Book reviews

J. Urquhart, M. Blunt, C. Pinnock, M. Dixon Greenwich Medical Media, 2003 This is the second edition of what has become an essential book for candidates preparing for the Primary FRCA and it has also been very popular with senior anaesthetic colleagues undertaking practice viva sessions. In addition, with the increasing emphasis on basic science in the Final FRCA, it is being revisited by candidates for this part of the examination. The Anaesthesia Viva 1 book addresses the physiology and pharmacology components of the examination syllabus. (A Viva 2 book published separately covers the questions on physics & clinical measurement, clinical anaesthesia, anatomy and safety). The format and style of the book remains the same as the first edition with the sub-division of the sections on physiology and pharmacology into chapters on each of the body systems. Two appendices and a good index conclude the book. Comprehensive answers accompany the questions posed in a viva style. A short highlighted textbox focuses on how to approach the question and where it may lead. A specimen answer then follows, frequently with clear diagrams, tables or ‘hooks’ on which to structure the required explanations. This is one of the strongest features of the book as it clearly demonstrates that success in a viva is not just about knowledge, but the ability to present material in a clear and organised manner. The publication of the syllabus for the primary examination by the Royal College of Anaesthetists has now changed. It is now contained within the ‘Knowledge’ section of the SHO Competency Based Training document, it is a formidable list of basic science subjects and is a challenge for the authors of such books attempting to cover it. These authors have based their selection of questions on their experience as examiners and this is very rewarding to candidates. However, I would disagree with the claims on the back cover of this issue that it is a ‘fully updated and revised second edition’. With only a few of the 164 questions being omitted or replaced, the vast majority are replicas of the first edition. This was particularly evident in the physiology chapter, where there is a absence of questions on the neuromuscular junction, and the pharmacology chapter, where questions on new drugs in the local anaesthetic and analgesic classes, and the concepts of TIVA/TCI were lacking. In this edition, I believe the expansion of the two appendices at the end of the book is the largest but unnecessary addition. The appendices cover 75 of the 193 pages in the book. Appendix 1 shows respiratory physiology curves and equations, most of which are already covered in the questions section. Appendix 2 lists the pharmacology of most of the drugs encountered by anaesthetists today. However, this information is readily available and with more detail in other pocket sized reference texts and the opportunity to ask more pharmacology questions in the viva style (e.g. compare and contrast) has been lost. Notable omissions in the appendix are the lack of chemical structure drawings that are so beloved by examiners, and the important new antiplatelet drugs. For the most part, this book achieves its aim of being a ‘source of vital information…and supply of questions’ for the intended readership. It does well to cover almost all of the fundamental areas of physiology and pharmacology. In particular, I valued the inclusion of the often skipped-over areas such as antibiotics, composition and production of bile and gastric juice. The succinct explanations of renal function and the clinical applications of respiratory principles (exercise, altitude) are also appreciated. To my knowledge, there are at present no direct competitors to this book. Until there are, it therefore remains an essential companion to candidates for the Primary FRCA exam and their teachers, and it therefore deserves a place in every departmental library.

Topic: Cardiac, Anesthesia and Surgical Outcomes
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences