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132 Cards in this Set
- Front
- Back
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Young man has removed his buprenorphine patch on themorning of surgery. What time till PLASMA reaches half original level A. 12 hours B. 18 hours C. 24 hours D. 30 hours E. 36 hours |
A. 12 hours |
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A 58yo with solitary hepatic metastasis from coloncancer scheduled for resection of R lobe of liver. Inorder to manage the riskof intra-operative haemorrhage, it is most important to maintain: A. High CVP in anticipation of heavyblood loss B. Decreased MAP to reduce arterialbleeding C. Decreased CVP to reduce venousbleeding D. Normal MAP in anticipation ofheavy blood loss E. Normal CVP to ensure adequatefilling of the heart. |
C. Decreased CVP to reduce venousbleeding |
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An 80yo man is having a transuretheral bladderresection, the surgeon is using diathermy close to the lateral bladder wallwhich results in patient thigh adduction. The nerve involved is: A. Inferior gluteal B. Obturator C. Pudendal D. Scaitic E. Superior gluteal |
B. Obturator |
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In Conn's syndrome, the usual derangement is: A. Hypoglycaemia, hypokalaemia andhypernatraemia B. Hypoglycaemia, hyperkalaemia andhyponatraemia C. Normoglycaemia, hypokalaemia andhypernatraemia D. Normoglycaemia, hyperkalaemia andhyponatraemia E. Hyperglycaemia, hyperkalaemia andhyponatraemia |
C. Normoglycaemia, hypokalaemia andhypernatraemia |
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A 60 year old woman is admitted to hospital withsubarachnoid haemorrhage. Her GCS is 11, and her blood pressure is 175/110mmHg. She is administered oral nimodipine. The main reason for this treatmentis: A. Control her blood pressure B. Manage acute hydrocephalus C. Prevent delayed cerebralischaemia D. Reduce the risk of rebleeding E. Treat angiographically-provencerebral vasospasm |
C. Prevent delayed cerebral ischaemia |
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You are the anaesthetist at a Caesarean Section for a36/40 gestation pregnancy. The baby at birth is floppy and apnoea. You decidethat positive pressure ventilation via mask is necessary. The recommended FiO2is: A. 0.21 B. 0.4 C. 0.6 D. 0.8 E. 1.0 |
A. 0.21 |
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You are inducing a 20-year-old female who has an IVcannula in her antecubital fossa which was inserted in the emergencydepartment. She complains of pain after 10mL of propofol and it becomes clearthat cannula is intraarterial. The best management option is: A. Intraarterial injection of 5mL 1%lignocaine B. Intraarterial injection of 30mLNormal Saline C. Intraarterial injection of 50mgpaperverine D. Intraarterial injection of 500uheparin E. Observation |
B. Intraarterial injection of 30mL Normal Saline E. Observation |
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When is it necessary to use glycine as irrigationfluid for TURP? A: For monopolar diathermy B: For bipolar diathermy C: For Nd:Yag laser D: Greenlight laser |
A: For monopolar diathermy |
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A 69 yo man is brought into ED by ambulance with acompound fracture of his forearm from an unwitnessed fall. Has a history ofschizophrenia and depression with uncertain medication compliance. He isconfused and agitated with generalised rigidity but no hyperreflexia. Obs - HR 120, BP 160/90, RR 18, Sats 98 Temp 38.8Likely Dx? A. Heat stress from anticholinergictherapy B. Hypoxic ischaemic encephalopathy C. Neuroleptic malignant syndrome D. Serotonin syndrome E. Pain from the compound fracture |
C. Neuroleptic malignant syndrome |
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With surgical bleeding, the first clotting factor toreach a critical level is A. I B. II C. VII D. X E. XIII |
A. I (Fibrinogen) |
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Anaesthetic and respirable gas supplies to walloutlets in the operating theatre is at pressures of A. 200kPa B. 400kPa C. 500kPa D. 750kPa E. 1200kPa |
B. 400kPa |
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The most useful sign to distinguish between severeserotonin syndrome and malignant hyperthermia are A. Clonus B. Hyperthermia C. Metabolic acidosis D. Muscle rigidity E. Wheeze |
A. Clonus |
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Patient having a laparotomy. On prednisolone for 6/12,10mg/day. What is the equivalent dose of dexamethasone? A) 2mg B) 4mg C) 6mg D) 8mg E) 10mg |
A) 2mg |
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Axillary arm block U/S presented similar to this ultrasound image. Nerves marked with numbers1-4 but not otherwise identified. Patient having an operation of a lacerated indexfinger under regional anaesthesia. Which combination will provide adequatecover? A) 1 and 2 B) 1 and 3 C) 2 and 3 D) 2 and 4 E) 3 and 4 |
A) 1 and 2 |
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Child 20kg having a caudal. Has a VF arrest postnon-responsive to usual treatments. What does of intralipid 20% would you give? A) 10mL B) 20mL C) 30mL D) 40mL E) 50mL |
C) 30mL |
