FANZCA Practice and Application 2

Question 1

A patient undergoing laparoscopic cholecystectomy develops sudden hypotension and raised end-tidal CO2 during insufflation. What is the most likely cause?

Accepted Answer

CO2 embolism

Answer

CO2 gas embolism during laparoscopic insufflation causes a characteristic rise in ETCO2 followed by a sudden fall as cardiac output drops, with concurrent hypotension.

Question 2

Which regional anaesthesia technique provides the best analgesia for a patient with fractured neck of femur awaiting surgical repair?

Accepted Answer

Fascia iliaca compartment block

Answer

The fascia iliaca compartment block reliably covers the femoral, lateral femoral cutaneous, and partially the obturator nerve, providing superior analgesia for femoral neck fractures.

Question 3

In a patient with severe mitral stenosis undergoing non-cardiac surgery, which haemodynamic goal is most important?

Accepted Answer

Avoid tachycardia to allow adequate ventricular filling

Answer

In mitral stenosis, tachycardia reduces diastolic filling time across the stenotic valve, causing a critical drop in cardiac output and pulmonary oedema.

Question 4

A 70 kg adult receives 2 mg/kg propofol for induction. Their blood pressure drops from 130/80 to 70/40 mmHg. What is the most appropriate immediate intervention?

Accepted Answer

Give metaraminol 0.5–1 mg IV bolus

Answer

Metaraminol 0.5–1 mg IV bolus is a practical first-line vasopressor for propofol-induced hypotension, restoring SVR rapidly without significant tachycardia.

Question 5

Which ventilation strategy is recommended during one-lung ventilation to minimise ventilator-induced lung injury?

Accepted Answer

Tidal volume 4–6 mL/kg IBW, PEEP 5 cmH2O

Answer

Lung-protective ventilation during one-lung ventilation uses low tidal volumes (4–6 mL/kg IBW) with moderate PEEP to reduce barotrauma and volutrauma.

(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 Practice and Application 2