FANZCA Airway Management and Techniques 3

Question 1

Which topical anaesthetic agent is most commonly used for awake fibreoptic intubation of the airway due to its rapid onset and relatively low systemic toxicity at clinical doses?

Accepted Answer

Lignocaine (lidocaine) 4%

Answer

Lignocaine (lidocaine) 4% is the most widely used topical agent for awake fibreoptic intubation due to its favourable safety profile, rapid onset, and well-established maximum safe dose of approximately 9 mg/kg when applied topically.

Question 2

During awake fibreoptic intubation, a superior laryngeal nerve block is performed to anaesthetise which anatomical region?

Accepted Answer

Piriform fossae and laryngeal inlet above the cords

Answer

The superior laryngeal nerve (internal branch) provides sensory innervation to the laryngeal inlet and piriform fossae above the vocal cords; blocking it anaesthetises this region to facilitate awake intubation.

Question 3

When sizing an endotracheal tube for a child using the age-based formula, which of the following correctly represents the uncuffed tube size calculation?

Accepted Answer

(Age/4) + 4

Answer

The standard formula for uncuffed endotracheal tube internal diameter in children is (age in years / 4) + 4, which reliably estimates appropriate tube size from approximately 1 to 8 years of age.

Question 4

A patient undergoing anaesthesia has a sudden decrease in end-tidal CO2 to near zero while the airway pressure remains normal and SpO2 begins to fall. What is the MOST likely diagnosis?

Accepted Answer

Pulmonary embolism

Answer

A sudden near-zero ETCO2 with previously normal ventilation (normal pressures) and concurrent haemodynamic collapse is the classic presentation of massive pulmonary embolism, which eliminates CO2 elimination by obstructing pulmonary circulation.

Question 5

Which of the following is a recognised contraindication to the use of a laryngeal mask airway (LMA) as the primary airway device during general anaesthesia?

Accepted Answer

Non-fasted patient undergoing emergency appendicectomy

Answer

A non-fasted patient (full stomach) is a recognised contraindication to LMA use as the device does not protect against pulmonary aspiration of gastric contents in the same way as a cuffed endotracheal tube.

(FANZCA) Fellowship of the Australian and New Zealand College of Anaesthetists Practice Test

(FANZCA) Fellowship of the Australian and New Zealand College of Anaesthetists Practice Test

FANZCA Airway Management and Techniques 3