2022.2 Flashcards
The knee is NOT innervated by the
? Common peroneal
? Tibial
? Obturator
? Posterior cutaneous nerve
? Saphenous
? Posterior cutaneous nerve
A 47-year-old man is anaesthetised for an elective laparoscopic cholecystectomy. Three minutes after induction, he is noted to have a heart rate of 130 bpm and systolic blood pressure of 60 mmHg. The most appropriate initial dose of adrenaline is
a. 20mcg
b. 100mcg
c. 1mg
b. 100mcg
what is everyone else?s thoughts, could be a?
The influence of end-stage renal disease on the plasma clearance and dose of sugammadex is that the
a. Prolonged clearance, dose reduce
b. Prolonged clearance, do not dose reduce
c. No change in clearance
b. Prolonged clearance, do not dose reduce
A patient under general anaesthesia monitored with transcranial cerebral oximetry has a decrease in their cerebral oxygen saturation. This is likely to be improved by an increase in all of the following EXCEPT
a. Increased minute ventilation
b. Deepen anaesthesia
c. Increase haematocrit
d. Increase MAP
a. Increased minute ventilation
A 54-year-old woman has a laryngeal mask airway (LMA) inserted for a surgical procedure. The following day she complains of tongue numbness and abnormal taste over the anterior two-thirds of the tongue. The most likely site of the nerve injury is the
a. Glossopharyngeal
b. Lingual
c. Inferior alveolar
d. Hypoglossal
b. Lingual
A 30-year-old previously healthy woman is four days post-caesarean section. You are asked to see her to manage her abdominal pain. Over the last two days she has had increasing abdominal pain, increasing abdominal distension, tachycardia and nausea. An abdominal x-ray shows a caecal diameter of 9 cm. After excluding mechanical obstruction, an appropriate management option is
a. Neostigmine
b.
a. Neostigmine
Large doses of sugammadex can potentially lead to
A) Hypoglycaemia
B) Hyperglycaemia
C) Hypotension
C) Hypotension
You are asked to review a 65-year-old man in the emergency department who has presented with hypoxia and confusion. The chest x-ray shows a left-sided
? Pneumonectomy
? Pleural effusion
? Pneumonia
? Pneumothorax
?
The initial management for a seizure during an awake craniotomy is
Cold saline
Midazolam
Propofol
Cold saline
The rate of drainage of cerebrospinal fluid via a lumbar drain is NOT influenced by the
?
?
A patient requiring an elective major joint replacement has had a recent stroke. The minimum recommended duration between the stroke and surgery is
a. 3 months
b. 6 months
c. 9 months
d. 12 months
b. 9 months
A 6-year-old patient (140 cm, 24 kg, BSA 0.97m2 ) is on hydrocortisone 15 mg/day. Perioperative glucocorticoid supplementation is
a. Not replace
b. Stress dose if on > 1/52
c. Stress dose if on > 2/52
d. Stress dose of in > 1/12
d. Stress dose of in > 1/12
For a 70-year-old patient on rivaroxaban with normal renal function a major guideline recommends proceeding with hip fracture surgery after two half-lives of the drug. This equates to
3d
12 hrs
24 hrs
24 hrs
Pulse pressure variation is defined as
- (SVmax - SVmin)/SVmean
- (PPmax - PPmin)/PPmean
- (SBPmax - SBPmin)/SBPmean
(PPmax - PPmin)/PPmean
A 50-year-old man is admitted with a stroke and undergoes cerebral angiography. The artery marked on angiography with the arrow is the
a. Anterior inferior cerebellar
b. Basilar
c. vertebral
d. Posterior inferior cerebellar artery
?
In Australia and New Zealand, the proportion of blood donors who are cytomegalovirus (CMV) seropositive is
6.5-8 per 100
6.5-8 per 1000
6.5-8 per 100 000
6.5-8 per 1 000 000
NONE of these are correct.
Actual rate is 60-85%
In critically ill patients undergoing mechanical ventilation, energy dense enteral nutrition (1.5 kcal/mL/kg) compared to routine (1 kcal/mL/kg) enteral feeding provides
a. No difference in outcomes
A 56-year-old patient presents with exertional syncope. The most likely diagnosis is
a. HOCM
b. Aortic stenosis
c. Prolonged QT syndrome
d. AMI
a. HOCM
A patient presents with sepsis-induced hypoperfusion or septic shock. The minimum suggested volume of intravenous crystalloid to be administered over the first three hours as outlined in the Surviving Sepsis Guideline is
?
