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Sweet Dreams Anaesthesia Podcast Network
CT10 Podcast: It is a Anaesthetic Primary Podcast series. We discuss various topics ranging from physiology, pharmacology, clinical measurement and equipment that are relevant to Anaesthesia training in Australia and New Zealand. Our aim is to share knowledge that can help medical and nursing staff working in anaesthesia.
Today I'm doing a 'Live Practice Viva'. Thanks to Nic for doing this and Celia for being a special guest examiner!! I hope you get some technical and non-technical skills from the video. We were able to cover four topics which were: Blood products (04:54), Opioids (09:55), Thermoregulation (14:51) and Blood Pressure Monitoring (19:53). We then go through some feedback. Hope you guys enjoy and thanks for watching! As always if you have any feedback let me know at anirudh@sweetdreamsanaesthesia.com
Today’s episode is huge!! I go through all the little things not covered in PK or PD with regards to general pharmacology. First, I go through broadly drug preparation and packaging within pharmaceutics (01:18) followed by isomerism (08:11). Then I move on to drug variability starting off with some definitions (19:05) and then moving on to changes in PD and PK among different physiological states (22:47) and pathological states (38:29). Lastly, I look at a classification for adverse drug reactions (44:20). As always, I finish with a look at the past SAQs (48:13). There were so many to go through here! Thanks for listening! As always if you have any feedback let me know
With 2025.1 written paper now behind us today I put myself to test and give you guys a “Live Perusal Demo.” I have not looked at the questions and hopefully you will see through my example we are all human and get nervous. It has been 3 years since I sat my primary so I was a bit rusty, but I hope to give you some tips for you to maximise your perusal time (02:23). Then I give you a live demo (07:38) followed by a review of my performance (24:22). I don’t go through any model answers here, I recommend looking at Dr Stan Tay’s youtube channel for this. Next episode I will go through ‘Drug Variability and Interactions.’ Thanks for listening! As always if you have any feedback let me know @ anirudh@sweetdreamsanaesthesia.com
In today’s episode I cover pharmacokinetics. Sorry for the delay but this was a big episode to record. I go through the ADME structure in order starting with absorption (04:21), distribution (15:34), metabolism (23:36) and elimination (30:37). Then I briefly look at intravenous infusion kinetics (35:33) followed by the past SAQ’s (41:25). There are so many SAQ’s to go through and for the purposes of time I have just looked at a select view. Next episode I will go through ‘Drug Variability and Interactions.’ Thanks for listening! As always if you have any feedback let me know @ anirudh@sweetdreamsanaesthesia.com
Today we start our new series of General Pharmacology Principles. The first topic is “Intro to Pharmacodynamics.” I start by discussing the different MOA a drug can work by and then having a deeper look at receptors (01:54). Then I look at the Law of Mass Action and how this applies to receptor affinity (10:32). This brings me to a very important LO which examines the dose-effect relationships of drugs with a look a at some really important graphs (13:42). There is only one SAQ to review at the end (29:56). Next episode I will go through ‘Intro to PK.’ Thanks for listening! As always if you have any feedback let me know @ anirudh@sweetdreamsanaesthesia.com
Happy New Year! I’m joined today with a very special guest and current primary exam examiner Dr Anthony. In this episode we take a in depth look at the Pharmacokinetics of Propofol TCI. Anthony has curated this talk over multiple years and starts of by explaining the main equations you should know (05:35). We then integrate these equations into the classic Propofol Cp vs Time graph (11:52). This leads us on to talking about the compartment model (20:11) and how this applies to the ‘Marsh’ TCI model (23:25). To help understand the concepts of rate constants (k) Anthony uses his bucket analogy (27:27). Then we apply this knowledge to understand effect site targeting (Ce) and run through some examples of differences in age (41:30) and weight (66:05). Finally, we finish with a brief look at the ‘Eleveld’ Model and the concept of Keo (72:40). A huge thank you to Anthony and as always if you have any feedback let me know.
I’m joined today by a special guest Justin and we go through an overlooked topic of ‘Immunology & Hypersensitivity.’ The first learning objective is to review how the body defends against infection (05:46) and then look how this is effects under anaesthesia (14:06). Finally, we have a long conversation about the pathophysiology of hypersensitivity (16:22) and the clinical context of the treatment of anaphylaxis (24:18). I want to thank Justin again for joining me today and as always if you have any feedback let me know.