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Labour epidural placed. Headache postpartum. Which ofthe following is inconsistent with post partum dural puncture headache. (a) Headache located frontal only (b) Presents > 24 hrs post partum (c) presents immediately post partum (d) associated with auditorysymptoms (e) associated with neck stiffness |
(c) presents immediately post partum |
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Eclamptic patient. Given Magnesium intravenously.Which of these symptoms is often associated with magnesium administration? (a) Bradyarrhythmia (b) Cardiac arrest (c) Hypotension (d) Depressed respiratory effort |
(c) Decreased respiratory effort (magpie 2002) |
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The clinical sign that a lay person should use todecide whether to start CPR is: (a) absence of breathing (b) loss of central pulse (c) loss of peripheral pulse (d) loss of consciousness (e) obvious airway obstruction |
(a) absence of breathing |
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What is the maintenance fluid rate for a 15kg child? a) 60ml/hr |
a) 60ml/hr |
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Patient's K+ is 7.0 what is the best initial management? a) give Ca b) give insulin/ dextrose |
a) give Ca |
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Which patients require antibiotic prophylaxis? a) Previous Mitral valve ring annuloplasty b) Previous patch repair of vsd |
Australian therapeutic guidelines for antibiotic prophylaxis against infective endocarditis 2008.
- Prosthetic cardiac valve or prosthetic material used for cardiac repair - Previous infective endocarditis - Cardiac transplant with subsequent development of cardiac valvulopathy - Congenital heart disease if: Unrepaired cyanotic defects incl. palliative shunts/conduits Completely repaired defects with prosthetic marterial or devices whether placed by surgery or catheter during the first 6 months after placement Repaired defects with residual defects at or adjacent to the site of a prosthetic patch or device - Rheumatic valvular heart disease (Indigenous Australians and NZers) Dental procedures involving manipulation of gingival tissue/perforation of oral mucosa Non-dental only if procedure is at a site of established infection |
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A 63 yo lady has a difficult thyroidectomy for cancer.Immediately post extubation she develops stridor and respiratory distress. The most likely cause is A) Hypocalcaemia B) recurrent laryngeal nerve palsies c) tracheomalacia d) Neck oedema and haematoma e) Vocal cord oedema |
B) recurrent laryngeal nerve palsies |
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A 23 yo has a traumatic brain injury. Which fluid is relatively contraindicated? a) Albumin b) Normal saline c) CSL d) Colloid e) Something else |
c) CSL- relative contra-indication ( Albumin absolute contra-indication - SAFE study) |
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50 something yr old smoker presents for laparotomy. RFTs given, what is the cause? FEV1, FVC both reduced, FEV1/FVC 98%. Reduced TLC, RV, DLCO 8 (pred = 30) (a) PE (b) Obesity (c) Bilateral phrenic nerve palsies (d) Pulmonary fibrosis (e) COPD |
Restrictive lung disease DLCO low -intrinsic lung disease DLCO normal -extrinsic cause (d) Pulmonary fibrosis |
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Traumatic brain injury patient. Cerebral angiogramshows Cerebral perfusion = 15mL/100g/min, cerebral oxygen consumption 3.5mL/100g/min. This is consistent with: (a) Cerebral hyperperfusion (b) Reperfusion injury (c) Cerebral ischaemia (d) Appropriate autoregulation (e) ?cereberalvasoconstriction |
(c) Cerebral ischaemia |
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Absolute contraindication to ECT: A. Cochlear implants B. Epilepsy C. Pregnancy D. Raised intracranial pressure E. Recent myocardial infarction |
D. Raised ICP ACUTE myocardial infarction possible contraindication not RECENT. Phaechromocytoma strong contraindication. Literature describes ECT with single cochlear implant not bilateral. |
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FFP is given to a patient to treat hypofibrinogenaemia. The volume required to raise the fibrinogen by 1g/L is A 1mL/kg B 5mL/kg C 10mL/kg D 20mL/kg E 30mL/kg |
E 30mL/kg |
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The diluted thrombin time measures the anticoagulantactivity of A apixaban B rivaroxaban C dabigatran D warfarin E heparin |
C dabigatran |
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In a trauma patient the main mechanism by which hypothermia exacerbates bleeding is by A altered blood viscosity B causing DIC C inhibition of clotting factors D potentiation of anticoagulanteffect of drugs used to treat DVT E decreases platelet number and function |
C inhibition of clotting factors |
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A patient having a liver resection suffers a haemodynamically significant venous air embolism. During resuscitation how do you best position the patient? A head up, right side down B head up, left side down C head up, no lateral tilt D head down, right side down E head down, left side down |
E head down, left side down |
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In a normal adult what amount of IV potassium chloride is needed to raise the serum potassium from 2.8 to 3.8mmol/L? A 10mmol/L B 20mmol/L C 50mmol/L D 100mmol/L E 200mmol/L |