30mls/kg
The modified Aldrete scoring system is used for determining the
a. Predicts difficulty of bag mask ventilation
b. Safety of day surgery
c. Discharge from recovery
d. Modification of recovery criteria
e. Discharge from hospital
c. Discharge from recovery
When using the ECG to time intra-aortic balloon counterpulsation, balloon inflation should occur at the
a. Start of T wave
b. Peak of T wave
c. End of T wave
d. R wave
e. P wave?
b. Peak of T wave
A 45-year-old male received a heart transplant one month ago. He develops a new supraventricular tachyarrhythmia without hypotension during a gastroscopy. The most appropriate therapy is
a. Adenosine
b. Amiodarone
c. Metoprolol
d. Digoxin
pre
c. Metoprolol
The most likely diagnosis for the following electrocardiograph is
???
???
A 60-year-old man remains unconscious after an isolated head injury. The systolic blood pressure (in mmHg) should be kept above
a. 100
b. 110
c. 120
a. 100
A 34-year-old for a diagnostic laparoscopy has a height of 158 cm and a weight of 120 kg (BMI 48 kg/m2 ). For induction of anaesthesia, appropriate drug dosing includes
???
???
Suxamethonium may be safely given to patients with (list of neuromuscular diseases given)
A - Hyperkalaemic periodic paralysis
B - Myasthenia gravis
C - Duchenne
D - MS
E - Guillian barrre
B - Myasthenia gravis
Non-anaesthetist practitioners wishing to provide procedural sedation should have training in sedation and/or anaesthesia for a minimum of
? 3 months
? 3 months
In a burns patient, the blood concentration of propofol is
A) Increased because of dehydration
B) Decreased because of increased metabolism
Decreased because of increased Vd
Decreased because of increased Vd
A 76-year-old man requires an emergency thoracotomy to treat an expanding haemothorax. He is mildly hypotensive and is not fasted. His plasma electrolytes and haemoglobin are below (hyperK). The most appropriate strategy to employ to intubate him with a double lumen endotracheal tube is to
a. Induce anaesthesia, paralyse with atracurium
b. Induce anaesthesia, paralyse with suxamethonium
c. Induce anaesthesia, paralyse with 1.2/kg roc
d. Awake intubation
c. Induce anaesthesia, paralyse with 1.2/kg roc
A patient with an acute subarachnoid haemorrhage arrives in the emergency department. Her Glasgow Coma Scale score is 10 and she has no motor deficit. A CT brain shows diffuse subarachnoid haemorrhage with no localised areas of blood > 1 mm thick, and no intracerebral nor intraventricular blood. Her World Federation of Neurosurgical Societies (WFNS) grade of subarachnoid haemorrhage is
a. 1
b. 2
c. 3
d. 4
e. 5
d. 4
Which of the following risk factors for preeclampsia in isolation would be sufficient to recommend commencing low-dose aspirin?
a. Autoimmune disease
b. family history of PET
a. Autoimmune disease
A woman is diagnosed with preeclampsia and fetal growth restriction at 30 weeks gestation. Her haemodynamics are most likely to show
a. High CO, high SVR
b. High CO, low SVR
c. Normal CO, high SVR
d. Normal CO, low SVR
e. Low CO, high SVR
e. Low CO, high SVR
A 15-year-old patient with a known prolonged QT interval has a ventricular tachyarrhythmia while being monitored postoperatively in the postanaesthesia care unit. The patient is alert, orientated and without chest pain but feels unwell. The best initial management is
A) DC cardioversion
B) Magnesium 2g infusion
Magnesium 2g bolus over 2-3min
Magnesium 2g bolus over 2-3min
An eight-year-old child with sickle cell disease is scheduled for emergency fixation of a fractured radius. Her haemoglobin is 80 g/L. The most appropriate management is
Transfuse hb >100
During spinal surgery, the anaesthetic agent that is least likely to decrease motor evoked potentials is
a) Opioids
b) Volatile
c) Propofol
d) Ketamine
e) Clonidine
a) Opioids
A four-year-old boy is in refractory ventricular fibrillation. The recommended dose of amiodarone is
a. 100mg
b. 80mg
c. 40mg
d. 20mg
b. 80mg
The correct blood collection tube for a mast cell tryptase test is a
A) Sodium citrate
B) Serum gel SST
B) Serum gel SST
All patients over 70 years of age having received either spinal or general anaesthesia at Hospital X are reviewed 3 years later to assess cognitive function. The aim of the study is to determine whether exposure to general anaesthesia or spinal anaesthesia impacts cognitive function. This trial design is best described as a
a. Cohort study
b. Case-control study
c. Case series
d.
