2022.1 Flashcards
The recommended filter grade of a needle to be effective in excluding microorganisms is
0.2 micron filter grade
A patient has severe hypokalaemia and is in cardiac arrest. The Australian Resuscitation Council and the New Zealand Resuscitation Council recommend intravenous potassium should be given as
IV bolus of 5mmol potassium chloride
A 75-year-old man has a loud ejection systolic murmur detected on clinical examination before a joint replacement. A focused transthoracic echocardiogram (TTE) detects a calcified aortic valve with a peak aortic jet velocity of 3 m/s. The peak gradient across the aortic valve is
4 x 3^2 = 36mmHg
Bernoulli equation: P=4(V^2) where P = peak pressure gradient, V = peak velocity through the valve
The current ANZCA guidelines for preoperative fasting of adult patients state that studies have shown that it is safe to administer
Up to 400ml of clear fluids 2hrs prior to surgery
Prescribed medications may be taken with a sip of water less than 2hrs prior to anaesthesia
You place a paravertebral catheter for postoperative analgesia at the level of T5 in an adult patient prior to a thoracotomy. Two minutes following the injection of 0.75% ropivacaine 10 mL, the patient becomes bradycardic, hypotensive and apnoeic. The most likely cause of the complication is
Intrathecal spread
A 54-year-old woman has a laryngeal mask airway inserted for a surgical procedure. The following day she complains of tongue numbness and abnormal taste over the posterior third of the tongue. The most likely site of the nerve injury is the
Glossopharyngeal nerve
The washing process of modern cell savers for intraoperative blood salvage removes all the following EXCEPT
Red cells, fetal RBCs
Plasma, platelets, clotting factors, heparin, free Hb, inflammatory mediators are discarded with wash solution
A patient with a haemopneumothorax has a chest drain in situ, which is attached to a three-bottle underwater seal drain apparatus. The system is attached to wall suction at -80 cmH20. This will cause
Pressure on the wall suction is irrelevant - safety feature of manometer bottle is that the distance below water = negative pressure geneated when suction is applied
You inadvertently place a 7.5Fr central venous catheter into the carotid artery of a patient undergoing an emergency laparotomy for peritonitis. The best course of management is to
Consult vascular surgeon at completion of case
A patient in atrial fibrillation with a CHA2DS2-VASc score of 2 has presented for elective hip surgery. Warfarin had been ceased for four days preoperatively and on the day before surgery the international normalized ratio (INR) was 2.1. The best course of action at this point is to
Delay elective surgery - low risk of thrombosis vs. high risk of bleeding
An anaesthetised patient is ventilated and has standard monitoring plus a central venous line. As surgery commences, the line isolation monitor alarms, indicating a potential leakage current of greater than 5 mA from one of the power circuits in use. The most appropriate action is to
Disconnect non-essential equipment 1 by 1 to identify fault
The dose of hydrocortisone that has equivalent glucocorticoid effect to 8 mg dexamethasone is
200mg
4mg dex = 25mg pred = 100mg hydrocortisone
In the World Maternal Antifibrinolytic (WOMAN) trial, tranexamic acid administration within three hours of birth reduced the
Incidence of death due to bleeding
But no statistical difference in incidence of death from all causes or hysterectomy within 42 days of randomisation
Preperitoneal pelvic packing is a surgical treatment of haemorrhage from a/an
Unstable pelvic fracture - both venous and arterial bleeding, prior to angiographic embolisation
The gauge pressure on a gas cylinder does NOT necessarily represent the contents remaining if the cylinder is filled with
NItrous oxide (if there is liquid portion in cylinder)
Maintaining a CO2 pneumoperitoneum at a pressure of 15mmHg is most likely to lead to
Increased SVR
<5mmHg: increased VR
5-15mmHg: compensation with increased SVR and maintained MAP
>15mmHg: decreased VR and MAP
Of the following, the drug most likely to cause pulmonary arterial vasodilation with systemic arterial vasoconstriction when used in low doses is
Vasopressin
You review a patient before major bowel surgery. Using the American Heart Association/American College of Cardiology consensus guidelines, you assess him as being at intermediate risk of a perioperative adverse cardiac event. When explaining this to the patient, this best translates to a numerical risk in the range of
Postdural puncture headache in obstetric anaesthesia is associated with a greater likelihood of all of the following EXCEPT
A woman with atrial fibrillation has no valvular heart disease. According to AHA guidelines, oral anticoagulants are definitely recommended if her CHA2DS2-VASc score is greater than or equal to
3 for females
2 for males
A 30-year-old parturient presents in labour. She has a history of Addison’s disease from autoimmune adrenalitis and has been taking prednisolone 6 mg daily for ten years. On presentation the patient is given hydrocortisone 100 mg intravenously. The most appropriate steroid replacement regimen the patient should receive during labour is
Either continuous IV infusion of hydrocortisone 200mg/24hr or IM hydrocortisone 50mg q6hrly with rapid tapering (over 1-3 days) to the regular replacement dose after an uncomplicated delivery
IV 100mg hydrocortisone should be injected at the onset of active labour (already given in the stem)
The fourth position of the international pacemaker (NBG) code represents the
Rate modulation and programmability
Position I - chamber(s) paced
Position II - chamber(s) sensed
Position III - response to sensing
Position IV - rate modulation
Position V - multisite pacing/antitachycardia features
Abnormal Q waves are NOT a feature of the electrocardiogram in
