ANZCA Final Exam Resources
Past Questions

icon picker
Vivas

Past Vivas
0
Exam
Title
Background
Opening Question
Categories
Pass Rate
2023.1
11
Viva 1
A 50-year-old man presents to the Emergency Department of your tertiary centre two hours after the onset of swelling in the face and lips.
Medications:
Ramipril 5 mg once daily
Rosuvastatin 10 mg once daily
Allergies: Shellfish
Open
As the duty anaesthetist, you have been telephoned by the Emergency Medicine physician and asked to assist with airway management. How will you respond to the request?
Resuscitation Trauma and Crisis Management
Airway Management
Safety and Quality in Anaesthetic Practice
56.7%
Viva 2
You are the anaesthetist for an upper limb orthopaedic list. The next patient on your list is a 55-year-old man for a left arthroscopic acromioplasty and rotator cuff repair in the beach chair position. The expected duration of surgery is 2.5 hours.
Medical history:
Currently well, generally active
Hypertension
Obesity (body mass index 35 kg/m2)
Smoker 10/day
No known allergies
Observations:
Height 178 cm
Weight 110 kg
Heart rate 65 beats per minute
Blood pressure 125/75 mmHg
Medications:
Irbesartan 150 mg mane

Open
Discuss your plan for this patient’s perioperative analgesia.
Perioperative Medicine
Regional and Local Anaesthesia
SSU: Orthopaedic Surgery
78.3%
Viva 3
You are reviewing a 10-year-old child on the day of surgery who has been scheduled for bilateral proximal femoral derotation osteotomies and tendon transfers with a left pelvic osteotomy. The child has a history of cerebral palsy, epilepsy, autism spectrum disorder and intellectual disability, attending a school for children with disability in year 3. They have had previous surgery on the right hip and can mobilise short distances with a frame but they use a wheelchair when out of the house.
Weight 25 kg.
Medications:
Baclofen 2.5 mg TDS
Gabapentin 30 mg nocte
Omeprazole 5 mg daily
Sodium valproate 250 mg BD
Open
Describe your key points of discussion with the parents of this child.
77.5%
Viva 4
An 88-year-old woman is scheduled for an elective transcatheter aortic valve implantation (TAVI). Her aortic stenosis has been under surveillance since she underwent two-vessel coronary bypass grafting nine years ago. She has experienced worsening exertional dyspnoea (NYHA III) and orthopnoea over the past six months and had an admission for heart failure last month that responded to diuretics.
She is an ex-smoker (30 pack-year history) with moderate chronic obstructive pulmonary disease. Her current FEV1 is 1.2 litres (56% predicted). She had one admission for a respiratory illness in 2021 when she experienced COVID-19 pneumonitis.
Medications:
Amlodipine 5 mg mane
Aspirin 100 mg mane
Pantoprazole 20 mg mane
Ramipril 5 mg mane
Symbicort Turbuhaler (budesonide/formoterol) 200/6 mcg 2 puffs inhaled bd
Salbutamol inhaled prn
Biometrics:
Height 178 cm
Weight 58 kg
Body mass index 18.3 kg/m2
Body surface area 1.73 m2
Open
What further information do you require on history?
General Anaesthesia and Sedation
Perioperative Medicine
SSU: Cardiac Surgery and Interventional Cardiology
79.2%
Viva 5
You are the anaesthetist in a regional hospital assigned to the morning emergency list. Your next patient is a 45-year-old man admitted the previous evening with haematuria and flank pain from a renal stone. He is booked for cystoscopy, laser litholapaxy and JJ stent insertion.
Past Medical History:
Hypertension
Type 2 diabetes mellitus
Ryanodine receptor mutation
Medications:
Metformin 500 mg BD
Ramipril 5 mg mane
CT Abdomen and Pelvis report conclusion:
The appearance of the left kidney is in keeping with obstructive uropathy and superimposed pyelonephritis.
Open
What discussion points will you highlight in your pre-anaesthesia consultation with this patient?
