Chapter 1.2 focuses on cardiac physiology, from the cardiac action potential to pacemaker cell physiology. We cover the anatomy of the arterial and venous coronary circulation with numerous clinically relevant applications. These topics are frequently examined and the chapter includes diagrams that can be expected to be understood.

Here we cover topics including glucose metabolism, the citric acid or Krebs cycle, starvation and the stress response to surgery, highly relevant to anaesthesia and postoperative care. We examine the major endocrine systems, their physiology in health and in disease states. These include the pituitary gland and hypothalamus, the adrenals and the thyroid gland. There is material on the liver and blood clotting, and basic protein structure with focus on haemoglobin.

Chapter 2.3 covers inhalational anaesthetic agents. In this section we look at the physical, pharmacokinetic and pharmacodynamic properties of different inhalational agents. We look at unique properties such as wash-in curves, the Meyer-Overton hypothesis and compare and contrast commonly used agents.

In this chapter we discuss analgesic agents used in anaesthesia and peri-operative care. The main focus is upon opioid agents, different classes and preparations, their uses, effects and side-effects. We go on to explore non-steroid anti-inflammatory agents and paracetamol, with a section on paracetamol toxicity.

Chapter 2.13 gives additional detail on the pharmacological management of major haemorrhage and reversal of anticoagulant agents. We discuss in detail the drug tranexamic acid, its preparation, mechanism of action, uses and indications and possible side effects.

This chapter covers drugs affecting the cardiovascular system in three distinct sections. Firstly we discuss antihypertensive agents, those used in anaesthesia and critical care, and those used in the community. We then go on to discuss antiarrhythmic agents and the Vaughan-Williams classification, with additional focus on digoxin and amiodarone. Finally we discuss inotropic and vasopressor drugs, both essential knowledge for the exam and clinical practice.

The final chapter in the book covers some specific electrical devices used in surgery, anaesthesia and critical care. Firstly, we discuss defibrillators where exam candidates are expected to have a good working knowledge and be able to both draw and explain the relevant electrical circuit. Secondly we discuss surgical equipment in LASER and diathermy, both of which carry detail in their different types, risks of harm and safety requirements. Finally the chapter discusses medical ultrasound, how it is generated and used in clinical practice.

This chapter covers the broad topics of neurophysiology. This includes the anatomy and physiology of the brain, in particular the cerebral arterial and venous circulations, cerebral spinal fluid production and function and the clinical relevance in neurocritical care. There is additional focus on the nerve axon, spinal cord and spinal cord reflex arcs.

Chapter 2.7 explores anticonvulsant drugs. This includes a segment on benzodiazepines commonly used for sedation and anaesthesia, their mechanism of action, uses, side effects and actions in overdose. We then discuss specific antiepileptic agents in detail and the management of status epilepticus.

Chapter 3.3 focusses on gas and flow of liquids. We include detailed information on the gas laws, the universal gas law and their clinical applications. We discuss the Dalton and Henry’s laws, the importance of understanding the terms critical temperature and pressure. We then move on to discuss flow, how it can be measured in anaesthetic systems using a number of different pieces of equipment and how understanding the difference between laminar and turbulent flow is important.

This chapter gives an overview of different antibiotic classifications, common antibiotic drugs and their mechanisms of action. We go on to discuss anti-fungal agents.

Content on the physiology of pregnancy focuses on the commonly examined areas including the cardiovascular, respiratory, endocrine and haematological changes in pregnancy, then the subsequent impact upon conduct of anaesthesia. We include a section on the materno-fetal circulation and the placenta, with an emphasis on the changes that occur at birth.

Chapter 3.6 covers heat, temperature and humidity. There is basic science material covering the physics of heat and temperature measurement, the different equipment available to use and how each has advantages and disadvantages. We then have a clinical focus on perioperative heat loss in theatre and how it can be managed and reduced, followed by management of severe hypothermia with rewarming. Humidity again covers the basic physics. its measurement and clinical relevance to anaesthesia practice.

Chapter 3.2 covers biological signals monitored during anaesthesia. We begin by focussing on the basic physics of biological signals including electro-cardiogram, electro-myelogram and electro-encephalograms. There is then detail on the monitoring of these signals and basic standards required for anaesthesia. We include a structured approach to the evaluation of an electrocardiogram which is a common exam question.