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I: Basic Sciences
1.1 Monitoring, Equipment and Clinical Measurement
Standards of Practice CAS Guidelines
Anesthetic Monitors Principles of function and sources of error Pulse oximetry Capnography and gas analysis Invasive and noninvasive blood pressure monitoring ECG CVP, PA Catheter TEE Neuromuscular blockade monitor EEG and evoked potentials Temperature monitoring
Anesthetic Gases, Storage and Piping Physics Safety standards and organization Oxygen delivery systems
Electricity Principles of electrical safety Hazards to the patient and anesthetist
The Anesthetic Machine Principles of operations – flowmeters, vapourizers, and ventilators Malfunctions Safety features – alarms
Ventilators Types Principles of operation Modes of ventilation
Circuits Physiology and techniques of humidification Types of circuits – advantages and disadvantages
Computers in Anesthesia Computerized record keeping
Infusion and PCA pumps Principles of function and limitations Cleaning / Sterilization of Equipment 1.2 Pharmacology
Principles of pharmacokinetics and pharmacodynamics
Detailed pharmacology of specific drug classes: Volatile anesthetic drugs Nitrous Oxide Induction agents Narcotics Neuromuscular blocking agents Anti-cholinesterases Benzodiazepines and other premedicats Anti-cholinergics Local anesthetics Inotropes and vasoactive drugs Anti-hypertensives Anti- arrhythmics Bronchodilators Hypoglycemics Anti-nauseants Aspiration prophylaxis drugs NSAID’s
Drug interactions and concurrent medications
Pharmacogenetics
Toxicology Prescription drugs Illicit drugs
1.3 Anatomy, Physiology, and Pathophysiology
a) Respiratory System
Anatomy Upper and lower respiratory tract anatomy Considerations re bronchoscopy and topicalization of airway Control of breathing Respiratory Mechanics and lung volumes Gas exchange Pulmonary function tests and blood gas analysis Ventilation/Perfusion matching Oxygen and carbon dioxide transport Pulmonary Circulation Respiratory Function during anesthesia Postoperative respiratory complications
Pathophysiologic States Obstructive lung disease Restrictive lung disease Bronchospasm ARDS Aspiration syndrome Embolic lung disease Pulmonary vascular disease Pulmonary hypertension Sleep apnea syndrome
Inhalational therapy Oxygen Helium Inhaled Bronchodilators Nitric oxide
Mechanical Ventilation Modes Physiologic Effects PEEP and Auto-PEEP
b) Endocrine and Metabolism
Diabetes Mellitus Hyper and Hypofunction of adrenal gland Hyper and hypofunction of Pituitary gland and hypothalamus Hyper and hyopfunction of Thyroid and Parathyroid DI, SIADH Calcium, Phosphate, and Magnesium homeostasis Carcinoid syndrome Malignant hyperthermia Surgery, anesthesia and stress response Thermoregulation
c) Liver
Anatomy Hepatic Circulation Liver Function Tests of Liver Function Effects of anesthesia and surgery on liver function Pathophysiologic states: Hepatitis – acute and chronic End stage liver disease Porphyria Hepatotoxins Postoperative jaundice Portal hypertension
d) Kidney
Anatomy Renal Function Renal Function Tests Effects of Anesthesia and Surgery on renal function Acid-base control Fluid and Electrolyte Balance Pathophysiologic States Acute and Chronic Renal Failure Principles of Dialysis Nephrotoxins
e) Hematology/Transfusion/Immunology
Hemoglobin Anemia’s Hemoglobinopathies Normal coagulation Anticoagulation and management of abnormal coagulation
Transfusion therapy – Indications for/risks/complications of: Blood Blood components Artificial colloids Risks/complications Blood substitutes
Autologous transfusion and blood conservation techniques
Blood Bank Procedures
Immunology Physiology of immune system Immunological diseases Anaphylaxis Management of immuno-compromised patients Transplantation/rejection Inflammatory response/SIRS
f) Cardiovascular
Anatomy Electrical activity and conduction Contractility Determinants of cardiac output Coronary Circulation Physiology of peripheral vasculature & microcirculation
Pathophysiologic States CAD Valvular Heart Disease Congenital heart disease Cardiomyopathies Pericardial disease CHF – left and right ventricular dysfunction Hypertension Arrhythmia’s
Physiology of CPR
g) Autonomic Nervous System
Anatomy Sympathetic receptors and transmitters Parasympathetic receptors and transmitters Anesthetic effects on the Autonomic Nervous System
Pathophysiologic States Autonomic Hyper-reflexia Congenital and Acquired diseases of autonomic function
h) Neuromuscular Junction
Neuromuscular transmission Tests of neuromuscular function
Pathophysiological States Myasthenia Gravis Myasthenic Syndrome
i) Central Nervous System
Anatomy – CNS and peripheral nervous system Neurotransmitters Intracranial Pressure Cerebral Circulation and Determinants of Cerebral Blood Flow Spinal Cord Function Effects of Anesthetics on the CNS
Pathophysiologic States Trauma to brain, spinal cord, peripheral nerves, Space occupying lesions Neuromuscular disease Paraplegia/quadriplegia |
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