ANZCA Final Exam Resources
ANZCA Final Exam Resources
Past Questions

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MCQs

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Past MCQs
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146
A patient who underwent a thoractomy 6 months ago reports ongoing pain caused by light brushing of clothes against the skin on the chest wall. This is known as
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According to Australian and New Zealand Committee on Resuscitation (ANZCOR) guidelines, during advanced life support for ventricular fibrillation, adrenaline 1mg should be administered
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The Sequential Organ Failure Assessment (SOFA) score is used in intensive care for the assesment of sepsis. This score does NOT include the
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In an adult patient with reduced mouth opening, insertion of a classic design LMA may be easier than with other supraglottic airways because of its
Open
You are asked to assess a patient in the intensive care unit who has a tracheostomy that may have become dislodged. To assess if the tracheostomy is patent you should NOT
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Albumin is contraindicated in
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A bleeding patient has ROTEM results including (ROTEM results shown). The most appropriate treatment is
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A 56-year-old patient presents with exertional syncope. The most likely diagnosis is
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The shoulder joint receives sensory innervation from all of the following nerves EXCEPT the
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The most likely diagnosis for the following electrocardiograph is
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The nerve labelled with an arrow in the diagram below (diagram of lumbar plexus shown) is the
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A pregnant woman requires a caesarean section delivery within 30 minutes for fetal distress. Her body mass index (BMI) is 26 kg/m2. She has multiple sclerosis with lesions in her brain and spinal cord and receives monthly injections of the disease-modifying drug ofatumumab. The most appropriate plan for her delivery is
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The needle whose tip is pictured is a
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Patients with rheumatoid arthritis and the most common form of atlantoaxial instability have a widened atlantodental interval. This is measured between the
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Abdominal compartment syndrome is defined by the presence of end-organ dysfunction with a lower limit of abdominal pressure measured at
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Pulmonary hypertension is defined as a mean pulmonary arterial pressure greater than
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Of the following, the patient characteristic associated with an increased risk of developing severe bone cement implantation syndrome is
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An inappropriate irrigation solution when using monopolar diathermy during transurethral resection of prostate would be
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The technique of airway pressure release ventilation
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The modified Aldrete scoring system uses all of the following EXCEPT the
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The ventilator waveforms shown represent
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An absolute contraindication to transoesophageal echocardiography is
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According to the ATACAS trial, the continuation of low-dose aspirin prior to cardiac surgery is associated, in the postoperative period, with
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A 43-year-old man is undergoing an elective endovascular coiling procedure for an 8 mm middle cerebral artery aneurysm. Midway through the procedure the interventionalist tells you they have ruptured the aneurysm. All of the following are appropriate initial interventions EXCEPT
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A patient will open her eyes in response to voice, speak with inappropriate words and withdraw to a painful stimulus. Her Glascow Coma Scale score is
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Intravenous dexmedetomidine use does NOT result in
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The risk of developing postherpetic neuralgia may be reduced by treating acute herpes zoster (shingles) with
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Rapid reversal of the anticoagulant effect of dabigatran can be achieved with
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The muscle or muscle group with the greatest sensitivity to the action of non-depolarising neuromuscular blocking agents is/are the
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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
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Based on this tracing (single ECG lead shown), the mode in which this pacemaker is operating is
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Elimination of remifentanil occurs following breakdown mainly by
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A patient who has had a previous axillary nodal dissection and who does not have lymphoedema of the affected arm presents for surgery. On the affected arm
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Synchronised direct current cardioversion is NOT indicated when the arrhythmia is
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In a 20-year-old with cystic fibrosis, the most likely finding on pulmonary function tests is
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Dulaglutide reduces blood glucose by
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Ongoing cerebral seizure activity induced by electroconvulsive therapy should be medically terminated after
