Lala & wady &, 3nd pnt SY Me Jed G2 es) Dee Gol Ceo Ll V/@. 7SApri el2 ee Sadat 02) Short Chon ce) an FET TALL, bauny fly tinsilliny opie nurse. Game. be Gor, Bain Hale be. dant coll fy et mLdhal cler You sunpect Po» Yealdliedl of olerclase . wha tee mane ge? novantic. anole a Ddhecokdy sh SI ASU. Ny Ten Meeting bine cheng b. Tridkcations fev Umvanive mech. wate or Conbrauid fer nenuiolve mechaméel. ventilation ? Dragger vet) ,' bo cs (anvaoive §/ nen Mesive Glaus O iralestve. SS nem lnuteiwe Cp ete Ub py Sarl <8 Cd GD 0 OY Gh &> Ne TN Sv Abe bs) Biss sULS ae bt dey BS As BA Bo ce Hebe pt. tame ty. LR him. Sre-gou. Suopack. that. he to Ce porseniny , hod you. toill marge. hem 2.0. . thet to fhe half fe of GvbuxyHb on air, on toot. Cu fon hejper beri. Oe. 7 : d= ARDS » hess er ober. betioeon Reale Cary inj y ARDS how lex ob] erential: belioeen Covelesgenie Ss prem Coyotes ne pl, coloma Aidhal are teens prods Shrabgieo ? 26Apnit 2o42. Ga) equipaents. (4) caleba ofefeie 5 hes mons perl» ite oh = BWIA JOM’ chrenn prerpure wrasse by pr of every moet -- Shige. clans bntiockat: 5 Conplixt b- Preume lage phim drwcits tb proicple , olecs it macoure Vedema r os Cito a Groteat onfie, Vorledile pressure Moaratir iE Gn be, Loreal. fr rmeanere. He kale} v. g the tn’ the los to verardad |e: the pisenatogr. ynearures Hos but Volume Gn be colonivce enVenthatais —» As bere 7 __ dh Voperizets >In olelschs typea » melhocla of heat Gmpgaonl- © 2. puilbe oxiney pin clablo dy chal o ite Z isobeste pest = and al which wneve- bons ww will be : on J ETL TT you ll RETT— rolontify pall mors by cponngs aavecl bout’, hat are ofker bypeo and iff you mention boer yerotant & be. aoled about thew lypeoArad Board Lx. ear (Wov. 9.012. ) Long Case: 47 years old female patient scheduled for hysterectomy. She has history of aortic valve surgery (unknown). She shows abnormal cervical spine flexion (permanent). thorathic scoliosis. Her labs show abnormal Hb, 5 gm\dl. MCH 15%. Pulmonary function test shows decreased FEV1 less than 70%. Also decreased VC less than 60%. On clinical examination BP140\70 mmhg. Chest shows fine basal cripitations by auscultation. Early diastolic murmur heared in the aortic area. Thyromental distance 3 cm. 1. Describe the case. 2. What do think this murmur represents? And what are the other diastolic murmurs you know? 3. What is your impression about the pulmonary function tests? Mixed obstructive and restrictive lung disease. 4.. If this patient did aortic valve replacement, what do you think the type of aortic valve is? Tissue or prosthetic valve? Tissue valve as there is no shadow of the prosthetic valve ring. 5. This patient was on oral anticoagulant, what is the therapeutic INR value? 22| | ' 6. What are the coagulation factors affected by the oral anticoagulant? 2,7,9,10. 7. What do we call those factors? Vit. K dependent factors. i 8. What is the half life of the oral anticoagulant? 30 hours. ‘9. How can you stop the oral anticoagulant? How can you | begin the low molecular weight heparin? 10. How and when can we resume the oral anticoagulant? i | 41, What is the shortest coagulation factor half life? Factor 8, 10 hours. '12. In this case if we want to correct the Hb, how can we do it? To what limit? How much packed RBCS do we have to give? And when? We have to give 4-5 units to reach by the Hb to 10 we have to give it 48 hours before the operation as the 2,3 diphosphglycerate needs about 48 hours to be reformed in the old blood in vitro otherwise the oxyhaemoglobin dissociation curve will be shifted to the left. . {13. How much one unit packed RBCS elevates the Hb? 1gm- 14. If this patient developed heart failure preoperative what are the possible causes? 15. What is the O2 flux? Write the equation. 16. In this case what is your decision? General or regional? 17. Is this patient difficult to be intubated? What is the normal Thyromental distance? 18. Suppose that for any reason there is no access for neuroaxial block (technical difficulties, patient refusal) how can you apply GA for the patient? 19. If the patient refused awake fiber optic intubation? What are the steps to intubate this patient? le Jaaiill | ll Ls algorism of difficult intubation. 20. If the patient developed bronchospasm during inhalational induction what is the most suitable action? 