Primary FRCA Revision Checklist

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PhysiologyBiochemistryAcid-base balance
Buffer systems
Regulation of pH
Body compartments and water
Osmolarity and partition of fluids
Cell membranes and receptors
Cellular transport
Cellular metabolism
Basal metabolic rate
Enzymes
Gene transcription, translation and protein synthesis
Membrane potential
RespiratoryVentilation and perfusion
Alveolar gas equation
Dead space
Bohr equation
Shunt
Alveolar time constants
V/Q matching
Lung mechanics
Lung volumes
Measuring lung volumes
Spirometry
Flow-volume loops
Compliance
Surfactant
Work of breathing
Control and gas transport
Control of breathing
The cough reflex
Gas exchange
Oxygen delivery and transport
Oxyhaemoglobin dissociation curve
Hypoxia
CO2 homeostasis
Physiological effects of hypercarbia
Pulmonary circulation
Pulmonary vascular resistance
Hypoxic pulmonary vasoconstriction
Applied respiratory physiology
Effect of IPPV
Effect of anaesthesia on lung function
Altitude (hypobaric pressures)
Diving (hyperbaric pressures)
Non-respiratory functions of the lung
CardiovascularThe heart
Cardiac action potentials
The ECG
Cardiac muscle contraction
The cardiac cycle
Cardiac pressure-volume loops
Control of the circulation
Control of blood pressure
Baroreceptors
Hormonal control of cardiac function
Control of cardiac output
The Valsalva manoeuvre
Frank-Starling relationship
Fluid responsiveness
Vascular physiology
CVP
Peripheral circulation
SVR
Venous return
Capillary dynamics
The lymphatic system
Special circulations
Coronary circulation
Pulmonary circulation
Pulmonary artery wedge pressure
Portal circulations
Organ oxygen consumption
Exercise physiology
Neurology and musculoskeletalNeurological
Action potentials
Neurones
The blood-brain barrier
Functional areas of the brain
Cranial nerves
Sympathetic nervous system
Parasympathetic nervous system
Enteric nervous system
Sleep
The EEG
Cerebral blood flow
Cerebral metabolic rate
CSF
ICP and the Monro-Kellie doctrine
Musculoskeletal
The neuromuscular junction
Skeletal muscle structure
Skeletal muscle contraction
Muscle spindles and Golgi tendon organs
Muscle reflexes
Smooth muscle function
PainClassification of pain (duration and nature)
Pain pathways
Pain gate theory
Visceral pain
Neuropathic pain
EndocrineHypothalamus and pituitary
Physiology of hormones
Hypothalamic-pituitary function
Posterior pituitary hormones
Growth hormone
Other anterior pituitary hormones
ACTH
Adrenal glands
Adrenal glands
Aldosterone
Cortisol
Androgens
Thyroid and parathyroid
Thyroid gland
Thyroid hormones
Calcium homeostasis
Hyperparathyroidism
Metabolism
Insulin
Diabetes
Obesity and its effects on organ systems
The stress response
The starvation response
RenalRenal blood flow
Blood supply and autoregulation
Renal blood flow
The nephron
Overview of the nephron
Glomerular filtration
Proximal convoluted tubule
Loop of Henle
Distal convoluted tubule
Collecting duct
Handling of solutes
Glucose handling
Potassium handling
Sodium (and chloride) handling
Water reabsorption
Regulation and dysfunction
Regulation of electrolyte balance
Regulation of pH
Hormonal functions of the kidney
AKI
CKD
GastrointestinalGastric anatomy in brief
Sphincters of the GI tract
Barrier pressure and the LOS
Functions of the stomach
Gastric acid secretion
Gastric emptying
GORD
The swallowing reflex
Nausea and vomiting
TPN
HepatobiliaryFunctions of the liver
Immune function of the liver
Liver anatomy and blood supply
Functional organisation of the liver
Biotransformation
Bile formation
Haem metabolism
Jaundice
Lactate metabolism
Protein metabolism
Iron homeostasis
The spleen
HaematologyRed blood cells
Platelets
Anaemia
Disorders of haemoglobin
Sickle cell disease
The clotting cascade
Disorders of coagulation
ABO and Rh antigens
Transfusion physiology
Transfusion reactions
Blood conservation strategies
ImmunologyOverview
Immune system
Cells of the immune system
Reticuloendothelial system
Autoimmunity and immunodeficiency
Allergy
PaediatricFoetal circulation
Physiological differences in children
The paediatric airway
ObstetricPhysiological changes in pregnancy
The placenta
Rhesus status
Foetal wellbeing and CTG monitoring
Anaesthesia in pregnancy