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Characteristics of post-operative visual loss due to vertebrobasilar ischaemia include
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The odds ratio is the measure of choice for a
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The diagnostic criterion for severe obstructive sleep apnoea in adults is an apnoea/hypopnoea index of at least
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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
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In a cardiac transplant recipient, hypotension due to general anaesthesia is least likely to respond to
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When the infraclavicular approach is used, the brachial plexus is blocked at the level of the
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A patient’s glomerular filtration rate is estimated at 35 mL/min/1.73m2. The patient’s chronic kidney disease can be classified as Stage
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Maintaining a CO2 pneumoperitoneum at a pressure of 15 mmHg is most likely to lead to
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The Myocardial Injury after Non Cardiac Surgery study showed elevated troponin in the first three post-operative days was strongly associated with
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The National Audit Project 6 found that the most common early clinical feature of perioperative anaphylaxis was
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You are inducing anaesthesia in a 20-year-old female through a cannula which was inserted in the right antecubital fossa while she was in the emergency department. After 10 ml of propofol has been injected, she complains of severe pain and it becomes clear that the cannula is intra-arterial. The most appropriate management is
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A patient with a history of restless leg syndrome is agitated in the post-anaesthesia care unit. After excluding other causes, the best treatment of the agitation in this patient is
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A man with a history of obesity and obstructive sleep apnoea has just had a transsphenoidal pituitary resection. Soon after extubation he is semi-conscious and is making a respiratory effort but has near complete upper airway obstruction with stridor. His arterial oxygen saturation is 93% and starting to fall. Your first actions should be to
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Measures to avoid venous air embolism when inserting an internal jugular central venous catheter in an awake patient include all of the following EXCEPT
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Diffusing capacity of the lungs for carbon monoxide (DLCO) is decreased in all of the following EXCEPT
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A patient who is day 3 post laparotomy has used 30 mg oxycodone intravenously via patient controlled analgesia in the last 24 hours. The approximate oral morphine equivalent daily dose is
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The recommended dose of IV adrenaline in a 15 kg, 5 year old child with grade 2 (moderate) perioperative anaphylaxis is
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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
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The success rate of stopping smoking before surgery is NOT improved by
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The condition for which you would have a lower arterial oxygen saturation target is
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In the thigh, the adductor canal is bordered by all of the following EXCEPT
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When performing cannulation of the median cubital vein the structure that is LEAST likely to be inadvertently punctured or damaged is the
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A patient has severe hypokalaemia and is in cardiac arrest. The Australian Resuscitation Council and the New Zealand Resuscitation Council recommend intravenous potassium should be given as
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You wish to place the tip of a central venous line at the cavo-atrial junction in an adult, which on a chest X-ray is at a level
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In the POISE study the use of beta blockers on the day of surgery as a cardio protective strategy in high risk patients has been associated with
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Following denervation injury to muscles, critical hyperkalaemia associated with suxamethonium administration can occur as early as
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A 25-year-old man suffers a burn involving 30% of his total body surface area. A cardiovascular physiological change expected within the first twenty-four hours is
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For an adult patient with septic shock, the 2021 Surviving Sepsis Guidelines suggest using procalcitonin to guide
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ANZCA guidelines recommend that under general anaesthesia, blood pressure should be measured no less frequently than every
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Suxamethonium is safe to use for muscle relaxation in a patient with
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The changes in oximetry seen after intravenous injection of indocyanine green are
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Regarding cardiopulmonary exercise testing before major surgery, oxygen pulse is the
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Appropriate surgical anaesthesia with sevoflurane is characterized by a frontal EEG showing
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The medical laser LEAST likely to cause eye injury is
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The smallest endotracheal tube that can be railroaded over an Aintree Intubation Catheter has an internal diameter of
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When performing an erector spinae block in the lumbar region local anaesthetic should be placed
