FANZCA Assessment and Evaluation 3

Question 1

Which electrocardiographic finding during preoperative assessment represents an absolute contraindication to elective non-cardiac surgery without further investigation?

Accepted Answer

New left bundle branch block (LBBB)

Answer

A new LBBB may indicate acute myocardial ischaemia or cardiomyopathy and mandates urgent cardiology evaluation before elective surgery.

Question 2

A patient with a known pheochromocytoma requires assessment before adrenalectomy. Which biochemical marker is the most sensitive indicator of catecholamine excess?

Accepted Answer

Plasma metanephrines

Answer

Plasma free metanephrines have a sensitivity >95% for phaeochromocytoma and are the preferred first-line biochemical test.

Question 3

When assessing depth of anaesthesia using the Bispectral Index (BIS), which range is targeted to minimise the risk of awareness while avoiding excessive depth?

Accepted Answer

40–60

Answer

A BIS of 40–60 corresponds to an adequate depth of general anaesthesia, balancing the risks of intraoperative awareness and excessive anaesthetic depth.

Question 4

In a patient with severe mitral stenosis, which haemodynamic goal is most critical during the perioperative period?

Accepted Answer

Controlled heart rate to optimise diastolic filling time

Answer

In mitral stenosis, a controlled (slow) heart rate is essential to allow adequate time for ventricular filling across the stenosed valve and maintain cardiac output.

Question 5

Which preoperative pulmonary function test result best predicts increased risk of postoperative pulmonary complications after thoracic surgery?

Accepted Answer

Predicted postoperative FEV1 (ppoFEV1) < 40%

Answer

A ppoFEV1 <40% after planned resection is a major predictor of postoperative respiratory insufficiency and mortality in thoracic surgery.

(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 Assessment and Evaluation 3