Finals SAQ Listing

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ANZCA Exam Reports

This is a list of Finals FANZCA Short Answer Questions organised by TOPIC. This is considered useful to give you an overview of what has been asked in any individual area.

NOTES

  • Some of the multipart questions span multiple topics but are only listed once.
  • Some questions are stems with follow-up questions. These are presented in bold.
  • Direct links to the Finals Examiner's Reports are provided in the box to the right.

Contents

View questions by paper

(Sep-2007 Q1)
(May-2007 Q1)
(May-2006 Q1)
(Sep-2005 Q1)
(May-2005 Q1)
(Sep-2004 Q1)
(May-2004 Q1)
(Sep-2003 Q1)
(May-2003 Q1)
(Sep-2002 Q1)
(May-2002 Q1)
(Sep-2001 Q1)
(May-2001 Q1)
(Aug-2000 Q1)
(Apr-2000 Q1)

Paediatrics

  • Finals May-2014 Q1 Outline the advantages and disadvantages of using the paediatric circle system and the Jackson-Rees modification of Ayre’s T-piece (Mapleson F) for anaesthesia in a 15 kg child.
  • Finals Oct-2013 Q10 A 7-year-old nonverbal girl with severe spastic cerebral palsy is scheduled for cystoscopy. Describe the important features of cerebral palsy relevant to planning anaesthesia for this procedure. (70%) What are the advantages and disadvantages of inhalational induction in this child? (30%)
  • Finals May-2013 Q10 List methods to prevent hypothermia in paediatric patients during anaesthesia and surgery, commenting on the effectiveness of each.
  • (Oct-2012 Q5) You are asked to assess a 4 year old child who is scheduled for a strabismus correction as a day case procedure. 1. What are the issues relevant to anaesthesia (70%). 2. What would prevent you from discharging this patient home after surgery? (30%).
  • Finals May-2012 Q9 A 3-year-old presents to the emergency department with a recent onset of stridor. List the differential diagnoses (30%) How do you differentiate between the potential causes of this stridor? (70%)
  • Finals Oct-2011 Q8 A child with active upper respiratory tract infection presents for general anaesthesia. a. Outline the factors that increase the rate of adverse respiratory events during anaesthesia. (50%)
b. How can you reduce the risk of an adverse event occurring? (50%)
  • Finals May-2011 Q9 You hear a cardiac murmur in a two-year-old child presenting for elective minor surgery. (a) What are the features of the murmur that would differentiate an innocent from a pathological murmur? (50%) (b) How would you evaluate this child’s fitness for anaesthesia from the cardiac perspective? (50%)
  • Finals May-2010 Q9 a. Describe the factors that influence emergence delirium in children. (50%) b. How would you manage emergence delirium in a 3 year old child having had myringotomy tubes inserted under general anaesthesia? (50%)
  • Finals Oct-2009 Q12 You are asked to give a practical tutorial on paediatric airway management to Emergency Department registrars at a large hospital. What are the important aspects of paediatric airway management that you would present to them?
  • (Apr-2009 Q13) Outline the steps you would take to ensure the safe introduction of elective paediatric surgery at your local private hospital.
  • (Oct-2008 Q7) A 6yo girl with severe spastic cerebral palsy presents for orthopaedic surgery to correct lower limb deformities. Outline the implications of cerebral palsy for anaesthesia management for this operation.
  • (May-2008 Q8) You are asked to provide assistance to resuscitate a baby. One minute after birth the baby is apnoeic, grey/blue all over, floppy and unresponsive to stimulation, with a pulse felt at the umbilical stump of 60/min. What is this baby's APGAR score? Describe your resuscitation of the baby.
  • (May-2008 Q11) You are the anaesthetist at a childrens' hospital. A 3yo schedules for dental restoration and extractions is found to have a systolic murmur during your preoperative assessment on the day of surgery. They have been on a waiting list for 6 months and have had a dental abscess that settled with antibiotics. Describe how you would evaluate the significance of this murmur and how this decision would affect your decision to proceed or not with surgery.
  • (Sep-2007 Q12) A 3 week old male infant who was born by uncomplicated vaginal delivery at term presents with projectile vomiting for 2 weeks. His weight is now 2.8 kg from a birth weight of 3.1kg. His presumed diagnosis is pyloric stenosis. His blood chemistry results are:
                Measured 	 Normal Range 
Na 	         129 mmol/L 	 135-145 mmol/L 
K 	         3.0 mmol/L 	 3.5-5.5 mmol/L 
Cl 	         84 mmol/L 	 95-110 mmol/L 
HCO3	         36 mmol/L 	 18-25 mmol/L 
Creatinine 	 69 μmol/L 	 20-75 mmol/L 
Glucose 	 3.0 mmol/L 	 2.5-5.5 mmol/L 

Explain how these abnormal results come about. Describe an appropriate fluid resuscitation regime for this infant. List the laboratory criteria by which you would consider him sufficiently resuscitated for surgery.

