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CLINICAL PRACTICE

• Discuss the differential diagnosis of massive pulmonary thromboembolism. Outline the management. (Jan’87)
• Discuss the management of a 60 year old man who needs a trans-urethral resection of the prostate. He has had a mitral valve replacement and is currently receiving warfarin therapy. (Jan’90)
• What is your choice of anaesthesia for pericardiectomy in constrictive pericarditis? Give reasons for your choice. – (Nov’96)
• Outline the key points in the management of a patient with massive haemorrhage. (Oct’00)
• What are the anaesthetic considerations in a patient with autonomic neuropathy? (Oct’01)
• A patient who has undergone a heart transplant requires non-cardiac surgery. What problems may this present for the anaesthetist? (Oct’01)

COMPLICATIONS

• What are the postoperative problems in the first 24 hrs after coronary artery bypass graft? How are they prevented? (Nov’97)
• What factors contribute to postoperative cognitive deficits in elderly surgical patients? How may these risks be minimised? (Nov’99)

ANATOMY

• Describe the anatomy of the anterior spinal artery. Discuss its clinical significance. (Jan’87)
• Describe the anatomy of the blood supply and venous drainage of the heart. (May’87)

HAEMATOLOGY

• Formulate a guideline for the peroperative administration of blood explaining the reasons for your recommendations. (Oct’01)

PHYSIOLOGY

• The electrical and mechanical events of the cardiac cycle (Sep’84)
• The cardiac conducting system and heart block (Apr’84)
• Write brief notes on the physiological responses that constitute the stress response to surgery. (Oct’00)

PHARMACOLOGY

• Propranolol (Sep’83)
• A patient on the intensive care unit has a mean arterial pressure of 130 mmHg. What drugs might be useful for reducing this to a safe level and what is the mechanism of action of each? (Nov’97)
• Discuss the perioperative management of the blood pressure of a patient undergoing removal of a phaeochromocytoma. (Oct’00)
• What are the therapeutic uses of magnesium and how does it work? (May’01)
• List the key clinical features, and commonest causative agents of severe anaphylaxis occurring during general anaesthesia. Outline its management. (Apr’02)

CARDIOPULMONARY BYPASS

• What are the principles of adult cardio-pulmonary bypass? What are the common complications of this procedure? (May’99)
• What are the possible deleterious consequences of cardiopulmonary bypass when used in coronary artery surgery? How may these be reduced? (Oct’02)

MYOCARDIAL ISCHAEMIA / INFARCTION

• A 64 year old man has carcinoma of the sigmoid colon. He had a myocardial infarct 10 weeks ago. Describe the anaesthetic management. (Jan’87)
• You have been asked to anaesthetize a 60 year old woman for ligation and stripping of varicose veins in one leg. She has a history of ischaemic heart disease. Explain briefly how suitability for her management in a day-case facility is assessed. (May’97)
• List, with reasons, the factors which affect the incidence of perioperative myocardial infarction. (Nov’98)
• What are the possible causes of intra-operative myocardial ischaemia in a 65 year old male undergoing major intra-abdominal surgery? Outline how the incidence of these may be minimised. (May’01)
  

PACEMAKERS / DYSRHYTHMIA

• Aetiology, diagnosis, complications and management of atrial fibrillation (Apr’84)
• Recognition and treatment of ventricular ectopic beats during anaesthesia (Sep’84)
• Patient with a pacemaker undergoing TURP (Jan’86)
• Causes and treatment of dysrhythmias during surgery (Feb’86)
• Causes and management of abnormal cardiac rhythms during anaesthesia (May’86)
• The first patient on your operating list tomorrow morning has an implanted (permanent) cardiac pacemaker. List with reasons, the relevant factors in your preoperative assessment. (May’97)
• An 80 year old lady with a sub-capital fractured neck of femur requires surgical fixation. She is found to be in fast atrial fibrillation. What are the important points in the preoperative preparation for anaesthesia in this case? (May’97)
• Classify the types of heart block. Outline appropriate treatment in the intraoperative period. (Nov’99)

INVESTIGATIONS

• How do you confirm brain stem death? Outline the management of such a patient before organ donations. (Jan’90)
• Describe the criteria and tests for brain stem death. Briefly indicate the neurological basis for each test. (May’01)
• A 70 year old man presents for a total hip replacement. He has no significant past medical history. At the anaesthetic assessment clinic he is noted to have a grade III ejection systolic murmur at the right sternal edge, radiating to his neck. Describe, with reasons, what investigations should be undertaken on this patient and explain how the results would affect your anaesthetic management. (Oct’01)
• What are the indications for a pre-operative chest radiograph. (Oct’02)

PERIOPERATIVE MONITORING

• Measurement of heart rate, arterial pressure and central venous pressure (May’83)
• The normal ECG (Sep’83)
• Anatomy relevant to internal jugular / subclavian vein cannulation (Feb’86)
• What can be measured or derived from a successfully placed multi-lumen flow directed pulmonary artery catheter? (May’87)
• What measurements and derived values can be made from pulmonary artery catheters used in the intensive care unit? Suggest a clinical application for each one. (May’97)
• Make a simple diagram, labelled to show the anatomical structures associated with the right internal jugular vein. List the complications of cannulation of this vessel, mentioning how each may be avoided. (Nov’97)
• List the factors associated with central venous catheter infections and suggest methods to limit such infections. (May’98)
• How can jugular venous bulb oxygen saturation be measured? What factors cause its value to increase or decrease? (May’00)
• How may coagulation be assessed in the perioperative period? (May’00)
• Discuss briefly the complications of placing a jugular central venous line. Where should the tip of a left internal jugular line lie and why? (Oct’01)
• Define contractility. Outline the methods available to the clinician to assess myocardial contractility in the peri-operative period. (Oct’02)

FANZCA QUESTIONS

• Influence of temperature on blood gas analysis (Jul’99)
• Aortic root and radial artery pressure waves (Jul’99)