E 200mmol/L Critical care and resuscitation 1999 If serum K+ >3mmol/L need 100-200mmol K+ to increase by 1mmol/L If serum K+ <3mmol/L need 200-400mmol K+ to increase by 1mmol/L = assuming normal distribution between cells and intracellular space |
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In a haemodynamically stable 20 year old man with blunt chest trauma, the best screening test to diagnose cardiac injury requiring treatment is: A CXR B serum CK-MB C serum troponin D 12 lead ECG E Transthoracic Echocardiogram |
C ECG Eastern Trauma guidelines say need BOTH ECG and troponin to rule out cardiac injury. But ECG previously acceptable by itself. |
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With regards to medical ethics, the concept of fidelity involves: A equitable distribution of resources B following a professional code of conduct C promoting well being D wise use of resources E witholding of futile treatments |
B following a professional code of conduct |
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What is the correct position for the tip of a PICC in a child a) Carina b) Below right tracheobronchialangle c) Above right heart border d) Sternoclavicular junction |
a) Carina |
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Image of a lateral C-spine Xray. Asked what thediagnosis was. Seemed to have anterior atlantoodentalinterval >9mm.] a) Atlantoaxial instability b) Retropharyngeal haematoma (?orabscess) c) Tear drop fracture d) Epiglottitis e) unilater facet joint dislocation |
a) Atlantoaxial instability |
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According to the ANZCA endorsed guidelines, what is the correct colour for the label for a subcutaneous ketamine infusion a) Pink b) Red c) Beige d) Blue e) Yellow |
c) Beige |
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Prior to nasal intubation you spray Lignocaine/Phenylephrine preparation (CoPhenylcaine) into the nose. Some lands in the eye. What happens? a) Ecchymosis b) Myosis c) Midriasis d) Proptosis e) Nistagmus |
c) Midriasis |
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You trial a new drug to prevent PONV. It is 50% more effective than the current drug. Four percent of people still experience PONV with the new drug. How many people need to receive the new drug in place of the current drug to have one person less suffering from PONV? a) 2 b) 8 c) 15 d) 25 e) 33 |
d) 25 |
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What does a white cylinder with a Grey colouredshoulders/neck contain? a) Medical air b) Carbon Dioxide c) Helium d) Oxygen e) Argon |
b) Carbon Dioxide |
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The best solution to ensure asepsis prior to neuraxialanaesthesia is A. 0.5% Chlorhexidine B. 0.5% Chlorhexidine with 70%alcohol C. 5% Povidine Iodine D. 5% Povidine Iodine with 70%alcohol E. 10% Povidine Iodine |
B. 0.5% Chlorhexidine with 70%alcohol |
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You are anaesthetising a 25 year male for an open appendicectomy. He has a Fontans circulation on a background of tricuspid atresia.The best strategy to manage his ventilation intraoperatively would be: A. Ensure adequate PEEP B. Decrease Inspiratory time C. Shorten I:E Ratio from 1:3 to1:1.2 D. Increase Inspiratory time butwith reduced inspiratory pressures E. Ensure adequate spontaneousventilation |
E. Ensure adequate spontaneous ventilation best answer for OPEN appendix B. Decrease inspiratory time best answer for laparoscopic (or increase expiratory time = to reduce mean airway pressure) |
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You are anaesthetising a 70 year old woman for CABGwith a pulmonary artery catheter in situ. After separation from bypass younotice frank, copious blood rising in the endotracheal tube. Your immediateaction should be to: A. Check ACT B. Insert a double lumen tube C. Reinstate bypass D. Administer protamine E. Pull back the pulmonary arterycatheter several centimetres |
C. Reinstate bypass |
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Penetrating injury to chest. What part of the heartmost likely injured? A. RV B. LV C. RCA D. LA E. RA |
A. RV |
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General anaesthesia is preferred for endoluminalstenting because: A. Ischaemic renal pain B. Prolonged periods of apnoearequired C. Painful aorta D. Major risk of haemorrhage E. Trash foot pain |
D. Major risk of haemorrhage Regional increasingly recommended for EVAR now. Can put to sleep after stenting. |
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Which volatile agent has got minimum effect on ICP at1 MAC a) isoflurane b) sevoflurane c) desflurane d) enflurane e) halothane |
b) sevoflurane |
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You are inserting a right internal jugular vein CVL.Why is it important to avoid turning the patient's head extremely to the left? a) Uncomfortable for the patient b) Increases risk of internal carotid artery puncture c) Compresses internal jugular veinand makes it more difficult to puncture d) Distorts the anatomy, making thevein more difficult to correctly identify e) Increases risk of externaljugular vein puncture |