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The drug that is LEAST likely to decrease blood flow to the splanchnic circulation is
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A randomised control trial is performed on a new antiemetic medication. The rate of nausea in the placebo group is 20% and in the treatment group the rate is 5%. The number needed to treat to prevent nausea with this new drug is
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The cardiac arrhythmia most commonly associated with the chronic use of methadone is
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A patient is dyspnoeic in the post anaesthesia care unit with oxygen saturations of 94% on 10 litres/min oxygen via face mask. A focused lung ultrasound is performed. The structures labelled with the white arrows represent
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The maintenance anaesthetic technique that has the lowest environmental impact from greenhouse gas is
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Cryoprecipitate is a concentrated source of all the following EXCEPT
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With regard to Donation after Circulatory Determination of Death (DCDD), the maximum acceptable time from withdrawal of cardio-respiratory support to cold perfusion for liver donation is
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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
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When commencing treatment of proximal deep vein thrombosis or pulmonary embolus, factor Xa inhibitors (apixaban, rivaroxaban) are preferred to dabigatran or warfarin because they do not require
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A patient with a history of hereditary angioedema presents to the emergency department with difficulty with breathing, abdominal pain and swelling of the face, hands and feet. The most effective therapy for managing this is
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A thoracic regional technique that will NOT provide analgesia for sternal fractures is a
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Drug classes demonstrated to reduce mortality in chronic heart failure with reduced ejection fraction include all of the following EXCEPT
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In the three-bottle chest drainage system set up shown, the maximum suction pressure (cmH2O) generated inside the underwater seal bottle would be minus
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Somatic pain in the second stage of labour is NOT transmitted via the
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Despite two separate 300 IU/kg doses of heparin, you have failed to attain your target activated clotting time prior to instituting cardiopulmonary bypass. An appropriate option now would be to give
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During a thyroidectomy, the surgeon is concerned the parathyroid glands have been devascularised. From the time of potential damage, a serum calcium level should be checked in
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A 35-year-old woman is brought to the emergency department following a suspected amitriptyline overdose. She has a Glasgow Coma Scale score of 6 and her blood pressure is 90/46 mmHg. Her electrocardiogram is most likely to show
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A patient with a perioperative troponin rise above the upper limit of normal, chest pain, left ventricular anterior regional wall motion abnormality, and atheroma with a partially occluding thrombus of the left anterior descending coronary artery has had a/an
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A patient requires elective surgery under general anaesthesia with neuromuscular relaxation. The recommended preoperative management of donepezil is to
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Cyclooxygenase type 2 inhibitors (COX-2) in pregnancy are considered
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A 75 year-old patient is given a Fleet® sodium phosphate enema prior to a colonoscopy. The hyperphosphataemia from the laxative can directly cause
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The electrolyte abnormality most associated with an increased risk of laryngospasm is
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The QRS axis of the attached electrocardiograph is closest to
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An anaesthetic drug that is safe to use for a patient with porphyria is
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A patient has received high dose hydroxycobalamin for refractory vasoplegia post cardiac surgery. Observed effects include all of the following EXCEPT
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The bioavailability of an oral dose of ketamine is approximately
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A venturi mask delivers a fraction of inspired oxygen of 0.28 at the recommended fresh gas flow rate of 6 litres per minute. Increasing the flow rate to 12 litres per minute will deliver a fraction of inspired oxygen of
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An inverted u wave is an electrocardiographic sign of
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The use of direct oral anticoagulants [DOAC] in atrial fibrillation is contraindicated in the presence of
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A 30 year old parturient presents in labour. She has a history of Addison's disease from autoimmune adrenalitis and has been taking prednisolone 6 mg daily for ten years. On presentation the patient is given hydrocortisone 100 mg intravenously. The most appropriate steroid replacement regime the patient should receive during labour is
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One metabolic equivalent (MET) is equal to
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A 64 year old man presenting for elective surgery is on thyroxine 100 mcg daily. His thyroid function tests are: (test results shown) These results are most consistent with