General Anaesthesia and Sedation
Perioperative Medicine
Resuscitation Trauma and Crisis Management
SSU: General Surgical Urological Gynaecological and Endoscopic Procedures
69.2%
Viva 6
You are working in the MRI suite of a major regional hospital providing general anaesthesia.
Your next patient is a 35 year-old woman with sensorineural hearing loss for a brain MRI. She requires anaesthesia because of severe anxiety and claustrophobia. Her completed Patient Health Questionnaire is attached.
She received oral diazepam 10 mg one hour ago as premedication. She is calm and mildly sedated in the anaesthesia room adjacent to the MRI scanner.
Open
Outline your preoperative assessment of this patient.
Perioperative Medicine
Airway Management
77.5%
Viva 7
You are called by the obstetrics registrar to insert an epidural catheter in a patient with preeclampsia for blood pressure management and labour analgesia. The patient is a 30-year-old primiparous woman who is at 35+5 weeks gestation. She has gestational diabetes (diet-controlled) and her only medication is low-dose aspirin for a family history of hypertension.
Open
How will you assess this patient?
SSU: Obstetric Anaesthesia and Analgesia
Resuscitation Trauma and Crisis Management
82.5%
Viva 8
You are the anaesthetist on-call for trauma in a major tertiary hospital. You have been asked to attend the Emergency Department for a 48-year-old man brought in by paramedics with stab wounds following a pub fight in a regional town two hours away.
He has no previous medical conditions and no known allergies.
You notice that he is obese. He is irritable but is obeying commands. He has a cut and bruising over his left eye. There are wounds on his abdomen covered by blood- soaked gauze packs, and further wounds on his leg, with a tourniquet on his upper thigh.
His observations are:
Heart rate 125 bpm Blood pressure 110/68 mmHg Respiratory rate 26 breaths per minute SpO2 96% on 10LO2/min via Hudson mask
The ED physician tells you that an eFAST scan is positive. The surgeon asks if you are able to go straight to theatre for exploratory laparotomy.
Open
Would you prioritise Computed Tomography (CT) scanning for this patient before going to the operating theatre?
Resuscitation Trauma and Crisis Management
85.8%
Viva 9
As the duty anaesthetist, you receive a phone call from the emergency department physician at your regional hospital, requesting help with an incoming trauma patient. A 35-year-old male incarcerated person is being transferred by paramedics following an assault two hours ago whilst he was having his meal. He was kicked and punched in both the face and chest and there was an attempted strangulation.
You are informed over the phone that the patient has difficulty breathing and has bruising and swelling to the front of his neck but otherwise appears stable.
He has no allergies and is not on any medications. He smokes 10-15 cigarettes a day and has no significant medical history.
Open
What actions will you take prior to the patient’s arrival?
Resuscitation Trauma and Crisis Management
Airway Management
73.9%
Viva 10
You are reviewing a 72-year-old woman in the anaesthetic bay of a metropolitan hospital. She is scheduled for an elective left total hip replacement and was previously assessed in the pre-anaesthetic clinic two months ago. Two years prior she underwent a right total knee replacement, which was complicated by a 48-hour High Dependency Admission as she was “slow to wake up” and required supplemental oxygen therapy.
Medical history:
Hypertension Obesity (body mass index 41 kg/m2)
Medications:
Atorvastatin 20 mg daily Candesartan/hydrochlorothiazide 16/12.5 mg daily
Open
Outline the areas of focus in your preoperative assessment of this patient.
Perioperative Medicine
Resuscitation Trauma and Crisis Management
SSU: Orthopaedic Surgery
Pain Medicine
79.5%
Viva 11
You are the on-duty anaesthetist in a large regional centre with a paediatric surgical service. You are called to assist in the Emergency Department with the management of an otherwise healthy 2-year-old girl who has ingested drain cleaner (sodium hydroxide) at home about two hours ago. There are concerns about likely aspiration or inhalational injury from vapours.
The Emergency Medicine specialist tells you that the girl was brought in to hospital by her mother after she found the child sitting on the kitchen floor with a pile of drain cleaner crystals next to her and crystals on her hands and inside her mouth. The mother was unable to quantify the amount ingested. The girl vomited once on the way to hospital and is currently drooling and distressed in her mother’s arms.