If says COMMON carotid then b) Increases risk of internal carotid artery puncture d) distorts the anatomy making the vein more difficult to correctly identify. |
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Patient two hours after bilateral crush injuries tolower limbs. What would you expect to see? a) Hypocalcaemia b) Hypokalaemia c) Hypophosphataemia d) Hypouricaemia e) Metabolic alkalosis |
a) Hypocalcaemia High calcium inside muscle which can precipitate inside injured muscle and give hypocalcaemia. |
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Delivery of neonate. Meconium liqour. Baby floppy,blue, apnoeic, pulse rate 90bpm. What is the next step in managment? a) Commence PPV b) Suction the trachea c) Commence CPR d) Dry and stimulate |
b) Suction the trachea (if not apnoeic don't suction) |
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You inject 10ml ropivicaine into a T5 paravertebralblock. Patient becomes bradycardic, hypotensive and apnoeic. What is the cause. A. Contralateral spread B. Intrathecal spread C. Inadvertent intravascularinjection D. Local anaesthetic toxicity |
B. Intrathecal spread |
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Medical therapy vs TAVI in inoperable patients. At 30days, decreased risk of: A B Myocardial infarct C Death D Stroke E Atrial fibrillation |
If Medical vs TAVI -medical lower risk of stroke at 30 days. TAVI higher all-cause mortality at 30 days but lower at 1 year B Myocardial infact C Death – reduces but not statistically significant (not at 30 days) D Stroke – TAVIincreased risk, also increased risk vascular complications E Atrialfibrillation – does reduce but not statistically significant |
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Glycine used during urology case. Osm is: A. B. 200 C. 250 D. 300 |
B. 200 |
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Volatile analysis in most anaesthetic machines is done via which method? A Gas chromatography B Infrared analyser C Raman spectometry |
B Infrared analyser |
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What is not a constituent of Prothrombinex VF? A. Antithrombin III B. Factor II C. Factor X D. Protein C E. Heparin |
D. Protein C |
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50yo lady for elective laparoscopic cholecystectomyseen in PreAdmission Clinic. No symptoms of heart disease, walks her dog for 30minutes each day. ECG [no image — described in words] shows LAD, RSR in V1,wide slurred S in V6 and QRS duration 0.13 msec. Your options: A. Give atropine premedication B. She needs a permanent pacemaker C. She needs temporary pacing wires D. Continue with the case E. Refer to cardiology OP prior todoing the case |
D. Continue with the case (LAD with RBBB = bifascular block. Pacemaker only if symptomatic) |
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You are performing epidural anaesthesia on an adultpatient. To minimize the chance of inserting the epidural catheter into a blood vessel you would: A. Inject saline through theepidural needle prior to threading the catheter B. Perform the proceedure with thepatient lateral rather than sitting C. Use a loss of resistance to airtechnique instead of loss of resistance to saline. |
B. Perform the procedure with the patient lateral (decreased engorgement lateral) (if sitting A best) |
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Failed intubation. Difficult ventilation. Rescued with a Classic(R) LMA. Decide to use a bronchoscope to intubatedown the LMA. Which device will allow you to intubate the patient safety? A. Aintree catheter B. Airway exchange catheter C. Gumelastic bougie D. Some angiogram wire I’ve neverheard of! E. Two paediatric endotracheal tubesside-by-side |
A. Aintree catheter |
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Blalock-Taussig shunt inserts into the right pulmonaryartery, originating from the: a) Right subclavian artery b) IVC c) SVC d) Aorta e) Axillary artery |
a) Right subclavian artery |
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Time taken for insulin to reduce K+ in hyperkalaemia A. 2 mins B. 4 mins C. 10 mins D. 20 mins E. 30 mins |
D. 20 mins (begins to work in 15 mins. Peak 30-60mins) |
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Increased risk with eye block: A: Peribulbar done medial canthus B: Peribulbar done inferior-temporal C: Sub-tenons D: <45 years age E: Another clearly wrong |
B: Peribulbar done inferior-temporal Recommendation do single Peribulbar approach in medial epicanthus because better akinesia and unlikely to need second top up. Less risk with medial canthus approach because can't go retrobulbar. |
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2/12 old baby. Initially on 30th centile and now on5th. Murmur, systolic, loud at apex. Pulses are weak, "most easily felt at the femoral". A: VSD B: Co-arctation C: Venous hum D: PDA |
A: VSD |
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Some diathermy pads have two separate electrodes on the patient pad, each with it's own cable back to the machine. Why? A: In case one fails the other canserve as a back-up B: One for coag and one for cutting C: For bipolar? - worded slightlydifferently D: For capacitance measurement -again wording not right E: For return electrode monitoring |
E: For return electrode monitoring |