e. RCT
a. Cohort study
All of the following conditions are associated with acromegaly EXCEPT
a. Abdominal aneurysm
b. Myocardial fibrosis
c. Biventricular enlargement
d. Arrhythmia
e. Left ventricular enlargement
a. Abdominal aneurysm
A patient in the intensive care unit has ventricular fibrillation two hours after her coronary artery bypass graft procedure. Recommended immediate management does NOT include
a) External CPR
b) Resternotomy
c) 1mg adrenaline
d) 3 stacked shocks
c) 1mg adrenaline
The sensor on a NIM (Nerve Integrity Monitor) endotracheal tube used for thyroid surgery directly records
a. Movement of cords
b. Electromyelography from laryngeal muscles
c. Action potential in recurrent laryngeal nerve
Electromyelograpy from laryngeal muscles
A drug that is contraindicated for a patient with a history of heparin-induced thrombocytopaenia is
a. Danaparoid
b. Bivalarudin
c. Prothrominex ? VF
c. Prothrominex ? VF
The estimated proportion of human induced climate change attributable to nitrous oxide is
A. 0.6%
B. 6%
C. 60%
B. 6%
Regarding cardiopulmonary exercise testing before major surgery, oxygen pulse is the
a. Stroke volume
b. VO2 per minute
a. Stroke volume
You are involved in the care of a two-year-old child who has ingested a button battery in the last four hours. You would consider giving
a. Milk,
b. Sodium bicarbonate
c. Pantoprazole
d. Sucralfate
e. Water
d. Sucralfate
The antiemetic that interferes with the effectiveness of oral hormonal contraception is
a. Arepitatant
b. Dexamethsaone
c. Cyclizine
a. Arepitatant
Despite an interscalene block being performed preoperatively for arthroscopic rotator cuff repair, a patient wakes up with posterior shoulder pain. The most appropriate procedure to consider would be a nerve block of the
? Suprascapular
? Supraclavicular
Suprascapular
Supraclavicular is blocked by an interscalene
Intraoperative lung protective ventilation strategies include all of the following EXCEPT
a. Alveolar recruitment manoeuvres
a. Alveolar recruitment manoeuvres
An absolute contraindication to transoesophageal echocardiography is
a. Previous oesophagectomy
b. Oesophageal stricture
c. Oesophageal varices
d. Previous bariatric surgery
a. Previous oesophagectomy
A 25-year-old ASA (American Society of Anesthesiologists) physical status classification I patient develops seizures five minutes after receiving a brachial plexus block with ropivacaine. Of the following, the most suitable initial intravenous treatment is
a. 500 mL IV crystalloid bolus
b. Intralipid 20% 1.5 mL/kg
c. Midazolam 0.1 mg/kg
d. Propofol 2-3 mg/kg
c. Midazolam 0.1 mg/kg
Regarding healthcare research, the SQUIRE guidelines describe
a. The methodology of how a systematic review is conducted
b. The methodology of how an RCT is conducted
c. How to report safety and quality improvement work in healthcare
c. How to report safety and quality improvement work in healthcare
According to National Audit Project (NAP) 5, the incidence of awareness during general anaesthesia is
a. 1:700
b. 1:8000
c. 1:10000
d. 1:19000
d. 1:19000
You are performing femoral venous cannulation in an obese man under ultrasound guidance. The image quality is suboptimal as the vein is deep. The best way to improve the image quality is to
a. Get probe with lower frequency
b. Get probe with higher frequency
a. Get probe with lower frequency
A patient is bleeding and her ROTEM displays a Fibtem A5 of 2 mm (normal > 4 mm). The most appropriate treatment is
a. tranexamic acid
b. cryo
c. FFP
d. Platelets
b. cryo
After ceasing smoking, a patient?s immune function has effectively recovered to normal after 6
a. Hours
b. Days
c. Weeks
d. Months
d. Months
The most consistent risk factor for postoperative vomiting in children is
a. Age > 3yrs
Recirculation is a cannula position complication specific to the use of
VA ECMO
VV ECMO
VV ECMO
The composition of blood returned to the patient from intraoperative cell salvage shows
a) Normal 2-3 dpg
b) Normal plasma proteins
c) Normal platelets
d) Reduced fat emboli
e) Reduced red cell fragments
Reduced fat emboli
