FANZCA Practice and Application 3

Question 1

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?

Accepted Answer

Awake fibreoptic intubation

Answer

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.

Question 2

Which agent is the preferred reversal for rocuronium-induced neuromuscular blockade in a patient with renal failure?

Accepted Answer

Sugammadex

Answer

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.

Question 3

A child weighing 20 kg requires endotracheal intubation. Using the Cole formula, what is the correct uncuffed ETT size?

Accepted Answer

5.0 mm

Answer

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.

Question 4

Which parameter most accurately reflects adequacy of neuromuscular reversal before extubation?

Accepted Answer

Train-of-four ratio ≥0.9 by acceleromyography

Answer

A TOF ratio ≥0.9 measured by quantitative acceleromyography is the most reliable indicator of adequate neuromuscular recovery and protects against residual paralysis.

Question 5

A patient on long-term opioid therapy for chronic pain presents for elective bowel resection. Perioperatively, which analgesic strategy is most appropriate?

Accepted Answer

Continue baseline opioid dose and use multimodal analgesia

Answer

Patients on chronic opioids should continue their baseline dose to prevent withdrawal, supplemented by multimodal analgesia including regional techniques.

(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 3