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Cisatracurium left out of fridge for 4 days. It’sefficacy is now: A. 60% B. 70% C. 90% D. 50% E. 99% |
E. 99% |
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In which type of von willebrand's disease is DDAVPcontraindicated? A. Type 1 B. Type 2a C. Type 2b D. Type 3 E. None of the above |
E. None of the above Type 2b traditionally contraindicated because can get thrombocytopenia with DDAVD. But some type 2b patients benefit from DDAVD without thrombocytopenia or thrombotic complications. Thrombocytopenia usually normalises within 2 hours. Type 3 DDAVP no effect. DDAVP treatment of choice in type 1. |
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This ECG with AAI pacing shows: The 12-lead ECG showed pacing spikes followed by p-waves, with QRS's following the p-waves with progressive prolongation of thePR until a QRS was dropped. In other word, second degree heart block (type 1,although the type was not required to answer the question). The ECG looked very much like "Example 8"from lifeinthefastlane. I think it was lifted from this website. (Did youget copyright permission, ANZCA??) A. Failure to capture B. CHB C. 2nd degree |
? 2nd degree heart block |
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The NAP4 audit showed that the most common cause ofairway problems/complications/disasters in INTENSIVE CARE is: A. Aspiration B. Dislodged tracheostomy tube |
B. Dislodged tracheostomy tube |
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The target serum magnesium level in a patient with pre-eclampsia receiving a magnesium infusion is A. 1-2 mmol/l B. 2-3.5 mmol/l C. 3-6 mmol/l D. 4-6 mmol/l E. 5-8 mmol/l |
B. 2-3.5 mmol/l |
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Timing of peak respiratory depression after intrathecal 300 mcg morphine: A. < 3.5 hours B. 3.5 – 7.5 hours C. 7 - 12.5 hours D. 12.5 -18 hours E. > 18 hours |
C. 3.5-7.5 hours ANZCA Blue book CEACCP Onset resp depression with intrathecal morphine 3.5-12hr with peak 6-12hr. Dose recommended: 20mcg/kg adult C-section 100-150mcg max Non-c-section 200mcg. 100mcg very low risk respiratory depression |
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What part of a modern anaesthesia machine allows jetventilation to be performed using the oxygen flush button? A. Non-return valve downstream ofthe vaporisers B. Pressure-limiting valve at theoutlet C. The presence of a common gasoutlet D. Presence of auxillary oxygenflowmeter |
A Non-return valve downstream of the vaporisers More accurate = one-way valve between oxygen flush and vaporisers. Allows high-pressure to be delivered to the common gas outlet. (Barash). |
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Red-man syndrome secondary to vancomycin is due to A Type II hypersensitivity reaction B Vasodilation C Mast cell degranulation D IgE immediated response E Serotonin release |
C Mast cell degranulation |
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Patient with IgA deficiency. What is the main issue inanaesthesia? A. Anaphylaxis to blood products B. Renal impairment C. D. Sensitivity to opioids E. Sensitivity to muscle relaxants |
A. Anaphylaxis to blood products |
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Cryo "should be used within" or "mustbe used within" or "is most effective if used within" (can'trecall exactly): A 30 minutes B 3 hours C 6 hours |
A 6 hours Australian transfusion. Once thawed Cryo should be maintained at 20-24 degrees C and used within 4-6hrs. |
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Designing a study on PONV. What is the advantage ofdesigning a study incorporating multivariate analysis? A Less type 1 error B Less complex C Less difficult to interpret D Less confounding E Fewer patients required |
A Less type 1 error |
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Bleeding intraopratively. TEG shown. What should beused to treat? A TXA B Platelets C Cryo D FFP |
A TXA |
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A size C oxygen cylinder (in New Zealand,"A") that reads 5000kpa contains approximately how many litres ofoxygen a. 100 b. 150 c. 200 d. 350 e. 600 |
b. 150 Size C 410-450L. Approx 15000kPa when full. |
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4-chamber TTE view. What lesion is present? Image showed mitral regurg. Think the image was fromthis here (but was black-and-white of course) A. mitral regurgitation |
A. mitral regurgitation |
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Appropriate infection control measures whenanaesthetising a patient with iatrogenic variant-CJD, the airway equipmentshould be: a. thrown away b. plastic sheath, reuse c. sterilization with ethyleneoxide
d. sterilization with heat at 134degrees for 3 minutes. e. autoclave |
a. thrown away |
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A varient on the theme of the previous questionreferring to PS9. Minimum requirements to provide sedation. This time asked whois necessary to provide conscious sedation, using propofol. A. medical practitioner trained in useof propofol B. medical practitioner trained in useof propofol + their assistant |
Need a medical practitioner or dentist trained in the use of Propofol and a proceduralist and assistant shared between the two. |
