Year

Paper

Q. No.

Question

2000

1

1

A patient is to have surgery for resection of an abdominal aortic aneurysm. What advantages does trans-oesophageal echocardiography have over ECG monitoring for intra-operative myocardial ischaemia?

2000

1

2

A patient is to have surgery for resection of an abdominal aortic aneurysm. Justify the measures you would use to minimise the risk of acute tubular necrosis if the surgeon is to clamp the supra-renal aorta.

2000

1

3

A patient is to have surgery for resection of an abdominal aortic aneurysm. What are the relative merits of sodium nitroprusside versus glyceryl trinitrate for the control of hypertension when the aorta is cross-clamped?

2000

1

4

You are asked to provide pain relief for a woman in labour. She is a primigravida, has twins and is 5 cm dilated. You provide epidural analgesia. Describe and give reasons for your choice and method of delivery of drug(s).

2000

1

5

You are asked to provide pain relief for a woman in labour. She is a primigravida, has twins and is 5 cm dilated. This patient is now ready for vaginal delivery, but perineal analgesia is inadequate. Discuss the method you would recommend to remedy this.

2000

1

6

You are asked to provide pain relief for a woman in labour. She is a primigravida, has twins and is 5 cm dilated. Indicate elements you consider important when obtaining consent for epidural analgesia in labour.

2000

1

7

You are asked to provide anaesthesia for an appendicectomy late at night. When you arrive, you smell alcohol on the surgeon's breath. How would you respond to this situation?

2000

1

8

You are asked to provide anaesthesia for an appendicectomy late at night. When you arrive, you smell alcohol on the surgeon's breath. What are your obligations if you suspect a colleague may be chronically impaired?

2000

1

9

You are asked to provide anaesthesia for an appendicectomy late at night. When you arrive, you smell alcohol on the surgeon's breath. What are the signs of alcohol abuse in a colleague?

2000

1

10

A three year old child is being assessed for insertion of middle ear drainage tubes. On examination you discover that the child has a precordial murmur. What information would you be seeking in your assessment of this child to decide if the murmur is innocent?

2000

1

11

A three year old child is being assessed for insertion of middle ear drainage tubes. On examination you discover that the child has a precordial murmur. If the child is found to have a ventricular septal defect, but is otherwise well, how will this influence your anaesthetic management?

2000

1

12

Describe the pharmacokinetics and dosing schedule of paracetamol for post operative analgesia.

2000

1

13

What are the considerations in setting the fresh gas flow rate when anaesthetising an adult with sevoflurane in nitrous oxide/oxygen being administered using a circle absorber system?

2000

1

14

Describe the pathophysiology and diagnosis of diabetes insipidus following head injury

2000

1

15

Describe the anatomy relevant to providing an ankle block for amputation of the great toe

2000

2

1

A 57 year old man with a primary lung tumour is scheduled to have a thoracotomy for a left pneumonectomy. Justify your choice of airway device for this surgery and describe how it is placed.

2000

2

2

A 57 year old man with a primary lung tumour is scheduled to have a thoracotomy for a left pneumonectomy. Discuss the advantages and disadvantages of using a bronchoscope to check the position of the device.

2000

2

3

A 57 year old man with a primary lung tumour is scheduled to have a thoracotomy for a left pneumonectomy. Outline your management of an oxygen saturation of 82% during one lung ventilation.

2000

2

4

A 46 year old male presents to a day procedure unit for a right knee arthroscopy. He wishes to avoid general anaesthesia as he has experienced significant nausea in the past. In performing a spinal anaesthetic for this procedure, what factors would you consider in choosing the local anaesthetic agent?

2000

2

5

A 46 year old male presents to a day procedure unit for a right knee arthroscopy. He wishes to avoid general anaesthesia as he has experienced significant nausea in the past. You perform a spinal anaesthesia. The following day the surgeon calls you because the patient is complaining of pain in his right thigh. What possible causes would you consider and how would you respond?

2000

2

6

A 46 year old male presents to a day procedure unit for a right knee arthroscopy. He wishes to avoid general anaesthesia as he has experienced significant nausea in the past. You perform a spinal anaesthesia. When you contact the patient that day, he tells you that he has been suffering from a moderately severe headache since arriving home. What information would you seek and what advice would you give him?

2000

2

7

Discuss serum tryptase as an investigation in current medical practice

2000

2

8

Compare the relative merits of gelatin-based intravenous solutions and dextran intravenous solutions.

2000

2

9

List the anatomical differences between the neonatal and adult airway. Include the significance of each difference.

