FRCA Curriculum – Physiology and Biochemistry

Competence	Source Curriculum	Description
General
PB_BK_01	Basic	Organization of the human body and control of internal environment
PB_BK_03	Basic	Cells; components and organelles
PB_BK_04	Basic	Function of cells; genes and their expression
PB_BK_05	Basic	Cell membrane characteristics; cell junctions, receptors
PB_BK_06	Basic	Protective mechanisms of the body
Biochemistry
PB_BK_07	Basic	Definition of pH. Strong and weak acids.
PB_BK_08	Basic	Acid base balance. Includes buffers, Henderson-Hasselbalch equation and anion gap
PB_BK_09	Basic	Ions e.g. Na+, K+, Ca++, Mg++, Cl-, HCO3
PB_BK_10	Basic	Cellular metabolism; aerobic vs anaerobic
PB_BK_11	Basic	Enzymes
Renal and Body Fluids
PB_BK_12	Basic	Capillary dynamics and interstitial fluid; osmosis, filtration and convection
PB_BK_13	Basic	Osmolarity: osmolality, partition of fluids across membranes, tonicity
PB_BK_14	Basic	Lymphatic system
PB_BK_15	Basic	Special fluids especially cerebrospinal fluid: also pleural, pericardial and peritoneal fluids
PB_BK_16	Basic	Active cellular transport mechanisms
PB_BK_49	Basic	Structure and function, renal circulation
PB_BK_50	Basic	Blood flow and glomerular filtration, plasma clearance and tubulo-glomerular feedback
PB_BK_51	Basic	Tubular function and urine formation; transport processes
PB_BK_52	Basic	Assessment of renal function
PB_BK_53	Basic	Regulation of water and electrolyte [Na+, K+, Ca++, Mg++, PO4–,] balance; response to fluid loss /hypovolaemia. Role of urea and creatinine measurement.
PB_IK_09	Intermediate	Disturbances of fluid balance, oedema and dehydration
PB_IK_15	Intermediate	Plasma electrolyte disturbances
PB_BK_54	Basic	Regulation of acid-base balance
PB_IK_10	Intermediate	Management of acid-base abnormalities
PB_BK_55	Basic	Micturition
PB_BK_56	Basic	Pathophysiology of acute renal failure
PB_IK_11	Intermediate	Renal tubular acidosis
PB_IK_12	Intermediate	Assessment of renal function
PB_IK_13	Intermediate	Renal failure and its management
PB_IK_14	Intermediate	Diuresis – action of diuretics
Haematology and Immunology
PB_BK_17	Basic	Blood: physical properties, components, functions
PB_BK_18	Basic	Red blood cells: production and turnover, haematinics, haemoglobin and its variants including abnormal haemoglobins eg thalassaemia, HbS
PB_BK_19	Basic	Anaemia: acute and chronic adaptations – Iron absorption, transportation, metabolism
PB_BK_20	Basic	Polycythaemia: causes and implications
PB_BK_21	Basic	Blood groups: ABO, Rhesus, others
PB_BK_22	Basic	Transfusion reactions; rhesus incompatibility
PB_BK_23	Basic	Haemostasis and coagulation, fibrinolysis – including abnormalities, congenital and acquired
PB_BK_24	Basic	Alternative oxygen carrying solutions
PB_BK_25	Basic	White blood cells: types, origins, characteristics, turnover
PB_BK_26	Basic	The inflammatory response, systemic inflammatory responses, hypersensitivity reactions
PB_BK_27	Basic	Immunity and allergy; innate vs acquired, non-specific vs specific, humoral vs cellular
PB_BK_28	Basic	Immunodeficiency – congenital and acquired
Muscle
PB_BK_29	Basic	Action potential generation and its transmission
PB_BK_30	Basic	Neuromuscular junction and transmission, motor end-plate
PB_BK_31	Basic	Disturbances of neuromuscular transmission
PB_BK_32	Basic	Myopathies – congenital and acquired
PB_BK_33	Basic	Muscle contracture – malignant hyperthermia, myoclonus, burns
PB_BK_34	Basic	Muscle types; skeletal, smooth, cardiac
PB_BK_35	Basic	Skeletal muscle excitation-contraction coupling
PB_BK_36	Basic	Smooth muscle contraction: sphincters
PB_BK_37	Basic	Motor unit concept
Heart / Circulation
PB_BK_38	Basic	Cardiac muscle contraction
PB_BK_39	Basic	The cardiac cycle: pressure volume relationships, work and power
