ANZCA Final Exam Resources
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Anaesthetic Viva
Crises
Viva Crises
Group
Crisis or Problem
Completed Stems
General Stem
Cardiac Stem
Obstetric Stem
Airway Stem
Paediatric Stem
Trauma Stem
Pain/Regional Stem
Neuro Stem
Question 1
Question 2
Question 3
Proposed Structure
Airway + Breathing
16
a CICO scenario
1
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What will you do?
Attempts at securing the airway from the mouth fail and the SpO2 continues to fall. What will you do now?
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a high risk extubation
1
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Outline your approach to this situation.
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a pneumothorax
0
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a tracheobronchial injury
0
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a tracheostomy disaster
1
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How do you manage this situation?
What are the possible causes of obstructed tracheostomy ventilation?
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acute pulmonary oedema
0
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acute severe asthma
1
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What will you do?
What is the management pathway for acute severe asthma?
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an acute exacerbation of COPD
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an airway disaster on the ward
1
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How will you manage this situation?
What is your general approach to the management of an airway disaster on the ward?
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an airway fire
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an inhalational injury
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flail chest
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massive haemoptysis
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perioperative aspiration
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respiratory arrest
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severe bronchospasm
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Circulation
26
a fat embolism
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a gas embolism
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a tension pneumothorax
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a traumatic aortic disruption
1
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Describe your management of this situation
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acute myocardial ischaemia
1
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What will you do?
What are the potential causes of myocardial ischaemia intraoperatively?
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an acute aortic dissection
1
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How would you manage this situation?
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an intra-arterial injection
0
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cardiac arrest
0
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cardiac tamponade
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coagulopathy in association with trauma or surgery
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hypercalcaemia
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hyperglycaemia
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hyperkalaemia
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hypermagnesaemia
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hypernatraemia
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hypocalcaemia
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hypoglycaemia
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hypokalaemia
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hypomagnesaemia
0
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hyponatraemia and hypoosmolality
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life-threatening bradycardia
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life-threatening tachycardia
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metabolic acidosis
0
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myocardial contusion
1
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How will you manage this patient?
What are the potential complications of a myocardial contusion?
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pulmonary embolism
0
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shock
0
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Disability
3
acute intracranial/subarachnoid haemorrhage
1
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How will you manage this patient?
What are your haemodynamic targets in a patient with an acute subarachnoid haemorrhage?
What are the possible immediate complications of an acute subarachnoid haemorrhage?
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acute spinal cord injury/neurogenic shock
1
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How will you manage this patient?
What are the principles of management for patients with acute spinal cord injury?
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acute traumatic brain injury
0
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Intraoperative
10
bradycardia
3
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What do you do?
What are the potential causes of this patient’s bradycardia?
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dyspnoea
3
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What do you do?
What are the possible causes of dyspnoea in this patient?
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high airway pressures
1
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What do you do?
What are the possible causes of high airway pressures in this patient?
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hypercapnia
1
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How do you manage this?
What are the possible causes of hypercapnia in this patient?
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hypertension
2
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What do you do?
What are the potential causes of hypertension in this patient?
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hypocapnia
1
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What would you do in this circumstance?
What are the possible causes of hypocapnia in this patient?
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hypotension
1
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What do you do?
What are the potential causes of hypotension in this patient?
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hypoxia
1
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What do you do?
What are the potential causes of hypoxia in this patient?
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oliguria/anuria
1
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How do you approach this problem?
What are the possible causes of oliguria or anuria in this patient?
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tachycardia
1
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How do you respond?
What are the possible causes of tachycardia in this patient?
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Recovery
13
airway compromise
1
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How would you manage this situation?
What are the potential causes of airway compromise in this patient?
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altered postoperative mental state
1
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How will you manage this situation?
What are the possible causes of this patient’s altered postoperative mental state?
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delirium
0
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emergence delirium
1
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How will you manage this situation?
What are risk factors for emergence delirium?
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failure to wake from anaesthesia
1
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hypertension
0
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hypotension
0
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hypoxia
0
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nausea and vomiting
0
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oliguria
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severe postoperative pain
0
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shock
0
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tachycardia
0
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Obstetric
14
abnormal placental implantation
1
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How will you approach this situation?
What are the considerations in a patient with placenta accreta syndrome?
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amniotic fluid embolism
0
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antepartum haemorrhage
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breech presentation
0
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cord prolapse
0
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eclampsia
0
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foetal death in utero
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maternal collapse
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neonatal resuscitation
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postpartum haemorrhage
1
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What do you do?
What are the possible causes of postpartum haemorrhage?
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premature labour
0
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shoulder dystocia
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uterine rupture
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vaginal birth after caesarean (VBAC)
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Other
17
a breathing circuit malfunction (stuck valve, massive leak)
1
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How do you manage this situation?
It becomes apparent that one of the valves inside the anaesthetic machine has become stuck. What do you do?
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a crush injury
0
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a high spinal
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a hyperosmolar, hyperglycaemic state
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a hypoosmolar state
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a pericardial effusion in the context of malignancy
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abdominal sepsis
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accidental awareness under anaesthesia
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acute cord compression in the context of malignancy
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acute drug intoxication
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acute pancreatitis
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altitude sickness
0
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an Addisonian crisis
0
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an anaesthesia machine/ventilator malfunction
0
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an ischaemic/haemorrhagic stroke
0
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an operating room fire
0
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envenomation
2
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How would you manage this situation?
What are the principles of management for an envenomation injury?
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