21. See the X-ray, give full comment? vid cle US sly US¥I Aialll 35> The positive data were cardimegaly, wires of median 30sternotomy, central hilar invasion (mostly cardiogenic ___ Pulmonary edema) '22.What is the degree of penetration of this X-Ray? Well penetrated as you can see the spinous processes of the thorathic vertebrae. } (23.1s it AP or PA? AP as the patient is intubated. _ 24.What do you think this type of pulmonary edema is cardiogenic or non cardiogenic? 25.This patient developed pulmonary edema post operative? What are the possible causes? '26.Haw can you differentiate between both types of pulmonary edema? ' Short Cases: 4- Motor car accident. The patient admitted in the emergency room. Vitally stable except for respiratory distress. Spo2 on 02 mask 90% | A. What is the first step you have to do? Chest X-Ray,B. If the X-Ray didn’t give a satisfactory result can you do any thing else? CT scan. C. You found longitudinal fracture in the ribs from 1 to 7 with paradoxical movement of the chest during respiration. What is your diagnosis? D. What is your plan of management for this patient? Conservative. E. How can you give analgesia to this patient? F.In PCA what are the opioids that can be given through it? G. What are the regional blocks that can be given to him? H. You begin the conservative management but the patient gets more distress. What will you do next? 1. You decided to intubate and ventilate the patient for how long you will do so? From 1 to 2 weeks. J. Where will you ventilate the patient? ICU K. If the patient stayed for 2 weeks what are the issues you have to take care about? Nosocomial infection, DVT, nutrition and bed sores. L. If you decide to begin feeding? What is much better for the patient enteral or parentral nutrition? 2-Advanced life support in details. Review the new ALS of 2012. 3L3- 45 years old male patient had fracture femur, scheduled for ORIF, He has history of gastric sleeve operation 2 years ago. He lost 50 Kg during those 2 years. A. What is the anaesthetic implications of this case? B. As this patient was obese what are the problems he had or may have? C. If this patient have obesity hypoventilation syndrome. How did he know this diagnosis? D. What are the investigations we have to do to him? E. What is your anaesthetic plan? Physics and Instruments: 4. What do you know about the anaesthesia circuits? What are their classifications? 2. Draw the iris T Piece? 3. What is the flow needed for controlled and spontaneous ventilation for this circuit? 4. if you have a 3 years old baby what is the flow needed for manual ventilation? Note that the least flow for this circuit 3 L\Min. 5. What is the modification done for this circuit? 6. What are the disadvantages of this circuit? 337. In the old Jackson Rey Modification of iris T piece there was a valve. Why this valve removed? As it cause increase in the resistance. 8. What do you know about BIS? 9. Is it reliable monitor? 10. What are the different readings and what it represents? 11. What is the principle of action of capnography? 12. Draw the capnography trace? 13. What each part of the trace represents? 14. Draw the capnography trace in case of oesophegeal intubation? 15. What are the types of capnography? 16. What are the advantages of each type? 17. What are the disadvantages of each type? 148. How can you perform check on the anaesthesia machine? 19. How do you know the 02 cylinder is filled? 20. How do you know the N20 cylinder is filled? 21. How can you check the inspiratory valve? 22. How can you check the expiratory valve? 23. Concerning the 02 analyzer is it reliable? 24, What are the indications of spinal anaesthesia? 25. What are the contraindications of spinal anaesthesia? 26. What are the types and names of the spinal needles? 27. What are the agents used in spinal anaesthesia? BY28. What are the adjuvants used in spinal anaesthesia? 29. What are the complications of spinal anaesthesia? 30. What are the supra glottis devices? 31. What are the types of laryngeal mask? 32. Concerning the fastrack how can you intubate through it? 33. If you can’t remove the fastrack after intubation what will you do? Leave it in place.OSCE & Oral Arab Board exam April 2013 Lone Case ; Case: Pheochromocytoma. 