This topic is presented as it might be encountered in the clinical science SOE, but could be met in the clinical section as a case-based discussion.

Nociceptors are the sensory receptor for pain and are widespread. They are responsive to different types of stimuli; mechanical, thermal or chemical. Stimulation of these nociceptors results in propagation of an impulse to the spinal cord.

The brachial plexus is formed from the anterior primary rami of C5 to T1 and provides all motor and sensory innervation to the upper limb. The nerves that make up the plexus lie in a sheath that extends from the tubercles of the transverse processes of the cervical vertebrae to the axilla; it is within this sheath that we would inject our local anaesthetic. As these five roots pass between scalenus anterior and medius, C5 and C6 join to form the upper trunk, the root of C7 continues as the middle trunk and C8 and T1 unite to form the lower trunk. The interscalene approach aims to anaesthetise the roots of the plexus.

A 40-year-old woman presents for formation of an arterio-venous fistula to allow dialysis. She has established end-stage renal failure secondary to diabetes.

As with many topics this question is likely to start with a generic discussion before moving on to specific points about how you would manage a patient presenting for daycase surgery.

Although relatively uncommon in routine practice, myasthenia gravis is one of a group of muscle diseases which are a beloved exam topic. This is because for each there are a number of specific perioperative issues. Your knowledge is explored through discussion of these issues. A useful way to introduce your answer is with an opening statement explaining the basis of the disorder and the main clinical features.

The most commonly used sites for central venous catheters (CVC) are the internal jugular, subclavian and femoral veins. Peripherally inserted central catheters (PICC) use the cephalic, basilic or brachial veins accessed in the antecubital fossa to cannulate the superior vena cava.

The overall aim of enhanced recovery is to help people recover more quickly after having major surgery and to improve the rehabilitation process. By following an enhanced recovery pathway, the patients’ pathophysiological and psychological response to surgery can be modified to reduce the stress response during the perioperative period.

This topic would be most likely to appear as part of either a long or short clinical case, as it allows ample opportunity to discuss common clinical problems.

You are asked to anaesthetise for an elective orthopaedic list. Your first patient is a 78-year-old woman for a right total knee replacement.

I would approach their airway assessment systematically, beginning with history, followed by examination, and then review relevant investigations. I use my assessment to identify potential difficulties in managing their airway, such as risk factors for a difficult intubation or mask ventilation, as well as consider other factors that influence my airway strategy such as risk of aspiration or rapid desaturation on induction.

A structured approach is vital to ensure that you do not forget any of the key points. It may be worth making an opening statement explaining the reason for all of these changes!

This subject would lend itself well to a clinical science physiology viva or could be approached via a specific case scenario in the clinical viva. Don’t be put off if you have little or no experience of anaesthetising neonates, a good understanding of the main principles and their relevance to anaesthetic practice will allow a confident answer.

A 55-year-old man requires admission to intensive care following deterioration with multiple organ failure from acute pancreatitis. He requires mechanical ventilation due to increasing oxygen requirements. A nasogastric tube is inserted to facilitate feeding.

You are in the pre-assessment clinic seeing a 66-year-old man for a right total hip replacement. The pre-assessment nurse identified a systolic murmur, and the patient suffers from angina and is notably breathless on minimal exertion.

The orbits are pyramid-shaped bony cavities containing the globe, muscles, nerves, tissue and blood supply to the eyes. The base of the pyramid is directed towards the face with the apex directed posteriorly and medially. To protect the orbital contents the orbit has strong bony margins comprised of seven main bones ().