Anzca Final March 2013

Front 1

1. The insulation on the power cord of a piece of class 1 equipment is faulty such that the active wire is in contact with the equipment casing. What will happen when the power cord is plugged in and the piece of equipment is turned on
A. The double insulation of the device will prevent macroshock when the outer casing is touched
B. The electrical fuse will immediately break and disconnect the device from the power supply
C. Equipotential earthing will prevent microshock
D. The Line Isolation Monitor will alarm and disconnect power to the device
E. The RCD will rapidly disconnect the device from the power supply

Back 1

B

Front 2

2. EZ99 According to the current ANZCA approved standards for labeling, the appropriate colour label for an intraosseous infusion is (some remember it saying INTERosseous, not intraosseous... possibly typo, possibly trick question)
A. Yellow
B. Beige
C. Pink
D. Blue
E. Red

Back 2

C

Front 3

3. An 8 year old 30kg girl presents for resection of a Wilms tumour. Her starting haematocrit is 35% and you decide that your trigger for transfusion will be 25%. The amount of blood that she will need to lose prior to transfusion is
A. 400mL
B. 500mL
C. 600mL
D. 700mL
E. 800mL

Back 3

C

Front 4

4. A 30 year-old pregnant patient develops contractions at 30/40 weeks gestation which of the following cannot be used for tocolysis
A. Clonidine
B. Indomethacin
C. Magnesium
D. Salbutamol
E. Nifedipine

Back 4

A

Front 5

5. A patient known to have porphyria is inadvertently administered thiopentone on induction of anaesthesia. In recovery the patient complains of abdominal pain, prior to having a seizure and losing consciousness. Which drug should NOT be given?
A. Pethidine
B. Diazepam
C. Haematin
D. Suxamethonium
E. Pregabalin

Back 5

A

Front 6

A patient with HOCM presents with dyspnoea and angina on exertion. Which of the following is the best agent to treat these symptoms
A. Glycerol trinitrate
B. Metoprolol
C. Morphine
D. Hydrochlorthiazide
E. Salbutamol

Back 6

B

Front 7

A patient undergoes a femoral-popliteal bypass and has a mildly elevated troponin on day 1 post-operatively. They are otherwise asymptomatic with no other signs/symptoms of myocardial infarction and have an uneventful recovery. What do you do?
A. Arrange for a cardiology follow-up and outpatient angiogram because he is at increased risk of future mycocardial infarction
B. Arrange coronary angiogram as an inpatient prior to discharge
C. Inform the patient that while the result is real the significance is questionable
D. Repeat in a weeks time as a second troponin is a better indicator of long-term myocardial infarction risk
E. Ignore the result as it is likely a laboratory error

Back 7

?A or B

Read VISION and stoelting

Front 8

A 40 year-old lady with a history of a bleeding diathesis presents for a tonsillectomy. What is the most likely cause?
A. Factor V Leiden
B. Protein S deficiency
C. Haemophilia B
D. Antithrombin III deficiency
E. Protein C deficiency

Back 8

C

Front 9

9. What is the most cephalad intervertebral space at which a spinal can be sited in a neonate where the risk of damage to the spinal cord is minimal
A. L1/2
B. L2/3
C. L3/4
D. L4/5
E. L5/S1

Back 9

D

Front 10

10. St John's Wort (Hypericum perforatum) potentiates the effects of
A. Dabigatran
B. Heparin
C. Warfarin
D. Aspirin
E. Clopidogrel

Back 10

E

Potentiates clopidogrel. (clopidogrel is a prodrug, and St John's Wort induces the enzyme that activates it) Reduces the effect or warfarin/heparin/dabigatran. Little effect on aspirin.