1. Define Ejection Fraction? 2. Give the equation for the O2 extraction in The tissues? 3.What is the amount of O2 extracted by the tissues per minute? 4. What is the O2 content in blood, give the equation? 5. What is O2 Flux defines and give the equation? 6. In the case the patient was undergoing mastectomy surgery sheexperienced anevent of sever hypertension, tachycardia and pulmonary edema then inthe ICU postoperative the patient become hypotensive and her EFby echo became 25%. z6b7. What is the cause of the decrease in the EF? Hypertension. If the cause is hypertension, what is the most affected part in the heart(what is the mechanism by which hypertension cause MI)?..... subendocardial ischemia. 8. What is your diagnosis for the case (give differential diagnosis)? 9. Doyouknow malignant hyperthermia, describe themechanism? 10.Describe motor end plate, mechanism of muscle contraction? 11. Describe the cycle of catecholamine synthesis? 12. What are the actions of adrenaline, name the receptors it workson? 13.Namethe alphaadrenergic antagonists (whatspecificand non specific}? 3414 as. 16, 17. 18. 19. 20. 21. 22. 23.Define the structures in the X-Ray? » How to prepare a patient scheduled for Pheochromocytoma? What are the investigations done for this patient?’ Isthe pulmonary edema cardiogenic or non cardiogenic? What is the time needed to prepare him? What are the criteria tell that thepatient is ready for surgery? Differentiatebetweenboth?.. .....Through PCWP (high in cardiogenic, normal in noncardiogenic) How to ventilate this patient? oon Qouy pleuse PEEP What is the pharmacologicalmanagement for this patient? X-Ray, Isthis X-Ray AP orPA?....AP dueto presenceofendotracheal tube. Pulmonary Artery Catheter. 3824.Givethe different structures and pressures the artery pass through? 25.Define the different parts of the cardiac shadowon the X-Ray? Short Cases: 1 Part 1. How the blood can be Preserved, Identify the preservative media? 2. Describe the life span of the different blood component invitro? 3. What isthe temperature at which the packed RBCs preserved? 4, What is the temperature at which the platelets preserved? 5, What is the haematocrit value of the packed RBCs unit, what is its volume ? 3936. what are the blood substitutes? 7.Name the different types of Colloids? 8. How can you compensate for the blood loss? 2" Part Patient with head rauma admitted to ICU, 1* day GCS was 12, 2nd day he lost consciousness GCS becomes 6. 1, What is the immediate management? 2. Define Glasgow Coma Scale? 3, What are the different component of GCS? 4, What is the least GCS?.....3 5. How can you measure the Intracranial Pressure? 6. How to decrease the intracranial Pressure? 7. How to protect the brain? Ho3" Part Advanced Life Support in details Collapsed patient on examination of the pulse it was VT and the patient is compromised ae 2 What is the immediate management? What are the shockable rhythms? When to start to give adrenaline?.......... after the 3" shock. When to start to give amiodarone?....after the 4" shock. I4° Part Pain management for Chest surgery . What is the WHO Pain Stepladder? 2. How can you perform pain management for this patient? . Can you use Pharmacological Combinations, give examples? . What is the most common and dangerous complication for intercostal nerve block and Why?.. se intravascular injection. . If youperform Thorathic epidural at what level you want to perform it?........ T6 or T7 . Can you do high lumber epidural for this case for pain control? .......yes. . What is the dose and concentrations of local anaesthetic in both?.......the dose is lower in thorathic but the concentration is higher. _ what are the local anaesthetics you use in this case and what are the toxic doses of them? 4LPhysics and instruments: 9- What are the Supraglottic devices? Draw the laryngeal tube? Draw the combi tube ? How can you measure the cardiac output ? Draw the pulmonary artery catheter ? What are the different openings of the catheter and where It lies? Is itcontains Thermometer or What are the different pressures the catheter pass through? Draw the waves the catheter shows during Insertion? 