Today is the last topic of our cardiac physiology series “Measurement.” I start of by looking at different techniques to measure non-invasive BP from auscultation (01:31) to oscillometry (07:03). Then I look at an invasive method being arterial lines and this is divided into how it works (11:15) and sources of error (17:54). The last LO for today covers different techniques to measure cardiac output (27:41). To finish as always, we look at the past SAQs (33:35). Thanks for listening! As always if you have any feedback let me know
In today’s episode I cover the ‘Past Saqs’ from ‘Applied Cardiac Physiology.” The first SAQ looks at the consequence of tourniquet release after two hours (01:23) followed by the process’s that cause oliguria in hypovolemic shock (09:45). Then I go through the model answers for CVS responses in severe blood loss (14:39), the effects of infusing Hartmann’s solution (16:51) and briefly the impact of IPPV (21:52). Finally, the remaining SAQs look at the effects of a central neuraxial blockade (22:44), the effects of a pneumoperitoneum (27:01) and the effects of ageing and obesity (30:57). Good luck to all the viva sitters this week and thanks for listening! As always if you have any feedback let me know
Today I'm doing a 'Live Practice Viva'. Thanks to Celia for doing this!! I hope you get some technical and non-technical skills from the video. The two topics were: Immune System and Neurophysiology. Topic 1 starts (02:32) with 1 minute thinking time and Topic 2 starts (07:33). We then go through some feedback. Thanks for watching! As always if you have any feedback let me know at anirudh@sweetdreamsanaesthesia.com
Today I cover the topic ‘Applied Cardiac Physiology.” This is the biggest topic so far in our cardiology series and I had to divide it into 2 parts. Today I look at the LO’s starting first with the CVS effects of pneumoperitoneum (01:19) and the effects that occur with changes in patient position (06:13). Then I discuss the cardiovascular responses to exercise (12:45), Valsalva (16:58) and positive pressure ventilation (22:30). Then we go into depth examining the changes that occur with ageing (28:42) and obesity (32:35). The final LO for today is multiple LO’s in one and a very deep dive looking into all aspects of shock (37:13). In Part 2 of this topic, I will go through the SAQs. Thanks for listening! As always if you have any feedback let me know
Today I cover the topic ‘Regional Circulation.” This has one very big learning objective that looks at the factors that govern blood pressure. To understand this, we have to first understand how the systemic circulation works (02:29) and second the physics which control blood flow (08:42), together this helps us to understand the factors that make blood pressure (18:07). I then take a deeper look at total peripheral vascular resistance (19:55) and microcirculation (24:49). The BIG topic for today is understanding the control arc of blood pressure (32:04) and this includes talking about the baroreceptor reflex. Finally, we look at some past SAQs (42:06). Next episode I will go through ‘Applied Cardiac Physiology.’ Thanks for listening! As always if you have any feedback let me know
Today I cover a huge topic ‘Control of Cardiac Output & Pressure.” This used to be one big learning objective with 4 subsections that I will go through today. Frist I define and describe the classic terms of preload, afterload and contractility (01:19). Then I delve into the frank starling mechanism (12:34). Followed by a long look at the Guyton Curves (16:02) and the LV Pressure-Volume Loop (28:38). At the end I have some time to look at the past SAQs (34:04). This is a very diagram heavy topic and I highly recommend reviewing these diagrams in detail in preparation for the exam. Next episode I will go through ‘Regional Circulation.’ Thanks for listening! As always if you have any feedback let me know
Today I cover the ‘Myocardial Oxygen Supply and Demand.' This topic has 2 main learning objectives, first I cover the anatomy of the heart including the coronary vessels (0:55) and then take a more in depth look at the factors that affect supply and demand (12:54). As always, I end with reviewing the past SAQs, today I have some from the ANZCA and the CICM exams (27:10). Next episode I will go through ‘Control of Cardia Output and Pressure.’ Thanks for listening! As always if you have any feedback let me know
