BJA 2024 Flashcards
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11 months infant boy was accidentally dropped and sustained acute head injury.
You are suspicious of a presence of intracranial bleed
i) Lists signs and symptoms of raised ICP neonate and infant (30%)
CT scan confirmed presence of extradural haematoma planned for craniotomy and evacuation of haematoma
ii) Discuss your intraoperative management including neuroprotective anaesthesia strategies and brain relaxation technique (50%) Justify your choice of osmotherapy agent in an attempt to reduce cerebral oedema"
Describe a clinical practice strategy ( i.e. intraoperative strategy) for the appropriate use of neuromuscular blocking agent relevant to its practical use, administration, monitoring and reversal of neuromuscular blockade for a patient undergoing a laparoscopic anterior resection.
“What are the important patient risk factors for OIVI/ OIRD
32 year old opioid dependent male is suspected to be narcotised from excessive fentanyl administration intraoperatively leading to OIRD. He was given naloxone to reverse this effect. List symptoms and signs of acute withdrawal of opioids as well as potential adverse effects of naloxone”
“15 year old male with septicaemia secondary to extra dural abscess is scheduled for emergency burrhole and evacuation of abscess
Discuss your preoperative management of sepsis with lactatemia prior to the surgery”
“What are assisted reproductive technology (ART) procedures? (20%)
Outline the anaesthetic considerations relevant to this field of medicine? (80%) “
“You are asked by your head of department to create a program to address issues of bias and prejudice within your institution.
Why is this important? (50%)
Outline your plan for developing this program (50%) “
A patient with a BMI of 41kg/m2 is scheduled on your list for an elective Total Knee Arthroplasty. Their medications include Targin 10/5mg PO TDS for knee pain. How will these factors affect your analgesic decision making for this patient?
“You are on call overnight at a major regional hospital. The obstetrics registrar calls and requests you attend urgently to anaesthetise a parturient with a suspected placental abruption for an emergency LUSCS. The patient is 38 weeks pregnant.
What further information would you like from the registrar? (25%)
What instructions would you give them to assist in preparing this patient for theatre? (25%)
Describe your planned anaesthetic management of this patient. (50%) “
A 35yoF is undergoing a transsphenoidal resection of pituitary adenoma for Cushing’s disease. Outline the intra-operative considerations.
Evaluate the use of prophylactic fibrinogen replacement in severe post-partum haemorrhage.
Outline the perioperative complications you anticipate when anaesthetising a 4yo child with uncorrected congenital heart disease.
“A 30yoF, G1P0, GBS +ve and PROM, presents with tachycardia, fever, with the most likely diagnosis being chorioamnionitis.
Justify your choice of antibiotics. (30%)
What are your considerations during labour and delivery? (70%)
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“Outline the effects of severe hypertension (50%)
Describe your management for hypertensive crisis (50%)
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Describe your approach and the issues related to spinal anaesthesia in a patient with scoliosis.
Evaluate the use of a peribulbar block, sub-Tenons block and general anaesthesia for cataract surgery.
The next patient on your list for an ACL repair is a transgender woman. How would this impact your preoperative assessment?
What are the management options for a patient with cardiogenic shock following an AMI?
Discuss the perioperative implications of osteogenesis imperfecta
Draw and label a bag mask ventilator. What factors affect oxygen delivery?
List the mechanical complications of CVC insertion. Describe how you can prevent mechanical complications of central venous catheter placement.