The diabetic medication that, as part of its therapeutic effect, significantly prolongs gastric emptying is
? Arabacose
? Meglitinide
? Dulaglutide
? Dulaglutide
The most likely side effect observed in the post anaesthetic care unit after the use of dexmedetomidine is
a. Bradycardia
b. Hypotension
B) Hypotension
When using cardioversion to revert a patient in atrial fibrillation to sinus rhythm, the direct current shock is synchronised with the ECG to coincide with the
a) P wave
b) Q wave
c) R wave
d) S wave
e) T wave
c) R wave
Adverse effects of the use of sodium-glucose co-transporter 2 inhibitors in the perioperative period do NOT include
a. Euglycaemic ketoacidosis
b. Hyperglycaemic ketoacidosis
c. Hypotension (or hypovolaemia)
d. UTI
e. Hypocalcaemia (or hyper)
b. Hyperglycaemic ketoacidosis
The electrolyte abnormality most associated with an increased risk of laryngospasm is
a. Hypercalcaemia
b. Hypocalcaemia
c. Hyperkalaemia
d. Hypokalaemia
e. Hyponatraemia
b. Hypocalcaemia
A 21-year-old patient with a history of schizophrenia on quetiapine develops tremor, restlessness, hyperreflexia, nausea and vomiting in the post-anaesthesia care unit following an emergency laparoscopic cholecystectomy. Her heart rate is 80 / minute, blood pressure 130/90 mmHg, and her temperature is 37.0 C. The most likely diagnosis is
? Seretonin syndrome
? Antichol syndrome
? Nms
? Psychosis
? MH
? Seretonin syndrome
The normal axial length of the globe of an adult eye is
a. 22mm
b. 23mm
c. 24mm
d. 25mm
e. 26mm
? BJA says 25mm
Elsewhere says 23-25
The Glasgow Coma Score of a patient whose best responses are: opening eyes to pain, making incomprehensible sounds, and withdrawing from pain is
a. 7
b. 8
c. 9
d.10
e.11
b. 8
A non-obese adult patient is administered a target-controlled propofol infusion for more than 15 minutes, with a constant target plasma concentration of 4 ?g/ml propofol. Compared to the Marsh model, the propofol dose given by the Schnider model will be a
a. Higher bolus, lower overall propofol
b. lower bolus, higher overall propofol
c.Lower bolus and lower overall propofol
d. Higher bolus and higher overall propfol
e. Higher (or lower) bolus, but whether overall greater amount will depend on duration of infusion
c.Lower bolus and lower overall propofol
You have been managing a case of malignant hyperthermia in an 80 kg man and have given a total of 400 mg of dantrolene (Dantrium). The amount of mannitol you have also administered is
0.1g
1g
0.6g
3g
6g
400mg = 20 vials of dantrium
dantrium has 3g per vial of mannitol
math aint mathing
The smallest recommended endotracheal tube that should be railroaded over an Aintree catheter has an internal diameter of
a. 6
b. 6.5
c. 7
d. 7.5
c. 7
A child with well controlled dysrhythmias has an ASA (American Society of Anesthesiologists) Physical Status classification of at least
a. 1
b. 2
c. 3
d. 4
e. 5
b. 2
According to ANZCA PS54(A), an anaesthetic machine requiring electrical power must, in the event of mains power failure, be able to operate under battery backup power for a minimum of
a. 30mins
b. 45 mins
c. 1hr
a. 30mins
You are inserting a pulmonary artery catheter in an intubated patient prior to cardiac surgery and a significant amount of blood appears in the endotracheal tube. The most appropriate specific initial management is to
a. Remove PAC and insert DLT
b. Wedge and insert DLT
c. Wedge and insert bronchial blocker
d. Withdraw 2cm and insert DLT
e. Withdraw and insert bronchial blocker
d. Withdraw 2cm and insert DLT
An analgesic which is a category A drug using the Australian and New Zealand categories for prescribing medicines in pregnancy is
a. Codeine
b. Endone
c. Tramadol
d. Clonidine
a. Codeine
A thoracic regional technique that will NOT provide analgesia for sternal fractures is a
? Transthoracic plane block
? Pec 1
? Pec 2
? ?anterior scalene
? Pec 1
A 72-year-old man with peripheral vascular disease presents for a femoral angioplasty and is currently taking aspirin. Regarding the perioperative management of his aspirin,
a. Continuing decreases risk of MI
b. Continuing decreases mortality
c. Ceasing decreases risk of renal dysfunction
d.