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A 42-year-old female is admitted with subarachnoid haemorrhage. She has a severe headache, has eyes open spontaneously, and is confused but is obeying commands. She is unable to move her left side. The World Federation of Neurological Surgeons grade is
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Hepatopulmonary syndrome can be treated with
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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
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The most effective treatment for pain following wisdom teeth extraction as a single oral dose is
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The maximum recommended cuff inflation pressure for the classic LMA is
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You have induced a 20-year-old male for appendicectomy with propofol, fentanyl and suxamethonium. You are maintaining anaesthesia with oxygen, air and sevoflurane. His heart rate has climbed to 150 /minute, the ETCO2 is 50 mmHg and his temperature is 40°C. After turning off the sevoflurane, you should
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When using the ECG to time intra-aortic balloon counterpulsation, balloon deflation should occur at the
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Individuals with Prader-Willi syndrome having an anaesthetic are at most risk of
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Cross clamping of the descending aorta is NOT expected to cause
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Of the following, the LEAST likely to occur during one-lung ventilation in the lateral decubitus position is
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Refeeding syndrome following the commencement of total parenteral nutrition is associated with the development of
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The peak effect of intravenous insulin on serum potassium when treating hyperkalaemia occurs at approximately
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A relative contraindication to a peribulbar needle technique for cataract surgery is
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This arterial blood gas is consistent with a diagnosis of
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Assuming a blood volume of 70 ml/kg, a massive transfusion in a 20 kg, 5-year-old child is defined as a three-hour packed red blood cell (PRBC) transfusion volume of
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According to the Association of Anaesthetists of Great Britain and Ireland (AAGBI) guidelines, an acceptable reason to delay surgery in a patient with a fractured neck of femur is
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Local anaesthetic blockade of the musculocutaneous nerve in the upper limb will result in weakness of
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In patients with symptomatic carotid stenosis, carotid endarterectomy can be performed within two weeks of initial symptoms if there is/are
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Of the following, the drug most likely to cause pulmonary arterial vasodilation with systemic arterial vasoconstriction when used in low doses is
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Complications of hyperbaric oxygen therapy do NOT include
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The option below which ranks these pressures from highest to lowest is (atm = atmosphere, cmH2O = centimetres of water, kPa = kilopascals, mmHg = millimetres of mercury, psi = pounds per square inch)
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A patient taking tranylcypromine, a monoamine oxidase inhibitor, requires elective surgery. The best management is to
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A 25-year-old woman is administered two doses of aprepitant for postoperative nausea and vomiting after a sleeve gastrectomy. She normally takes the oral contraceptive pill. You should advise her to use alternative contraception for the next
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A four-year-old boy with a history of waddling gait, larger than normal calves and frequent falls receives a spontaneously breathing volatile-based anaesthetic with sevoflurane. One hour into the case he develops peaked T waves and then the end-tidal CO2 begins to rise. The most appropriate immediate treatment is to
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Jet ventilation for shared airway surgery is traditionally delivered at pressures in atmospheres (atm) of
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A 46-year-old woman with menorrhagia is booked for abdominal hysterectomy. Her preoperative bloods show (electrolyte results shown) The most likely reason for these findings is
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The BALANCED Anaesthesia Study compared older patients having deep anaesthesia (bispectral index target of 35) to lighter anaesthesia (bispectral index target of 50). It assessed postoperative mortality and a substudy assessed postoperative delirium. These showed that, compared to light anaesthesia, deep anaesthesia causes
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A 58-year-old man with ischaemic cardiomyopathy is undergoing a ventricular tachycardia ablation procedure in the catheter laboratory. Partway through the procedure his systolic blood pressure abruptly falls from 110 mmHg to 50 mmHg. The most likely cause for his hypotension is
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A 25-year-old male has continued post operative 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 (test results shown). The most likely diagnosis is
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The coronary artery most likely occluded in this ECG of an acute ST-elevation myocardial infarction is the
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According to the Fourth Consensus Guidelines for the Management of Post-operative Nausea and Vomiting (PONV) published in 2020, multimodal PONV prophylaxis should be implemented in adult patients
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The most appropriate initial diagnostic test for a suspected phaeochromocytoma is a/an
