ANZCA Final Exam Resources
ANZCA Final Exam Resources
Past Questions
MCQs
Colour indicates an exact duplicate of a stem from a previous sitting (but not necessarily the same options). There are a total of unique stems from total stems ()
745
864
86.2%
Past MCQs
Exam
Stem
Research Status
Comments
2023.2
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
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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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2023.1
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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
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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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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
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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
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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)
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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
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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
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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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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
Complete
Open
You are planning to extubate a patient following airway surgery. The patient has FAILED the cuff-leak test when
Complete
Open
Under the NEXUS criteria, requirements to clear the cervical spine of trauma patients without radiographic imaging include all of the following EXCEPT
Complete
Open
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
Complete
Open
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
Complete
Open
A technique which is NOT effective in providing analgesia for a sternal fracture is a
Complete
Open
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
Complete
Open
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
Complete
Open
Patients with rheumatoid arthritis and the most common form of atlantoaxial instability have a widened atlantodental interval. This is measured between the
Complete
Open
Reviewing the below image (ultrasound image shown), in order to safely perform an erector spinae block the probe needs to be moved
Inadequate Context
Open
Suxamethonium may be safely given to patients with
Complete
Open
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
Complete
Open
The antiemetic action of aprepitant is via receptors for
Complete
Open
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
Complete
Open
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
Complete
Open
A patient requiring an elective major joint replacement has had a recent stroke. The minimum recommended duration between the stroke and surgery is
Complete
Open
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
Complete
Open
Therapeutic privilege is defined as
Complete
Open
A central venous catheter is recognised as being inadvertently placed in the common carotid artery five hours after insertion. The most appropriate management is
Complete
Open
The glucagon-like peptide-1 receptor (GLP-1) agonist semaglutide is associated with
Complete
Open
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
Complete
Open
The following is a chest X-ray from a patient complaining of dyspnoea after thoracic surgery. The diagnosis is
Complete
Open
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
Complete
Open
A nerve that does NOT provide sensory innervation to the shoulder joint is the
Complete
Open
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
Complete
Open
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
Complete
Open
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
Complete
Open
In patients with primary adrenal insufficiency, a markedly elevated renin is most likely due to
Complete
Open
A risk factor for the development of chronic postsurgical pain is having
Complete
Open
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
Complete
Open
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
Complete
Open
ANZCA recommends that after confirmed COVID-19 infection, non-urgent elective major surgery should be delayed for a minimum of
Complete
Open
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
Complete
Open
Sacubitril use reduces the plasma levels of
Complete
Open
A drug that is NOT useful for the treatment of vasoplegic shock is
Complete
Open
A man has symptomatic carbon monoxide poisoning. His pulse oximetry (SpO2) and arterial blood gas (PaO2) would be expected to show
Complete
Open
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
Complete
Open
A diagnosis of metabolic syndrome is NOT supported by
Complete
Open
The nerve most likely to be inadequately anaesthetised with an incomplete interscalene brachial plexus block is the
Complete
Open
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
Complete
Open
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
Complete
Open
Ongoing cerebral seizure activity induced by electroconvulsive therapy should be medically terminated after
Complete
Open
Of the following drugs, the LEAST likely to cause pulmonary vasodilation when used at low doses in patients with chronic pulmonary hypertension is
Complete
Open
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
Complete
Open
Cryoprecipitate contains coagulation factors
Complete
Open
Three-factor prothrombin complex concentrate reverses warfarin therapy within
Complete
Open
The difference between a size 5.0 microlaryngeal tube (MLT) and a standard size 5.0 endotracheal tube is that the size 5 MLT
Complete
Open
A third heart sound at the apex may be heard in
Complete
Open
Consideration for same-day discharge in an ex-premature infant after orchidopexy for undescended testis would be suitable at a minimum postmenstrual age of
Complete
Open
A feature that is atypical of multiple sclerosis is
Complete
Open
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
Complete
Open
The tip of an ideally-placed intra-aortic balloon catheter should lie in the
Complete
Open
Tranexamic acid is NOT useful for managing
Complete
Open
A 40-year-old woman is administered a nerve block for extraction of her right lower wisdom tooth. The nerve that should be blocked is the
Complete
Open
An adult patient undergoing surgical aortic valve replacement is in ventricular fibrillation after the removal of the aortic cross clamp and requires internal defibrillation. It has been shown it is safe to deliver a charge of up to
Complete
Open
During neonatal resuscitation, the pulse oximeter should be placed on the
Complete
Open
The causes of macrocytic anaemia include
Complete
Open
The function of the (electrical) earth conductor in operating theatre patient monitoring equipment is to
Complete
Open
The next patient on your endoscopy list is a 50-year-old woman who has been scheduled for gastroscopy and colonoscopy under sedation, after unsatisfactory proceduralist-supervised midazolam and fentanyl sedation in the past. She states that she has egg anaphylaxis and carries an adrenaline (epinephrine) auto-injector. The most appropriate agent to use for her sedation is
Complete
Open
During standard diagnostic nocturnal polysomnography for investigation of obstructive sleep apnoea, apnoea is defined as cessation of airflow for
Complete
Open
A healthy woman is admitted to the obstetric unit with threatened preterm labour at 29 weeks gestation. Her blood pressure is 140/80 mmHg. A magnesium sulfate infusion is indicated for the purpose of
Complete
Open
You are asked to review a 5-year-old child weighing 24 kg in the recovery room for acute pain management after a tonsillectomy performed for obstructive sleep apnoea. The most appropriate analgesic regimen would be
Complete
Open
The bioavailability of an oral dose of ketamine is approximately
Complete
Open
A patient presents for a transurethral resection of the prostate (TURP). He had a single drug-eluting coronary stent for angina pectoris inserted six months ago and is taking clopidogrel and aspirin. The most appropriate preoperative management of his medications is to
Complete
Open
Of the following, the drug that is LEAST likely to provide effective analgesia following paediatric tonsillectomy is
Complete
Open
A 72-year-old woman on aspirin therapy presents to her ophthalmologist for follow up three days after you performed a transconjunctival peribulbar block for cataract surgery on her left eye. She complains of painless periorbital swelling, erythema and mild chemosis which started the day after surgery but is improving. She also had a peribulbar block three weeks ago for surgery on the other eye. The most likely diagnosis is
Complete
Open
This 12 lead ECG shows
Complete
Open
A 25-year-old woman has critical bleeding following major trauma. Her blood group is unknown. Fresh frozen plasma that she receives should ideally be from
Complete
Open
The success rate of stopping smoking before surgery is NOT improved by
Complete
Open
A woman who is to undergo a caesarean section reports that she is allergic to amoxicillin. The reaction is limited to a rash. For surgical antimicrobial prophylaxis, you should administer
Complete
Open
Compared to a continuous epidural infusion, patient controlled epidural analgesia does NOT reduce
Complete
Open
The use of erythropoietin before major surgery results in
Complete
Open
Anaesthesia-induced rhabdomyolysis differs from malignant hyperthermia in that it is NOT
Complete
Open
Of the following, the drug which is most effective in the management of severe hyperthermia in serotonergic syndrome is
Complete
Open
In order to minimise the risk of cardiac arrhythmia, surgical diathermy has been designed to operate with
Complete
Open
The medication most strongly associated with an acute primary hypotensive reaction following transfusion of blood products is
Complete
Open
2022.2
142
The knee is NOT innervated by the
Complete
Open
A 47-year-old man is anaesthetised for an elective laparoscopic cholecystectomy. Three minutes after induction, he is noted to have a heart rate of 130 bpm and systolic blood pressure of 60 mmHg. The most appropriate initial dose of adrenaline is
Complete
Open
The influence of end-stage renal disease on the plasma clearance and dose of sugammadex is that the
Complete
Open
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
Complete
Open
A 54-year-old woman has a laryngeal mask airway (LMA) inserted for a surgical procedure. The following day she complains of tongue numbness and abnormal taste over the anterior two-thirds of the tongue. The most likely site of the nerve injury is the
Complete
Open
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
Not Started
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Large doses of sugammadex can potentially lead to
Complete
Open
You are asked to review a 65-year-old man in the emergency department who has presented with hypoxia and confusion. The chest x-ray shows a left-sided
Inadequate Context
Open
The initial management for a seizure during an awake craniotomy is
Not Started
Open
The rate of drainage of cerebrospinal fluid via a lumbar drain is NOT influenced by the
Not Started
Open
A patient requiring an elective major joint replacement has had a recent stroke. The minimum recommended duration between the stroke and surgery is
Not Started
Open
A 6-year-old patient (140 cm, 24 kg, BSA 0.97m2) is on hydrocortisone 15 mg/day. Perioperative glucocorticoid supplementation is
Not Started
Open
For a 70-year-old patient on rivaroxaban with normal renal function a major guideline recommends proceeding with hip fracture surgery after two half-lives of the drug. This equates to
Not Started
Open
Pulse pressure variation is defined as
Not Started
Open
A 50-year-old man is admitted with a stroke and undergoes cerebral angiography. The artery marked on angiography with the arrow is the
Inadequate Context
Open
In Australia and New Zealand, the proportion of blood donors who are cytomegalovirus (CMV) seropositive is
Not Started
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In critically ill patients undergoing mechanical ventilation, energy dense enteral nutrition (1.5 kcal/mL/kg) compared to routine (1 kcal/mL/kg) enteral feeding provides
Not Started
Open
A 56-year-old patient presents with exertional syncope. The most likely diagnosis is
Not Started
Open
A patient presents with sepsis-induced hypoperfusion or septic shock. The minimum suggested volume of intravenous crystalloid to be administered over the first three hours as outlined in the Surviving Sepsis Guideline is
Not Started
Open
The modified Aldrete scoring system is used for determining the
Not Started
Open
When using the ECG to time intra-aortic balloon counterpulsation, balloon inflation should occur at the
Complete
Open
A 45-year-old male received a heart transplant one month ago. He develops a new supraventricular tachyarrhythmia without hypotension during a gastroscopy. The most appropriate therapy is
Not Started
Open
The most likely diagnosis for the following electrocardiograph is
Inadequate Context
Open
A 60-year-old man remains unconscious after an isolated head injury. The systolic blood pressure (in mmHg) should be kept above
Not Started
Open
A 34-year-old for a diagnostic laparoscopy has a height of 158 cm and a weight of 120 kg (BMI 48 kg/m2). For induction of anaesthesia, appropriate drug dosing includes
Not Started
Open
Suxamethonium may be safely given to patients with (list of neuromuscular diseases given)
Not Started
Open
Non-anaesthetist practitioners wishing to provide procedural sedation should have training in sedation and/or anaesthesia for a minimum of
Not Started
Open
In a burns patient, the blood concentration of propofol is
Not Started
Open
A 76-year-old man requires an emergency thoracotomy to treat an expanding haemothorax. He is mildly hypotensive and is not fasted. His plasma electrolytes and haemoglobin are below. The most appropriate strategy to employ to intubate him with a double lumen endotracheal tube is to
Not Started
Open
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 > 1 mm thick, and no intracerebral nor intraventricular blood. Her World Federation of Neurosurgical Societies (WFNS) grade of subarachnoid haemorrhage is
Not Started
Open
Which of the following risk factors for preeclampsia in isolation would be sufficient to recommend commencing low-dose aspirin?