?
A 50-year-old man has the following pulmonary function test result: FEV1:FVC > 0.7, restrictive pattern. DLCO normal.
. The most consistent diagnosis is
a. Asthma
b. COPD
c. Guillian-Barre
d. Interstitial lung disease
e. ?Pulmonary hypertension
c. Guillian-Barre
A patient with acute right heart failure secondary to acute myocardial infarction is likely to have a/an
?
You are called to recovery to review an 80-year-old woman post neck of femur fracture fixation performed under general anaesthesia with a fascia iliaca block. She has a history of mild dementia. She has become confused and agitated after initially being cooperative and pain-free. The most appropriate drug therapy to manage her is intravenous
Fentanyl
Olanzapone
Midazolam
haloperidol
Haloperidol
In preschool-aged children having tonsillectomy under general anaesthesia, delirium is more likely with the use of
a. Use of volatile
The curve labelled ?b? is most likely to represent the flow?volume loop of a patient with
? Vocal cord palsy
? Tracheal stenosis
?
A 72-year-old woman on aspirin presents to her ophthalmologist for follow-up three days after you performed a transconjunctival peribulbar block for cataract surgery on her left eye. She complains of painless periorbital swelling, erythema, and mild chemosis which started the day after surgery but is improving. She had a peribulbar block three weeks ago for surgery on the other eye. The most likely diagnosis is
? Hyaluronidase allergy
? Conjunctivitis
? Retrobulbar haemorrhage
? Periorbital cellulitis
Post operative oedema
Post operative oedema
You have diagnosed anaphylaxis in an eight-year-old girl having an appendicectomy. She weighs 20 kg and has refractory bronchospasm despite an adrenaline (epinephrine) infusion running at 15 mcg/min. The recommended initial dose of salbutamol (100 mcg/puff) via metered dose inhaler is
? 12 puffs
? 6 puffs
? 2 puff
? 4 puff
? 8 puff
? 12 puffs
For a skewed distribution of data the best measure of dispersion of data is the
? Confidence interval
? Standard deviation
? Inter quartile range
? Standard error
? ? Another ? Mean
? Inter quartile
The analgesic drug with the most favourable Number Needed to Treat (NNT) for neuropathic pain is
a. Amitriptyline
b. Gabapentin
c. Tramadol
d. Pregabalin
a. Amitriptyline
This ultrasound image is acquired in preparation for a thoracic erector spinae plane block. The structure indicated by the arrow is the
? Rhomboids
? Trapezius
? Subcutaneous tissue
? Erector plane
?