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An adult patient is administered a target controlled propofol infusion for more than 30 minutes with a constant effect-site target of 4 mcg/ml propofol plasma concentration. Compared to the Schnider model, the propofol dose given by the Eleveld model will be a
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A 4 week old full term neonate with an inguinal hernia, who is otherwise healthy, has an ASA (American Society of Anesthesiologists) classification of at least
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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
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This patient has been requested to look straight ahead. He is suffering from a right (photo of eyes with divergent gaze shown)
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A baby is brought to the emergency department three days after a term home birth. It has not been feeding well and has had few wet nappies. The child is grey in appearance and femoral pulses are difficult to palpate. You note an enlarged liver and marked tachycardia. Pulse oximetry reveals saturations of 75% despite oxygen being administered. You suspect a duct-dependent circulation. The best initial management is
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A woman with atrial fibrillation has no valvular heart disease. According to AHA guidelines, oral anticoagulants are definitely recommended if her CHA2DS2-VASc score is greater than or equal to
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The antiemetic least likely to precipitate an arrhythmia in a patient with this ECG is
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The CRASH-2 trial showed tranexamic acid administration to trauma victims results in a reduction in
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Of the following, the lowest level at which neurogenic shock is likely if an acute spinal cordinjury were to occur at that level is
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144
One metabolic equivalent (1 MET) is defined as the
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A Laser-Flex tube has a double cuff with two separate pilot balloons. The correct colours of the pilot balloons are that
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The initial treatment of a trigeminocardiac reflex during skull base surgery should be
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You have diagnosed malignant hyperthermia in a person weighing 80 kg. Australian and New Zealand guidelines recommend an initial dose of dantrolene (Dantrium) of
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In order to provide anaesthesia of the scalp for awake craniotomy, it is necessary to block branches of the
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The parameter that changes most with increasing age in the otherwise normal lung is the
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You are called to an airway emergency in the intensive care unit. A 40-year-old woman with morbid obesity and pneumonia had an elective percutaneous tracheostomy inserted eight hours previously. She is sedated, paralysed and ventilated. After being turned for pressure care, she desaturates and there is no clear CO2 trace on capnography. The tracheostomy tube is still in the neck but you are concerned it has been displaced. Your immediate management should be to
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In patients without other comorbidities, bariatric weight loss surgery is indicated when the body mass index (kg/m2) is greater than
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A patient with long-term severe anorexia nervosa is commenced on a normal diet. Three days later she develops cardiac failure and exhibits a decreased level of consciousness. The most important parameter to assay and normalise is the plasma
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A 69-year-old man is dyspnoeic and complains of right shoulder tip pain whilst in the postanaesthesia care unit after a laparoscopic-assisted anterior resection. A focused thoracic ultrasound is performed and an image of the right lung is shown below. This represents
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Rotational thromboelastometry (ROTEM) is performed on a bleeding patient with the following series of graphs produced. The most appropriate therapy to be administered is
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A 50-year-old man presents with a subarachnoid haemorrhage. He undergoes cerebral angiography and the frontal view is shown below. His cerebral aneurysm is in the
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A patient with idiopathic pulmonary hypertension has had a right heart catheter with the following results. The transpulmonary gradient is
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Desufflation after surgical pneumoperitoneum is NOT associated with an increase in
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A woman is having a potentially curative primary breast cancer resection. Compared with a sevoflurane and opioid technique, using a regional anaesthesia-analgesia technique with paravertebral block and a propofol infusion will result in
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The main advantage of using noradrenaline (norepinephrine) over phenylephrine for the prevention of hypotension as a result of spinal anaesthesia for elective caesarean section is
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A feature of citrate toxicity following massive blood transfusion is
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Features of hypocalcaemia include all of the following EXCEPT
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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 μg/mL propofol. Compared to the Marsh model, the propofol dose given by the Schnider model will be a
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You are called to assist in the resuscitation of a 75-year-old patient in the emergency department who is in extremis with severe hypotension and hypoxaemia. The image shown is of a focused transthoracic echocardiogram, parasternal short axis view. The most likely diagnosis is