PharmacologyPharmacokineticsAbsorption, distribution, metabolism and excretion
Absorption
Distribution
Principles of metabolism
CYP450 enzyme system
Pharmacogenetics
Excretion
Effects on pharmacokinetics
Drugs and the liver
Drugs and the kidney
Effects of altered physiological states
Pharmacokinetic modelling
Principles of modelling
Hysteresis (in pharmacology)
Volume of distribution
Clearance and elimination
Context sensitive half-time
Types of pharmacokinetic models
One compartment model
Two compartment model
Three compartment model
TIVA
PharmacodynamicsDrug structure and action
Isomerism
Bonds
Drug action
Receptors and their subtypes
Drug-receptor interactions
Affinity, efficacy and potency
Agonists
Antagonists
Tachyphylaxis and tolerance
Enzymes and interactions
Enzyme kinetics
Enzyme inducers
Enzyme inhibitors
Adverse drug reactions
Drug interactions
Pharmacodynamic interactions
IV anaestheticsTheories of mechanisms of action of anaesthetics
The ideal IV anaesthetic agent
Propofol
Ketamine
Barbiturates
General pharmacology of barbiturates
Thiopental
Methohexital
Phenobarbital
Etomidate
Inhaled anaestheticsPrinciples
The ideal inhalational agent
Partition coefficients
Speed of onset
MAC and potency
Effects of altitude
Agents
Halothane
Isoflurane
Enflurane
Sevoflurane
Desflurane
Methoxyflurane
Nitrous oxide
Entonox
Xenon
Helium
Nitric oxide
Local anaestheticsGeneral principles of local anaesthetic pharmacology
Amides
Lidocaine
(Levo)bupivacaine
Ropivacaine
Prilocaine
Esters
Amethocaine
Cocaine
Local anaesthetic toxicity
Neuromuscular blocking drugsThe ideal neuromuscular blocking agent
Suxamethonium
Non-depolarising agents in general
Aminosteroids
Rocuronium
Vecuronium
Pancuronium
Benzylisoquinoliniums
Atracurium (inc. cisatracurium)
Mivacurium
D-tubocurarine and gallamine
Reversal and others
Anticholinesterases inc. neostigmine
Sugammadex
Dantrolene
Toxins at the NMJ
Paracetamol and NSAIDsProstaglandins and cyclo-oxygenase
NSAIDs in general
Paracetamol
Aspirin
Acetic acid derivatives
Ibuprofen and other non-specific COX inhibitors
Meloxicam
Specific COX-2 inhibitors
OpioidsPrinciples
Endogenous opioids
Opioid receptors
Morphine and friends
Morphine
Diamorphine
Codeine (and dihydrocodeine)
Fentanyl and friends
Fentanyl
Alfentanil
Remifentanil
Sufentanil in brief
Pethidine
Loperamide in brief
Other opioids
Tramadol and tapentadol
Methadone
Buprenorphine
Partial agonists and mixed agonist/antagonists
Naloxone
Nitazenes
Opioid side-effects
Opioid-related harm (inc. opioid stewardship)
Opioid-induced ventilatory impairment (OIVI)
Opioid-induced hyperalgesia (OIH)
Effects on the immune system
Other analgesicsClonidine
Dexmedetomidine
Nefopam
Drugs targeting specific sodium channels in brief
Respiratory systemβ2-adrenoreceptor agonists
Theophylline and aminophylline
Doxapram
Cardiovascular systemSympathomimetics
Sympathomimetics in general
Natural catecholamines
Synthetic catecholamines
Alpha adrenoreceptor agonists
Beta adrenoreceptor agonists
Ephedrine
Vasopressin and friends
Other positive inotropes
Classification of inotropes
Selective phosphodiesterase III inhibitors
Levosimendan
Other inotropes
Alpha and beta antagonists
Non-selective alpha antagonists
Selective alpha antagonists
Beta blockers in general
Cardioselective beta blockers
Acebutolol
Propranolol and sotalol
Labetalol
Anti-arrhythmics
Physiology of anti-arrhythmics
Classification of anti-arrhythmic drugs
Class Ia anti-arrhythmics
Class Ib anti-arrhythmics
Class Ic anti-arrhythmics
Class II anti-arrhythmics (beta blockers)
Amiodarone (class III)
Verapamil
Digoxin
Adenosine
Vasodilators
Classification of vasodilators
Sodium nitroprusside
Nitrates
Nicorandil
Calcium channel antagonists
Diltiazem
Dihydropyridines
Hydralazine and minoxidil
Diazoxide
Sildenafil and bosentan
Anti-hypertensives
Classification of anti-hypertensives
ACE inhibitors
Angiotensin II receptor antagonists
Methyldopa
Adrenergic neurone blockade
Ganglion blockers
Central nervous systemBenzodiazepines
Relevant physiology
Benzodiazepines in general
Midazolam
Other benzodiazepines
Flumazenil
Z-drugs
Antidepressants and antipsychotics
Classification of antidepressants
SSRIs
MAOIs
SNRIs (inc. duloxetine)
Tricyclic antidepressants (inc. amitriptyline)
Tetracyclic antidepressants
Lithium
Antipsychotics
Anti-epileptic drugs
Classification of anti-epileptics
Phenytoin
Valproate
Carbamazepine
Phenobarbital
Lamotrigine
Gabapentinoids
Vigabatrin
Others
L-dopa
Sumatriptan
Gastrointestinal systemAnti-emetics
Phenothiazines
Butyrophenones
Benzamides
Anti-muscarinics
Anti-histamines (H1 antagonists)
Serotonin receptor antagonists
Neurokinin receptor antagonists
Dexamethasone (as an anti-emetic)
Miscellaneous anti-emetics
Gastroprotection and motility
Antacids
H2 receptor antagonists
Proton pump inhibitors
Mucosal protectors
Prokinetics
Renal systemClassification of diuretics
Acetazolamide
Mannitol
Loop diuretics
Thiazide diuretics
Amiloride
Spironolactone
Endocrine systemHormone preparations
Corticosteroids
Dexamethasone
Thyroxine
Drugs used in hyperthyroidism
Diabetic drugs
Classification of diabetic drugs
Therapeutic insulin
Acarbose
SGLT-2 inhibitors
Meglitinides
Sulphonylureas
GLP-1 analogues
DPP-4 inhibitors
Metformin
Thiazolidinediones
Stratification of therapy
Clotting cascadeClassification of drugs affecting coagulation
Anti-platelets
Aspirin (as an anti-platelet)
P2Y12 ADP receptor inhibitors
Other anti-platelets
Anticoagulants
Heparinoids
Unfractionated heparin
Low molecular weight heparins
Warfarin
Direct thrombin inhibitors
Direct factor Xa inhibitors
DOAC choice and monitoring
Others
Protamine
Aprotinin
Tranexamic acid
Fibrinolytics
Drugs used in obstetricsOxytocin analogues
Ergometrine
Prostaglandin analogues
Tocolytics in brief
Fluids and electrolytesFluid comparisons
Crystalloids
Colloids
Magnesium
Potassium
Phosphate
Calcium
AntimicrobialsAntibiotic principles
Bacteria
Antibiotics in general
Classification of antibiotics
Antibiotics on RRT
β-lactams
Penicillins in general
Specific penicillins
Cephalosporins
Carbapenems
Monobactams
Other antibiotics
Glycopeptides
Fluoroquinolones
Rifamycins
Nitroimidazoles
Macrolides
Aminoglycosides
Clindamycin
Tetracyclines
Fusidanes
Trimethoprim
Antivirals and antifungals
Antiviral principles and classification
Aciclovir
Zidovudine
Antifungal principles
Azoles
Polyenes
Amphotericin B