The most common complication of extracorporeal membrane oxygenation (ECMO) in adults is
a. Bleeding
b. Thrombosis
c. Vascular damage
d. Inadvertent decannulation
a. Bleeding
A 25-year-old male has continued postoperative bleeding after an extraction of an impacted third molar tooth under a general anaesthetic. The patient mentions that his father bruises quite easily. His coagulation screen reveals elevated APTT, normal PT. The most likely diagnosis is
a. Factor V Leiden deficiency
b. Haemophilia A
c. Haemophilia B
d. von Willebrand disease
d. von Willebrand disease
Blockade of the superficial cervical plexus includes the
a. Transverse cervical nerve
b. Greater occipital nerve
a. Transverse cervical nerve
Of the following, the substance LEAST likely to cause lactic acidosis is
? Acetazolamide
? Metformin
? Adrenaline
? Propofol
? Methanol
Propofol
You will anaesthetise a 39-year-old woman for a laparoscopic cholecystectomy. She has a history of mastocytosis and has never had an anaesthetic in the past. A drug which you should avoid is
Morphine
? Fentanyl
? Ropivacaine
Morphine
A test for a condition which has a prevalence of 1 in 1,000 has a sensitivity of 100% and a specificity of 90%. The probability of a patient who receives a positive result actually having the condition is
a. 90%
b. 99%
c. 1%
d. 100%
C. 1%
A woman experiences a postpartum haemorrhage associated with uterine atony that is unresponsive to oxytocin and ergometrine. The recommended intramuscular dose of carboprost (15-methyl prostaglandin F2 alpha) to be administered is
a. 250mcg IM once
b. 250mcg IM q15min up to 2mg
c. 500mcg IM
d. 500mcg IV
e. 250mcg IV
b. 250mcg IM q15min up to 2mg
A patient has blunt chest trauma. A thoracotomy is indicated if the immediate blood drainage after closed thoracostomy is greater than
a. 500mL
b. 750mL
c. 1L
d. 1.2L
e. 1.5L
e. 1.5L
Anterior spinal artery syndrome would NOT result in
a. Bladder dysfunction
b. Motor loss
c. Loss of pain
d. Loss of proprioception
e. Loss of vibration
d. Loss of proprioception
e. Loss of vibration
?Retained proprioception and vibratory sensation due to intact dorsal columns?
The amount of intravenous potassium chloride required to raise the plasma potassium level from 2.8 mmol/L to 3.8 mmol/L in a normal adult is approximately
10 mol
20mmol
50
100mmol
200mmol
100mmol
A five-month-old child is to undergo routine elective morning surgery. Current ANZCA guidelines advise minimum fasting intervals prior to anaesthesia of
Formula for 4 hrs, breast milk for 3 hrs, clear fluids for 1hr
Of the following, the condition that is an absolute contraindication to administration of electroconvulsive therapy is
a. 3rd trimester pregnancy
b. Intracranial mass lesion
c. Unruptured AAA
d. Unruptured cerebral aneurysm
e. Raised ICP
e. Raised ICP
Your patient underwent a stellate ganglion block two hours ago. Prior to discharge you are asked to review the patient in recovery because of a droopy upper eyelid. The patient would also be expected to have ipsilateral
a. Dilated pupil not reactive to light
b. Dilated pupil reactive to light
c. Pinpoint pupil not reactive to light
d. Pinpoint pupil reactive to light
d. Pinpoint pupil reactive to light
A raised (> 140% predicted) single-breath diffusing capacity of the lung for carbon monoxide (DLCO) can be caused by
? Pulmonary haemorrhage
? Pulmonary HTN
? Asthma
? Emphysema
Interstitial lung disease
? Pulmonary haemorrhage
Asthma also increases dlco
You are performing a focused cardiac ultrasound in the postanaesthesia care unit on a patient who is hypotensive for unclear reasons. His heart rate is 100 beats/min. The left ventricular velocity time integral is 10 cm. The left ventricular outflow area is 3 cm2 . The left ventricular ejection fraction is 25%. The right ventricular systolic pressure is 40 mmHg. The inferior vena cava diameter is 20 mm. The estimated cardiac output is
? a. 2L/min
b. 3L/min
c. 4L/min
d. 5L/min
e. 6L/min
?
b. 3L/min
Of the following, the congenital condition LEAST commonly associated with obstructive sleep apnoea in children is
? Spina bifida
? Tetralogy
? Dmd
? Downs
Pierre robin
? Spina bifida
An open Ivor-Lewis oesophagectomy is performed via a
a. Laparotomy left thoracotomy
b. Laparotomy, left neck incision
c. Left thoracotomy, left neck incision
d. Left thoracotomy
e. Laparotomy, right thoracotomy
e. Laparotomy, right thoracotomy
Of the following, the procedure that is most commonly associated with chronic pain after surgery is
a. Amputation
b. Mastectomy
c. Inguinal hernia repair
d. Thoracotomy
a. Amputation
The nerve labelled with the arrow in the diagram is the (diagram of the brachial plexus)
A. Radial nerve (pretty sure it was this)
B. MC nerve
C. Median nerve
A. Radial nerve (pretty sure it was this)
Of the following, all are useful for the treatment of status epilepticus EXCEPT
Unsure of possible answers.