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In subarachnoid block for caesarean section, hyperbaric local anaesthetic compared to regular local anaesthetic has been shown to reduce the
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Pulse pressure variation is defined as
Open
The BALANCED Anaesthesia Study compared older patients having deep anaesthesia (bispectral index target of 35) to lighter anaesthesia (bispectral index target of 50). It assessed postoperative mortality, and a substudy assessed postoperative delirium. These showed that, compared to light anaesthesia, deep anaesthesia causes
Open
According to National Audit Project (NAP) 5, the incidence of awareness during general anaesthesia for lower segment caesarean section should be quoted as
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A 75-year-old man has this right heart catheter trace as part of his investigation of dyspnoea. His pulmonary capillary wedge pressure is 24 mmHg. The most likely diagnosis is
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According to the ANZICS Statement on Death and Organ Donation (2021), for the diagnosis of brain death after resuscitation and return of circulation following cardiorespiratory arrest, clinical testing should be delayed for at least
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The glossopharyngeal nerve does NOT supply sensory innervation to the
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The following pressure-volume loop is displayed on your ventilator screen. The shape of this loop indicates
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A patient has an acute attack of shingles (herpes zoster). The development of post- herpetic neuralgia can best be reduced by the administration of
Open
An otherwise healthy child with a history of leukaemia four years ago, now in remission, has an American Society of Anesthesiologists (ASA) classification of at least
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The Sequential Organ Failure Assessment (SOFA) score is used in intensive care for the assessment of sepsis. This score does NOT include the
Open
Causes of exhaled carbon dioxide detection following oesophageal intubation include all of the following EXCEPT
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Double sequential external defibrillation is performed by applying two shocks from
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Diagnostic criteria for adult systemic inflammatory response syndrome include all of the following EXCEPT
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Cerebral salt wasting and syndrome of inappropriate antidiuretic hormone secretion (SIADH) have the following common features EXCEPT for
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This Doppler trace obtained by transoesophageal echocardiography of the descending aorta suggests
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According to Australian and New Zealand Anaesthetic Allergy Group (ANZAAG) anaphylaxis guidelines for adults, cardiopulmonary resuscitation should commence at a systolic blood pressure of less than
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To assist with guiding intravenous fluid resuscitation in adults with sepsis or septic shock, the 2021 Surviving Sepsis Guidelines suggest using any of the following EXCEPT
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Findings associated with massive pericardial tamponade include
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A patient will open her eyes in response to voice, speak with inappropriate words and withdraw to a painful stimulus. Her Glasgow Coma Scale score is
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The nerve labelled with the arrow in the diagram is the (diagram of the brachial plexus shown)
Open
Burns sustained from electrocardiography equipment during magnetic resonance imaging (MRI) scanning are minimised by
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Despite two separate 300 IU/kg doses of heparin, you have failed to attain your target activated clotting time prior to instituting cardiopulmonary bypass. An appropriate option now would be to give
Open
A patient is suffering an acute myocardial infarction. Australian and New Zealand guidelines recommend the threshold for the use of supplemental oxygen is when the SpO2 falls below
Open
In a 20-year-old with cystic fibrosis, the most likely finding on pulmonary function tests is
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Self-report of pain in children is usually possible by the age of
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The dose of hydrocortisone that has equivalent glucocorticoid effect to dexamethasone 8 mg is
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In preschool-aged children having tonsillectomy under general anaesthesia, delirium is more likely with the use of
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According to the Australian and New Zealand Anaesthetic Allergy Group (ANZAAG) guidelines for the investigation of a suspected anaphylactic reaction, serum tryptase should be measured at
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To provide anaesthesia to the medial malleolus, the key nerve to block is the
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The technique of airway pressure release ventilation
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Application of a pacemaker magnet to a dual-chamber implanted pacemaker would be expected to convert the operating mode to
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In children, severe sleep apnoea is suggested by an apnoea-hypopnoea index greater than
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In a patient with glucose-6-phosphate dehydrogenase deficiency (G6PD), the intravenous agent that should be avoided is
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A new antiemetic reduces the risk of postoperative vomiting by 20%. In a population with a baseline risk of postoperative vomiting of 10%, the number needed to treat is
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The odds ratio is the measure of choice for a