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Intubation view: Little space between epiglottis and posteriorpharyngeal wall. What is the modified C&L classification? A 2A B 2B C 3A D 3B E 4 |
C 3A Has to be stuck down for 3B |
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What feature most increases vasospasm in setting of SAH? A. Size of aneurysm B. Age of patient C. Position of Aneurysm D. large amount of blood on CT E. GCS on arrival to ED |
D. large amount of blood on CT Position of bleeding ie basal cisterns, fissures, intraventricular associated with increased vasospasm Vessel narrowing greatest near site of ruptured aneurysm Vasospasm correlated with extravasated blood products BJA 2012 Delayed Cerebral Ischaemia |
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Line isolation monitor alarming at 5ma – what do to? A. Disconnect non essentialequipment 1 by 1 to identify fault B. Ignore it |
B. Disconnect non-essential equipment 1 by 1 to identify the fault. Line isolation monitor -usually last piece of equipment plugged in Residual Current Device -you have to take everything out, re-trip and then start adding devices back in one by one |
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Maintenance fluid rate in 15kg child – mls/hr A. 40mls/hr B. 50mls/hr C. 90mls/hr D. 300mls/hr |
B. 50mls/hr |
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"Hypothermia makes bleeding in trauma worsebecause..." A. Reduced platelet function AND Number B. Reduced activity of clottingfactors |
B. Reduced activity of clotting factors Reduced platelet function MOST important but unsure if also number |
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Most effective (?quickest) way to reduce serum K+level in hyperkalaemia 8.0meq/L? A. Calcium gluconate B. Resonium C. Salbutamol NEB D. 15 units actrapid and 50 mls of50% Dextrose E. Sodium bicarbonate ?50mmol |
D. 15 units actrapid and 50 mls of50% Dextrose |
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ECG rhythm strip. Showed regular pacing spike followedby wide QRS complexes. But once there is a narrow QRS occurring without apacing spike, followed shortly-after by a pacing spike but no capture. Can'tfind anything matching it on Google. What does ECG show? A. AAI with failure to capture B. AAI with failure to sense C D. VVI with failure to capture E. VVI with failure to sense |
E. VVI with failure to sense |
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Relative contraindications to mediastinoscopy include A. Cervical spondylosis B. Emphysema C. Mediastinal lymphadenopathy D. Poor left ventricular function E. Superior vena cava syndrome |
E. Superior vena cava syndrome Cervical spondylosis depends on degree of neck symptoms/movement |
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How should you dose suxamethonium for intubation in anobese patient? a) Lean body weight b) Ideal body weight c) Ideal body weight + 25% d) Actual body weight e) Actual body weight + 25% |
d) Actual body weight |
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Time to onset of TRALI with transfusion? a) 2 hours b) 4 hours c) 12 hours d) 24 hours e) 48 hours |
b) 2 hours Critical care medicine 2008. Classic TRALI within 1-2hrs of blood products - ARDS Delayed TRALI 2-72hrs after massive transfusion (probably different but overlapping pathothologies) - other risk factors for ARDS; don't meet definition for TRALI; develop delayed ARDS |
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When performing regional anaesthesia for eye surgery,needle damage to the globe of the eye is more common with: A. a globe axial length of less than25 mm B. patients aged less than 45 years C. peribulbar block using theinferotemporal approach D. peribulbar block using the medialcanthus approach E. sub-Tenon block |
D. peribulbar block using the inferotemporal approach Medial canthus -space between the orbital wall and globe is free from blood vessels |
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Best method to assess reversal of neuromuscularblockade? A. Sustained head lift 5 sec B. Sustained leg lift 5 sec C. TOF 0.9 with accelerometer Definitelyspecified, with accelerometer D. DBS no fade E. Tetanus 50Hz F. Tidal volumes... |
C. TOF 0.9 with accelerometer |
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The Neonatal Facial Coding Scale (NFCS), used toassess pain in neonates, includes all of the following EXCEPT A. brow bulge B. chin quiver C. closed mouth D. deep nasolabial fold E. eyes squeezed shut |
C. closed mouth |
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What is the best measure of the anticoagulant effectof Dabigatran? A. APTT B. Dilute thrombin time C. Prothrombin time D. Bleeding time E. TEG |
B. Dilute thrombin time |
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Small air bubbles in the arterial line system willALWAYS REDUCE the A. Dampening coefficient B. Extrinsic Coefficient C. Measured systolic pressure D. Measured MAP E. Resonant frequency |
E. Resonant frequency |
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A patient undergoing liver surgery has a venous airembolism, what is the most appropriate position to place them in: a. Reverse trendelenburg, right sideup b. Reverse trendelenburg left sideup c. Reverse trendelenburg, neutral d. Trendelenburg right side up e. Trendeleburg left side up |
