Practice and Application Flashcards
7 cards from real FANZCA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Practice and Application flashcards as text
A patient with known difficult airway presents for elective surgery. The previous anaesthetic record documents 'grade 3 view, bougie-assisted intubation.' Which initial approach is most appropriate?
Answer: Awake fibreoptic intubation
A grade 3 view on prior laryngoscopy with the need for adjuncts indicates a genuinely difficult airway; awake fibreoptic intubation maintains spontaneous ventilation and is the safest strategy.
Which agent is the preferred reversal for rocuronium-induced neuromuscular blockade in a patient with renal failure?
Answer: Sugammadex
Sugammadex encapsulates rocuronium and is effective regardless of renal function, though the complex may accumulate; it remains preferred over neostigmine which requires ACh esterase activity.
A child weighing 20 kg requires endotracheal intubation. Using the Cole formula, what is the correct uncuffed ETT size?
Answer: 5.0 mm
The Cole formula (age/4 + 4) for a 20 kg child typically corresponds to approximately 5 years of age, giving a tube size of 5.0 mm.
Which parameter most accurately reflects adequacy of neuromuscular reversal before extubation?
Answer: Train-of-four ratio ≥0.9 by acceleromyography
A TOF ratio ≥0.9 measured by quantitative acceleromyography is the most reliable indicator of adequate neuromuscular recovery and protects against residual paralysis.
A patient on long-term opioid therapy for chronic pain presents for elective bowel resection. Perioperatively, which analgesic strategy is most appropriate?
Answer: Continue baseline opioid dose and use multimodal analgesia
Patients on chronic opioids should continue their baseline dose to prevent withdrawal, supplemented by multimodal analgesia including regional techniques.
During spinal anaesthesia for Caesarean section, the patient develops hypotension to 70/40 mmHg and nausea. What is the first-line treatment?
Answer: Phenylephrine 100 mcg IV bolus or noradrenaline infusion
Current evidence favours vasopressors (phenylephrine or noradrenaline) over ephedrine as first-line for spinal hypotension in obstetrics due to better foetal acid-base outcomes.
When performing an interscalene brachial plexus block, which structure is most at risk of injury from needle placement?
Answer: Phrenic nerve
The phrenic nerve runs adjacent to the brachial plexus at the interscalene level and is blocked in nearly 100% of cases, causing ipsilateral hemidiaphragm paresis.