CCT in Anaesthetics - Core Level Training

Published: 15/08/2019

Physiology and Biochemistry

Demonstrates knowledge of:
GENERAL

Competence

Description

Assessment

Methods

GMP

PB_BK_01

Organization of the human body and control of internal environment

A,C,E

1

PB_BK_02a

Changes at birth and in early life

A,C,E

1

PB_BK_02b

Changes with advancing age

A,C,E

1

PB_BK_03

Cells; components and organelles

A,C,E

1

PB_BK_04

Function of cells; genes and their expression

A,C,E

1

PB_BK_05

Cell membrane characteristics; cell junctions, receptors

A,C,E

1

PB_BK_06

Protective mechanisms of the body

A,C,E

1

BIOCHEMISTRY

Competence

Description

Assessment

Methods

GMP

PB_BK_07

Definition of pH. Strong and weak acids.

A,C,E

1

PB_BK_08

Acid base balance. Includes buffers, Henderson-Hasselbalch equation and anion gap

A,C,E

1

PB_BK_09

Ions e.g. Na+, K+, Ca++, Mg++, Cl-, HCO3-

A,C,E

1

PB_BK_10

Cellular metabolism; aerobic vs anaerobic

A,C,E

1

PB_BK_11

Enzymes

A,C,E

1

BODY FLUIDS AND THE FUNCTIONS AND CONSTITUENTS

Competence

Description

Assessment

Methods

GMP

PB_BK_12

Capillary dynamics and interstitial fluid; osmosis, filtration and convection

A,C,E

1

PB_BK_13

Osmolarity: osmolality, partition of fluids across membranes, tonicity

A,C,E

1

PB_BK_14

Lymphatic system

A,C,E

1

PB_BK_15

Special fluids especially cerebrospinal fluid: also pleural, pericardial and peritoneal fluids

A,C,E

1

PB_BK_16

Active cellular transport mechanisms

A,C,E

1

HAEMATOLOGY AND IMMUNOLOGY

Competence

Description

Assessment

Methods

GMP

PB_BK_17

Blood: physical properties, components, functions

A,C,E

1

PB_BK_18

Red blood cells: production and turnover, haematinics, haemoglobin and its variants including abnormal haemoglobins eg thalassaemia, HbS

A,C,E

1

PB_BK_19

Anaemia: acute and chronic adaptations – Iron absorption, transportation, metabolism

A,C,E

1

PB_BK_20

Polycythaemia: causes and implications

A,C,E

1

PB_BK_21

Blood groups: ABO, Rhesus, others

A,C,E

1

PB_BK_22

Transfusion reactions; rhesus incompatibility

A,C,E

1

PB_BK_23

Haemostasis and coagulation, fibrinolysis  – including abnormalities, congenital and acquired

A,C,E

1

PB_BK_24

Alternative oxygen carrying solutions

A,C,E

1

PB_BK_25

White blood cells: types, origins, characteristics, turnover

A,C,E

1

PB_BK_26

The inflammatory response, systemic inflammatory responses, hypersensitivity reactions

A,C,E

1

PB_BK_27

Immunity and allergy; innate vs acquired, non-specific vs specific, humoral vs cellular

A,C,E

1

PB_BK_28 Immunodeficiency – congenital and acquired A,C,E 1
MUSCLE

Competence

Description

Assessment

Methods

GMP

PB_BK_29

Action potential generation and its transmission

A,C,E

1

PB_BK_30

Neuromuscular junction and transmission, motor end-plate

A,C,E

1

PB_BK_31

Disturbances of neuromuscular transmission

A,C,E

1

PB_BK_32

Myopathies – congenital and acquired

A,C,E

1

PB_BK_33

Muscle contracture – malignant hyperthermia, myoclonus, burns

A,C,E

1

PB_BK_34

Muscle types; skeletal, smooth, cardiac

A,C,E

1

PB_BK_35

Skeletal muscle excitation-contraction coupling

A,C,E

1

PB_BK_36

Smooth muscle contraction: sphincters

A,C,E

1

PB_BK_37

Motor unit concept

A,C,E

1

HEART/CIRCULATION

Competence

Description

Assessment

Methods

GMP

PB_BK_38

Cardiac muscle contraction

A,C,E

1

PB_BK_39

The cardiac cycle: pressure volume relationships, work and power

A,C,E

1

PB_BK_40

Rhythmicity of the heart; cardiac impulse generation

A,C,E

1

PB_BK_41

Regulation of cardiac function; general and cellular

A,C,E

1

PB_BK_42

Control of cardiac output [including Starling relationship]

A,C,E

1

PB_BK_43

Fluid challenge and heart failure, types of shock

A,C,E

1

PB_BK_44

Electrocardiogram and arrhythmias, origin of ECG, effects of temperature, ischaemia, infarction and electrolyte imbalance

A,C,E

1

PB_BK_45

Neurological and humoral control of systemic blood pressures, blood volume and blood flow [at rest and during physiological disturbances e.g. exercise, haemorrhage and Valsalva manoeuvre]

A,C,E

1

PB_BK_46

Peripheral circulation: capillaries, vascular endothelium and arteriolar smooth muscle

A,C,E

1

PB_BK_47

Functions of endothelium

A,C,E

1

PB_BK_48

Characteristics of special circulations including: pulmonary, coronary, cerebral, renal, portal, transitional and fetal

A,C,E

1

RENAL TRACT

Competence

Description

Assessment

Methods

GMP

PB_BK_49

Structure and function, renal circulation

A,C,E

1

PB_BK_50

Blood flow and glomerular filtration, plasma clearance and tubulo-glomerular feedback

A,C,E

1

PB_BK_51

Tubular function and urine formation; transport processes

A,C,E

1

PB_BK_52

Assessment of renal function

A,C,E

1

PB_BK_53

Regulation of water and electrolyte [Na+, K+, Ca++, Mg++, PO4--,] balance; response to fluid loss /hypovolaemia. Role of urea and creatinine measurement.