  • (May-2007 Q4)A 2 year old child has burns to lower body from immersion into a hot bath. Describe your assessment and management of pain and fluid requirements in the first 2 hours following injury.
  • (Sep-2006 Q10) Discuss in detail the technique of rapid sequence induction with cricoid pressure in a child. Include the reasons for your choice of relaxant.
  • (Sep-2005 Q1) What are the indications for tracheal intubation in a 3 year old who presents with "croup"? Describe your technique for intubation.
  • (May-2004 Q12) Working in a small obstetric unit you are asked to attend at the birth of a child where there is meconium stained liquor. How will you manage the infant's resuscitation?
  • (May-2004 Q13) Describe the characteristics of a ventilator suitable for neonates.
  • (Sep-2003 Q2) A 4 yo boy weighing 15kg presents for day surgery repair of a left inguinal hernia for which you plan general anaesthesia and caudal block. He has no significant past history, and is well. Justify your choice of agent(s) for caudal injection for this child.
  • (May-2003 Q2) A four week old infant presents for bilateral inguinal herniotomy at a free-standing day surgery unit with a significant paediatric caseload. This infant is to have a general anaesthetic. The parents wish to return to the country that evening. Is the use of a laryngeal mask an acceptable option for airway management? Justify your answer.
  • (May-2003 Q1) How would you provide post-op analgesia for this infant? Include information on dosage and routes of administration.
  • (May-2003 Q3) On what basis would you decided if it is appropriate for this infant to return to the country that evening?
  • (Sep-2001 Q1) You discover a heart murmur, which has not been noted before, in a 3 yo child presenting for elective inguinal hernia repair. How would you assess this child at the bedside with respect to this murmur, and what findings would prompt you to refer this child to a cardiologist prior to surgery?
  • (Sep-2001 Q2) A cardiological opinion is sought, and echocardiography is advised. The child becomes extremely upset, and the paediatrician and parents ask you to sedate him for the procedure. How will you manage this?
  • (Sep-2001 Q3) The echocardiogram is reported as normal and the cardiological opinion is that the murmur is physiological and of no concern. Outline and justify your plan for postoperative analgesia following the hernia repair, including after discharge.
  • (May-2001 Q7) An 8 month old, 10 kg infant presents for laparotomy following failed barium enema reduction of an intussusception. Describe and justify your perioperative fluid management.
  • (May-2001 Q8) At the completion of surgery the haemoglobin is measured at 70g/L. Would you transfuse this patient? Justify your answer.
  • (May-2001 Q9) In what circumstances would it be reasonable to provide continuous epidural analgesia for postoperative pain relief in this child?
  • (Aug-2000 Q9) List the anatomical differences between the neonatal and adult airway. Include the significance of each difference.
  • (Apr-2000 Q10) A three year old child is being assessed for insertion of middle ear drainage tubes. On examination you discover that the child has a precordial murmur. What information would you be seeking in your assessment of this child to decide if the murmur is innocent?
  • (Apr-2000 Q11) If the child is found to have a ventricular septal defect, but is otherwise well, how will this influence your anaesthetic management?
  • (Aug99) A nine year old child with spina bifida presenting for a tendon transfer procedure is said to have multiple allergies including latex and antibiotics. How would you decide whether or not the child has latex allergy?
  • (Aug99) If the child does have latex allergy, describe the precautions that should be taken peri-operatively to prevent this child developing a latex reaction?
  • (Aug99) What would you advise the parents regarding the risks that latex allergy adds to the perioperative period?
  • (Apr99) A 4 yo boy weighing 15kg presents for day surgery repair of a left inguinal hernia for which you plan GA and a caudal block. He has no significant past history and is well. Describe how you would perform a caudal injection for this child.
  • (Apr99) Justify your choice of agent(s) for caudal injection for this child.
  • (Apr99) If his parents express concern about caudal analgesia, what alternative analgesia options would you offer? Include a brief comment on their particular advantages and disadvantages.
  • (Jul98) Compare propofol with sevoflurane as the sole anaesthetic general anaesthetic agent for a 3 yo child requiring insertion of drainage tubes for chronic otitis media.
  • (Apr97) A 14yo girl, 130cm tall, with idiopathic scoliosis is scheduled for corrective fixation via a thoracotomy. Controlled hypotension will be used. What are the options available for providing collapse of the right lung?
  • (Apr97) Two hours into the operation the urine output is measured as 5 ml (in two hours). How would you manage this?
  • (Apr97) At the time of skin closure her core temperature is 34.1 degrees celcius. How would you manage this?
  • (Aug96) A 3 year old child presents with respiratory distress associated with a respiratory tract infection. How would you assess the need for tracheal intubation?
  • (Aug96) Describe the facilities you require when you decide to intubate the trachea.
  • (Aug96) What are the possible causes of cardiac arrest in this child one hour after intubation?
  • (Apr96) What are your views on the statement: "children having a tonsillectomy should not be prescribed narcotic analgesics post-operatively"?