However according to up date pharmacological management involves:
1st line: Benzodiazepine. IV lorazepam, IM/IN midazolam, PR diazepam
2nd line: Antiseizure meds: Levetiracetam, phenytoin, Valproate
3rd line: Phenobarbital, lacosamide
When used for prolonged analgesia in a healthy adult, the recommended maximum dose of ropivacaine via continuous infusion or bolus dosing in a 24-hour period is
770
? 620
? 192
770
According to the RELIEF study, in major abdominal surgery a liberal fluid strategy (10 mL/kg of crystalloid at induction followed by 8 mL/kg/hour during the case) compared to a restrictive fluid strategy, results in
A. Decreased acute kidney injury
B. Increased mortality
C. Decreased mortality
D. No difference in wound infection
E. Increased bowel anastomosis breakdown
A. Decreased acute kidney injury
Based on this ECG tracing, the mode in which this pacemaker is operating is
? Failure to capture
? Failure to sense
?
The prevention of microbial contamination of living tissues or sterile materials is known as
a. Asepsis
b. Sterilisation
c.
a. Asepsis
A 45-year-old man is ventilated in the intensive care unit and is in a critical state. His pulmonary artery wedge pressure is 26 mmHg, cardiac index is 1.7 L/minute/m2 and his PaO2/FiO2 ratio is 200 mmHg. A decision is made to place him on extracorporeal membrane oxygenation. The most appropriate mode is
a. AV
b. VA
c. Some weird description
d. Some weird description
e. Some weird description
b. VA
A 48-year-old man is day two post-laparoscopic high anterior resection. He has used 42 mg of intravenous morphine in the past 24 hours. You wish to start him on oral tapentadol immediate release. The most appropriate equianalgesic dosage would be
A. 50mg QID PO
B. 100mg QID PO
C. 150mg QID PO
D. 200mg QID PO
B. 100mg QID PO
During an infraclavicular approach to the brachial plexus, the tip of the needle is positioned closest to the
Trunks
Division
Roots
Cords
Branches
Cords
The Pin Index System positions on a C size cylinder of medical oxygen are
2,5
In a previously normal patient with cardiac failure secondary to acute pulmonary embolism, the best choice of vasoactive agent for initial treatment is
Isoprenaline
? Dobutamine
? Noradrenaline
Milrinone
? Noradrenaline
You are reviewing a primigravida at 32 weeks gestation with a Fontan circulation in the anaesthetic preassessment clinic. Peripartum care should avoid the use of
a. Nitrous
b. Ergometrine
c. Atenolol
d. Terbutaline
e. Epidural with 2% lignocaine with adrenaline
b. Ergometrine
Cyclooxygenase type 2 inhibitors (COX-2) in pregnancy are considered
A. Not safe
B. Safe in 1 st trimester
C. Safe in 3rd trimester
D. Should not be used after 48hours to delivery
E. Safe outside of 1st trimester and up to 48hrs prior to delivery in third trimester
D. Should not be used after 48hours to delivery
Compared to a normothermic patient, a patient with mild intraoperative hypothermia (35.0 oC) will have
a. Increased blood loss, no effect on INR or APTT
b. Increased blood loss increased INR
c. Increased blood loss increased APTT
d. No change in blood loss, increased INR
e. No change in blood loss, increased APTT
a.?
c. Increased blood loss increased APTT
The 2012 Berlin definition of the acute respiratory distress syndrome (ARDS) defines moderate disease as one with a PaO2 / FiO2 ratio (in mmHg) of
a. 100-200
b. 200-300
c. <100
d. >300
a. 100-200
Normal (0.9%) saline has the physical properties of
a. Na 154, Cl 154. Osmolality 308
a. Na 154, Cl 154. Osmolality 308
The piece of airway equipment shown is a
CMAC
CMAC video stylet
Flexible intubating device
Light wand
?
The medication most strongly associated with an acute primary hypotensive reaction following transfusion of blood products is
? Aspirin
? Metoprolol
? Perindopril
? digoxin
Perindopril
A patient has return of spontaneous circulation (ROSC) but remains unresponsive after cardiac arrest. ANZCOR Guidelines recommend all the following measures EXCEPT
a. Temp 32-36o
b. ETCO2 25-45mmHg
c. MAP > 70mmHg
d. Titrate insulin infusion to aim BSL < 10mmol/L
e. SpO2 94-98%
b. ETCO2 25-45mmHg
1 MAC of sevoflurane affects the sensory evoked potential signal for spinal surgery by
?