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According to the categorisation system used in Australia and New Zealand for prescribing medicines safely in pregnancy, category X denotes drugs which are
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A patient is undergoing a posterior spinal fusion with somatosensory evoked potential (SSEP) monitoring. Ischaemia is suggested by
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The initial management for a seizure during an awake craniotomy is
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An absolute contraindication to skin prick testing for the diagnosis of allergies is
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A 63-year-old man has undergone a right pneumonectomy for malignancy. Twelve hours postoperatively he suddenly develops profound hypotension and shock. Clinical examination reveals a raised central venous pressure. The most useful IMMEDIATE action would be to
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In cardiac surgery a low-normal central venous pressure and a low blood pressure with a hyperdynamic heart is suggestive of
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Expected features of Guillain-Barré syndrome include
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In Australia and New Zealand, the proportion of blood donors who are cytomegalovirus (CMV) seropositive is
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A 36-year-old woman sustains an injury to her left arm and presents with pain. She informs you that she experiences unpleasant intermittent and spontaneous shooting sensations in her arm. This sensation is
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The sensory supply of the external nose is provided by all of the following nerves EXCEPT the
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Of the following drugs, the LEAST suitable for managing atrial arrhythmias in a patient with a left ventricular assist device is
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A level two check of the inhalational anaesthesia delivery device does NOT include checking the
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A 30-year-old woman has her bipolar disorder well controlled with lithium therapy. The analgesic agent LEAST suitable for her is
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You are planning to extubate a patient following airway surgery. The patient has FAILED the cuff-leak test when
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Under the NEXUS criteria, requirements to clear the cervical spine of trauma patients without radiographic imaging include all of the following EXCEPT
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You are called to recovery to review an 80-year-old woman after 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 is pain-free. The most appropriate drug therapy to manage her is intravenous
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The neurosurgical registrar has telephoned about a patient with a spinal cord tumour who is on the list for tomorrow. The registrar tells you the patient has Brown-Séquard syndrome (hemisection of the spinal cord). On clinical examination, below the level of the lesion, you would expect to find all EXCEPT
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A technique which is NOT effective in providing analgesia for a sternal fracture is a
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A newborn baby is pale, limp, grimacing with stimulation, gasping weakly, and has a pulse rate of 90 beats per minute. This corresponds to an Apgar score of
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A patient’s glomerular filtration rate is estimated at 35 mL/min/1.73m2. The patient’s chronic kidney disease can be classified as Stage
Open
Patients with rheumatoid arthritis and the most common form of atlantoaxial instability have a widened atlantodental interval. This is measured between the
Open
Reviewing the below image (ultrasound image shown), in order to safely perform an erector spinae block the probe needs to be moved
Open
Suxamethonium may be safely given to patients with
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A 24-year-old man has been brought into the emergency department with a traumatic fracture of the femur. His observations are: heart rate 90 beats per minute; blood pressure 120/80 mmHg; respiratory rate 25 breaths per minute. A peripheral VENOUS blood gas sample shows a pH of 7.29. The arterial blood pH can be estimated to be
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The antiemetic action of aprepitant is via receptors for
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In a 21-year-old man with an isolated acute severe traumatic brain injury, systolic blood pressure should be maintained at a level equal to or greater than
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A patient you anaesthetised for a cervical fusion reports rapidly progressing unilateral visual loss commencing two days postoperatively. Fundoscopic examination reveals optic disc oedema. The most likely diagnosis is
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A patient requiring an elective major joint replacement has had a recent stroke. The minimum recommended duration between the stroke and surgery is
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A multitrauma patient is being managed with a resuscitative endovascular balloon occlusion device of the aorta (REBOA) as part of damage control resuscitation. The balloon has been inserted for intractable pelvic bleeding. The most appropriate location for the device placement is between the
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Therapeutic privilege is defined as
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A central venous catheter is recognised as being inadvertently placed in the common carotid artery five hours after insertion. The most appropriate management is
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The glucagon-like peptide-1 receptor (GLP-1) agonist semaglutide is associated with
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A five-year-old child weighing 25 kg is to be strictly nil by mouth overnight following a laparotomy. The most appropriate fluid prescription is