Obstetrics and Gynaecology

  • Finals May-2010 Q5 A 26 year old woman with subclinical myotonic dystrophy presents to the high risk obstetric clinic. She is 25 weeks pregnant in her first pregnancy and otherwise well. She hopes for a normal vaginal delivery. Describe and justify your recommendations for the management of her analgesia for labour and the perioperative management of any potential operative delivery.
  • Finals Oct-2010 Q8 How and why is cardiopulmonary resuscitation modified for the pregnant patient at term compared with the non-pregnant patient?
  • Finals May-2012 Q5 A healthy 28-year-old primigravida is scheduled for elective lower segment caesarean section for breech presentation at 39 weeks gestation.
You have performed a spinal anaesthetic using 0.5% bupivacaine 2.2 ml and fentanyl 15 μg (total volume 2.5 ml). Describe the issues in assessing adequacy of the block for the planned surgery (50%) Describe the options for managing an inadequate block recognised prior to commencement of surgery (50%)
  • Finals May-2013 Q7 A 25 year old woman at 28 weeks gestation, with a body mass index (BMI) of 45 attends the high risk obstetric clinic. Outline the pathophysiology of morbid obesity affecting pregnancy and describe the implications for obstetric anaesthetic care.
  • Finals Oct-2009 Q13 You see a 28-year-old woman at the pre-admission clinic who is 32 weeks pregnant. She weighs 150kg and has gestational diabetes. She is hoping to have a normal vaginal delivery at term. What are the issues you would discuss with her during the appointment? (50%) What would you recommend for her management when she goes in to labour? (50%)
  • Finals Oct-2013 Q13 You are asked to assess a 35-year-old woman on labour ward. She has uncontrolled hypertension at 34 weeks’ gestation. Her blood pressure is 180/110 mmHg and urinalysis shows 3+ of protein. Her obstetrician wants to deliver her by caesarean section as soon as feasible. Outline your management to optimise her status prior to transfer to theatre.
  • Finals Oct-2011 Q4 While performing an epidural for labour analgesia in an otherwise healthy primigravida during the first stage of labour you inadvertently cause a dural puncture with the Tuohy needle.
  • (Oct-2012 Q11) You have been asked to provide anaesthesia for a lower uterine segment caesarean section in a woman at 38/40. She has a pacemaker-AICD implanted for a known cardiomyopathy. Her current echo demonstrates an EF of 35% with mild to moderate left ventricular global hypokinesis. Clinically, the patient feels very well. 1. What additional preparations with respect to her cardiovascular system would you make to ensure the safe management of this patient during her Caesarean section? 2. Outline the relative benefits and risks of a regional technique compared with general anaesthesia in this patient.
  • (Apr-2009 Q8) Outline the features and clinical management of amniotic fluid embolism.
  • (Oct-2008 Q8) A 25yo primigravida patient presents to the delivery suite at 38 weeks gestation complaining of a headache and difficulty with her vision. Her BP is 180/115 and she has clonus. CTG monitoring shows no indications of foetal distress. Outline your initial management of her pre-eclampsia
  • (May-2008 Q7) 34yo woman presents at 36 weeks gestation with an anterior placenta previa and a caesarean section is scheduled. She has no intercurrent health problems. She has a history of two caesarean sections under regional anaesthesia. Describe and justify the changes this history would make to your pre-operative and intra-operative plan for CS.
  • (Sep-2007 Q8) You are asked to provide epidural pain relief for a woman in labour. She is primigravida, and is 3cm dilated. Describe and justify both your choice of drugs for and the mode of administration of epidural analgesia in this situation.
  • (Sep-2006 Q7)While performing an epidural for labour analgesia in an otherwise healthy primigravida in first stage you inadvertently cause a dural puncture with the Touhy needle. Describe and justify your management of this complication.
  • (May-2006 Q15) Discuss the elements you consider important when obtaining consent for epidural analgesia in labor.
  • (May-2004 Q14) Discuss the contra-indications to spinal anaesthesia for caesarean section.
  • (Sep-2003 Q4) A 28 yo woman with a past history of two caesarian sections is at 34 weeks gestation with placenta praevia demonstrated by ultrasound. She is Jehovah's witness and will not accept blood products under any circumstances. She requires casesarian section. Do you consider regional anaesthesia a reasonable first option in this case? Give reasons.
  • (May-2003 Q7) A primiparous patient in active labour at 3 cm dilatation requests epidural analgesia. Examination reveals she has a temperature of 39.5 degrees. What impact does this fever have on your decision to provide epidural analgesia?
  • (May-2003 Q8) Which complications would you discuss with this patient when obtaining consent for an epidural? Include your estimates of the incidence of these complications.
  • (May-2003 Q9) An epidural is placed. Two days later she complains of back pain, urinary incontinence and a weak sensation in her right leg. How would you manage this problem?
  • (Sep-2001 Q7) After 10 hours labour, a healthy 28 yo primiparous woman at term requests epidural analgesia. Her cervix is 8cm dilated. Discuss the assertion that "a combined spinal epidural technique is a better choice of analgesia for this woman".
  • (Sep-2001 Q8) She reaches full dilatation and delivers before any block is performed. Following delivery she has a retained placenta. Justify your choice of anaesthetic technique for manual removal of placenta.
  • (Apr-2000 Q4) You are asked to provide pain relief for a woman in labour. She is a primigravida, has twins and is 5cm dilated. You provide epidural analgesia. Describe and give reasons for your choice and method of delivery of drug(s).
  • (Apr-2000 Q5) The patient is now ready for vaginal delivery, but perineal analgesia is inadequate. Discuss the method you would recommend to remedy this.
  • (Apr-2000 Q6) Indicate elements you consider important when obtaining consent for epidural analgesia in labour.
  • (Aug99) A 31 yo primigravida at 36 weeks gestation presents with a blood pressure of 170/110 mmHg, proteinuria, persistent headache and hyperreflexia. She requires delivery by caesarian section within 3 hours. How would you manage her blood pressure in the time before surgery?
  • (Aug99) Justify your choice of anaesthesia for caesarian section.
  • (Aug99) If she had an uneventful general anaesthetic, but started convulsing in the recovery ward two hours post-operatively, how would you manage this?
  • (Jul98) A 34 yo woman requires repeat lower section caesarean section. Last time she had a Caesarean section her post operative course was complicated by dural puncture headache (following dural puncture with a 16G needle), as well as a deep venous thrombosis. She won't have general anaesthesia. How would you minimise the problem of post dural puncture headache on this occasion.
  • (Jul98) Describe and justify the regional anaesthesia technique you would choose for this woman.
  • (Jul98) Describe and justify your prophylaxis against deep venous thrombosis for her. (begin your answer by stating in just a word or two the regional anaesthesia technique you have chosen).
  • (Apr96) You are asked to attend a patient who cannot move her legs twelve hours after a vaginal delivery. The last epidural top-up used 0.25% bupivacaine and occurred shortly before delivery. How would you manage her leg weakness?
  • (Apr96) Comment on the choice of 0.25% bupivacaine for her analgesia.
  • (Apr96) Discuss the methods which may identify an inadvertant epidural venous cannulation during labour.