PhysicsPrinciplesSI units
Mathematics
Simple mechanics
Principles of measurement
Calibration
Damping
Noise
Decontamination
GasesSolids, liquids and gases
Gas laws
Critical temperature and pressure
Saturated vapour pressure
Avogadro's hypothesis
Other gas laws
Flow and hydrostaticsDensity and viscosity
Flow
Bernoulli, Venturi and Coanda
Flow measurements
Hydrostatics
Doppler effect
Ultrasound theory
Uses of ultrasound
Heat and temperatureLaws of thermodynamics
Heat and temperature
Latent heat
Adiabatic change
Isotherms
Temperature regulation
Heat loss
HumidityHumidity
Measurement of humidity
Clinical importance of humidity
Water bath humidifiers
Humidifying nebulisers
HME filters
Bacterial filters
Osmoles and solubilityWater as a solvent
Surface tension
Solubility
Osmoles and diffusion
Colligative properties
Measuring osmolality
Partition coefficients
Light and LASERsElectromagnetic spectrum
Light
LASERs
LASER safety
ElectricityPrinciples
Definitions
UK electricity
Earth connection
Series and parallel circuits
Bridge circuits
Resistance and reactance
Capacitors
Inductors
Transformers
Amplifiers
Clinical applications and safety
Defibrillators
Electrical interference
Biological signals
Diathermy
Classification of electrical equipment
Electrical safety
Shock
MagnetismMagnetism
Induction of magnetic fields
MRI
CT