Open
What are the important issues to consider in the assessment of this child?
70.5%
2022.2
0
2022.1
0
2021.2
0
2021.1
2
Viva 1
A 47-year-old male is brought into the emergency department of a tertiary hospital where you are the anaesthetist on call.
He has sustained abdominal gunshot wounds about 2 hours ago with only minor revealed bleeding obvious. He is diaphoretic and agitated requiring restraint. Your help is required to assist keeping him still enough for larger bore intravenous access (he currently has a 20 gauge cannula) and CT angiogram. He is believed to have recently used methamphetamine.
He has a background of illicit drug use and a known methamphetamine induced cardiomyopathy (ejection fraction 20-30% on recent echocardiogram). He has extremely poor dentition (“Meth Mouth”).
Open
How would you assess his volume status for anaesthetic intervention prior to imaging?
Resuscitation Trauma and Crisis Management
71.0%
Viva 2
You are called to the Emergency Department at 12pm to assess a 75-year-old female with an acute anterior cerebral circulation ischaemic stroke. She has facial paresis, arm weakness and abnormal speech.
Her past history includes atrial fibrillation, type 2 diabetes and hypertension.
Her medications are:
The onset of symptoms was 2 hours prior to admission. Her GCS is 15 and she is compliant with instructions. She has been scheduled for urgent clot retrieval.
Open
What will you do when you arrive in the Emergency Department?
Resuscitation Trauma and Crisis Management
SSU: Neurosurgery and Neuroradiology
88.0%
2020.2
0
2020.1
0
2019.2
0
2019.1
0
2018.2
0
2018.1
0
2017.2
0
2017.1
0
2016.2
0
2016.1
0
2015.2
16
Viva 1
You are the duty anaesthetist in a teaching hospital.
The anaesthetist in the emergency theatre is a senior registrar. His next patient is an obese 56-year-old man for laparoscopic cholecystectomy, following a recent episode of pancreatitis.
As you pass the anaesthetic holding area the registrar is finishing his preoperative assessment of the patient.
You notice that the patient has a hoarse voice and appears somewhat short of breath.
Open
How will you proceed?
General Anaesthesia and Sedation
75.0%
Viva 2
Your junior anaesthetic registrar calls you from the emergency department where he has just assessed a 20-year-old woman who requires an urgent laparoscopic appendicectomy.
He states that the patient says she was a blue baby and had several complex cardiac operations when she was a child.
Her current medications are:
aspirin 100 mg daily
enalapril 5 mg daily
digoxin 250 µg daily
frusemide 80 mg daily
She has no allergies.
Here are schematic representations of a normal cardiac circulation and the patient’s current Fontan circulation.
Open
What further information would you like?
Perioperative Medicine
SSU: General Surgical Urological Gynaecological and Endoscopic Procedures
71.2%
Viva 3
Following a fall, a 78-year-old man needs a dynamic hip screw for an intertrochanteric fracture.
His past history includes:
Ischaemic heart disease
STEMI in 2014 followed by coronary stenting for double vessel disease
latest LVEF 23% with severe segmental left ventricular impairment and stage C heart failure
NYHA III
Peripheral vascular disease
open abdominal aortic aneurysm repair in 2010
right leg claudication
Hypertension
Poorly controlled gastro-oesophageal reflux
His current medications:
aspirin 100 mg mane
quinapril 20 mg mane
frusemide 40 mg bd
metoprolol 25 mg bd
spironolactone 25 mg bd
omeprazole 20 mg mane
His recent blood tests show: (reference range)
Haemoglobin 110 g/l (130–170)
Platelets 95 x109 /l (150–450)
Albumin 29 g/l (35–55)
Open
What are the important preoperative issues in this patient?
Perioperative Medicine
SSU: Orthopaedic Surgery
63.7%
Viva 4
You are the on-call consultant anaesthetist and currently at home.
At 7 pm you receive a call from your first year trainee anaesthetic registrar who is attending a referral in the emergency department.