Not Started
Open
A woman is diagnosed with preeclampsia and fetal growth restriction at 30 weeks gestation. Her haemodynamics are most likely to show
Not Started
Open
A 15-year-old patient with a known prolonged QT interval has a ventricular tachyarrhythmia while being monitored postoperatively in the postanaesthesia care unit. The patient is alert, orientated and without chest pain but feels unwell. The best initial management is
Not Started
Open
An eight-year-old child with sickle cell disease is scheduled for emergency fixation of a fractured radius. Her haemoglobin is 80 g/L. The most appropriate management is
Not Started
Open
During spinal surgery, the anaesthetic agent that is least likely to decrease motor evoked potentials is
Not Started
Open
A four-year-old boy is in refractory ventricular fibrillation. The recommended dose of amiodarone is
Not Started
Open
The correct blood collection tube for a mast cell tryptase test is a
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Open
All patients over 70 years of age having received either spinal or general anaesthesia at Hospital X are reviewed 3 years later to assess cognitive function. The aim of the study is to determine whether exposure to general anaesthesia or spinal anaesthesia impacts cognitive function. This trial design is best described as a
Not Started
Open
All of the following conditions are associated with acromegaly EXCEPT
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A patient in the intensive care unit has ventricular fibrillation two hours after her coronary artery bypass graft procedure. Recommended immediate management does NOT include
Not Started
Open
The sensor on a NIM (Nerve Integrity Monitor) endotracheal tube used for thyroid surgery directly records
Not Started
Open
A drug that is contraindicated for a patient with a history of heparin-induced thrombocytopaenia is
Not Started
Open
The estimated proportion of human induced climate change attributable to nitrous oxide is
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Regarding cardiopulmonary exercise testing before major surgery, oxygen pulse is the
Not Started
Open
You are involved in the care of a two-year-old child who has ingested a button battery in the last four hours. You would consider giving
Not Started
Open
The antiemetic that interferes with the effectiveness of oral hormonal contraception is
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Open
Despite an interscalene block being performed preoperatively for arthroscopic rotator cuff repair, a patient wakes up with posterior shoulder pain. The most appropriate procedure to consider would be a nerve block of the
Not Started
Open
Intraoperative lung protective ventilation strategies include all of the following EXCEPT
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Open
An absolute contraindication to transoesophageal echocardiography is
Not Started
Open
A 25-year-old ASA (American Society of Anesthesiologists) physical status classification I patient develops seizures five minutes after receiving a brachial plexus block with ropivacaine. Of the following, the most suitable initial intravenous treatment is
Not Started
Open
Regarding healthcare research, the SQUIRE guidelines describe
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Open
According to National Audit Project (NAP) 5, the incidence of awareness during general anaesthesia is
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Open
You are performing femoral venous cannulation in an obese man under ultrasound guidance. The image quality is suboptimal as the vein is deep. The best way to improve the image quality is to
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Open
A patient is bleeding and her ROTEM displays a Fibtem A5 of 2 mm (normal > 4 mm). The most appropriate treatment is
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Open
After ceasing smoking, a patient’s immune function has effectively recovered to normal after
Not Started
Open
The most consistent risk factor for postoperative vomiting in children is
Not Started
Open
Recirculation is a cannula position complication specific to the use of
Not Started
Open
The composition of blood returned to the patient from intraoperative cell salvage shows
Not Started
Open
The diabetic medication that, as part of its therapeutic effect, significantly prolongs gastric emptying is
Complete
Open
The most likely side effect observed in the post anaesthetic care unit after the use of dexmedetomidine is
Not Started
Open
When using cardioversion to revert a patient in atrial fibrillation to sinus rhythm, the direct current shock is synchronised with the ECG to coincide with the
Not Started
Open
Adverse effects of the use of sodium-glucose co-transporter 2 inhibitors in the perioperative period do NOT include
Complete
Open
The electrolyte abnormality most associated with an increased risk of laryngospasm 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
Not Started
Open
The normal axial length of the globe of an adult eye is
Not Started
Open
This lung ultrasound image is consistent with
Complete
Open
The Glasgow Coma Score of a patient whose best responses are: opening eyes to pain, making incomprehensible sounds, and withdrawing from pain is
Not Started
Open
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
Not Started
Open
You have been managing a case of malignant hyperthermia in an 80 kg man and have given a total of 400 mg of dantrolene (Dantrium). The amount of mannitol you have also administered is
Not Started
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The smallest recommended endotracheal tube that should be railroaded over an Aintree catheter has an internal diameter of
Complete
Open
A child with well controlled dysrhythmias has an ASA (American Society of Anesthesiologists) Physical Status classification of at least
Not Started
Open
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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Open
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
Not Started
Open
An analgesic which is a category A drug using the Australian and New Zealand categories for prescribing medicines in pregnancy is
Not Started
Open
A thoracic regional technique that will NOT provide analgesia for sternal fractures is a
Not Started
Open
A 72-year-old man with peripheral vascular disease presents for a femoral angioplasty and is currently taking aspirin. Regarding the perioperative management of his aspirin,
Not Started
Open
A 50-year-old man has the following pulmonary function test result: (provided). The most consistent diagnosis is
Not Started
Open
A patient with acute right heart failure secondary to acute myocardial infarction is likely to have a/an
Not Started
Open
You are called to recovery to review an 80-year-old woman post 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 pain-free. The most appropriate drug therapy to manage her is intravenous
Not Started
Open
In preschool-aged children having tonsillectomy under general anaesthesia, delirium is more likely with the use of
Not Started
Open
The curve labelled ‘b’ is most likely to represent the flow–volume loop of a patient with
Not Started
Open
A 72-year-old woman on aspirin presents to her ophthalmologist for follow-up three days after you performed a transconjunctival peribulbar block for cataract surgery on her left eye. She complains of painless periorbital swelling, erythema, and mild chemosis which started the day after surgery but is improving. She had a peribulbar block three weeks ago for surgery on the other eye. The most likely diagnosis is
Not Started
Open
You have diagnosed anaphylaxis in an eight-year-old girl having an appendicectomy. She weighs 20 kg and has refractory bronchospasm despite an adrenaline (epinephrine) infusion running at 15 mcg/min. The recommended initial dose of salbutamol (100 mcg/puff) via metered dose inhaler is
Not Started
Open
For a skewed distribution of data the best measure of dispersion of data is the
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Open
The analgesic drug with the most favourable Number Needed to Treat (NNT) for neuropathic pain is
Not Started
Open
This ultrasound image is acquired in preparation for a thoracic erector spinae plane block. The structure indicated by the arrow is the
Not Started
Open
The most common complication of extracorporeal membrane oxygenation (ECMO) in adults is
Not Started
Open
A 25-year-old male has continued postoperative 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: (provided). The most likely diagnosis is
Not Started
Open
Blockade of the superficial cervical plexus includes the
Not Started
Open
Of the following, the substance LEAST likely to cause lactic acidosis is
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Open
You will anaesthetise a 39-year-old woman for a laparoscopic cholecystectomy. She has a history of mastocytosis and has never had an anaesthetic in the past. A drug which you should avoid is
Not Started
Open
A test for a condition which has a prevalence of 1 in 1,000 has a sensitivity of 100% and a specificity of 90%. The probability of a patient who receives a positive result actually having the condition is
Not Started
Open
A woman experiences a postpartum haemorrhage associated with uterine atony that is unresponsive to oxytocin and ergometrine. The recommended intramuscular dose of carboprost (15-methyl prostaglandin F2 alpha) to be administered is
Not Started
Open
A patient has blunt chest trauma. A thoracotomy is indicated if the immediate blood drainage after closed thoracostomy is greater than
Not Started
Open
Anterior spinal artery syndrome would NOT result in
Not Started
Open
The amount of intravenous potassium chloride required to raise the plasma potassium level from 2.8 mmol/L to 3.8 mmol/L in a normal adult is approximately
Not Started
Open
A five-month-old child is to undergo routine elective morning surgery. Current ANZCA guidelines advise minimum fasting intervals prior to anaesthesia of
Not Started
Open
Of the following, the condition that is an absolute contraindication to administration of electroconvulsive therapy is
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Your patient underwent a stellate ganglion block two hours ago. Prior to discharge you are asked to review the patient in recovery because of a droopy upper eyelid. The patient would also be expected to have ipsilateral
Not Started
Open
A raised (> 140% predicted) single-breath diffusing capacity of the lung for carbon monoxide (DLCO) can be caused by
Not Started
Open
You are performing a focused cardiac ultrasound in the postanaesthesia care unit on a patient who is hypotensive for unclear reasons. His heart rate is 100 beats/min. The left ventricular velocity time integral is 10 cm. The left ventricular outflow area is 3 cm2. The left ventricular ejection fraction is 25%. The right ventricular systolic pressure is 40 mmHg. The inferior vena cava diameter is 20 mm. The estimated cardiac output is
Complete
Open
Of the following, the congenital condition LEAST commonly associated with obstructive sleep apnoea in children is
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An open Ivor-Lewis oesophagectomy is performed via a
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Of the following, the procedure that is most commonly associated with chronic pain after surgery is
Complete
Open
The nerve labelled with the arrow in the diagram is the (diagram of the brachial plexus)
Not Started
Open
Of the following, all are useful for the treatment of status epilepticus EXCEPT
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Open
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
Not Started
Open
According to the RELIEF study, in major abdominal surgery a liberal fluid strategy (10 mL/kg of crystalloid at induction followed by 8 mL/kg/hour during the case) compared to a restrictive fluid strategy, results in
Not Started
Open
Based on this ECG tracing, the mode in which this pacemaker is operating is
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The prevention of microbial contamination of living tissues or sterile materials is known as
Complete
Open
A 45-year-old man is ventilated in the intensive care unit and is in a critical state. His pulmonary artery wedge pressure is 26 mmHg, cardiac index is 1.7 L/minute/m2 and his PaO2/FiO2 ratio is 200 mmHg. A decision is made to place him on extracorporeal membrane oxygenation. The most appropriate mode is
Not Started
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A 48-year-old man is day two post-laparoscopic high anterior resection. He has used 42 mg of intravenous morphine in the past 24 hours. You wish to start him on oral tapentadol immediate release. The most appropriate equianalgesic dosage would be
Not Started
Open
During an infraclavicular approach to the brachial plexus, the tip of the needle is positioned closest to the
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The Pin Index System positions on a C size cylinder of medical oxygen are
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In a previously normal patient with cardiac failure secondary to acute pulmonary embolism, the best choice of vasoactive agent for initial treatment is
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You are reviewing a primigravida at 32 weeks gestation with a Fontan circulation in the anaesthetic preassessment clinic. Peripartum care should avoid the use of