EquipmentAirway equipmentAirway scopes
Direct laryngoscopes
Video laryngoscopes
Flexible bronchoscope
Tubes
Endotracheal tubes
Double-lumen tubes and endobronchial blockers
Tracheostomy tubes
Supraglottic airway devices
Breathing circuits
Classification and function of breathing systems
The Mapleson classification
Mapleson A
Mapleson B and C
Mapleson D
Mapleson E and F
The circle system
Self-inflating resuscitator (bag-valve-mask)
The anaesthetic machineThe machine
General features
Machine check
Safety features
Disconnection monitors
Pressure regulators
Rotameters
Vaporisers
Vaporisers in general
Plenum vaporisers
Desflurane vaporiser
Draw-over vaporisers
Vaporisers at altitude
Waste, suction and ventilation
Pollution
Scavenging
Soda lime
Suction system
Ventilators
Ventilator alarms
Medical gasesCylinders and piped gas
Medical oxygen
Oxygen delivery devices
High-flow nasal oxygen
Vacuum-insulated evaporator (VIE)
Nitrous oxide
Carbon dioxide
Measuring gasesMonitoring standards in general
Respiratory monitoring
Pulse oximetry
Co-oximeters
Blood gas analysis
pH measurement
Measurement of anaesthetic gases
Methods of measuring gases in general
Infrared spectroscopy
Other methods
Methods used in research
Capnography
CO2 measurement inc. Severinghaus electrode
O2 measurement inc. paramagnetic analysis
Polarographic (Clark) electrode
Galvanic (Hersch) fuel cell
Pressure, flow and volume
Measurement of gas pressure
Measurement of gas flow
Measurement of gas volume
Cardiovascular equipmentBlood pressure and ECG
Non-invasive blood pressure monitoring (discontinuous)
Non-invasive blood pressure monitoring (continuous)
Invasive blood pressure monitoring
The ECG (equipment)
Cardiac output monitoring
Cardiac output monitoring (summary)
The Fick principle
Transthoracic impedance
Transcutaneous Doppler
PA catheter
Indicator/dye dilution method
Thermodilution method
Trans-oesophageal Doppler
Pulse contour analysis
PiCCO
Devices
Cardiac implantable electronic devices (e.g. pacemakers)
Intra-aortic balloon pump
Neurological monitoringDepth of anaesthesia monitoring (summary)
Bispectral index (BIS)
EEG entropy
CFM and CFAM
Evoked potentials
Other depth of anaesthesia methods
Peripheral nerve stimulators
Monitoring depth of neuromuscular blockade
Point of care and temperature devicesTemperature measurement devices
Intra-operative temperature measurement
Point of care testing
Visco-elastic haemostatic assays (e.g. TEG, ROTEM)
HemoCue
Glucometer and ketone meter
Equipment for regional anaesthesiaEpidural equipment
Spinal equipment
Needles for regional anaesthesia
Fluid management and drug deliveryIntravenous access devices
Intraosseous devices
Fluid warming
Rapid transfusers
Cell salvage
Infusion pumps
Patient-controlled analgesia devices
Haemofilters and dialysis circuits

AnatomySurface anatomyThe antecubital fossa
The axilla
The anterior and posterior triangles of the neck
The femoral triangle
Upper airway anatomyThe mouth
The nose
The pharynx
The larynx
Transverse section at C6
Transverse section and laryngoscopic views of the larynx
The tracheobronchial treeThe trachea
The bronchi
The pleura
Transverse section at T4
The mediastinumThe mediastinum
The oesophagus
The diaphragm
The thoracic inlet
Cardiovascular anatomyCoronary vasculature
Veins of the neck
Internal jugular vein
Arteries of the limbs
Cranial and central nervous system anatomyCranial anatomy
Base of skull foramina
Facial bones and their fractures
The bony orbit
CNS anatomy
The trigeminal nerve
The facial nerve
The vagus nerve
The cervical plexus
Spinal cord anatomy
Peripheral nervous system anatomyUpper limb and thorax
The brachial plexus
Brachial plexus blocks
The intercostal nerves
The trunk
Abdominal wall and inguinal nerves
Truncal nerve blocks
The lower limb
Lumbar plexus
Femoral nerve and blocks
Obturator nerve
Sacral plexus
Sciatic nerve and blocks
Tibial nerve
Common peroneal nerve
Nerves at the ankle and blocks
Bony anatomyThe first rib
The vertebral column and cervical, thoracic and lumbar vertebrae
Sacrum and coccyx

StatisticsTypes of data
Spread and central tendency
Standard error of the mean
Confidence intervals
Null hypothesis
Sensitivity and specificity
Relative risk and odds ratios
Types of statistical testing
Correlation
Bias
Clinical studies
Phases of drug trials

  