Mixed Deck — All FANZCA Topics Flashcards

What does a positive 'cannot intubate, cannot oxygenate' (CICO) scenario mandate according to FANZCA airway management guidelines?

Answer: Immediate front-of-neck airway (FONA) access via cricothyrotomy or tracheotomy

FANZCA and ANZCA guidelines mandate immediate front-of-neck airway access (scalpel cricothyrotomy as the default technique) when both ventilation and intubation fail, to prevent hypoxic brain injury and death.

Which equation correctly expresses alveolar ventilation (VA)?

Answer: VA = (tidal volume − dead space) × respiratory rate

Alveolar ventilation accounts for physiological dead space, so only the portion of tidal volume reaching alveoli (tidal volume minus dead space) contributes to gas exchange, multiplied by respiratory rate.

A patient receives propofol via a target-controlled infusion (TCI). The Marsh model uses which variable as its primary input for volume of distribution calculations?

Answer: Total body weight

The Marsh model uses total body weight as its primary input, which can lead to overdosing in obese patients compared to models like Schnider that use age and lean body weight.

A 55-year-old patient with NYHA Class III heart failure needs emergency appendicectomy. Preoperative echo shows EF 25%. Which anaesthetic induction agent best preserves haemodynamic stability?

Answer: Etomidate 0.3 mg/kg

Etomidate causes minimal cardiovascular depression and is the preferred induction agent for haemodynamically compromised patients with severe left ventricular dysfunction.

Under the principle of justice as applied to resource allocation in anaesthesia, a clinician should:

Answer: Allocate resources based on clinical need and benefit, applying fair and consistent criteria

Justice in healthcare requires that limited resources be allocated on the basis of clinical need and likely benefit using transparent, equitable criteria, not social worth or financial status.

The Frank-Starling law of the heart states that within physiological limits, increased ventricular end-diastolic volume leads to:

Answer: Increased stroke volume

The Frank-Starling mechanism describes how increased preload (end-diastolic volume) stretches myocardial fibres, optimising actin-myosin overlap and increasing the force of contraction, thereby increasing stroke volume.

Which educational principle explains why spacing anaesthesia study sessions over time leads to better long-term retention than a single massed study block?

Answer: The spacing effect

The spacing effect demonstrates that distributing practice over time produces stronger memory consolidation than equivalent massed practice.

Which statistical method is most appropriate to assess inter-rater reliability between two FANZCA examiners scoring the same candidate's viva performance?

Answer: Cohen's kappa

Cohen's kappa specifically measures agreement between two raters beyond chance, making it the standard for inter-rater reliability of categorical scores.

A 68-year-old patient is scheduled for elective total hip replacement. Which preoperative assessment tool best predicts postoperative delirium risk?

Answer: Confusion Assessment Method (CAM) baseline

Baseline cognitive assessment using tools such as CAM or the Mini-Mental State Examination identifies pre-existing cognitive impairment, which is the strongest independent predictor of postoperative delirium.

Functional residual capacity (FRC) is the lung volume at which:

Answer: Elastic recoil of the lung equals outward chest wall recoil

FRC is the resting end-expiratory lung volume where the inward elastic recoil of the lung exactly balances the outward recoil of the chest wall, requiring no active muscle work.

In perioperative quality improvement, which of the following is an example of a 'balancing measure' when implementing a fast-track extubation protocol?

Answer: Rate of unplanned reintubation within 24 hours

Balancing measures detect unintended consequences of an improvement intervention; unplanned reintubation rate would indicate whether fast-track extubation compromises respiratory safety.

Which methodology uses the Plan-Do-Study-Act cycle?

Answer: Continuous Quality Improvement (CQI)

The PDSA cycle is a cornerstone of CQI methodology, providing a structured approach to testing and implementing changes.

A 45-year-old woman undergoing thyroid surgery develops sudden onset stridor and respiratory distress 30 minutes postoperatively. What is the first step in assessment and management?

Answer: Open the wound at the bedside to relieve haematoma compression

Post-thyroidectomy airway compromise from expanding haematoma is a surgical emergency; wound opening at the bedside to decompress the haematoma is the immediate life-saving manoeuvre.

During an initial assessment, what should be documented first?

Answer: Chief complaint and history of present illness

The chief complaint and history of present illness establish the reason for the visit and provide context for the examination.

Which educational activity is mandatory for Fellows to complete annually to maintain their membership?

Answer: Completing mandatory professional development activities.

To maintain their membership, Fellows of FANZCA are required to complete mandatory professional development activities annually. These activities are designed to ensure continuous learning, skill maintenance, and adherence to the highest professional standards. This ongoing commitment is crucial for upholding the quality and safety of anaesthetic practice.

Which opioid receptor subtype is primarily responsible for analgesia at the spinal cord level?

Answer: Mu (μ)

Mu (μ) receptors mediate the predominant analgesic effects of opioids at both spinal and supraspinal levels, as well as respiratory depression and euphoria.

A trainee anaesthetist is struggling with time management in the operating theatre. According to adult learning principles, the most effective intervention would be to:

Answer: Provide supervised deliberate practice with structured debriefing

Adult learners benefit most from experiential learning combined with immediate, structured feedback rather than passive theory alone.

The Haldane effect describes:

Answer: Increased CO2 carrying capacity of deoxygenated haemoglobin

The Haldane effect describes how deoxygenated haemoglobin carries more CO2 than oxygenated haemoglobin, facilitating CO2 uptake in tissues and release in the lungs.

Which body is responsible for setting and administering the FANZCA examinations?

Answer: The Australian and New Zealand College of Anaesthetists (ANZCA)

ANZCA is the professional college responsible for setting, administering, and awarding the FANZCA fellowship examinations.

According to the Difficult Airway Society (DAS) guidelines adopted in Australian and New Zealand anaesthetic practice, what is the maximum number of intubation attempts recommended before declaring a failed intubation?

Answer: 3 attempts

DAS guidelines recommend no more than 3 laryngoscopy attempts (including one by a senior anaesthetist) before declaring failed intubation and moving to the next step in the algorithm.