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Open
Cyclooxygenase type 2 inhibitors (COX-2) in pregnancy are considered
Complete
Open
Compared to a normothermic patient, a patient with mild intraoperative hypothermia (35.0 oC) will have
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The 2012 Berlin definition of the acute respiratory distress syndrome (ARDS) defines moderate disease as one with a PaO2 / FiO2 ratio (in mmHg) of
Not Started
Open
Normal (0.9%) saline has the physical properties of
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The piece of airway equipment shown is a
Inadequate Context
Open
The medication most strongly associated with an acute primary hypotensive reaction following transfusion of blood products is
Not Started
Open
A patient has return of spontaneous circulation (ROSC) but remains unresponsive after cardiac arrest. ANZCOR Guidelines recommend all the following measures EXCEPT
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Open
1 MAC of sevoflurane affects the sensory evoked potential signal for spinal surgery by
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Open
The image below shows a normal central venous pressure (CVP) trace on the left. The CVP trace shown on the right is most consistent with
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A patient is anaesthetised from the awake state to a state of surgical anaesthesia with propofol or a volatile anaesthetic. As the depth of anaesthesia increases, the patient’s electroencephalogram (EEG) will show oscillations that are of
Not Started
Open
Analysis of variance (ANOVA) is a statistical test to determine
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Open
Created by the Global Initiative for Chronic Obstructive Lung Disease (GOLD 2017), the numerical GOLD classes 1 to 4 are classes of severity for chronic obstructive pulmonary disease (COPD). These classes are based on an assessment of the
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Open
The drug of choice for the treatment of duct-dependent congenital heart disease is
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Predictors of difficult sedation (agitation or inability to complete the procedure) of patients undergoing gastroscopy do NOT include
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A patient presents for endoscopic retrograde cholangiopancreatography (ERCP) with a history of previous post-ERCP pancreatitis. The management most likely to reduce the likelihood of pancreatitis is
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A 72-year-old patient is undergoing resection of an anterior skull based tumour using a combined endoscopic and frontal craniotomy approach. Seven hours into the procedure she has a large diuresis of pale urine and you suspect she may have developed diabetes insipidus. The most appropriate test result to confirm your diagnosis in this setting is a
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The amount of fresh frozen plasma that needs to be administered (in mL/kg) to increase plasma fibrinogen levels by 1 g/L is
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Unsupported ventilation in a non-anaesthetised patient with long-standing tetraplegia is improved when
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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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The use of intraoperative dexamethasone for tonsillectomy
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When using an endotracheal tube in an adult, the highest recommended cuff pressure to avoid mucosal ischaemia is
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A 55-year-old man with no past history of ischaemic heart disease is three days post-total hip replacement surgery. He has an episode of chest pain that sounds ischaemic, began at rest and lasts 30 minutes before resolving fully. There are no ECG changes nor troponin rise. The diagnosis is
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According to the ANZICS Statement on Death and Organ Donation 2021, circulatory determination of death in the context of organ donation requires the absence of evidence of circulation for at least
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A six-year-old child weighing 20 kg presents to hospital two hours after sustaining a burn to 25% of her body. Appropriate fluid management should include 1000 mL Hartmann’s solution in the next
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Dabigatran differs from rivaroxaban and apixaban because it inhibits
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The recommended antibiotic prophylaxis for surgical termination of pregnancy is
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A 45-year-old man presents with a history of shortness of breath and the following flow-volume loop is obtained. This is most consistent with
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A 72-year-old female smoker with hypertension presents to the emergency department with a wrist fracture after a fall. She has been increasingly tired and confused over the previous week. Her serum and urine electrolytes are (supplied). The most likely diagnosis is
Inadequate Context
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A 74-year old man complains of chest pain. An electrocardiograph is performed and displayed here. The occluded coronary artery could be the
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The recommended filter grade of a needle to be effective in excluding microorganisms is
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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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A 75-year-old man has a loud ejection systolic murmur detected on clinical examination before a joint replacement. A focused transthoracic echocardiogram (TTE) detects a calcified aortic valve with a peak aortic jet velocity of 3 m/s. The peak gradient across the aortic valve is
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The current ANZCA guidelines for preoperative fasting of adult patients state that studies have shown that it is safe to administer
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A two-year-old boy with a history of respiratory tract infection one week previously has just undergone squint surgery. His airway was managed with a size 4.5 mm cuffed endotracheal tube. The surgery was unremarkable. Twenty minutes after extubation he is awake and appears anxious, with stridor and a visible tracheal tug. His oxygen saturation is 96% on room air. The best initial management of this child is to administer
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You place a paravertebral catheter for postoperative analgesia at the level of T5 in an adult patient prior to a thoracotomy. Two minutes following the injection of 0.75% ropivacaine 10 mL, the patient becomes bradycardic, hypotensive and apnoeic. The most likely cause of the complication is
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A patient is anaesthetised from the awake state to a state of surgical anaesthesia with propofol or a volatile anaesthetic. As the depth of anaesthesia increases, the patient’s electroencephalogram (EEG) will show oscillations that are of
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A 54-year-old woman has a laryngeal mask airway inserted for a surgical procedure. The following day she complains of tongue numbness and abnormal taste over the posterior third of the tongue. The most likely site of the nerve injury is the
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The washing process of modern cell savers for intraoperative blood salvage removes all the following EXCEPT
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A patient with a haemopneumothorax has a chest drain in situ, which is attached to a three-bottle underwater seal drain apparatus. The system is attached to wall suction at -80 cmH20. This will cause
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You inadvertently place a 7.5Fr central venous catheter into the carotid artery of a patient undergoing an emergency laparotomy for peritonitis. The best course of management is to
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A patient in atrial fibrillation with a CHA2DS2-VASc score of 2 has presented for elective hip surgery. Warfarin had been ceased for four days preoperatively and on the day before surgery the international normalized ratio (INR) was 2.1. The best course of action at this point is to
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An anaesthetised patient is ventilated and has standard monitoring plus a central venous line. As surgery commences, the line isolation monitor alarms, indicating a potential leakage current of greater than 5 mA from one of the power circuits in use. The most appropriate action is to
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The dose of hydrocortisone that has equivalent glucocorticoid effect to 8 mg dexamethasone is
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In the World Maternal Antifibrinolytic (WOMAN) trial, tranexamic acid administration within three hours of birth reduced the
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Preperitoneal pelvic packing is a surgical treatment of haemorrhage from a/an
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The gauge pressure on a gas cylinder does NOT necessarily represent the contents remaining if the cylinder is filled with
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Maintaining a CO2 pneumoperitoneum at a pressure of 15 mmHg is most likely to lead to
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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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When fresh frozen plasma is administered to treat hypofibrinogenaemia in a bleeding patient, the volume required to achieve an increase in plasma fibrinogen concentration of one gram per litre is
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You review a patient before major bowel surgery. Using the American Heart Association/American College of Cardiology consensus guidelines, you assess him as being at intermediate risk of a perioperative adverse cardiac event. When explaining this to the patient, this best translates to a numerical risk in the range of
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Postdural puncture headache in obstetric anaesthesia is associated with a greater likelihood of all of the following EXCEPT
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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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When using cardioversion to revert a patient in atrial fibrillation to sinus rhythm, the direct current shock is synchronised with the ECG to coincide with the
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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 regimen the patient should receive during labour is
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The fourth position of the international pacemaker (NBG) code represents the
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Abnormal Q waves are NOT a feature of the electrocardiogram in
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In a 5-year-old child with severe life-threatening anaphylaxis and no intravenous access, the recommended initial dose of intramuscular adrenaline is
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A four-year-old boy is in refractory ventricular fibrillation. The recommended dose of amiodarone is
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In comparison with fresh frozen plasma, cryoprecipitate contains an increased concentration of factor
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Jet ventilation for shared airway surgery is traditionally delivered at pressures in atmospheres (atm) of
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Following the initial subarachnoid haemorrhage from a ruptured aneurysm, the patient is at greatest risk of rebleeding during the following
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The sensory innervation to the larynx above the vocal cords is provided by the
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The oral morphine equivalent of tapentadol 50 mg (immediate release) is
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The EXTEM plot from a ROTEM sample is shown. The most appropriate treatment for this bleeding patient is
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A risk factor for the development of torsade de pointes is
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In adults the spinal cord usually extends from the brainstem to the level of the inferior margin of the
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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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The manufacturer’s instructions for use of the i-gel supraglottic airway device recommend a minimum patient weight of
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A derived value from an arterial blood gas sample is
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The most clinically useful indicator of effective ventilation during neonatal resuscitation is an improvement in
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In the awake term neonate the systolic arterial blood pressure is normally approximately