Today I’m back with the first topic for Cardiac Physiology – ‘Electrophysiology.’ This is a huge first topic despite only covering two learning objects. I start by covering the ionic basis of automaticity (01:22) then look at the normal and abnormal process of cardiac excitation (04:02). I briefly then cover the basis of an ECG (12:58), the factors that affect cardiac electrical activity along with the pathway of electrical activity generation in the heart (17:55). Finally, to finish this first mammoth learning objective I describe the mechanical events of the cardiac cycle (21:51). The second learning objective for today cover the process of excitation contraction coupling (28:42) which is favourite of some examiners by linking it to cardiac pharmacology. As always, I end with reviewing the past SAQs, today I have some from the ANZCA and the CICM exams (36:33). Next episode I will go through ‘Myocardial O2 Supply and Demand.’ Thanks for listening! As always if you have any feedback let me know
Happy New Year listeners! Today’s "MiniPod" is sadly my last for a few months as I take a break to sit my part 2 exam. I have put a lot in this pod and it’s not really that “mini.” I first start by discussing the foetal circulation and the shunts that help this circulation with the transition from foetal to neonatal circulation (01:30). Then I look at the differences in the anatomy of neonatal airway and the clinical implications of this (09:48). Finally, we look that physiological difference between a neonate and adult (15:44). As always we look at the past SAQS (23:48) and opening viva stem (38:38). Hope you guys enjoy the pod and thank you for your support, see you in a few months! If you have any questions please email me! As always thank you for listening!
Today’s "MiniPod" reviewed the physiological changes that occur in pregnancy with a focus on the cardiorespiratory systems. I initially give a brief overview of the factors that cause these changes (00:40) followed by first looking at the cardiovascular system changes (02:40) and then the respiratory system (09:42). With these topics it's key to have a structure, describing pregnancy by trimesters and having broad subheadings allow you to get breadth of knowledge across. I utilise this approach as we look at the past SAQs (15:18) and then the past opening viva stems (23:45). I hope you enjoy the Podcast and next time we complete our maternal minipod section by talking about the foetal circulation and comparing and contrasting the neonatal and adult respiratory system. If you have any questions please email me! As always thank you for listening!
Today I'm back with another practice Viva. Thanks to Abe for doing this!! I hope you get some technical and non-technical skills from the video. The two topics were: General Anaesthesia/Sleep and Blood glucose/Insulin. Topic 1 starts (01:55) with 1 minute thinking time and Topic 2 starts (07:50). We then go through some feedback. Thanks for watching! As always if you have any feedback let me know at anirudh@sweetdreamsanaesthesia.com
Today I'm back with another practice Viva. Thanks to Ben for doing this!! I hope you get some technical and non-technical skills from the video. The two topics were: Oxygen supply to the Anaesthetic Machine and Oxytocin. Topic 1 starts (02:00) with 1 minute thinking time and Topic 2 starts (08:00). We then go through some feedback. Thanks for watching! As always if you have any feedback let me know at anirudh@sweetdreamsanaesthesia.com
My first ever reaction pod! The 2023.2 primary exam was unexpected in many ways and I think is the biggest hint so far that the primary exam is changing! I share my big takeaways and don’t worry because I have some tips on how you can succeed with future sittings. I quickly recap the 15 saqs (01:26) and the discuss my first takeaway (05:21) which is that saqs are now more about understanding and clinical application rather than facts. I give my tips on what this means on how you should approach study and then discuss my second takeaway (18:01). Then I have two more takeaways (24:18) and (28:12) which you will have to listen to find out! I hope you enjoy this pod and remember this is my opioin, it doesn’t represent the view of ANZCA or anyone else!
Today’s "MiniPod" discussion went a bit longer than expected and I covered the Neuromuscular Junction and Suxamethonium. I broke the NMJ physiology into three sections, firstly looking at acetylcholine itself, then the pathway of the action potential across the NMJ and lastly the types of ACH receptors (01:19). Then for the first time on this pod we discuss the pharmacology of a drug, looking at the pharmaceutics, pharmacodynamics and pharmacokinetics of Sux (14:59). After covering these core topics, I look at the past SAQs with a big focus on the adverse effects of Sux (23:03). As always, we finish by reviewing some opening viva stems with today’s focus being broad opening answers (31:30). I hope you enjoy the Podcast and if you have any questions please email me! As always thank you for listening!