Cardiac and Vascular Surgery

  • Finals Oct-2010 Q12 What are the advantages and disadvantages of general versus local anaesthesia for carotid endarterectomy?
  • Finals Oct-2013 Q5 An adult patient is scheduled for formation of an arterio-venous fistula at the wrist. Describe the nerve supply relevant to this surgery. (30%) Discuss the suitability of an interscalene block in this situation. (70%)
  • Finals Oct-2013 Q3 Outline the principles of stroke volume variation (SVV) measurement. (50%) Describe how SVV measurement can be used to assist haemodynamic optimisation in a patient undergoing major elective abdominal surgery. (50%)
  • (Oct-2012 Q3) 1. What are the prerequisites for separation from standard cardiopulmonary bypass after uneventful coronary artery bypass surgery? (50%). 2. What are the likely causes of hypotension in the immediate post-separation period? (50%)
  • (Sep -2007 Q9) "It's no longer justifiable to use aprotinin during cardiac surgical procedures". Discuss.
  • (May-2007 Q14) An otherwise fit 30 yr old man is having microvascular reimplantation of his forearm. Describe methods available to optimise the perfusion of the perfusion of the reimplanted limb in the post-operative period.
  • (Sep-2006 Q3) Describe the cardiovascular changes which occur during clamping and unclamping of the supra-renal aorta during repair of an abdominal aortic aneurysm in a patient with normal ventricular function and outline your strategies to maintain critical organ perfusion during these times.
  • (May-2006 Q11) Discuss the principles underlying the management of a general anaesthetic for carotid endarterectomy.
  • (May-2005 Q6) Compare the use of a pulmonary artery catheter and transoesophageal echo in evaluating cardiac function intraoperatively.
  • (May-2004 Q11) Discuss the strategies you would consider in order to protect renal function during a laparotomy for an abdominal aneurysm repair.
  • (Sep-2003 Q14) All patients who present for coronary bypass surgery should be classified as ASA status 4 or 5 - discuss this statement.
  • (May-2002 Q1) A 68 yo man presents for repair of a rapidly expanding AAA. He has been a heavy smoker (80 pack years) until 5 months previously when he had a myocardial infarction. He has been treated for hypertension for the last 13 years and is currently taking atenolol, nitroglycerine and diltiazem. What clinically significant information can be obtained if a pulmonary artery catheter is placed for his operation and how would it influence the anaesthetic management?
  • (May-2002 Q2) Compare the use of a pulmonary artery catheter and transoesophageal echo in evaluating cardiac function intraoperatively in this patient.
  • (May-2002 Q3) Describe the management of a rise in CVP from 15 to 23 mmHg two minutes after aortic cross clamping
  • (Apr-2000 Q1) A patient is to have surgery for resection of a AAA. what advantages does TOE have over ECG monitoring for intra-operative myocardial ischaemia?
  • (Apr-2000 Q2) Justify the measures you would use to minimise the risk of acute tubular necrosis if the surgeon is to clamp the supra-renal aorta.
  • (Apr-2000 Q3) What are the relative merits of sodium nitroprusside vs glyceryl trinitrate for control of hypertension when the aorta is cross clamped?
  • (Jul98) A patient was scheduled for elective repair of an abdominal aortic aneurysm. During preparation for anaesthesia, the 8.5 french gauge introducer sheath intended for the internal jugular vein was inserted into the carotid artery. How could the risk of this incident occurring be minimised?
  • (Jul98) When the problem has been recognised, what is the appropriate management?
  • (Jul98) Discuss the choice of the internal jugular vein as the initial site to attempt central vein cannulation in this patient.