The patient is a 36-year-old G3P2 pregnant woman, with vaginal bleeding at 33 weeks gestation.
Her previous deliveries were by elective caesarean section.
An ultrasound scan at 28 weeks apparently showed a low lying placenta, but she has not had further follow-up.
Open
What further information do you need and how will you advise the registrar?
SSU: Obstetric Anaesthesia and Analgesia
86.2%
Viva 5
You are the on-call consultant anaesthetist at a large regional hospital.
The anaesthetic registrar rings to inform you of a 24-year-old man booked for knee washout for septic arthritis.
The patient has been unwell for one week with fever, rigors and chills. His left knee has been painful and swollen for three days.
He initially presented to a peripheral hospital 12 hours earlier. After cultures were taken and antibiotics commenced he was transferred for further orthopaedic assessment and management.
His only relevant past history is recreational intravenous drug abuse.
The patient has arrived in the anaesthetic bay and looks unwell.
His vital signs are:
Heart rate 115 /minute
Blood pressure 80/40 mmHg
SpO2 90% (on room air)
Temperature 38.6 C
Open
How will you respond to the registrar’s phone call?
Resuscitation Trauma and Crisis Management
SSU: Orthopaedic Surgery
73.8%
Viva 6
You are on the pain round with the acute pain nurse when you attend an emergency buzzer call on the ward.
An elderly patient has collapsed in the bathroom and is unconscious.
You are the most senior doctor in attendance.
Open
How will you manage this situation?
71.2%
Viva 7
You receive a trauma call to the emergency department of the regional hospital where you are working.
The paramedics have brought in a 30-year-old male who fell from a quad bike while intoxicated. He was dragged some distance before the quad bike rolled onto his legs, pinning him.
On arrival in the emergency department, he is conscious, screaming and has mangling injuries to his lower limbs. Bilateral arterial tourniquets are in situ. He has tyre marks across his abdomen and an open abdominal wound contaminated with dirt and grass.
Open
Outline your priorities in the initial management of this patient.
75.0%
Viva 8
You are the on-call consultant anaesthetist, working on-site at a large regional hospital with a paediatric surgical service.
The surgical registrar phones and asks you to review a four-year-old boy on the children’s ward who has an acute abdomen, for which his consultant would like to book urgent surgery.
The boy has no significant past medical, family or social history.
Open
Describe your initial management.
77.5%
Viva 9
You are the duty anaesthetist at a regional centre, and are urgently called to the emergency department.
Following a drunken fight over dinner, a 38-year-old man has been stabbed in the neck with a kitchen knife, which is still deeply embedded.
He is being cooperative with the emergency department staff.
Open
How will you respond?
73.3%
Viva 10
A 26-year-old man is booked for an urgent laparotomy by the general surgeons.
He was admitted to hospital five days earlier with an acute spinal injury and his surgeons are concerned that he has infarcted bowel.
Open
What are your main concerns and what will you do to explore these concerns?
81.3%
Viva 11
A 46-year-old woman is attending the pre-admission clinic prior to a left total hip replacement for severe osteoarthritis.
She has longstanding schizophrenia with associated intellectual impairment and lives in supported accommodation.
She suffers from behavioural problems including screaming and hair pulling, and is requiring increasing analgesia and sedative medication.
She is 163 cm tall and weighs 125 kg, with body mass index of 47.
Her current medications:
oxycodone 5 mg qid
chlorpromazine 200 mg bd
haloperidol 5 mg bd
diazepam 5 mg qid
Her carer states that eight years earlier, whilst the patient was having her gallbladder out, there was “difficulty placing a breathing tube”.
Open
What particular issues do you anticipate in this patient?
80.0%
Viva 12
You are the consultant covering labour ward at a regional hospital, where the anaesthetist is notified of all high-risk admissions.
You have been called to see Mrs Smith, a 36-year-old primigravida at 38 weeks gestation, who was admitted one hour earlier with severe pre-eclampsia.
Her blood pressure on arrival was 200/100 mmHg.