PB_BK_40	Basic	Rhythmicity of the heart; cardiac impulse generation
PB_BK_41	Basic	Regulation of cardiac function; general and cellular
PB_BK_42	Basic	Control of cardiac output [including Starling relationship]
PB_BK_43	Basic	Fluid challenge and heart failure, types of shock
PB_IK_04	Intermediate	Hypovolaemia and shock – neurohumoral adaptions
PB_IK_03	Intermediate	Heart failure – systolic vs diastolic, high vs low cardiac output
PB_BK_44	Basic	Electrocardiogram and arrhythmias, origin of ECG, effects of temperature, ischaemia, infarction and electrolyte imbalance
PB_IK_01	Intermediate	Abnormal electrocardiogram and arrhythmias; electrophysiological basis of arrhythmias
PB_BK_45	Basic	Neurological and humoral control of systemic blood pressures, blood volume and blood flow [at rest and during physiological disturbances e.g. exercise, haemorrhage and Valsalva manoeuvre]
PB_BK_46	Basic	Peripheral circulation: capillaries, vascular endothelium and arteriolar smooth muscle
PB_BK_47	Basic	Functions of endothelium
PB_BK_48	Basic	Characteristics of special circulations including: pulmonary, coronary, cerebral, renal, portal, transitional and fetal
PB_IK_02	Intermediate	Cardiomyopathy and abnormal ventricular function – congenital and acquired
PB_IK_05	Intermediate	Ischaemic heart disease
PB_IK_06	Intermediate	Valvular defects – stenotic vs regurgitant
PB_IK_07	Intermediate	Hypertension – systemic and pulmonary
PB_IK_08	Intermediate	Common congenital heart defects – including PFO, ASD, bicuspid AV, VSD
Respiration
PB_BK_57	Basic	Gaseous exchange: O2 and CO2 transport, hypoxia and hyper- and hypocapnia, hyper- and hypobaric pressures
PB_BK_58	Basic	Function of haemoglobin in oxygen carriage and acid-base equilibrium
PB_BK_59	Basic	Pulmonary ventilation: volumes, capacities, flows, dead space, compliance, work of breathing
PB_BK_60	Basic	Effect of IPPV on lungs
PB_BK_61	Basic	Mechanics of ventilation: ventilation/perfusion abnormalities, regional V/Q, surfactant
PB_BK_62	Basic	Control of breathing, acute and chronic ventilatory failure, effect of oxygen therapy
PB_BK_63	Basic	Effects of altitude
PB_IK_22	Intermediate	Effects of changes in ambient pressure
PB_BK_64	Basic	Non-respiratory functions of the lungs
PB_IK_19	Intermediate	Disorders of respiratory mechanics, gas exchange and gas transport
PB_IK_20	Intermediate	Disorders of the pulmonary circulation – arterial vs venous
PB_IK_21	Intermediate	Respiratory failure and ventilatory support; consequences of positive pressure ventilation
Nervous System
PB_BK_65	Basic	Neuronal structure and function
PB_BK_66	Basic	Resting membrane potential, action potentials, conduction, synaptic mechanisms, actions of neurotransmitters
PB_BK_67	Basic	The brain: functional divisions
PB_BK_68	Basic	Brain stem; organization, interconnections
PB_BK_69	Basic	Intracranial pressure: cerebrospinal fluid, blood flow
PB_IK_28	Intermediate	Control of cerebral circulation, intracranial and intraocular pressures
PB_BK_70	Basic	Maintenance of posture
PB_BK_71	Basic	Autonomic nervous system; organization, ganglia, adrenergic vs cholinergic
PB_IK_29	Intermediate	Disorders of the autonomic nervous system
PB_BK_72	Basic	Neurological reflexes: monosynaptic, polysynaptic, stretch, inhibition
PB_BK_73	Basic	Motor function: basal ganglia, spinal and peripheral
PB_BK_74	Basic	Sense: receptors, nociception, proprioception, sight, taste, smell, hearing, balance, touch, temperature
PB_BK_75	Basic	Pain: afferent nociceptive pathways, dorsal horn, peripheral and central mechanisms, neuromodulatory systems, supraspinal mechanisms, visceral pain, neuropathic pain, influence of therapy on nociceptive mechanisms