Neurosurgery

  • Finals May-2010 Q7 A 43 year old female with a Grade 1 subarachnoid haemorrhage is scheduled for coiling of her middle cerebral artery in the radiology suite. Discuss the important issues to consider when providing anaesthesia for this patient.
  • Finals Oct-2011 Q7 Four hours after multi-level laminectomy with instrumentation, your patient complains of unilateral visual loss. 
a. What is your differential diagnosis? (40%)
b. How can you minimise the risk of visual complications in the prone patient? (60%)
  • Finals Oct-2011 Q6 A 50-year-old patient presents for urgent craniotomy and decompression of a subdural haematoma. Two days ago he was well, but now has a Glasgow Coma Scale score of 11. He is combative and has pulled out his intravenous line. On inspection there are no obvious veins for cannulation. a. List the options available for induction and intubation. (30%) b. Describe and justify your preferred approach. (70%)
  • Finals May-2012 Q7 List the methods of assessing intracranial pressure (ICP) (30%) Evaluate the role of ICP monitoring in the setting of traumatic brain injury 
(70%)
  • Finals Oct-2009 Q15 Describe the principles of cerebral protection in a patient with an isolated closed head injury.
  • (Apr-2009 Q11) A 40 yo otherwise healthy male presents following a sub-arachnoid haemorrhage. He is scheduled for clipping of a middle cerebral artery aneurysm. Outline the major issues in providing anaesthesia for this patient and describe how you would address them.
  • (Oct-2008 Q10) Discuss the management of cerebral vasospasm following the coiling of a cerebral aneurysm.
  • (May-2008 Q12) Outline the issues involved in the pre-operative assessment of the patient presenting for transphenoidal surgery for acromegaly.
  • (Sep-2006 Q8) Describe the principles of cerebral protection in a patient with an isolated closed head injury.
  • (May-2005 Q1) Discuss the perioperative use of nimodpine for a patient undergoing clipping of a cerebral aneurysm.
  • (Sep-2004 Q7) Describe the pathophysiology and diagnosis of diabetes insipidus following head injury.
  • (May-2004 Q5) Discuss the methods you would use to reduce cerebral swelling during craniotomy for removal of tumour in an adult
  • (Aug-2000 Q10) A 75 yo man is scheduled for a 2 level posterior spinal fusion under general anaesthesia in the prone position. He suffers from stable angina, for which he takes sublingual glyceryl trinitrate. He also takes oral morphine for his back pain. What hazards will his position for surgery present and how may they be minimised?
  • (Aug-2000 Q11) His peroperative blood pressure is 150/90 and the surgeon requests induced hypotension. Justify the level you would lower the blood pressure to and the method chosen.
  • (Aug-2000 Q12) Half way during the first-level fusion, the electronic anaesthetic machine diagnoses that it has an internal fault and without warning shuts all functions off including gas delivery, ventilation and monitoring. How will you manage this situation?
  • (Jul97) What are the advantages and disadvantages of the use of nitrous oxide in general anaesthesia for intracranial surgery?
  • (Apr96) A previously well 38 yo man presents for urgent clipping of a middle cerebral artery aneurysm. He has photophobia, and a blood pressure of 150/90. Give an account of how you would minimise the risk of arterial hypertension at tracheal intubation.
  • (Apr96) Evaluate the use of nitrous oxide as a component of your general anaesthetic for this man.
  • (Apr96) Outline how you would manage post-operative vasospasm in this patient.