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Predictors of successful awake extubation after volatile anaesthesia in infants do NOT include
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A man underwent a heart transplant 12 months ago. A drug or therapy which is likely to result in an exaggerated effect in him is
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A 30-year-old woman has had a free flap operation of eight hours duration. She received an intraoperative remifentanil infusion and was given 10 mg morphine 30 minutes before the end of the operation. In recovery her pain score has increased from 6/10 on arrival in recovery to 9/10 in spite of a further 10 mg of intravenous morphine. The most likely diagnosis is
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Propofol infusion syndrome is characterised by all of the following EXCEPT
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Of the following, the drug with the LEAST effect on serum potassium is
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The risk of a perioperative respiratory adverse event in a child is least likely to be increased by
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The underlying trigger for the development of acute traumatic coagulopathy is
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Differential hypoxia is a syndrome characterised by lower arterial oxygen saturation in the upper body. It is a complication specific to the use of
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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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A 54-year-old woman had a laryngeal mask airway inserted during anaesthesia. The next day she reports hoarseness. On indirect laryngoscopy the right vocal cord is in a paramedian position and is lower than the left vocal cord. The most likely site of the nerve injury is the right
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A patient undergoing robotic prostatectomy with volume-controlled ventilation has the following ventilatory measurements (supplied). The static compliance is
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A patient presents for endoscopic retrograde cholangiopancreatography (ERCP) with a history of previous post-ERCP pancreatitis. The management most likely to reduce the likelihood of pancreatitis is
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Idarucizumab is used to reverse life-threatening gastrointestinal bleeding associated with
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When compared to the interscalene block, the supraclavicular block has the advantage that
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A ten-year-old child (weight 30 kg) presents to the emergency department in status epilepticus. He has received one dose of 15 mg midazolam buccally prior to his arrival. According to Advanced Paediatric Life Support Australia (APLS) guidelines the next drug treatment should be intravenous
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In long-term use of nonsteroidal anti-inflammatory drugs, the risk of thromboembolic complications is lowest with
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A 74-year-old man presents for a femoral popliteal artery bypass procedure for peripheral limb ischaemia. Regarding its role in modifying his perioperative cardiovascular risk, clonidine
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A 45-year-old man presents on the day of surgery for an elective inguinal hernia repair. He is well but is noted to be mildly jaundiced. He takes simvastatin for hyperlipidaemia and has no other medical history. He consumes about three standard drinks of alcohol per day and does not smoke. He briefly experimented with illicit drugs more than ten years ago. His laboratory results show: (supplied) The most likely diagnosis is
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A 50-year-old man is admitted with a stroke and undergoes cerebral angiography. The artery marked by the arrow on the angiogram is the
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The most common cause of maternal mortality in women with preeclampsia is
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A patient with a body mass index 34 kg/m2 with no other disease has an ASA (American Society of Anesthesiologists) Physical Classification of at least
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Ehlers-Danlos Syndrome is associated with each of the following EXCEPT
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The effect of a drop in patient core temperature from 37 C to 34
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According to the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3), sepsis is defined as
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According to the 6th National Audit Project, the likelihood that a patient who reports an allergy to penicillin has a true allergy is approximately
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The calculation of the initial dose of suxamethonium for a morbidly obese patient should be based upon
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A 70-year-old man undergoes a stress echocardiogram as part of his preoperative preparation before a total hip replacement. If he has clinically significant coronary artery disease, the earliest indicator during his test is most likely to be
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Regarding the Australian and New Zealand categorisation system for prescribing medicines in pregnancy, Category C medicines are ones which
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An adult male patient has a haemoglobin level of 80 g/L and his blood film shows a reticulocyte count of 10%. These findings are compatible with
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Once a transfusion of a unit of packed red blood cells is commenced, the transfusion of that unit should be completed within
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The most reliable clinical indicator of opioid-induced ventilatory impairment (OIVI) is decreased
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A straight laryngoscope blade is likely to be more useful than the Macintosh blade when performing direct laryngoscopy in patients with all of the following EXCEPT
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Prolonged paralysis associated with mivacurium is most appropriately managed with
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The mechanism of action of tranexamic acid is to inhibit the formation of
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Local anaesthetics may exacerbate symptoms in patients with
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According to the international consensus statement on uterotonic agents during caesarean section published in 2019, the suggested initial bolus dose of oxytocin to be administered after delivery of the fetus during an elective caesarean section is
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A patient with bipolar disorder is on long-term lithium therapy. The medication that should be avoided is
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A 45-year-old woman is being assessed for liver transplantation. In order to determine the severity of her liver disease the Model for End-stage Liver Disease score is derived using the international normalised ratio, serum bilirubin and
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The most common type of perioperative stroke is
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A risk factor for postoperative nausea and vomiting in adults is age less than
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A patient has a known IgE-mediated allergy to penicillin. The cephalosporin with the lowest risk of allergic cross-reactivity is
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A 68-year-old woman presents with a loud systolic murmur in the anaesthesia room before total hip joint arthroplasty. A transthoracic echocardiogram is performed (image provided) and shows
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A 78-year-old man is undergoing left heart catheter angiography. A graph displaying pressures in the aorta (Ao) and left ventricle (LV) as well as electrocardiography trace over time is demonstrated below. These pressure recordings are characteristic of
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The abnormality shown in this image (image of shoulder shown) is LEAST likely to be caused by an injury to the
Inadequate Context
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The biochemical diagnosis of a growth hormone (GH)-secreting tumour such as in acromegaly is based on oral glucose tolerance test demonstrating
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Complex regional pain syndrome is NOT characterised by
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A 45-year-old woman is reviewed in the preadmission clinic. She is scheduled to undergo a microwave endometrial ablation for menorrhagia in one week’s time. Her preoperative laboratory investigations include the following blood results (full blood examination and iron studies shown). The most appropriate course of action would be to
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The outer diameter of an Aintree Intubation Catheter is
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Extended life plasma is thawed fresh frozen plasma which can be stored at 2 to 6 C for a maximum period of
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Created by the Global Initiative for Chronic Obstructive Lung Disease, the alphabetical GOLD groups A to D are tools for the assessment of chronic obstructive pulmonary disease. These classes are based on
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Red man syndrome as a consequence of vancomycin administration is caused by
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A 35-year-old patient is undergoing a diagnostic laparoscopy. Three minutes after insufflation of CO2 her oxygen saturation falls to 85%. You note decreased air entry on the left side of her chest. Lung ultrasound on the left reveals lung pulse and no lung sliding. The best first action is to
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A 26-year-old patient presents with exertional syncope. The most likely diagnosis is
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Bowel preparation prior to elective colorectal surgery is associated with
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The part of the lung that is typically divided into apical, anterior and posterior segments is the
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The most common cause of bilateral blindness following spinal surgery and anaesthesia is
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The 2012 Berlin definition of the Acute Respiratory Distress Syndrome (ARDS) defines moderate disease as one with a PaO2 / FiO2 ratio (in mmHg) of
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This image is an apical four chamber view obtained by transthoracic echocardiography. The artery that supplies the area indicated by the arrow is the
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A patient has undergone a multilevel cervical spine fusion and upon emergence from anaesthesia reports complete visual loss. Fundoscopic examination shows a pale optic disc with haemorrhages. This supports a diagnosis of
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An asymptomatic 65-year-old male with squamous cell carcinoma of the left lung has been referred for assessment of suitability for lung resection. There is no evidence of spread on computerised tomography scanning. PaCO2, electrocardiogram, full blood count and electrolytes are normal. His SpO2 on room air is 95%. His forced expiratory volume in one second is 2.3 litres (predicted 3.3 litres) and forced vital capacity is 3.4 litres (predicted 4.4 litres). The most appropriate course of action is to
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Findings associated with massive pericardial tamponade include
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The first-line drug recommended by both the Australian Resuscitation Council and the New Zealand Resuscitation Council to treat severe cyanide poisoning is
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Complications of severe anorexia nervosa (body weight < 40% ideal) include all of the following EXCEPT
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A patient requires a peripherally inserted central venous catheter. Electrocardiographic (ECG)- aided tip localisation is used to site the tip of the catheter. The initial ECG from the catheter is shown. The ECG when the catheter is placed appropriately will be
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You are asked to review a patient two days after a surgically difficult total knee replacement that was undertaken under tourniquet. The anaesthesia and analgesia technique used was spinal anaesthesia in combination with an ultrasound-guided adductor canal block and high-volume local anaesthetic infiltration by the surgeon. The patient complains of a new onset of leg weakness on the operative side. The nerve LEAST likely to be involved in this weakness is the