a. Trendelenburg, right sideup |
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During interscalene block placement get medialmovement of the scapula. This is secondary to stimulation of: A: long thoracic nerve B: dorsal scapula nerve C: suprascapular nerve D: supraclavicular nerve E: accessory nerve |
B: dorsal scapula nerve Protraction of scapula ie forward rounding shoulder = abduction serratus anterior = thoracodorsal nerve (off posterior cord) Retraction ie adduction pinches shoulders together = rhomboids and middle trapezius = dorsal scapula nerve. |
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Blue urticaria is a complication of A B Methylene blue C Patent blue V D Anaphylaxis |
C Patent blue V |
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Subtenon’s block. What is the BEST position to insertblock? A. Inferonasal B. Inferotemporal C. Superonasal D. Superotemporal E. Medial / canthal |
A. Inferonasal |
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Most cephalic interspace in neonate to perform spinalwhile minimising the possibility of spinal cord puncture A. L1-L2 B. L2-L3 C. L3-L4 D. L4-L5 E. L5-S1 |
D. L3-L4 Neonate spinal cord ends at L2-3 c.f. adults L1 Truffier's line crosses L4-5 c.f. adult L3-4. |
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With respect to a patient with Multiple sclerosis,which of the following alters the risk of a flair post partum a) An Epidural b) A spinal c) A flair in the year pre-partum d) A general anaesthetic e) Breast feeding |
C. A flair in the year pre-partum PRIMS study. |
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Adenosine can be used to terminate an arrhythmia due to: A. Atrial fibrillation B. Atrial flutter C. WPW D. ??VT E. ??Torsafes |
C. WPW Beta-blockers safe -slows AV node but doesn't speed up the pathway. Adenosine blocks the AV node but won't modify the pathway. There is a theoretical issue that you get uninterrupted accessory pathway conduction but not the case in reality (from clever EP cardiologist) |
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Mast cell tryptase half life: 1 hours 3 hours 6 hours 12 hours |
3 hours Actual answer 2 hours from AZNCA endorsed document |
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Best indicator of Severe pulm HT: mean PA pressure 45mmHg orthopnoea PND ex tol less than 4 mets fev1, ... |
Mean PAP 45mmHg |
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Young pregnant patient with mild mitral regurgitationand moderate mitral stenosis, normal LV function. The best delivery method: A. Epidural anaesthesia LSCS B. Spinal with LSCS C. Epidural analgesia and normalvaginal delivery D. GA LSCS E. Normal vaginal delivery withremifentanil PCA |
C. Epidural analgesia and normalvaginal delivery |
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Contained one of the following St John wort questionsfrom Mar13 or Aug13. Can't remember which one!
St John's Wort (Hypericum perforatum) potentiates theeffects of A. Dabigatran B. Heparin C. Warfarin D. Aspirin E. Clopidogrel |
E. Clopidogrel |
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St John's wort will reduce the effect of A. aspirin B. clopidogrel C. dabigatran D. heparin E. warfarin |
E. warfarin |
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7/7 post laparotomy platelet down to 40, no bleedingor bruising, but has painful swollen lower leg, most appropriate tx? Fondaparinux lepirudin IV heparin clexane warfarin |
lepirudin |
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Type 1 diabetes fasting since 2200, insulin infusioncommenced 0700, BSL 7, what is MOA of insulin? Skeletal uptake liver uptake inhib glucagon (release) inhib glycogenolysis |
Inhibit glycogenolysis in hyperglycaemia states stops liver production of glucose and stimulates uptake. In fasting probably most important role is to decrease production glucose in the liver. |
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A three year old girl for an elective hernia repair isseen immediately prior to surgery. It is revealed she had 100mL of apple juice2 hours ago. The best course of action is to: A. Postpone surgery for 2 hours B. Postpone surgery for 4 hours C. Postpone surgery for 6 hours D. Cancel surgery E. Continue with surgery |
E. Continue with surgery |
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Acute intermittent porphyria, signs except: abdominal pain hypotension confusion tachycardia peripheral neuropathy |
hypotension |
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Audit in department of prevalence of acute myocardialischaemia in vascular surgery. What type of data is this? Nominal ordinal categorical non-parametric numerical |
Categorical |
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Preop clinic carotid endarterectomy asks about GA vsLA, you tell her: GA and LA has similar risk of stroke GA has slightly increased risk ofstroke than LA LA has slightly increased risk ofstroke than GA GA has significantly increased riskof stroke than LA LA has significantly increasedstroke than GA |
GA and LA has similar risk of stroke GALA trial. Only difference was regional associated with less wound haematoma. Do what works for anaesthetist. |
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Threshold for micro shock: 1uA 10uA 1mA 5mA 10mA |