Equipment

  • Finals Oct-2009 Q10 Describe the differences between biphasic and monophasic manual external cardiac defibrillators. (50%) What is the “synchronize” button for? When would you use it? (20%) List the potential hazards of defibrillation. (30%)
  • Finals Oct-2011 Q1 Compare and contrast oxygen delivery by nasal prongs, simple facemask and Venturi mask.
  • Finals May-2012 Q15 With regard to oxygen therapy for patients in a general postoperative ward Describe the options available (30%) What are the justifications for your choice for a particular patient? (70%)
  • Finals Oct-2013 Q7 Discuss the safe use of arterial tourniquets for orthopaedic procedures.
  • Finals May-2012 Q14 a. What do the terms decontamination, disinfection and sterilisation mean? (30%) b. What measures should be in place to minimise the risk of transmission of infection to the respiratory tract of patients via anaesthetic equipment? (70%)
  • Finals May-2013 Q2 Outline the features of the anaesthetic machine that ensure safe gas delivery to the patient.
  • Finals May-2011 Q13 You are involved in the planning of a new Day Surgery Unit. (a) What systems would you put in place to reduce the likelihood of a power failure? (50%) (b) Outline a protocol for dealing with power failures. (50%)
  • (Oct-2012 Q15) 1. Classify the possible causes for patient awareness under general anaesthesia (70%). 2. Evaluate the evidence for the use of Bispectral Index monitoring in reducing the risk of awareness (30%).
  • (May-2010 Q1) List the complications associated with the use of limb tourniquets during surgery. (60%) How can these complications be minimised? (40%)
  • (Apr-2009 Q1) What do the terms decontamination, disinfection and sterilisation mean? (30%) What measures should be in place to minimise the risk of transmission of infection to the respiratory tract of patients via anesthetic equipment (70%)
  • (Apr-2009 Q2) What are the essential safety requirements for delivery of gases via anaesthetic machines and their associated breathing circuits in use in Australia and New Zealand? (do not include ventilators or scavenging in your answers).
  • (Oct-2008 Q1) Outline the operating principles and safety features of a modern variable bypass out of circuit vaporiser.
  • (May-2008 Q1) Outline how oxygen is stored at the hospital and delivered to operating theatres up to and including the wall outlet. In your answer include features that ensure the safety of the system.
  • (Sep-2007 Q1) Explain the features of the electrical power supply to operating theatres that protect patients from marcoshock.
  • (May-2007 Q2) How does soda lime work? List the hazards associated with its use.
  • (May-2007 Q6) List the patterns of peripheral nerve stimulation that may be used to monitor non-depolarising neuromuscular blockade during anaesthesia and describe how each is used in clinical practice.
  • (May-2007 Q9) The T-Piece is obsolete in modern anaesthesia practice. Discuss.
  • (May-2005 Q6) Compare the use of a pulmonary artery catheter and transoesophageal echocardiography in evaluating cardiac function intraoperatively.
  • (May-2005 Q8) Draw a circle breathing system and give reasons for the location of the components.
  • (May-2005 Q15) Discuss the advantages and disadvantages of intra-operative blood salvage
  • (Sep-2004 Q6) What are the considerations in setting the fresh gas flow rate when anaesthetising an adult with sevoflurane and nitrous oxide using a circle absorber system?
  • (Sep-2004 Q15) Describe the function of the anaesthetic circuit shown in the diagram (Mapleson F - Jackson-Reece modification of the Ayers t piece)
  • (May-2004 Q15) "Use of bis or other similar monitor should be the standard of care during total intravenous anaesthesia". Discuss this statement.
  • (Sep-2003 Q5) What is micro-shock? Outline methods designed to prevent it occurring in the operating theatre.
  • (May-2003 Q15) Describe the features of an ideal disconnection alarm.
  • (May-2001 Q4) Discuss the advantages and disadvantages of: Directed blood donation (i.e. from a known donor to a specific recipient).
  • (Apr-2000 Q13) What are the considerations in setting the fresh gas flow rate when anaesthetising an adult with sevoflurane in nitrous oxide, oxygen being administered using a circle absorber system?
  • (Aug99) Draw a circle breathing system and give reasons for the location in the circle of the one way valves and the Adjustable Pressure Limiting valve.
  • (Aug99) What is micro-shock? Outline methods to prevent it occurring in the operating theatre.
  • (Apr99) Describe the use of a nerve stimulator to monitor neuromuscular blockade during general anaesthesia for intracranial surgery.
  • (Apr98) Describe the use of a nerve stimulator to monitor neuromuscular blockade during general anaesthesia for intracranial surgery.
  • (Jul97) Describe the safety features of a hospital oxygen supply system, from the vacuum insulated evaporator oxygen storage to an operating room outlet.
  • (Jul97) Describe the principles of measurement by which oxygen concentration in inspired gas cen be measured, where mass spectrometry is not available.
  • (Jul97) Contrast a bourdon gauge with a variable orifice flowmeter for the measurement of gas flow.
  • (Apr97) What are the hazards of using soda lime for carbon dioxide absorption?
  • (Apr97) How does pulse oximetry differ from laboratory co-oximetry performed on a blood specimen?
  • (Aug96) Describe the principles of measurement used in a volatile anaesthetic agent monitor in an operating theatre where mass spectrometry is not available.
  • (Aug96) Describe the safety features which may be incorporated in the flowmeter bank of a modern anaesthetic machine.
  • (Aug96) Explain why end-tidal CO2 tension may differ from arterial blood carbon dioxide tension.
  • (Aug96) How should a laryngeal mask airway be processed to avoid cross infection between patients.
  • (Apr96) How would you check a circle breathing system with carbon dioxide absorber, but without a mechanical ventilator, from the common gas outlet to the patient connection?