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When using an endotracheal tube in an adult, the highest recommended cuff pressure to avoid mucosal ischaemia is
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A drug which does NOT increase the defibrillation threshold in a patient with an implanted cardioverter defibrillator is
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The nerve labelled by the arrow in the diagram (image of brachial plexus given) is the
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A test for a condition which has a prevalence of 1 in 1000 has a sensitivity of 100% and a specificity of 90%. The probability of a patient who receives a positive result actually having the condition is
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This posteroanterior chest X-ray shows enlargement of the
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Your patient has been administered 50 mL of oral 5-aminolevulinic acid hydrochloride (Gliolan) three hours prior to her scheduled craniotomy for resection of a glioblastoma. Care should be taken perioperatively to avoid the adverse effect of
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Anaesthesia-induced rhabdomyolysis differs from malignant hyperthermia in that it is NOT
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You are planning to perform a peribulbar block and wish to check the axial length of the eye prior to proceeding. The average axial length of the globe in adults as measured by ultrasound is
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A 25-year-old man suffers a 30% total body surface area burn. A physiological change expected within the first 24 hours is
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Of the following clinical conditions, difficult intubation is LEAST likely to be associated with
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Somatosensory evoked potentials (SSEPs) are used to monitor spinal cord function during scoliosis surgery. They are LEAST affected by
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Suxamethonium may be safely given to patients with
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A 65-year-old man presents to the preadmission clinic two weeks prior to his total knee replacement. His blood results include haemoglobin 100 g/L, ferritin 20 μg/L and normal C-reactive protein. The best course of action is to
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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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To allow cardiopulmonary bypass in a patient with heparin resistance, fresh frozen plasma may be administered in order to increase the level of
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The image shows results from noninferiority trials. The trial labelled N is best described as
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The radial artery pressure trace shown below is from a patient who has an intra-aortic balloon pump in situ. The device has been switched to 1:2 augmentation to assess the timing. The trace shows an augmented beat followed by a nonaugmented beat. With respect to the augmentation, the trace shows
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A patient is undergoing treatment for a malignant hyperthermia crisis. Active cooling should be ceased when the patient’s core temperature has dropped to
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A 63-year-old woman is to undergo an elective total hip replacement. Her past medical history includes hypertension, stroke, type 2 diabetes mellitus, chronic atrial fibrillation and chronic renal impairment with an estimated creatinine clearance of 46 mL/min. Her medications include dabigatran 150 mg bd for stroke prevention. Perioperatively, her dabigatran therapy should
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A 50-year-old man with carcinoid syndrome having a resection of a peripheral hepatic metastasis develops a sudden fall in BP from 110/70 mmHg to 85/50 mmHg without significant bleeding. The most appropriate management is
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The nerve(s) that need to be blocked with local anaesthetic to achieve complete anaesthesia for amputation of the fifth toe is/are
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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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Venous air embolism during frontal craniotomy is most likely to arise from the
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St. John’s wort (herbal medicine Hypericum perforatum) will reduce the effects of
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The QRS axis for the electrocardiogram shown is
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You are about to anaesthetise a 25-year-old man for an open appendicectomy. He has a history of tricuspid atresia for which he has had a Fontan procedure. An important goal in managing his ventilation under anaesthesia is to ensure
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According to the ‘Fourth Consensus Guidelines for the Management of Postoperative Nausea and Vomiting (PONV)’ published in 2020, multimodal PONV prophylaxis should be implemented in adult patients
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When using ROTEM thromboelastometry, the APTEM test is used to assess
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Of the following, the drug that is LEAST likely to provide effective analgesia following paediatric tonsillectomy is
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You are anaesthetising a patient for implantation of an automated implantable cardioverter defibrillator. The patient is a 48-year-old with dilated cardiomyopathy and pulmonary hypertension. The preoperative echocardiogram report states that the estimated pulmonary artery systolic pressure is 55 mmHg, and that there is mild right ventricular systolic dysfunction. To avoid worsening right ventricular function during induction, it would be best to consider using
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Regarding healthcare research, the PICO framework describes
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A 36-year-old man complains of left calf pain for two weeks. His pain is worse on walking but not completely relieved by sitting or lying down. On examination, he has mild weakness of left big toe extension. The most likely finding on MRI would be
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A normal sized six-year-old girl has a haemoglobin of 70 g/L following surgery. The volume of packed red blood cells that you would plan to infuse to raise her haemoglobin to 80 g/L is
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A 57-year-old female smoker presents for a laparotomy with the following pulmonary function tests (supplied) They are consistent with a diagnosis of
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A 24-year-old man with Wolff-Parkinson-White syndrome is having anaesthesia for a knee arthroscopy. During the procedure he develops the following rhythm. His blood pressure is 100/65 mmHg. The most appropriate treatment is
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The train-of-four (TOF) ratio above which the majority of anaesthetists will NOT be able to visually detect fade on TOF stimulation is
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A high mixed venous oxygen saturation (SvO2) is most likely to be associated with
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You have anaesthetised a 25-year-old woman for a sleeve gastrectomy. She normally takes the oral contraceptive pill. You used rocuronium and at the end of the case reversed it with 4 mg/kg of sugammadex. Prior to discharge you should advise her to use non-hormonal contraception for the next
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Moderate obstructive sleep apnoea in children is diagnosed by an apnoea-hypopnoea index of
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2021.2
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A woman experiences a post-partum haemorrhage associated with uterine atony that is unresponsive to oxytocin and ergometrine. The recommended intramuscular dose of carboprost (15-methyl prostaglandin F2 alpha ) to be administered is
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A 74-year old man in the post-anaesthesia care unit complains of chest pain. An electrocardiogram (ECG) is performed. The occluded coronary artery is the
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Techniques to improve the speed of onset and spread of a peribulbar block include all of the following EXCEPT
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An adult with renal failure on regular haemodialysis has an ASA (American Society of Anesthesiologists) physical status classification of at least
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The breast does NOT receive sensory innervation from the
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A derived value from an arterial blood gas sample is
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A patient presents with a serum sodium of 110 mmol/L. A feature NOT consistent with a diagnosis of syndrome of inappropriate antiduretic hormone (SIADH) is
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Identified risk factors for opioid-induced ventilatory impairment DO NOT include
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Risks associated with robot-assisted laparoscopic prostatectomy surgery in comparison with open prostatectomy include all of the following EXCEPT
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The most likely complication from ultrasound guided left internal jugular central venous line insertion is
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Benzatropine ameliorates the side effects of drugs that antagonise
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Regarding healthcare research, the PICO framework describes
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The drug of choice for the treatment of duct dependent congenital heart disease is
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A patient has blunt chest trauma. A thoracotomy is indicated if the immediate blood drainage after closed thoracostomy is greater than
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A factor that is NOT used to calculate the Child-Pugh score is
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The relatively slower onset of action of bupivacaine with adrenaline in brachial plexus anaesthesia compared to other local anaesthetics relates to
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You administer a dose of intravenous indocyanine green to facilitate videoangiography during cerebral aneurysm surgery. The changes in pulse oximetry (SpO2) and cerebral oxygen tissue saturation (SctO2) you expect to see on your monitors are
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The CRASH-2 trial showed tranexamic acid administration to trauma victims results in a reduction in
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An awake patient in the post-anaesthesia care unit complains of breathlessness. The FiO2 is 0.4 via a facemask. An arterial blood gas taken at the time shows PaO2 135 mmHg, PaCO2 48 mmHg, and SpO2 100% The alveolar-arterial gradient (in mmHg) is approximately
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A 69-year-old woman has a recent onset of dyspnoea and undergoes a right heart catheterisation, with results displayed below. Her pulmonary capillary wedge pressure is 10 mmHg. The most likely diagnosis is
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A ten-year-old boy (weight 30 kg) has a displaced distal forearm fracture that requires manipulation and application of plaster. The volume of 0.5% lidocaine (lignocaine) that should
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be used for intravenous regional anaesthesia (Bier block) is
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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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Of the following, the lifestyle modification that is least effective in reducing essential hypertension is
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Sensory innervation of the cornea is by the
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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
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quite easily. His coagulation screen reveals: (Coagulation tests provided). The most likely diagnosis is
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The condition in which volatile anaesthesia is least appropriate is
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International guidelines state that patients presenting for major surgery have inadequate or low iron stores if their serum ferritin level is less than
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Globe perforation during eye block is more common in myopic eyes because the
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A drug which is likely to slow the heart rate in a patient with a heart transplant 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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High-risk transthoracic echocardiogram findings associated with aortic dissection include all of the following EXCEPT