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The following is a chest X-ray from a patient complaining of dyspnoea after thoracic surgery. The diagnosis is
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A 65-year-old man with hypertension, type 2 diabetes and significant obstructive sleep apnoea on CPAP is scheduled for an abdominoperineal resection, with a high dependency unit admission planned postoperatively. He currently takes a calcium channel blocker, a sodium-glucose cotransporter 2 (SGLT2) inhibitor and metformin. ANZCA guidelines recommend withholding SGLT2 inhibitors
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A nerve that does NOT provide sensory innervation to the shoulder joint is the
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For a woman who has a history of preeclampsia in a previous pregnancy, the intervention with the best evidence for prevention of preeclampsia during future pregnancies is
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You are using intraoperative cell salvage during a high-risk caesarean section. The salvaged blood has been washed and reinfused through a leukodepletion filter. This process should remove all of the following EXCEPT
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You are performing a regional block for analgesia following knee surgery. You have an ultrasound probe scanning the anterior mid-thigh. The muscle indicated by the arrow in the ultrasound image below is the
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In patients with primary adrenal insufficiency, a markedly elevated renin is most likely due to
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A risk factor for the development of chronic postsurgical pain is having
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According to the Fourth Consensus Guidelines for the Management of Post- operative Nausea and Vomiting (PONV) published in 2020, multimodal PONV prophylaxis should be implemented in adult patients
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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 greater than 1mm thick, and no intracerebral or intraventricular blood. Her World Federation of Neurosurgical Societies (WFNS) grade of subarachnoid haemorrhage is
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ANZCA recommends that after confirmed COVID-19 infection, non-urgent elective major surgery should be delayed for a minimum of
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A 35-year-old woman is brought to the emergency department following a suspected amitriptyline overdose. She has a Glasgow Coma Scale score of 6 and her blood pressure is 90/46 mmHg. Her electrocardiogram is most likely to show
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Sacubitril use reduces the plasma levels of
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A drug that is NOT useful for the treatment of vasoplegic shock is
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A man has symptomatic carbon monoxide poisoning. His pulse oximetry (SpO2) and arterial blood gas (PaO2) would be expected to show
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A 60-year-old woman presents for thrombectomy with left lower leg ischaemia. She has not received any medications since presentation and takes none at home. The sole abnormality on laboratory testing is an activated partial thromboplastin time (APTT) of 52 seconds. The most likely cause of the raised APTT is
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A diagnosis of metabolic syndrome is NOT supported by
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The nerve most likely to be inadequately anaesthetised with an incomplete interscalene brachial plexus block is the
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A 58-year-old man with alcohol-related cirrhosis is booked to undergo a transjugular intrahepatic portosystemic shunt (TIPS) procedure. The calculation of his MELD-Na score to estimate his mortality risk requires all of the following EXCEPT
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Following the insertion of a peripherally inserted central catheter (PICC) into the cephalic vein in the upper arm, the patient complains of numbness in their forearm. It is likely that during insertion the operator has injured the
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Ongoing cerebral seizure activity induced by electroconvulsive therapy should be medically terminated after
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Of the following drugs, the LEAST likely to cause pulmonary vasodilation when used at low doses in patients with chronic pulmonary hypertension is
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According to the Revised Cardiac Risk Index, a 72-year-old male scheduled for a laparoscopic cholecystectomy with a history of hypertension, 20 pack-year history of smoking, type 2 diabetes requiring insulin and a previous stroke has a score of
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Cryoprecipitate contains coagulation factors
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Three-factor prothrombin complex concentrate reverses warfarin therapy within
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The difference between a size 5.0 microlaryngeal tube (MLT) and a standard size 5.0 endotracheal tube is that the size 5 MLT
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A third heart sound at the apex may be heard in
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Consideration for same-day discharge in an ex-premature infant after orchidopexy for undescended testis would be suitable at a minimum postmenstrual age of
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A feature that is atypical of multiple sclerosis is
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A patient with severe abdominal trauma develops acute respiratory distress syndrome. A diagnosis of abdominal compartment syndrome is confirmed if the patient also has a sustained intraabdominal pressure greater than
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The tip of an ideally-placed intra-aortic balloon catheter should lie in the