ANZCA Part 2 MCQs - 2015

A young man has removed his buprenorphine patch on the morning of surgery. How long will it be before his plasma level reaches half its original level?

A young man has removed his fentanyl patch on the morning of surgery. How long will it be before his plasma level reaches half its original level?

A 58 year old with a solitary hepatic metastasis from colon cancer is scheduled for a resection of a right lobe of liver. In order to manage the risk of intra-operative haemorrhage, it is most important to maintain:

An 80 year old man is having a transuretheral bladder resection. The surgeon is using diathermy close to the lateral bladder wall which results in patient thigh adduction. The nerve involved is:

In Conn's syndrome, the usual derangement is

A 60 year old woman is admitted to hospital with a subarachnoid haemorrhage. Her GCS is 11 and her blood pressure is 175/110 mmHg. She is administered oral nimodipine. The main reason for this treatment is:

You are the anaesthetist at a Caesarean Section for a 36/40 gestation pregnancy. The baby at birth is floppy and apnoeic. You decide that positive pressure ventilation via mask is necessary. The recommended FiO2 is:

You are inducing a 20-year-old female who has an IV cannula in her antecubital fossa which was inserted in the emergency department. She complains of pain after 10mL of propofol and it becomes clear that cannula is intraarterial. The best management option is:

When is it necessary to use glycine as irrigation fluid for TURP?

A 69 yo man is brought into ED by ambulance with a compound fracture of his forearm from an unwitnessed fall. Has a history of schizophrenia and depression with uncertain medication compliance. He is confused and agitated with generalised rigidity but no hyperreflexia. Obs - HR 120, BP 160/90, RR 18, Sats 98 Temp 38.8 Likely Dx?

With surgical bleeding, the first clotting factor to reach a critical level is

Anaesthetic and respirable gas supplies to wall outlets in the operating theatre is at pressures of

The most useful sign to distinguish between severe serotonin syndrome and malignant hyperthermia are

A patient is having a laparotomy, who has been on prednisolone for 6 months at 10mg/day. What is the equivalent dose of dexamethasone?

A 20kg child has just had a caudal block but immediately has a VF arrest and is non-responsive to usual treatments. What dose of intralipid 20% would you give?

An epidural for labour is placed. She then has a headache postpartum. Which of the following is inconsistent with a post-dural puncture headache.

An eclamptic patient is given IV Magnesium. Which of these symptoms is often associated with magnesium administration?

The clinical sign that a lay person should use to decide whether to start CPR is:

What is the maintenance fluid rate for a 15kg child?

Patient's K+ is 7.0 what is the best initial management?

Which patients require antibiotic prophylaxis?

A 63 yo lady has a difficult thyroidectomy for cancer. Immediately post extubation she develops stridor and respiratory distress.

A 23 yo has a traumatic brain injury. Which fluid is relatively contraindicated?

A 53 year old smoker presents for a laparotomy. PFT results are:

FEV1 and FVC - both reduced
FEV1/FVC 98%
TLC, RV, DLCO 8 (30% of predicted)

What is the cause?

A Traumatic Brain Injury patient has a cerebral angiogram that shows:

Cerebral perfusion = 15mL/100g/min,
Cerebral oxygen consumption = 3.5mL/100g/min.

This is consistent with:

Absolute contraindication to ECT:

FFP is given to a patient to treat hypofibrinogenaemia. The volume required to raise the fibrinogen by 1g/L is

The diluted thrombin time measures the anticoagulant activity of:

In a trauma patient the main mechanism by which hypothermia exacerbates bleeding is by

A patient having a liver resection suffers a haemodynamically significant venous air embolism. During resuscitation how do you best position the patient?

In a normal adult what amount of IV potassium chloride is needed to raise the serum potassium from 2.8 to 3.8mmol/L?

In a haemodynamically stable 20 year old man with blunt chest trauma, the best screening test to diagnose cardiac injury requiring treatment is:

With regards to medical ethics, the concept of fidelity involves:

What is the correct position for the tip of a PICC in a child?

According to the ANZCA endorsed guidelines, what is the correct colour for the label for a subcutaneous ketamine infusion?

Prior to nasal intubation you spray Lignocaine/Phenylephrine preparation (CoPhenylcaine) into the nose. Some lands in the eye. What happens?

You trial a new drug to prevent PONV. It is 50% more effective than the current drug. Four percent of people still experience PONV with the new drug. How many people need to receive the new drug in place of the current drug to have one person less suffering from PONV?

What does a white cylinder with a grey coloured shoulder/neck contain?

The best solution to ensure asepsis prior to neuraxial anaesthesia is:

You are anaesthetising a 25 year male for an open appendicectomy. He has a Fontans circulation on a background of tricuspid atresia. The best strategy to manage his ventilation intraoperatively would be:

You are anaesthetising a 70 year old woman for a CABG with a pulmonary artery catheter in situ. After separation from bypass you notice frank, copious blood rising in the endotracheal tube. Your immediate action should be to:

Consider the following arterial blood gases. (Ref ranges in brackets)
-pH 7.28
-PaCO2 36
-Bicarbonate 18 mmol.l-1 (18-25)
-Base excess -7 mmol.l-1 (-4- +3)
-Na+ 142 mmol.l-1 (135-145)
-Cl- 112 mmol.l-1 (98-110)
These blood gases are consistent with:

A 30 year old woman is admitted to ICU after a 500mg/kg aspirin overdose. What is the most effective therapy to enhance her elimination of the aspirin?

MELD score: INR, Cr, Na, and

Endovascular coiling of cerebral aneurysm under GA, patient suddenly develop hypertension. What is the most likely cause?

A 70 year old is is intubated and ventilated post-laparotomy. He has CSL running @60ml/hr, with an NGT on suction with continuing high output. His ABG shows an appropriate pO2, pCO2 32, pH 7.66, Na 144, K 3.5, Cl 76. He has a normal creatinine and raised urea. How should you improve his acid base status? (Had a very very very long stem, with very long answers, but this was the gist, and I'm pretty confident with the answers except the first 2 fluid options).

What is the most sensitive monitor for detecting a venous air embolus during neuroanaesthesia?