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You are involved in the care of a two-year-old child who ingested a button battery within the last 4 hours. You should consider giving
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Stellate ganglion block is NOT contraindicated in patients with
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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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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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You are examining the precordium of a patient in the preadmission clinic and hear a fourth heart sound at the apex. This finding is consistent with
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A patient with an acute subarachnoid haemorrhage arrives in the emergency department. Her Glasgow Coma Scale is 10 and she has no motor deficit. A CT brain shows diffuse subarachnoid haemorrhage with no localised areas of blood > 1mm thick, and no intracerebral nor intraventricular blood. Her World Federation of Neurosurgical Societies (WFNS) grade of subarachnoid haemorrhage is
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Non-anaesthetist practitioners wishing to provide procedural sedation should have training in sedation and/or anaesthesia for a minimum of
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In a patient with tetraplegia who develops autonomic dysreflexia, the expected haemodynamic response is
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Open
The cardiac axis of this electrocardiogram is
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The most reliable clinical indicator of opioid-induced ventilatory impairment (OIVI) is decreased
Not Started
Open
A patient presents for endovascular clot retrieval after experiencing a right hemisensory loss and right homonymous hemianopia. The vessel most likely occluded is the left
Not Started
Open
The function of the bottle labelled 'D' in the diagram below is to protect against the consequences of
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Open
A trainee becomes aware that a patient they have just anaesthetised for emergency surgery is breastfeeding and seeks your advice regarding recommencement of breast feeding. You advise that breast feeding is contraindicated because during the admission today the patient received
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A patient undergoing robotic prostatectomy with volume-controlled ventilation has the following ventilatory measurements: (Ventilator parameters given) The static compliance is
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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 25-year-old ASA (American Society of Anesthesiologists) physical staus classification 1 patient develops seizures five minutes after receiving a brachial plexus block with ropivacaine. Of the following, the most suitable initial intravenous treatment is
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Complications of hyperbaric oxygen therapy include all of the following EXCEPT
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Analysis of variance (ANOVA) is a statistical test to determine
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Open
The oral morphine equivalent of tapentadol 50 mg (immediate release) is
Not Started
Open
Allergic cross-reactivity between penicillins and cephalosporins is mediated by the
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Open
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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Open
Of the following, the incidence of venous air embolism is considered highest for (list of surgical procedures given)
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Intraoperative cell salvage is contraindicated in
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A 76 year old woman who is spontaneously breathing through a tracheostomy tube with an inner cannula becomes acutely breathless. Despite application of high flow oxygen, her respiratory rate is 40 breaths per minute and her SpO2 is 82%. The next most appropriate step in her airway management is to
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The anion which contributes the most to the anion gap is
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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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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 patient who usually takes oral morphine 50 mg bd develops a bowel obstruction and experiences withdrawal symptoms. They may be described as having
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Open
The image below on the left shows a normal central venous pressure (CVP) trace. The CVP trace in the image below on the right is most consistent with
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A 26-year-old man is brought into the Emergency Department four hours after an accidental chemical exposure during crop spraying. His clinical signs include bradycardia, vomiting, diarrhoea, coughing, miosis and weakness. A drug which is NOT recommended during his resuscitation and treatment is
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A new volatile agent is developed. The property it shares with sevoflurane that will enable it to be used in a sevoflurane vapouriser and deliver an accurate concentration is its
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When performing a brachial plexus block at the level of the axilla, the structure indicated by the arrow is the
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The diffusing capacity of the lungs for carbon monoxide (DLCO) is likely to be decreased with
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The use of erythropoietin before major surgery results in
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Predictors of successful awake extubation after volatile anaesthesia in infants include
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The maximum warm ischaemia time acceptable for procuring the kidney following donation after circulatory death (DCD) is
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The risk of postoperative respiratory failure in myasthenia gravis is increased by the administration of
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A patient with known type 3 von Willebrand disease presents with persistent epistaxis. First-line medical therapy should include
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ANZCA fasting guidelines classify all of the following as clear fluids EXCEPT
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A patient has return of spontaneous circulation (ROSC) but remains unresponsive after cardiac arrest. ANZCOR Guidelines recommend all the following measures EXCEPT
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Your patient has been administered 50 mL of oral 5–aminolevulinic acid hydrochloride (Gliolan) three hours prior to her scheduled craniotomy for resection of a glioblastoma. Care should be taken perioperatively to avoid the adverse effect of
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The most common cause of mortality in children with diabetic ketoacidosis is
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An electrocardiogram (ECG) abnormality which is NOT usually associated with severe anorexia nervosa is
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You have been asked to provide general anaesthesia for a complex thoracic endovascular aortic aneurysm repair. After the placement of a lumbar drain the recommended safe time before the administration of intravenous heparin is
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The image below shows results from non inferiority trials. The trial labelled 'M' is best described as
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Painless post-operative visual loss with preserved pupillary reflexes is most likely due to
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A 50-year-old man is admitted with a stroke and undergoes cerebral angiography. The artery marked with an arrow on the angiogram below is the
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The oculocardiac reflex results in
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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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With regard to the risk of postoperative surgical-site infection, 8 mg dexamethasone administered intraoperatively has
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Intraoperative lung protective ventilation strategies include all of the following EXCEPT
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A 65 year old woman is dyspnoeic after a total hip replacement. A lung ultrasound is performed in the post-anaesthesia care unit, with a still image shown below. The likely cause of the dyspnoea is
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Local anaesthetic-induced myotoxicity is most likely to be associated with
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The abnormality shown in this image is LEAST likely to be caused by an injury to the
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Postdural puncture headache in obstetric anaesthesia is associated with a greater likelihood of all of the following EXCEPT
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The most common type of perioperative stroke is
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Hepcidin production is inhibited in response to
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Open
The most common cause of cor pulmonale is
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A risk factor which increases the likelihood of developing local anaesthetic systemic toxicity is
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The medical laser LEAST likely to cause eye injury is
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Open
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
Not Started
Open
Of the following, the LEAST likely cause of high anion gap metabolic acidosis is
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The most common complication of extracorporeal membrane oxygenation (ECMO) in adults is
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The power board on the back of the anaesthesia machine has caught fire during an elective case. This should be extinguished with
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The most common presenting rhythm associated with maternal cardiac arrest is
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The number of segments in the lower lobe of the left lung is
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Cardiovascular effects of hyperthyroidism include
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Open
The coagulopathy that can result from intrahepatic cholestasis of pregnancy is due to
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A man who had successful treatment of a germ cell tumour ten years ago presents for laparoscopic appendectomy. Your intraoperative management should consider
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Open
The muscle or muscle group with the greatest resistance to the action of non-depolarising neuromuscular blocking agents is the
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A patient presents for a trans-urethral resection of the prostate (TURP). He had a single drug-eluting coronary stent for angina pectoris inserted six months ago and is taking clopidogrel and aspirin. The most appropriate preoperative management of his medications is to
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A ten year old child (weight 30 kg) presents to the emergency department in status epilepticus. He has received one dose of 15 mg midazolam buccally prior to his arrival. According to Advanced Paediatric Life Supprt, Australia (APLS) guidelines the next drug treatment should be intravenous
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A peripheral intravenous cannula is being inserted in the forearm of a man having a hemicolectomy. The skin asepsis preparation NOT suitable for this procedure is
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In pulmonary function testing the presence of airflow limitation is defined by a post-bronchodilator FEV1/FVC ratio less than
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A 30-year-old man with morbid obesity (body mass index [BMI] 55 kg/m2) presents for middle ear surgery. The most appropriate bolus dose of propofol for induction should be based on
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A 30 year old athlete undergoing a knee arthroscopy under general anaesthesia becomes tachycardic intraoperatively. A 12-lead electrocardiogram (ECG) is obtained. The most likely diagnosis is
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A 45-year-old man has the following results on his blood biochemistry testing: (Liver Function
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Tests shown). The most likely diagnosis is
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The Vortex Approach to airway management does all of the following EXCEPT
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A structure that is NOT clamped during a Pringle manoeuvre is the