She was commenced on oral labetalol by her obstetrician, who was then called away to an emergency caesarean section.
When you enter her room with the midwife, you find Mrs Smith semiconscious on the floor, leaning against her bed.
Open
What is your immediate management of this situation?
85.3%
Viva 13
You are called to the cardiac catheter lab to provide assistance with a 54-year-old man.
On arrival you find the patient is agitated and has severe central chest pain.
The cardiology professor wants you to “put the patient to sleep” immediately.
This is the patient’s 12 lead ECG.
Open
What does this ECG show? How will you manage this situation?
78.7%
Viva 14
A 64-year-old woman is booked for frameless stereotactic craniotomy and debulking of a temporal lesion, to be done within 24 hours, following presentation with a generalised seizure.
Her past medical history includes longstanding bronchiectasis and recently diagnosed pulmonary hypertension.
Her current medications:
fluticasone/salmeterol inhaler bd
frusemide 40 mg daily
bosentan 125 mg bd
ciprofloxacin (just completed two week course)
dexamethasone 4 mg qid (for the past 24 hours)
phenytoin 300 mg daily (for the past 24 hours)
Her MRI scan is shown here.
Open
How will you assess her fitness to undergo this procedure?
88.0%
Viva 15
You are the on-call consultant anaesthetist in a tertiary hospital.
You are called to the emergency department to assist in the management of a 52-year-old male pedestrian hit by a car.
Preliminary information from the ambulance service is as follows:
Four fractured limbs, pelvic binding, open leg fractures.
Cervical collar in situ.
Intubated for low Glasgow Coma Scale (GCS) score.
Past history of cirrhosis and portal hypertension.
Open
What will you do before the patient arrives?
81.3%
Viva 16
You are called by the emergency department staff of a children’s hospital.
A six-year-old girl is being brought by ambulance following a fall from a horse.
She was not wearing a helmet.
In the ambulance, her eyes are shut, she is moaning and not responding to pain. Her pupils are reacting sluggishly to light, but they are equal and not dilated.
Open
How will you prepare for her arrival in the emergency department?
74.7%
2015.1
16
Viva 1
You are the on-call consultant anaesthetist on Sunday morning at a district general hospital. You receive a telephone call from the emergency department registrar, who says:
“We have a man down here with an injury to his face from an angle grinder. We’re worried about his airway. He’s bleeding profusely and we need you straight away.”
You are currently anaesthetising an ASA physical status 3 patient for laparotomy, with a first year trainee anaesthetic registrar.
Open
What will you do?
Resuscitation Trauma and Crisis Management
Safety and Quality in Anaesthetic Practice
82.0%
Viva 2
You are the anaesthetist for the emergency list. The gastroenterology registrar has contacted you to book a patient for endoscopic retrograde cholangiopancreatography.
The patient is a 38-yr-old pregnant woman at 35 weeks' gestation, who has presented to the emergency department with acute ascending cholangitis.
Her vital signs are:
Her full blood count shows:
Open
What other condition may have a similar clinical presentation in this patient and how would you exclude this?
Resuscitation Trauma and Crisis Management
SSU: Obstetric Anaesthesia and Analgesia
77.0%
Viva 3
You are the senior duty anaesthetist in a major metropolitan hospital. You receive a call from the emergency department regarding a four-year-old girl, who has presented with post-tonsillectomy haemorrhage. Her initial surgery was performed in a private hospital seven days earlier.
Her vital signs are:

Open
Describe your initial assessment and management in the emergency department.
Resuscitation Trauma and Crisis Management
SSU: Paediatric Anaesthesia
80.0%
Viva 4
An 86-year-old woman is admitted for repair of a fractured neck of femur following a fall.
Her surgery has been postponed for several days because of lack of theatre time.
You are seeing the patient for the first time in the holding bay of theatre.
She has a past history of hypertension and congestive cardiac failure. Her regular medications are metoprolol 25 mg daily and frusemide 40 mg daily.
Open
How will you proceed?
SSU: Orthopaedic Surgery
84.0%
Viva 5
You are in the pre-anaesthesia assessment clinic.
