FANZCA Perioperative Care and Management Flashcards
6 cards from real FANZCA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
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What is the Mallampati classification system used for in anesthetic preoperative assessment?
Answer: Predicting the ease of tracheal intubation based on oropharyngeal visibility
The Mallampati score (classes I–IV) assesses visibility of oropharyngeal structures with maximal mouth opening, correlating with difficulty of laryngoscopy and intubation.
In perioperative anesthetic management, which strategy is recommended for patients at high risk of postoperative nausea and vomiting (PONV)?
Answer: Multimodal prophylaxis including TIVA with propofol, ondansetron, and dexamethasone
Multimodal PONV prophylaxis combining TIVA (propofol-based), antiemetics from different classes (5-HT3 antagonists, corticosteroids), and minimizing opioids is recommended for high-risk patients.
What does a bispectral index (BIS) value of 40–60 indicate during general anesthesia?
Answer: An adequate level of hypnosis with low risk of awareness
A BIS value of 40–60 reflects adequate anesthetic depth for surgical stimulation with a low probability of intraoperative awareness, according to manufacturer and clinical guidelines.
Which parameter most reliably indicates return of adequate neuromuscular function before tracheal extubation using quantitative monitoring?
Answer: Train-of-four ratio (TOF ratio) ≥ 0.9
A quantitative TOF ratio of ≥ 0.9 measured by acceleromyography is the gold standard for confirming adequate neuromuscular recovery before extubation, as clinical tests are unreliable for detecting residual block.
In perioperative cardiac risk assessment, what does the Revised Cardiac Risk Index (RCRI) estimate?
Answer: Risk of major adverse cardiac events (MACE) after noncardiac surgery
The RCRI uses six independent predictors (ischemic heart disease, heart failure, cerebrovascular disease, diabetes on insulin, creatinine >2 mg/dL, high-risk surgery) to estimate perioperative MACE risk.
What is the significance of measuring lactate levels perioperatively in critically ill or high-risk surgical patients?
Answer: Elevated lactate indicates tissue hypoperfusion and anaerobic metabolism, guiding resuscitation targets
Perioperative hyperlactatemia (>2 mmol/L) reflects inadequate tissue oxygen delivery and anaerobic metabolism, serving as a resuscitation endpoint and predictor of morbidity and mortality.