10uA is the acceptable minimum escape current to prevent microshock Microshock is a current less than 1mA which requires a means to bypass the skin resistance in order to cause hazard. |
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Asystolic arrest adrenaline just given, how often doyou give adrenaline? |
Every 4 minutes |
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Laser flex tube with double cuffs - how to inflatecuff(s)? A Inflate proximal then distal B Inflate distal then proximal C ?Inflate both with saline? D Inflate distal only E Inflate proximal only |
A Inflate proximal then distal |
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Patient with HOCM has HR 60, SBP 70 post induction,what to do: give volume adrenaline metaraminol ?beta-blocker |
Metaraminol |
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The following changes occur in aging except: increased CSF volume |
increased CSF volume |
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Paediatric paracetamol loading dose PR mg/kg: 7.5 10 15 20... |
20 |
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Postpartumpost epidural with peripheral neurology. lumbosacral plexus palsy |
lumbosacral plexus palsy |
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Posterior cord of brachial plexus weakness ofwrist extension |
weakness ofwrist extension |
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Endocarditis prophylaxis A Bicuspid valve B Congenital repair > 12 months ago C Rheumatic heart valve D Uncorrected cyanotic heart disease E MVP + ?MR |
D Uncorrected cyanotic heart disease |
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1mg/kg rocuronium given in 70kg patient. Now CICO.What is the total dose of sugammadex that you will give? |
16mg/kg = 1120mg |
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Whydon’t you turn head too much in awake pt for CVC insertion? |
excessive turning should be avoided as it changes the relationship of the vein and artery and can collapse the vein |
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Maxsize vessel for CVC insertion |
? |
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How do you prevent breath stacking in COPD |
Limited expiratory flow rate Increase I:E ratio to allow longer expiratory time (because of airway narrowing results in the next inhalation occurring before expiration of the previous breath is complete, and leads to ‘breath stacking’ or ‘air trapping’ and the development of intrinsic positive end-expiratory pressure) |
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CVC just inserted into patient. LIM then goes off. What do you do? |
When the monitor is alarming, there is a single fault in the system, but there still needs to be another one in order to deliver a shock. If the alarm is going off, the last piece of equipment plugged in is usually suspect and should be unplugged. |
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Pneumoperitoneum created, sinus brady down to 20BPM. What to do? |
Release pneumoperitoneum |
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Cellsalvage results in less what? |
Overall use of allogenic blood |
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6 week old baby is booked for elective right inguinalhernia repair. An appropriate fasting time is A. 2 hours for breast milk B. 4 hours for formula C. 5 hours for breast milk or formula D. 6 hours for solids E. 8 hours for solids, 4 hours for all fluids. |
B. 4 hours for formula |
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The size (in French gauge) of the largest suctioncatheter which can be passed through a size 8 endotracheal tube which will takeup not greater than half the internal diameter is size: A. 6 B. 8 C. 10 D. 12 E. 14 |
D. 12 |
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A 20 year old man was punched in the throat 3 hoursago at a party. He is now complaining of severe pain, difficulty swallowing,has a hoarse voice and had has some haemoptysis. What is your next step in his management? A. Awake Fibreoptic Intubation B. CT scan for laryngeal fractures C. Direct laryngoscopy after topicalising with local anaesthetic D. Nasopharyngoscopy by an ENT surgeon E. Soft tissue xray of the neck |
E. soft tissue x-ray neck Major signs and symptoms suggestive of significant airway injury - Subcut empysema - Dyspnoea - Stridor - Inability to tolerate the supine position (should be assumed to have cricotracheal separation and undergo immediate tracheostomy) Minor - local swelling and tenderness - hoarseness voice - dysphagia - haemoptysis ANZCA blue book 2005 |
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What gestation to monitor uteroplacental flow inlady having coiling? A 20 weeks B 24 weeks C 28 weeks D 32 weeks E 36 weeks |
B 24 weeks |
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A nulliparous woman in labour for 8 hours withepidural analgesia has a fever 37.6 degrees. The most likely reason for this is A. altered thermoregulation B. chorioamnionitis C. urinary tract infection D. inflammatory response E. neuraxial infection |
D. inflammatory response |
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What is not an element of Child Pugh score? a. GGT b. Albumin c. Bilirubin d. INR e. Encephalopathy |
a. GGT |