PB_IK_27	Intermediate	Mechanisms of pain; somatic, visceral, neuropathic
PB_BK_76	Basic	Spinal cord: anatomy and blood supply, effects of spinal cord section
PB_BK_77	Basic	Nausea and vomiting
PB_IK_23	Intermediate	Consciousness and sleep
PB_IK_24	Intermediate	Depth of anaesthesia – effects of anaesthetics on neurotransmission
PB_IK_25	Intermediate	Consequences of spinal cord injury and deafferentation
PB_IK_26	Intermediate	Monitoring of spinal cord function under general anaesthesia
Liver
PB_BK_78	Basic	Functional anatomy and blood supply, immunological functions
PB_BK_79	Basic	Metabolic and digestive functions
PB_IK_16	Intermediate	Hepatic failure
PB_IK_17	Intermediate	Jaundice
PB_IK_18	Intermediate	Porphyria
GastroIntestinal
PB_BK_80	Basic	Gastric function; secretions, nausea and vomiting
PB_IK_30	Intermediate	Nausea and vomiting
PB_BK_81	Basic	Gut motility, sphincters and reflex control – neurohumoral integration
PB_IK_31	Intermediate	Oesophageal reflux
PB_BK_82	Basic	Digestive functions; composition of secretions; digestion of carbohydrates, lipids, proteins, vitamins, minerals
PB_BK_83	Basic	Immune functions
PB_IK_32	Intermediate	Obstruction of bowel – physiological consequences
PB_IK_33	Intermediate	Swallowing disorders
PB_IK_34	Intermediate	The mucosal barrier
Metabolism and Body Temperature
PB_BK_84	Basic	Energy homeostasis. Energy balance and nutritional status. Body mass/composition: body mass index, body fat estimation. Functional measurements: e.g. handgrip strength, work/exercise capacity. Biochemical measurements. Immune function.
PB_BK_85	Basic	Principles of nutrition: carbohydrates, fats, proteins, vitamins and minerals. Energy requirements/expenditure and measurement.
PB_BK_86	Basic	Metabolic pathways, energy production and enzymes; metabolic rate; lactate metabolism
PB_BK_87	Basic	Hormonal control of metabolism: regulation of plasma glucose, response to trauma
PB_BK_88	Basic	Physiological alterations in starvation, obesity [including normal and abnormal BMI ranges], exercise and the stress response.
PB_IK_37	Intermediate	Starvation / obesity
PB_BK_89	Basic	Body temperature and its regulation, [including differences at extremes of age]
PB_IK_36	Intermediate	Hyperthermia and hypothermia
PB_IK_35	Intermediate	Hormonal and metabolic response to trauma
PB_IK_38	Intermediate	Structure and function of the endocrine system; endocrine abnormalities of significance to anaesthesia – e.g. Cushing’s, Addison’s, diabetes mellitus, hypothyroidism, hypopituitarism, phaeochromocytoma. The stress response
Endocrinology
PB_BK_90	Basic	Hormones; types, receptors, heirarchy, extracellular signalling
PB_BK_91	Basic	Mechanisms of hormonal control; feedback mechanisms, effects on membrane and intracellular receptors
PB_BK_92	Basic	Hypothalamic and pituitary function
PB_BK_93	Basic	Adrenocortical hormones
PB_BK_94	Basic	Adrenal medulla; adrenaline and noradrenaline
PB_BK_95	Basic	Pancreas; insulin, glucagons and exocrine function
PB_BK_96	Basic	Thyroid and parathyroid hormones and calcium homeostasis
Obstetrics, Paediatrics and Advancing Age
PB_BK_98	Basic	Materno-fetal, fetal and neonatal circulation
PB_BK_99	Basic	Function of placenta; placental transfer
PB_BK_100	Basic	Fetus; physiological changes at birth
PB_BK_101	Basic	Lactation
PB_IK_39	Intermediate	Effects of prematurity
PB_BK_02a	Basic	Changes at birth and in early life
PB_IK_40	Intermediate	Developmental changes in infancy and childhood, including psychological aspects
PB_BK_97	Basic	Physiological changes associated with pregnancy
PB_IK_41	Intermediate	Physiology of normal and abnormal pregnancy, including physiology of labour and childbirth
PB_BK_02b	Basic	Changes with advancing age
PB_IK_42	Intermediate	Changes in the elderly