I'm back today with another "MiniPod" where we discuss the principles of Pulse Oximetry and sources of error. This is a core clinical measurement topic and an examiner favourite with a low SAQ pass rate. I first start off with the basic principles of how the device works (00:40) and then talk about the common sources of error (08:19). Then I look at the past SAQ's, lucky there is only two options on what can be asked (12:52). Finally, we look at the past viva opening stems and discuss some weird questions that can be asked (16:49). I hope you enjoy the Podcast and if you have any questions please email me! As always thank you for listening!
Today is the first "MiniPod" where we discuss the ionic basis of automaticity the normal and abnormal processes of cardiac excitation. In other words the Slow response Action Potential vs Fast response Action Potential. I have divided these episodes into three sections: facts and knowledge, past SAQs and reviewing viva opening stems. I start with a basic review of pacemaker cells in the heart (01:48), then compare the fast vs slow AP (06:56). We look at a model answer for past SAQs (15:42) and then look at the viva stems with links to other concepts (23:09). I hope you enjoy this new structure for the Podcast and if you have any questions please email me! As always thank you for listening!
We are back with the official launch of Season 2!! This is an amazing episode where I am joined by 3 candidates that have just passed the Primary Exam in 2023.1. Nathan, San-Rene and Elliot are so open and honest about the real struggles of sitting the Primary Exam and share their journey from the contemplative phase and study planning to the written exam and then finally the viva's. We explore some real challenges such as how to study for the exam while maintaining a normal family life and what it's like to bounce back and re-sit the exam. Confidence is a big theme in today’s episode for success. At the end of the day this is just an exam, it’s not bigger than life and that perspective should not be forgotten. I will be back in two weeks with our first ‘mini-pod’ covering 'Cardiac Action Potentials'. Thanks for listening! As always if you have any feedback let me know!
Today we come to the end of the Respiratory Physiology Topic and finish with ‘Respiratory Measurement.’ This is a nice way to finish a huge section of the curriculum and there are only two LO’s to cover. First I look at respiratory acidosis (02:56) and then I look at various methods to measure to respiratory function (i.e Flow-Volume Loops) (09:29). As always, we finish by going over the past SAQ’s from the ANZCA and CICM exam (20:41). Now this episode marks the end of our normal format for a short period as I study for the Part 2 exam, we will change and only cover one LO at a time going forward so please send in your request to anirudh@sweetdreamsanaesthesia.com Thanks for listening! As always if you have any feedback let me know!
Today we have a special podcast with ‘Written Exam Tips.’ I have broken up my experience of sitting the primary exam into 4 sections heading into the last 2 weeks before the written exam. Firstly, I explain how to plan and set a study schedule for the last two weeks (01:35). Then I explain what I did the night before the exam and how to get yourself ready for the big day (10:16). Then we look at what to expect on the day of the exam itself and all the little details so you don’t get stressed out (13:07). Finally, I explain what it’s like after the exam and how to get some kind of normal back in your life (18:48). What I share today is just my experience, please understand that it won’t be suited for every individual, but I hope to give you an insight into these last 2 weeks. Thanks for listening and good luck to all the candidates! As always if you have any feedback let me know!
Today we look at ‘Applied Respiratory Physiology!’ This is another big topic and it’s the culmination of all our other episodes. We start by discussing the fundamental basis for preoxygenation which is a must know LO (01:09). Then we assess how anaesthesia and different patient positions effect the respiratory system (07:18). I then go over what the effects of IPPV are and how PEEP is used to mitigate this (12:14). The next LO covered breaks down the changes that occur with ageing, morbid obesity, exercise and altitude on the respiratory system (17:20). The last LO for today switches focuses and here I outline the causes of hypoxemia and hypoxia (25:54). Now there are a lot of key SAQ’s for this episode and that takes up a big chunk of this episode (31:19). This is the second last episode for respiratory physiology and we will finish with ‘Respiratory Measurement.’ Thanks for listening! As always if you have any feedback let me know!