A,C,E

1

PB_BK_54

Regulation of acid-base balance

A,C,E

1

PB_BK_55

Micturition

A,C,E

1

PB_BK_56

Pathophysiology of acute renal failure

A,C,E

1

RESPIRATION

Competence

Description

Assessment

Methods

GMP

PB_BK_57

Gaseous exchange: O2 and CO2 transport, hypoxia and hyper- and hypocapnia, hyper- and hypobaric pressures

A,C,E

1

PB_BK_58

Function of haemoglobin in oxygen carriage and acid-base equilibrium

A,C,E

1

PB_BK_59

Pulmonary ventilation: volumes, capacities, flows, dead space, compliance, work of breathing

A,C,E

1

PB_BK_60

Effect of IPPV on lungs

A,C,E

1

PB_BK_61

Mechanics of ventilation: ventilation/perfusion abnormalities, regional V/Q, surfactant

A,C,E

1

PB_BK_62

Control of breathing, acute and chronic ventilatory failure, effect of oxygen therapy

A,C,E

1

PB_BK_63

Effects of altitude

A,C,E

1

PB_BK_64

Non-respiratory functions of the lungs

A,C,E

1

NERVOUS SYSTEM

Competence

Description

Assessment

Methods

GMP

PB_BK_65

Neuronal structure and function

A,C,E

1

PB_BK_66

Resting membrane potential, action potentials, conduction, synaptic mechanisms, actions of neurotransmitters

A,C,E

1

PB_BK_67

The brain: functional divisions

A,C,E

1

PB_BK_68

Brain stem; organization, interconnections

A,C,E

1

PB_BK_69

Intracranial pressure: cerebrospinal fluid, blood flow

A,C,E

1

PB_BK_70

Maintenance of posture

A,C,E

1

PB_BK_71

Autonomic nervous system; organization, ganglia, adrenergic vs cholinergic

A,C,E

1

PB_BK_72

Neurological reflexes: monosynaptic, polysynaptic, stretch, inhibition

A,C,E

1

PB_BK_73

Motor function: basal ganglia, spinal and peripheral

A,C,E

1

PB_BK_74

Sense: receptors, nociception, proprioception, sight, taste, smell, hearing, balance, touch, temperature

A,C,E

1

PB_BK_75

Pain: afferent nociceptive pathways, dorsal horn, peripheral and central mechanisms, neuromodulatory systems, supraspinal mechanisms, visceral pain, neuropathic pain, influence of therapy on nociceptive mechanisms

A,C,E

1

PB_BK_76

Spinal cord: anatomy and blood supply, effects of spinal cord section

A,C,E

1

PB_BK_77

Nausea and vomiting

A,C,E

1

LIVER

Competence

Description

Assessment

Methods

GMP

PB_BK_78

Functional anatomy and blood supply, immunological functions

A,C,E

1

PB_BK_79

Metabolic and digestive functions

A,C,E

1

GASTROINTESTINAL

Competence

Description

Assessment

Methods

GMP

PB_BK_80

Gastric function; secretions, nausea and vomiting

A,C,E

1

PB_BK_81

Gut motility, sphincters and reflex control – neurohumoral integration

A,C,E

1

PB_BK_82

Digestive functions; composition of secretions; digestion of carbohydrates, lipids, proteins, vitamins, minerals

A,C,E

1

PB_BK_83

Immune functions

A,C,E

1

METABOLISM

Competence

Description

Assessment

Methods

GMP

PB_BK_84

Energy homeostasis. Energy balance and nutritional status. Body mass/composition: body mass index, body fat estimation.

Functional measurements: e.g. handgrip strength, work/exercise capacity. Biochemical measurements. Immune function.

A,C,E

1

PB_BK_85

Principles of nutrition: carbohydrates, fats, proteins, vitamins and minerals. Energy requirements/expenditure and measurement.

A,C,E

1

PB_BK_86

Metabolic pathways, energy production and enzymes; metabolic rate; lactate metabolism

A,C,E

1

PB_BK_87

Hormonal control of metabolism: regulation of plasma glucose, response to trauma

A,C,E

1

PB_BK_88

Physiological alterations in starvation, obesity [including normal and abnormal BMI ranges], exercise and the stress response. 

A,C,E

1

PB_BK_89

Body temperature and its regulation, [including differences at extremes of age]

A,C,E

1

ENDOCRINOLOGY

Competence

Description

Assessment

Methods

GMP

PB_BK_90

Hormones; types, receptors, heirarchy, extracellular signalling

A,C,E

1

PB_BK_91

Mechanisms of hormonal control; feedback mechanisms, effects on membrane and intracellular receptors

A,C,E

1

PB_BK_92

Hypothalamic and pituitary function

A,C,E

1

PB_BK_93

Adrenocortical hormones

A,C,E

1

PB_BK_94

Adrenal medulla; adrenaline and noradrenaline 

A,C,E

1

PB_BK_95

Pancreas; insulin, glucagons and exocrine function

A,C,E

1

PB_BK_96

Thyroid and parathyroid hormones and calcium homeostasis

A,C,E

1

PREGNANCY

Competence

Description

Assessment

Methods

GMP

PB_BK_97

Physiological changes associated with pregnancy

A,C,E

1

PB_BK_98

Materno-fetal, fetal and neonatal circulation

A,C,E

1

PB_BK_99

Function of placenta; placental transfer

A,C,E

1

PB_BK_100

Fetus; physiological changes at birth

A,C,E

1

PB_BK_101

Lactation

A,C,E

1