Viva 3

Describe the physiology of pain with respect to its mediators and pathways.

Candidates were expected to provide a definition for pain, discuss the pathways involved in
the transmission of pain signals, and list the common mediators. Additional questions related
to sensitisation (peripheral and central) and the Gate Control theory (G2c).
Candidates were also asked to compare the pharmacology of local anaesthetics with
particular reference to lignocaine and bupivacaine (G2b). As with any question related to
pharmacology, candidates were expected to discuss factors listed under “General
Pharmacology” in the syllabus:
“An understanding of the pharmacology of a drug implies an understanding of the relevant
pharmaceutics, pharmacokinetics (including dosage), and pharmacodynamics (including
adverse effects and drug interactions).”
Candidates were asked to list the different potential modes of administration of local
anaesthetic agents (G2c).
Candidates were also asked to describe the anatomy relevant to the insertion of a lumbar
epidural catheter