Today we look at ‘Pulmonary Circulation!’ Lucky for us this is not a big topic and it’s kind of a breather before our next episode. We start by discussion the anatomy of the pulmonary and bronchial circulation (00:52) and outline the differences between the pulmonary and systemic circulation (04:34). The most important LO in this topic is factors that affect pulmonary vascular resistance, and this takes up majority of the episode (09:14). The last LO assesses pulmonary HTN with a brief introduction of drugs used for control/treatment of pulmonary HTN (20:02). As always, we end by looking at the key SAQs from the ANZCA and ICU exams (23:51) and there is no summary needed today. I will release a Special Episode 2 weeks before the written exam and the next episode we will go through ‘Applied Respiratory Physiology.' Thanks for listening! As always if you have any feedback let me know!
Today’s topic is a big one! I start of by assessing the vertical gradient of pleural pressure (01:25). Then discuss a favourite topic closing capacity and its significance (05:53). I then explain the different types of dead space and how this links in West’s Zones of the lung (14:24). Then I look at the opposite spectrum and discuss shunt and all things that are venous admixture (27:04). Putting this together we analyse the regional differences in ventilation and-perfusion inequalities (34:31). Our last learning objective is a brief classification of V/Q measurement techniques (40:23). As always, we end by looking at the key SAQs from the ANZCA and ICU exams (42:25) and then I summarise todays topic (61:56). I will release a Special Episode 2 weeks before ethe written exam and the next episode we will go through ‘Pulmonary Circulation.' Thanks for listening! As always if you have any feedback let me know!
We start the New Year with discussing ‘Gas Transport in Blood’. There are 4 learning objectives and this is a MUST KNOW TOPIC. I first look at the oxygen cascade (01:38) and then examine oxygen carriage in blood and the all-important oxygen dissociation curve (08:32). Then I discuss CO2 carriage and compare the CO2 dissociation curve with the ODC (22:27). Then I describe the Oxygen Flux equation (a very common viva question) and discuss markers of oxygen delivery (29:17). Finally, there are key SAQs from the ANZCA and ICU exams that I have a look at and breakdown (33:14) and then I summarise todays topic (47:52). I will release a Special Episode 2 weeks before ethe written exam and the next episode we will go through ‘V/Q Relationships.' Thanks for listening! As always if you have any feedback let me know!
Today I take a look at ‘Functional Anatomy’. There are 6 learning objectives and this is a jam packed podcast. I first look at upper airway anatomy with a big focus on the larynx (01:11) and then look at lower airway anatomy and breakdown ‘Weibels Zones’ and alveoli structure (16:47). Then I discuss important respiratory reflexes and how anaesthetics agents can affect these reflexes using the reflex arc (22:51). Then I change pace and talk about humidity and the importance of humidification (33:05) and look at the last LO the non-ventilatory functions of the lung (41:21). Finally, I have a look at some of the past SAQs from previous ANZCA and ICU exams (47:34) and then summarise the main points (63:51). Next episode we will go through ‘Gas Transport in Blood.' Thanks for listening! Happy New Year and as always if you have any feedback let me know!
Today I take a look at ‘Gas Volumes & Exchange’. There are 5 learning objectives that I go through. Firstly, looking at physics of gas flow and its relationship with resistance (00:41). Followed by the factors that affect airway resistance (11:03) and how it can be measured (18:11). Then I discuss lung volumes and capacities and how they can be measured (21:18). This leads in to talking about Fick’s law and an explanation of perfusion and diffusion limitation across the alveoli with respect to O2 and CO2 (28:57). With our final LO being diffusion capacity and measurement of this (34:26). Finally, we have a look at some of the past SAQs from previous ANZCA exams (39:26) and then summarise the main points (51:15).
In this episode we take a look at the physiology behind 'Mechanics of Breathing'. This is a big section of the Respiratory Physiology topic and has 7 learning objectives. We breakdown the anatomy of the diaphragm (00:24), then look at surfactant and its role with reducing surface tension (08:06). We take a deep dive into compliance of the lung and chest (15:57) followed by an explanation of fast and slow alveoli (28:44) and understanding work of breathing (32:31). Finally we have a look at some of the past SAQs from previous ANZCA exams (42:18) and then summarise the main points (48:01).
In this episode we take a look at the physiology behind control of ventilation. This is the first section in our Respiratory Physiology topic. At the end we also have a look at some of the past SAQs from previous ANZCA exams. Next episode we will go through 'Mechanics of Breathing.'
As always if you have any feedback or questions please email.