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A forest plot is a commonly used tool in meta-analysis. It presents
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Of the following, the procedure that is most commonly associated with chronic pain after surgery is
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Performing a superficial cervical plexus block will block all of the following nerves EXCEPT the
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Suxamethonium causes a sustained contraction of the extraocular muscles for up to
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Findings associated with massive pericardial tamponade include
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A 59-year-old lady presents for elective coronary artery graft surgery. She has a pulmonary artery catheter inserted with the waveforms displayed below. Her cardiac output is 4.5 L/min. Her mean pulmonary artery pressure is 33 mmHg. The most likely explanation for the waveforms seen is that she has
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A patient with a history of paroxysmal atrial fibrillation and chronic obstructive airways disease develops a wheeze intraoperatively which resolves with administration of salbutamol via the endotracheal tube. Soon after, he develops rapid atrial fibrillation with a ventricular rate of 120 beats per minute, a BP of 90/60 and an ETCO2 of 40mmHg. His regular medications are inhaled salbutamol, inhaled salmeterol and digoxin 125mcg daily. The next most suitable treatment is
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A man with atrial fibrillation has no valvular heart disease. According to joint American Heart Association (AHA), American College of Cardiology (ACC) and Heart Rhythm Society (HRS) guidelines, oral anticoagulants are definitely recommended if his CHA2DS2-VASc score is greater than or equal to
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The advantage of the Mapleson E circuit in paediatric anaesthesia is due to its
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A 50 year old man has the following pulmonary function test result: (Results displayed) The diagnosis is most consistent with
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When performing a paediatric pain assessment, the five elements assessed to obtain the FLACC score are
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Local anaesthetic blockade of the sciatic nerve results in loss of function of all of the following EXCEPT
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Methylene blue may be used in the treatment of all of the following conditions EXCEPT
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A respiratory effect of high flow nasal oxygen therapy is
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A bleeding patient has ROTEM results including (results displayed) . The most appropriate treatment is
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Cryoprecipitate contains all of the following EXCEPT
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The size 5 i-gel® supraglottic airway is recommended for patients who weigh over
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A normal 75 kg term parturient may be expected to have a total blood volume of
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The nerve labelled by the arrow in the diagram below is the
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The intrinsic muscles of the larynx do NOT include
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Of the following, the deficit that DOES NOT result from damage to the common peroneal nerve is
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A patient has numbness and weakness in her hand postoperatively. You are trying to distinguish between an ulnar nerve lesion and a C8-T1 radiculopathy. You can diagnose a C8-T1 radiculopathy if she has weakness
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The domains described in the Edmonton Frail Scale do NOT include
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In a patient with anaemia of chronic disease, of the following the most likely to be elevated is
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The apical four–chamber view of a transthoracic echocardiogram below shows
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The equipment shown in the picture below is a
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The estimated proportion of human induced climate change attributable to nitrous oxide is
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2021.1
143
The optimal position, under ultrasound guidance, to place a catheter tip to provide continuous erector spinae plane block for post-thoracotomy analgesia is
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A structure that is NOT clamped during a Pringle manoeuvre is the
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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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The part of the lung that is typically divided into superior, medial, anterior, lateral and posterior segments is the
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A 48 year old male is day two post-laparoscopic high anterior resection. He has used 42 mg of intravenous morphine in the past 24 hours. You wish to start him on oral tapentadol immediate release. The most appropriate equianalgesic dosage would be
Incomplete
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A patient with a purely metabolic acidosis has a serum bicarbonate of 14 mmol/L and a lactate of 3.8 mmol/L. The expected PaCO2 is
Incomplete
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High-risk transthoracic echocardiogram findings associated with aortic dissection include all of the following EXCEPT
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The equipment shown in the picture is a (airway device shown)
Inadequate Context
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In the treatment of persistent mucosal bleeding in patients with von Willebrand disease type 3, desmopressin (DDAVP) is
Incomplete
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Of the following, the incidence of venous air embolism is considered highest for
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Considering emergency front-of-neck airway access, the major blood vessel that is most likely to lie anterior to the trachea above the sternal notch is the
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The recommended cleaning protocol for a laryngoscope handle which has been used but which has no visible soiling is
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A patient has numbness and weakness in her hand postoperatively. You are trying to distinguish between an ulnar nerve lesion and a C8-T1 radiculopathy. You can diagnose a C8-T1 radiculopathy if she has weakness
Incomplete
Open
Suxamethonium may be safely given to patients with
Incomplete
Open
In cardiac surgery, volatile-based anaesthesia compared to total intravenous anaesthesia
Incomplete
Open
A 45-year-old man has the following results on his blood biochemistry testing (Liver function tests shown). The most likely diagnosis is
Inadequate Context
Open
A patient presents for endovascular clot retrieval after experiencing a right hemisensory loss and right homonymous hemianopia. The vessel most likely occluded is the left
Incomplete
Open
A third heart sound at the apex may be heard with
Incomplete
Open
The management of a patient who has experienced a cardiac arrest within 10 days of cardiac surgery should NOT routinely include
Incomplete
Open
The most common cause of cor pulmonale is
Incomplete
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The risk of major bleeding in patients taking direct oral anticoagulants (DOACs) is NOT significantly increased by commencing administration of
Incomplete
Open
A patient who usually takes oral morphine 50 mg bd develops a bowel obstruction and experiences withdrawal symptoms. They may be described as having
Incomplete
Open
The following muscles of the larynx are all innervated by the recurrent laryngeal nerve, EXCEPT
Incomplete
Open
According to the ANZCA 'Guideline on infection control in anaesthesia', skin preparation prior to central neuraxial blockade should be performed using
Incomplete
Open
A patient has bipolar disorder and is on long term lithium therapy. An analgesic which should be avoided is
Incomplete
Open
Local anaesthetic systemic toxicity does NOT manifest as
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A 10-year-old boy (weight 30 kg) has a displaced distal forearm fracture that requires manipulation and application of plaster. The volume of 0.5% lidocaine (lignocaine) that should be used for intravenous regional anaesthesia (Bier block) is
Incomplete
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A patient had prolonged surgery with a laryngeal mask airway in situ. The following day she reports a problem with her tongue. You examine her and see the following when she protrudes her tongue: The most likely cause of the abnormality is
Inadequate Context
Open
Warmer' rapid fluid infuser system is a (list of intravascular catheters)
Inadequate Context
Open
The most reliable clinical indicator of opioid-induced ventilatory impairment (OIVI) is decreased
Incomplete
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Of the following, the device that delivers the greatest flow when using 'Level 1® Fast Flow Fluid
Incomplete
Open
The image below shows a normal central venous pressure (CVP) trace on the left. The CVP trace shown on the right is most consistent with
Inadequate Context
Open
In patients without other co-morbidities, bariatric weight loss surgery is indicated when the body mass index (kg/m2) is greater than
Incomplete
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A condition or therapy that is NOT a contraindication to hyperbaric oxygen therapy is
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A respiratory effect of high flow nasal oxygen therapy is
Incomplete
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The breast does NOT receive sensory innervation from the
Incomplete
Open
Unsupported ventilation in a non-anaesthetised patient with long-standing tetraplegia is improved when
Incomplete
Open
The domains described in the Edmonton Frail Scale do NOT include
Complete
Open
The function of the bottle labelled 'D' in the diagram below is to protect against the consequences of (diagram of chest drain bottles)
Inadequate Context
Open
Hepcidin production is inhibited in response to
Incomplete
Open
A 25-year-old man suffers a 30% total body surface area burn. A cardiovascular physiological change expected within the first 24 hours is
Incomplete
Open
Of the following, the lifestyle modification that is least effective in reducing essential hypertension is
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An ECG abnormality which is NOT usually associated with severe anorexia nervosa is
Incomplete
Open
Intraoperative lung protective ventilation strategies include all of the following EXCEPT
Incomplete
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A 100 kg 32-year-old male presents two hours after suffering a 30% total body surface area electrical burn. He has had no resuscitation fluids. The infusion rate of isotonic crystalloid resuscitation fluid required for this man for the next six hours is
Incomplete
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A man who had successful treatment of a germ cell tumour 10 years ago presents for laparoscopic appendectomy. Your intraoperative management should consider
Incomplete
Open
The apical four–chamber view of a transthoracic echocardiogram below shows
Incomplete
Open
An 84-year-old woman with dementia presents for surgery for a breast lump. She lives in a care facility and is accompanied by the nurse manager from the facility and her son. Neither have a written legal authority to act on her behalf. Regarding consent for her surgery
Incomplete
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A 30-year-old woman, gravida 2, parity 1, undergoes an elective lower segment caesarean section for breech presentation. The international consensus statement on the use of uterotonic agents recommends that the first line uterotonic management is
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The advantage of the Mapleson E circuit in paediatric anaesthesia is due to its
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Open
The implemention of comprehensive multidisciplinary geriatric assessments in the peri-operative period has been shown to
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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
Incomplete
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A 55-year-old man with no past history of ischaemic heart disease is three days post-total hip replacement surgery. He has an episode of chest pain characteristic of angina which began at rest and lasted thirty minutes before resolving fully. There are no ECG changes. Six hours later there is a troponin rise above the 99th percentile upper reference limit. The diagnosis is
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The ANZCA Choosing Wisely recommendations advise avoiding all of the following EXCEPT
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A woman with preeclampsia presents with a blood pressure of 150/100 mmHg. An appropriate first line treatment to reduce the blood pressure is