Anatomy

Finals Oct-2009 Q6 Identify the structures labeled A to H on this normal chest X-ray. (40%)
Describe the arterial blood supply and venous drainage of the myocardium. (60%)

Finals Oct-2010 Q2 (a) Describe the arterial blood supply of the spinal cord. (50%)
(b) Why is spinal cord function at risk during open repair of a thoracic aortic aneurysm and what measures are available to reduce this risk? (50%)

Finals May-2012 Q12 Describe the anatomy of the epidural space (50%) What are the clinical implications of the anatomical differences between 
thoracic and lumbar epidural spaces in the placement and management of epidural analgesia? (50%)

  • (Oct-2012 Q12) Describe the anatomy of the transversus abdominis plane relevant to regional anaesthesia (70%). List the complications associted with TAP block (30%).
  • (Apr-2009 Q10) Draw a diagram illustrating the bronchial anatomy to the level of the lobar bronchi (50%) and describe how you would use a fibreoptic bronchoscope to correctly position a R sided DLT (50%)
  • (Sep-2007 Q10) Describe the blood supply to the spinal cord. Explain the determinants of spinal cord perfusion.
  • (May-2008 Q3) Describe the anatomy of the brachial plexus relevant to performing and interscalene block under ultrasound guidance. Include a drawing of the real or sono-anatomy you would see in a transverse view of the brachial plexus at the point of needle insertion.
  • (Sep-2005 Q4) Describe the anatomy of the trigeminal nerve relevant to local anaesthesia for dental extraction.
  • (May-2005 Q3) Outline the anatomy of the right internal jugular vein as it is relevant to your preferred method of percutaneous cannulation.
  • (Sep-2004 Q8) Describe the anatomy relevant to providing an ankle block for surgery on the big toe.
  • (May-2004 Q10) Describe the anatomy relevant to a digital nerve block of the ring (4th) finger
  • (May-2003 Q4) Describe the anatomy of the ulnar nerve, relevant to supplementation of an interscalene brachial plexus block which is inadequate for an operation on the hand.
  • (Sep-2001 Q15) Describe the anatomy of the brachial plexus relevant to risks associated with the interscalene block.
  • (Apr99) Describe the anatomy of the brachial plexus relevant to risks associated with the supraclavicular block.
  • (Jul98) Describe the anatomy of the trigeminal nerve and its branches relevant to providing anaesthesia of the teeth and gums.
  • (Jul97) Describe the anatomy of the 6th intercostal space at the angle of the rib, relevant to an intercostal nerve block.
  • (Apr97) Describe the anatomy of the orbit relevant to peribulbar block for cataract extraction
  • (Apr96) Describe the anatomy relevant to an interscalene block for post-operative analgesia.

General Surgery

  • Finals Oct-2009 Q14 A patient has smoked 20 cigarettes a day for over 25 years. What are the expected physiological changes that would occur in the first 3 months following cessation of smoking? Include a time frame for the changes you describe. (60%) What are the clinical benefits, with regard to anaesthesia, of smoking cessation in this patient? (40%)
  • (Apr-2009 Q6) Describe the physiological effects of pneumoperitoneum with CO2 for laparoscopic surgery.
  • (Oct-2008 Q5) An otherwise well 60-year-old man is ahving a radical prostatectomy. list abd briefly evaluate strategies to prevent peri-operative thromboembolism.
  • (May-2005 Q2) Discuss ways in which the risk of deep venous thrombosis can be minimised in adult patients having intra-abdominal surgery.
  • (May-2004 Q4) An 85 year old female presents with a 3 day history of bowel obstruction. The duty surgeon wants to perform a laparotomy as soon as possible. Discuss the main factors determining the optimal time for anaesthesia and surgery.
  • (May-2002 Q4) A morbidly obese patient (160kg, 165cm) with sleep apnoea requiring the use of CPAP mask develops actue cholecystitis. He is febrile and sweaty, with warm peripheries. Blood pressure is 110/70. Heart rate is 110/min. He is scheduled for urgent cholecystectomy. His saturation on arrival in the operating theatre is 93% on O2 (nasal prongs 2l/min). Discuss the advantages and disadvantages of an awake intubation in this patient.
  • (May-2002 Q5) Outline the implications of this operation being performed as an open rather than a laparoscopic procedure in this patient.
  • (May-2002 Q6) Justify your plan for postoperative respiratory care of this patient following an open procedure.
  • (Aug-2000 Q13) A patient is referred to see you six weeks before her scheduled cholecystectomy. The significant features of her history and exam are: Age 42, weight 140kg, height 171cm. Medication: oral contraceptive pill. Allergies: peanuts (severe asthma); some cosmetics; penicillin (itchy rash). Smokes 60 cigs per day for 20 years. Discuss the anaesthetic related risks associated with laparoscopic as compared to open surgery in this patient.
  • (Aug-2000 Q14) What will you advise her regarding the risks of continuing to smoke prior to the operation?
  • (Apr99) A 52 yo man, height 1.75m weighing 130kg presents for laparoscopic cholecystectomy under GA. History and examination reveal no other abnormality. How does this patients obesity influence your anaesthetic management up to the time of the first incision?
  • (Apr99) Explain the physiological effects of a carbon dioxide pneumoperitoneum in this man.
  • (Apr99) Open cholecystectomy becomes necessary. The surgeon requests that you place an epidural catheter for postoperative analgesia. Outline the issues which should be considered in responding to this request.
  • (Aug96) An otherwise healthy 25 year old woman undergoes hysteroscopic endometrial ablation. After an uneventful general anaesthetic she is slow to wake in the recovery ward and becomes restless and confused. How would you diagnose the cause of this delayed recovery?
  • (Aug96) While you are assessing her, she begins to convulse. Describe your management.
  • (Aug96) Compare the pharmacology of diazepam and thiopentone, with respect to the management of the patient's convulsions.