The image below shows a normal central venous pressure (CVP) trace on the left. The CVP trace shown on the right is most consistent with
( Pressures were overall elevated ~20cm H2O, looked similar to tamponade)
a. Tricuspid regurg
b. Mitral stenosis
c. Mitral regurg
d. Pericarditis
e. Tamponade
?
A patient is anaesthetised from the awake state to a state of surgical anaesthesia with propofol or a volatile anaesthetic. As the depth of anaesthesia increases, the patient?s electroencephalogram (EEG) will show oscillations that are of
a. Increased amplitude, decreased frequency
b. Increased frequency, decreased amplitude
c. No change in either
a. Increased amplitude, decreased frequency
Analysis of variance (ANOVA) is a statistical test to determine
a. Means of 2 or more groups are the same
a. Means of 2 or more groups are the same
Created by the Global Initiative for Chronic Obstructive Lung Disease (GOLD 2017), the numerical GOLD classes 1 to 4 are classes of severity for chronic obstructive pulmonary disease (COPD). These classes are based on an assessment of the
a. FEV1
a. FEV1
The drug of choice for the treatment of duct-dependent congenital heart disease is
a. Alprostadil (PGE1)
b. Prostacyclin
c. Carboprost
d. Sildenafil
e. NSAIDs
a. Alprostadil (PGE1)
Predictors of difficult sedation (agitation or inability to complete the procedure) of patients undergoing gastroscopy do NOT include
a. Old age
b. Longer procedure
c. Failure to undertake pre-procedure assessment
d.
a. Old age
A patient presents for endoscopic retrograde cholangiopancreatography (ERCP) with a history of previous post-ERCP pancreatitis. The management most likely to reduce the likelihood of pancreatitis is
a. PR indomethacin
b. NAC infusion
a. PR indomethacin
A 72-year-old patient is undergoing resection of an anterior skull based tumour using a combined endoscopic and frontal craniotomy approach. Seven hours into the procedure she has a large diuresis of pale urine and you suspect she may have developed diabetes insipidus. The most appropriate test result to confirm your diagnosis in this setting is a
a. Low serum SIADH
b. High serum sodium
c. Low serum osmolality
d. Urine Na > 20mmol/L
b. High serum sodium
The amount of fresh frozen plasma that needs to be administered (in mL/kg) to increase plasma fibrinogen levels by 1 g/L is
a. 5 mls/kg
b. 10 mls/kg
c. 15mL/kg
d. 30 mls/kg
d. 30mls/kg
Unsupported ventilation in a non-anaesthetised patient with long-standing tetraplegia is improved when
a. Supine, something about recoil
b. Supine, due to greater diaphragmatic excursion
c. Upright
d. Upright
e. Upright
B. Supine
Drug classes demonstrated to reduce mortality in chronic heart failure with reduced ejection fraction include all of the following EXCEPT
? BB
? ARB
? ACE
? Diiretics
? Diiretics
When using an endotracheal tube in an adult, the highest recommended cuff pressure to avoid mucosal ischaemia is
a. 10
b. 20
c. 30
d. 40
e. 50
c. 30
A 55-year-old man with no past history of ischaemic heart disease is three days post-total hip replacement surgery. He has an episode of chest pain that sounds ischaemic, began at rest and lasts 30 minutes before resolving fully. There are no ECG changes nor troponin rise. The diagnosis is
a. MINS
b. NSTEMI
c. STEMI
d. Unstable angina
e. No formal diagnosis
d. Unstable angina
According to the ANZICS Statement on Death and Organ Donation 2021, circulatory determination of death in the context of organ donation requires the absence of evidence of circulation for at least
a. 3mins
b. 5 mins
c. 10 mins
d. 20 mins
b. 5 mins
A six-year-old child weighing 20 kg presents to hospital two hours after sustaining a burn to 25% of her body. Appropriate fluid management should include 1000 mL Hartmann?s solution in the next
6 hours
6 hours
Dabigatran differs from rivaroxaban and apixaban because it inhibits
? Blocks thrombin
? Blocks xa
? Blocks x
? Blocks thrombin
The recommended antibiotic prophylaxis for surgical termination of pregnancy is
a. Clindamycin 600 mg
b. Cephalexin 500 mg
c. Doxycycline 400
d. Cephazolin 2g
e. Cephazolin 2g and metronidazole
c. Doxycycline 400