This 54-year-old truck driver is scheduled for excision of a posterior fossa meningioma in a few weeks' time.
His height is 175 cm and weight 140 kg (body mass index 46).
His comorbidities include type 2 diabetes, hypertension and chronic back pain.
His current medications are:
metformin 1 g tds
quinapril 20 mg bd
oxycodone (sustained release) 20 mg bd
paracetamol 1 g qid
His observations are:
Blood pressure 145/85 mmHg
Heart rate 90 /minute (sinus rhythm)
SpO2 95% (on room air)
Open
What are the important preoperative issues in this man?
Perioperative Medicine
SSU: Neurosurgery and Neuroradiology
89.0%
Viva 6
It is 0900 hours on Saturday morning; you are working in a large regional hospital and respond to a trauma call to the emergency department.
A young man has sustained injuries from an accident when his motorbike hit a tree. He was initially found confused at the scene by a passing motorist.
On arrival in the emergency department he is uncooperative and smells of alcohol. He has obvious large lacerations to his head and lower limbs.
His observations are:
Blood pressure 90/50 mmHg
Heart rate 120 /minute
Respiratory rate 22 /minute
SpO2 95%
Temperature 35.3°C
Open
How will you approach this uncooperative patient?
Resuscitation Trauma and Crisis Management
83.0%
Viva 7
You arrive in the emergency department to assist with the management of an acutely unwell 76-year-old man, who has re-presented to hospital a week after thoracoscopy and talc pleurodesis for a non-resolving left-sided malignant pleural effusion.
Two years ago he was diagnosed with lung cancer, which was treated with chemotherapy and radiotherapy. Twelve months ago he developed atrial fibrillation and also suffered a mild left cerebrovascular accident, with no residual deficit.
He has more recently been referred to the Palliative Care team who have commenced him on pregabalin and tramadol because he is intolerant to morphine, fentanyl and oxycodone.
His current medications are:
digoxin 0.125 mg daily
warfarin 4 mg daily
pregabalin 150 mg bd
tramadol (sustained release) 150 mg bd
His vital signs are:
Blood pressure 83/41 mmHg
Heart rate 125 /minute
Respiratory rate 26 /minute
SpO2 93% (O2 6 l/minute via Hudson mask)
Temperature 36.1°C
Open
Please comment on his chest X-ray and how it will influence your initial management.
Resuscitation Trauma and Crisis Management
77.0%
Viva 8
You are called by the emergency department registrar to help with the management of a 33-year-old man who has just presented, shouting about extreme pain in his left hand.
He is on the methadone maintenance program and has accidently injected a solution made with crushed oxycodone tablets into his brachial artery.
His hand is pale with mottled fingertips.
He is restless, agitated, and behaving in a threatening manner to the staff, who have been unable to perform any interventions.
Open
Describe how you would approach this patient, and your thoughts on initial pain management.
Resuscitation Trauma and Crisis Management
SSU: Vascular Surgery and Interventional Radiology
79.0%
Viva 9
It is 1100 hours on Saturday morning and you are working in a large metropolitan hospital. You have just finished a case when you are phoned by the registrar in the high dependency unit.
An 84-year-old man who underwent neck dissection for melanoma two days ago is now in respiratory distress. A large right-sided neck swelling has developed over the last two hours.
His SpO2 is 97% on 15 l/minute of oxygen; his blood pressure is 140/80 mmHg and his heart rate is 95 /minute.
He has a background history of atrial fibrillation and transient ischaemic attacks, for which he takes dabigatran, 110 mg twice daily, as his only medication.
Dabigatran was ceased two days preoperatively and recommenced orally three hours ago. He was bridged with enoxaparin; the last dose of enoxaparin 1.5 mg/kg was 12 hours ago.
You have two minutes to consider the case as you proceed to the high dependency unit.
Open
What further key information do you want to obtain once you get to the bedside?
SSU: Head and Neck ENT Dental Surgery and ECT
Resuscitation Trauma and Crisis Management
72.1%
Viva 10
A pregnant woman at 36 weeks' gestation presents in respiratory distress to the emergency department of your hospital.