10- What are we use to measure the COP?.....Iced saline 4311-Is there any other method? ceed dye dilution technique 12-What is better the iced saline or the die ? Why? ae Iced saline 13-How can we prevent hypothermia in the OT? 14-What is the temperature of the OT? 15-How can we humidify the gas reaching the patient? 16-What are the sizes of the cylinder? 17-How much can the E & H 02 Cylinder accommodate? 18-What is the size we use in the anaesthesia machine?....... E type 19-How can we know that the cylinder is empty in the 02 cylinder ce 20-How can we know that the cylinder empty in the N20 cylinder? 21-What type of flowmeter the rotameter is ? 22-How it behaves in the upper part and inthe lower part? 4y3rd part of Arab Board Exam Nov.2013 1* Day Physics and equipments: 1-non Invasive pr. measurement and vaporizer mech. 2-Types of LMA 3- Pulse oximeter andbreathing circuits 4- Pulmonary function tests Short cases: 1- Kyphoscoliosis and wake uptest2 2- Head trauma In ERGCS 6, management in ER and ICU 3- ECG reading and chest Xray 4- OSA. 5-Myasthenia gravis with nerve stimulator 456- Spinal in primigravida and aortocaval compression (others PDPH) Lone cases: 1- Elderly pt with moderate AS for RT hemicolectomy with continous bleeding 8.5 gm/dl afier two Packed RBCs. 2- Elderly had mandlblectomy with fibular graft which was infected and bleed from major vessele injury and trachaostomy removed 4 days ago presented for another tracheostomy under GA. 2"4 Day physics and equipments: 1. Epidural set. 2. Capnograph 463rd Day Physics and equipments: 1- Defibrillator, types, how it works, cinical applications. 2- Double lumen tube, indications, types, differences between types, confirm position. 3- PCA, indications, drugs used, components of the device, side effects, hazards, precautions 4- BIS, indications, significance, significance of isoelectric pattern 5- Humidity, definition, types, measurement, how to humidify patient's gas flow, why? Short cases: 1- Awareness during Anaesthesia, definition, types, common surgeries, causes, diagnosis, treatment. Rupture eye injury anesthetic management, rapid sequence induction, complications ofsuxamethonium. ee3. Closed circuit 4. Temp. Monitoring Short cases: 1. Diabetes 2. Sickle cell disease 3. TeF (tracheo-oesoph.Fistula) 4. Tachycardia algorhythm Lone cases: 14- Obst hge. Diabetic. Breach. Placenta brevia. Obese. Multiple Cs 2- Old age. Ischemic HD. CABAG. Heart failure fracture humerous. Vascular injury. Regional vs general. 4+&3- Laparoscopic surgery, anesthetic considerations. 4- Mythenia Gravis, diagnosis, treatment, preparation for surgery, criteria of post operative mechanical ventilation, intraoperative management, criteria of extubation 5- Oxygen delivery equation in full details 6- Ejection fraction equation in details 7- CVP waves and their significance, central line catheter indication and complications. Long cases: 4- Clinical case of mitral regurgitation or aortic stenosis, how to manage it in details. 2- Clinical case of internal hge, IHD grade 4, heparin coagulopathy: assessment, preparation, management. 79Arab Board Exam in Sudan ( March 2014 ) OSCE: 4 CXR 4ECG 1ABG 1 CT Brain Intubating LMA FOB Nasopharyngeal Airway Invasive BP waves PFTs waves DLT 1* Day Case: HOCM 2"! Day cases: Fallot tetralogy Cerebral aneurysm Amniotic fluid embolism Epidural was inserted for vaginal delivery & after 3 h patient got SOB for D.D ? Day case surgery. Sickle cell anemia Pheochromocytoma Airway assessment 5oPhysics & instrument: Pressure Temperature Humidity Invasive Blood Pressure Capnography Rotameter Vaporizer Mapelson classification 5)3" ARAB BOARD © __ tab board exam in cairo 26-4- 2015 first day 1- epiglottitis how to management 2- female patient 80 year old for rt hemicolectomy with aortic stenosis and anemic HB was 8.5 3- post tonsillectomy bleeding - fracture humerus what are regional anaesthesia can use in this case 4- ARDS management - postpartum bleeding 5- PCA - stander monitoring 6- modern anaesthesia machine check - ICP definition , how to measure, effect of anaesthetic drug on it how to manage it Labour and es in ankylosing spondylitis Ankle block PONV Cerebral protection Capnography Septic shock after perforated peptic ulcer Nerve stimulator Us physics One lung ventilation Neck hematoma after neck dissection and infected tracheostomy with hemodynamic unstability St