ENT and Maxillofacial Surgery

  • Finals May-2013 Q4 a. Describe the sensory innervation of the respiratory passage from the nostrils to, and including, the vocal cords (50%). 
b. List the indications and contraindications for nasal intubation (50%).
  • Finals May-2012 Q8 A 35-year-old female is booked for thyroidectomy. Her blood results are as follows.

Thyroid stimulating hormone (TSH, thyrotropin) 0.1 Total Thyroxine (Total T4) 20 Free Thyroxine (Free T4) 4 Free Tri-iodothyronine (Free T3) 120 (N 0.3 – 3 mIU/l) (N 4 – 11 μg/dl) (N 0.7 – 1.8 ng/dl) (N 60 – 175 ng/dl) Interpret the thyroid function tests (10%) Justify when you would proceed to thyroidectomy in this patient (50%) What is the management of an intraoperative thyrotoxic crisis? (40%)

  • (Oct-2012 Q13) Discuss the key areas of concern in your preoperative assessment of a patient for excision of a large tonsillar mass.
  • (Apr-2009 Q12) Describe your management of a patient who has had a total thyroidectomy who develops respiratory distress in the recovery room.
  • (May-2008 Q9) A 25 yo man is to have laser surgery for a vocal cord papilloma. What are the hazards associated with the use of laser in this situation and how can they be minimsed?
  • (Sep-2004 Q10) Justify the use of a laryngeal mask airway in a 25 yo, 80kg man having general anaesthesia for removal of 4 molar teeth.
  • (Sep-2003 Q13) How can recurrent laryngeal nerve function be assessed in the postoperative period?
  • (Aug99) A healthy 25 you, 80kg man had general anaesthesia for the elective removal of 4 molar teeth. The anaesthetist uses a laryngeal mask airway (LMA). Justify the use of a LMA for this procedure.
  • (Aug99) Halfway through surgery, the capnograph trace becomes flat. Describe your management.
  • (Aug99) Discuss methods of postoperative analgesia for this surgery.
  • (Apr99) A 55 yo adult is to have nasal polypectomy under general anaesthesia. The patient has nocturnal oesophageal reflux and extensive fixed uppper dental prostheses. How would you reduce the risk of perioperative dental damage?
  • (Apr99) How can problems associated with the use of vasoconstrictors in nasal surgery be prevented?
  • (Apr99) Describe the management of systemic toxicity resulting from the use of vasoconstrictors in nasal surgery.
  • (Apr98) An obese 40 yo man with a history of snoring presents for septoplasty and cautery of turbinates. At the pre-anaesthetic consultation, what clinical features on history and examination would suggest to you that he may have sleep apnoea?
  • (Apr98) Discuss your plan for intra-operative airway management for this patient.
  • (Apr98) How would sleep apnoea influence your post operative management including provision of analgesia?

Continued on next page

The following topics are now on page 2:

Trauma

Go to Finals SAQ-page 2

Thoracic Surgery

Go to Finals SAQ-page 2

Eye Surgery

Go to Finals SAQ-page 2

Regional Anaesthesia

Go to Finals SAQ-page 2

Professional Issues

Go to Finals SAQ-page 2

Complications of Anaesthesia

Go to Finals SAQ-page 2

Airway Management

Go to Finals SAQ-page 2

Cardiology

Go to Finals SAQ-page 2

Infection and Antibiotics

Go to Finals SAQ-page 2

Allergy and Anaphylaxis

Go to Finals SAQ-page 2

Psychiatry

Go to Finals SAQ-page 2

Pain

Go to Finals SAQ-page 2

Pharmacology

Go to Finals SAQ-page 2

Statistics

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Medicine

see page 2

Environmental Hazards

Go to Finals SAQ-page 2

Day Surgery

Go to Finals SAQ-page 2

Intensive Care and Resuscitation

Go to Finals SAQ-page 2

Pre-operative Assessment

Go to Finals SAQ-page 2


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