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The modified Aldrete scoring system uses all of the following EXCEPT
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A 69-year-old woman has a recent onset of dyspnoea and undergoes a right heart catheterisation, with results displayed below. Her pulmonary capillary wedge pressure is 10 mmHg. The most likely diagnosis is
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A transhiatal oesophagectomy is performed via a
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Perioperative overheating is most likely to cause worsening of symptoms of
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Open
If group A RhD negative fresh frozen plasma is not available for use in an A RhD positive patient, of the following your next best choice should be
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The lung ultrasound finding most consistent with atelectasis is three or more
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A 40-year-old man suffers a hydrofluoric acid burn to 60% of his total body surface area in an industrial accident. An expected electrolyte disturbance is
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The following ECG is consistent with
Inadequate Context
Open
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
Incomplete
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A 26-year-old man is brought into the Emergency Department four hours after an accidental chemical exposure during crop spraying. His clinical signs include bradycardia, vomiting, diarrhoea, coughing, miosis and weakness. A drug which is NOT recommended during his resuscitation and treatment is
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A patient with C6 tetraplegia is undergoing removal of bladder stones under general anaesthesia. The blood pressure rises to 166/88 mmHg. The appropriate response is to
Incomplete
Open
A patient presents with a serum sodium of 110 mmol/L. A feature NOT consistent with a diagnosis of syndrome of inappropriate antiduretic hormone (SIADH) is
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Of the following, the LEAST likely cause of high anion gap metabolic acidosis is
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A neonate born by emergency caesarean section is limp, pale, has a weak grimace and weak cry, and a heart rate of 60 beats per minute. The Apgar Score is
Incomplete
Open
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
Incomplete
Open
The abnormality shown in this image is LEAST likely to be caused by an injury to the (image of a patient’s back shown)
Inadequate Context
Open
Once a unit of fresh packed red blood cells has been removed from controlled refrigeration the transfusion should be completed within
Incomplete
Open
The following is an image from a focussed cardiac ultrasound in a patient with dyspnoea presenting for thoracic surgery. The diagnosis is
Inadequate Context
Open
A drug which is likely to slow the heart rate in a patient with a heart transplant is
Incomplete
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Risk factors for chronic postsurgical pain do NOT include
Complete
Open
Chronic recreational use of nitrous oxide may lead to
Incomplete
Open
In critically ill patients undergoing mechanical ventilation, energy dense enteral nutrition (1.5 kcal/mL/kg) compared to routine (1 kcal/mL/kg) enteral feeding provides
Incomplete
Open
The most likely cause of hip adduction in a patient undergoing transurethral resection of a bladder tumour is
Incomplete
Open
You are involved in the care of a two-year-old child who has ingested a button battery in the last four hours. You would consider giving
Incomplete
Open
In elderly patients without diabetes mellitus the use of aspirin in primary prevention of disease
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Open
The risk of a perioperative respiratory adverse event in a child is least likely to be increased by
Incomplete
Open
The atmospheric lifetime of nitrous oxide (in years) is approximately
Incomplete
Open
The main advantage of using norepinephrine (noradrenaline) over phenylephrine for the prevention of hypotension as a result of spinal anaesthesia for elective caesarean section is
Incomplete
Open
Effective pharmacotherapy options to support smoking cessation in the perioperative period include all of the following EXCEPT
Incomplete
Open
Cardiovascular effects of hyperthyroidism include
Incomplete
Open
During trauma resuscitation in adults, contraindications to blind nasogastric tube insertion include all of the following EXCEPT
Incomplete
Open
A patient with a history of restless leg syndrome is experiencing significant agitation in the postanaesthesia care unit. After excluding other precipitating causes, the best treatment of the agitation in this patient is
Incomplete
Open
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
Incomplete
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The most common cause of postoperative visual loss after spinal surgery is
Incomplete
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A 30-year-old woman is administered an anaesthetic for a laparoscopic cholecystectomy for acute cholecystitis. She is breastfeeding her six-week-old infant. During anaesthesia she receives the following drugs: propofol, fentanyl, sevoflurane, rocuronium, oxycodone, parecoxib, ondansetron, sugammadex and cefuroxime. The best advice regarding breastfeeding after anaesthesia is to
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Open
Regarding healthcare research, the SQUIRE guidelines describe
Incomplete
Open
You are resuscitating a 60 kg man in cardiac arrest secondary to severe hyperkalaemia. You decide to give intravenous sodium bicarbonate. Australian and New Zealand resuscitation guidelines state the initial dose of 8.4% sodium bicarbonate should be
Complete
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You are anaesthetising a 35-year-old woman undergoing a laparoscopic appendectomy. She uses a levonorgestrel-releasing intrauterine device (Mirena®) for contraception and you have used sugammadex for reversal of neuromuscular blockade at the end of the procedure. Your postoperative advice to her regarding contraception should state that
Incomplete
Open
Benztropine ameliorates the side effects of drugs that antagonize
Incomplete
Open
Blocking the sciatic nerve results in loss of function of all of the following EXCEPT
Complete
Open
Infection control management of patients with carbapenemase-producing Enterobacteriaceae (CPE) infection should include all of the following EXCEPT
Incomplete
Open
You have been asked to anaesthetise a patient with a history of severe depression which has been well controlled on moclobemide. The most appropriate medications in combination with propofol are
Complete
Open
A 50 year old man has the following pulmonary function test result. The most consistent diagnosis is
Inadequate Context
Open
The nerve labelled with the arrow in the diagram is the (diagram of a nerve plexus shown)
Inadequate Context
Open
A 25-year-old ASA I patient develops ongoing seizures five minutes after receiving a brachial plexus block with ropivacaine. Of the following, the most suitable initial intravenous treatment is
Incomplete
Open
Of the following classes of medication for diabetes mellitus, the most likely to cause hypoglycaemia in the fasted patient are the
Incomplete
Open
Non-anaesthetist practitioners wishing to provide procedural sedation should have training in sedation and/or anaesthesia for a minimum of
Incomplete
Open
You give a dose of intravenous indocyanine green to facilitate videoangiography during cerebral aneurysm surgery. The displayed pulse oximetry (SpO2) and cerebral oxygen tissue saturation (SctO2) changes you expect to see are
Incomplete
Open
The minimum microshock current required to elicit ventricular fibrillation is
Incomplete
Open
Local anaesthetic-induced myotoxicity is most likely to be associated with
Incomplete
Open
Sensory innervation of the cornea is by the
Incomplete
Open
The most effective therapy for the prevention of an acute attack in the perioperative period is
Incomplete
Open
A patient with a history of hereditary angiooedema requires an appendectomy for acute appendicitis.
Incomplete
Open
The substance that should be avoided in a patient with history of anaphylaxis to MMR vaccine is
Incomplete
Open
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
Incomplete
Open
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
Incomplete
Open
Globe perforation during eye block is more common in myopic eyes because
Incomplete
Open
A common electrolyte disturbance following the administration of ferric carboxymaltose is
Incomplete
Open
A man is brought into hospital after a motor vehicle accident 45 minutes ago. His chest x-ray is shown. This is most consistent with a left-sided
Inadequate Context
Open
The direct physiological effects of electroconvulsive therapy include
Incomplete
Open
A patient requiring an elective joint replacement has had a recent stroke. The minimum time to wait after the stroke before proceeding with surgery is
Incomplete
Open
A 30-year-old professional athlete who underwent a knee arthroscopy under general anaesthesia becomes tachycardic in the recovery room. His non-invasive systolic blood pressure is 90 mmHg. A 12-lead ECG is obtained. The most appropriate therapy is
Incomplete
Open
A patient undergoing robotic prostatectomy with controlled mandatory volume ventilation has the following measurements: (plateau pressure, PEEP, autoPEEP, peak pressure, tidal volume given). The static compliance is
Incomplete
Open
A normal 75 kg term parturient may be expected to have a total blood volume of
Incomplete
Open
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
Incomplete
Open
Toxicity of methylene blue is likely to be seen after single bolus dose (in mg/kg) greater than
Incomplete
Open
The drug which has the LEAST impact on somatosensory evoked potentials (SSEPs) monitored in a 15-year-old patient undergoing scoliosis surgery is
Incomplete
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According to National Audit Project (NAP) 5, the incidence of awareness during general anaesthesia using a non-relaxant technique with a volatile agent is
Incomplete
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A 45-year-old man has poor oxygenation in the post-anaesthesia care unit after a low anterior resection. His chest x-ray is below. The most likely diagnosis is
Incomplete
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The 12 lead ECG shown is most consistent with acute total occlusion of the
Incomplete
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The independent predictors for severe bone cement implantation syndrome (BCIS) in cemented hemiarthroplasty for hip fracture do NOT include
Incomplete
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The recommended antibiotic prophylaxis for insertion of an intrauterine device is
Incomplete
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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
Inadequate Context
Open
In maternal cardiac arrest the most common arrhythmia is
Incomplete
Open
Of the following, allergy based on cross reaction to penicillin sensitivity is most likely with
Incomplete
Open
A 50-year-old man is seen prior to his hip revision surgery. His blood results are (FBE and Iron Studies shown). The most likely diagnosis is
Inadequate Context
Open
The best patient position to evaluate the gastric contents with ultrasound is
Incomplete
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The coagulopathy that can result from intrahepatic cholestasis of pregnancy is due to
Incomplete
Open
A man presents with a fractured tibia. He has increasing pain in his leg, loss of sensation on the plantar surface of his foot and weakness of toe flexion. This is most consistent with a compartment syndrome of the leg in the
Complete
Open
Major international guidelines recommend maintaining the core body temperature between 32°C and 36°C in comatose patients after
Incomplete
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Predictors of successful awake extubation after volatile anaesthesia in infants include
Incomplete
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Severe obstructive sleep apnoea in a 6-year-old child is confirmed if during polysomnography the apnoea/hypopnea index (AHI) is greater than or equal to
Incomplete
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When performing a brachial plexus block at the level of the axilla, the structure indicated by the arrow is the (ultrasound image shown)
Inadequate Context
Open
The composition of blood returned to the patient from intraoperative cell salvage shows
Incomplete
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All of the following conditions are associated with acromegaly EXCEPT
Incomplete
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In the morbidly obese the induction dose of propofol should be calculated based on
Incomplete
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The intubating dose of atracurium in a patient with post-polio syndrome should be
Incomplete
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The most common cause of mortality in children with diabetic ketoacidosis is
Incomplete
Open
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