The obstetrician asks you to review the patient as her condition is rapidly deteriorating and he wants to deliver the baby.
Open
How will you assess this patient?
Resuscitation Trauma and Crisis Management
SSU: Obstetric Anaesthesia and Analgesia
81.4%
Viva 11
It is 1100 hours on Monday morning, and you are the anaesthetist for the emergency list at a large regional hospital.
The paediatric surgical registrar has booked a 12-year-old boy for drainage of a large pleural effusion. He thinks the effusion is secondary to pneumonia and tells you that the child looks unwell.
The interventional radiologist will insert the chest drain, under ultrasound guidance, in the radiology suite.
You send your anaesthetic registrar to the emergency department to assess the child.
You are able to view the child’s chest X-ray on the radiology information system.
Open
Having seen this chest X-ray, what information will you require from the anaesthetic registrar?
SSU: Paediatric Anaesthesia
Resuscitation Trauma and Crisis Management
70.9%
Viva 12
A 56-year-old woman with a body mass index of 45 and known metastatic ovarian cancer has presented to the emergency department of a peripheral hospital with severe pain in her right thigh following a seemingly trivial injury.
You have been asked to assist with her pain management.
The X-ray of her lower limb is shown.
Her usual medications are:
morphine (sustained release) 60 mg tds
tramadol 100 mg qid
morphine syrup 30 mg q4h prn (for breakthrough pain)
Open
How will you manage this patient?
Pain Medicine
79.1%
Viva 13
After taking your patient to the post-anaesthesia care unit (PACU), you are asked by nursing staff to review another patient.
He is a 28-year-old man who has had a left craniotomy for excision of a tumour. The nurse has been unable to contact the anaesthetist who was involved with the case.
The patient has been in the PACU for one hour. In the last ten minutes he has become increasingly restless, agitated, and hypertensive.
His blood pressure, measured from a radial arterial line, is 200/100 mmHg.
Open
Outline your initial assessment and treatment in the PACU.
Resuscitation Trauma and Crisis Management
SSU: Neurosurgery and Neuroradiology
89.5%
Viva 14
You are the anaesthetist on trauma call at a tertiary hospital.
The retrieval service has just brought a 26-year-old man to the emergency department following an industrial blast injury.
He has sustained burns to his anterior chest, abdomen, and legs.
He is already intubated.
His vital signs are:
Blood pressure 80/45 mmHg
Heart rate 110 /minute
SpO2 80% (FiO2 1.0)
Temperature 36.5°C
Open
Describe your initial management of this patient.
Resuscitation Trauma and Crisis Management
SSU: Plastic Reconstructive and Burns Surgery
82.6%
Viva 15
You are the on-call consultant anaesthetist in a tertiary referral hospital and are called to the emergency department.
A previously fit and well 70 kg 16-year-old girl has presented with acute shortness of breath. She has been generally unwell for three months, with a cough, increasing breathlessness, and occasional fevers.
She takes no regular medication.
Her observations are:
Blood pressure 100/70 mmHg
Heart rate 140 /minute
SpO2 92% (room air)
Respiratory rate 40 /minute
On entering the emergency department you see her chest X-ray on the viewing screen.
Open
What does the chest X-ray show, and how will you assess this patient?
Resuscitation Trauma and Crisis Management
SSU: Paediatric Anaesthesia
73.3%
Viva 16
You are in the pre-anaesthesia assessment clinic.
A 72-year-old man is scheduled for excision of a dorsal right forearm squamous cell carcinoma with a large rotation flap closure.
It is expected to take two to three hours, and is planned for next week.
His past history includes severe chronic obstructive pulmonary disease, asthma, and chronic renal impairment.
The patient does not speak English and an interpreter is present.
Open
Please comment on his chest X-ray, shown here.
Perioperative Medicine
SSU: Plastic Reconstructive and Burns Surgery
75.6%
Want to print your doc?
This is not the way.
Try clicking the ⋯ next to your doc name or using a keyboard shortcut (
CtrlP
) instead.