2000

2

10

A 75 year old man is scheduled for a two-level posterior spinal fusion under general anaesthesia in the prone position. He suffers from stable angina, for which he takes sublingual glyceryl trinitrate. He also takes oral morphine for his back pain. What hazards will his position for surgery present and how may they be minimised?

2000

2

11

A 75 year old man is scheduled for a two-level posterior spinal fusion under general anaesthesia in the prone position. He suffers from stable angina, for which he takes sublingual glyceryl trinitrate. He also takes oral morphine for his back pain. His preoperative blood pressure is 150/90 and the surgeon requests induced hypotension. Justify the level you would lower the blood pressure to and the method chosen.

2000

2

12

A 75 year old man is scheduled for a two-level posterior spinal fusion under general anaesthesia in the prone position. He suffers from stable angina, for which he takes sublingual glyceryl trinitrate. He also takes oral morphine for his back pain. Half way during the first-level fusion, the electronic anaesthetic machine diagnoses that it has an internal fault and without warning shuts all functions off including gas delivery, ventilation and monitoring. How will you manage this situation?

2000

2

13

A patient is referred to see you six weeks before her scheduled cholecystectomy. The significant features of her history and examination are: Age 42, Weight 140kg, Height 171cm Medication: Oral contraceptive pill. llergies: Peanuts (severe asthma); some cosmetics; penicillin (itchy rash) . Smokes 60 cigarettes per day for 20 years. Discuss the anaesthetic-related risks associated with laparoscopic as compared to open surgery in this patient

2000

2

14

A patient is referred to see you six weeks before her scheduled cholecystectomy. The significant features of her history and examination are: Age 42, Weight 140kg, Height 171cm Medication: Oral contraceptive pill. llergies: Peanuts (severe asthma); some cosmetics; penicillin (itchy rash) . Smokes 60 cigarettes per day for 20 years. What will you advise her regarding the risks of continuing to smoke prior to the operation?

2000

2

15

A patient is referred to see you six weeks before her scheduled cholecystectomy. The significant features of her history and examination are: Age 42, Weight 140kg, Height 171cm Medication: Oral contraceptive pill. Allergies: Peanuts (severe asthma); some cosmetics; penicillin (itchy rash) . Smokes 60 cigarettes per day for 20 years. Discuss premedication in this patient.

1999

2

1

A 31 year old primigravida at 36 weeks gestation presents with a blood pressure of 170/110 mmHg, proteinuria, persistent headache and hyperreflexia. She requires delivery by caesarean section within three hours. How would you manage her blood pressure in the time before surgery?

1999

2

2

A 31 year old primigravida at 36 weeks gestation presents with a blood pressure of 170/110 mmHg, proteinuria, persistent headache and hyperreflexia. She requires delivery by caesarean section within three hours. Justify your choice of anaesthesia for caesarean section.

1999

2

3

A 31 year old primigravida at 36 weeks gestation presents with a blood pressure of 170/110 mmHg, proteinuria, persistent headache and hyperreflexia. She requires delivery by caesarean section within three hours. If she had had an uneventful general anaesthetic, but started convulsing in the recovery ward two hours post-operatively, how would you manage this?

1999

2

4

A healthy 25 year old, 80 kg man has general anaesthesia for the elective removal of 4 molar teeth. The anaesthetist uses a laryngeal mask airway (LMA). Justify the use of a LMA for this procedure.

1999

2

5

A healthy 25 year old, 80 kg man has general anaesthesia for the elective removal of 4 molar teeth. The anaesthetist uses a laryngeal mask airway (LMA). Halfway through the surgery, the capnograph trace becomes flat. Describe your management.

1999

2

6

A healthy 25 year old, 80 kg man has general anaesthesia for the elective removal of 4 molar teeth. The anaesthetist uses a laryngeal mask airway (LMA). Discuss methods of post-operative analgesia for this surgery.

1999

2

7

An 83 year old woman slips and sustains a left Colles' fracture after a birthday lunch, and is booked for manipulation and plaster of her fracture. Discuss the benefits and drawbacks of intravenous regional anaesthesia for this patient.

1999

2

8

An 83 year old woman slips and sustains a left Colles' fracture after a birthday lunch, and is booked for manipulation and plaster of her fracture. Give reasons for your choice and dose of local anaesthetic agent for intravenous regional anaesthesia.

1999

2

9

An 83 year old woman slips and sustains a left Colles' fracture after a birthday lunch, and is booked for manipulation and plaster of her fracture. You choose intravenous anaethesia. What hazards does the use of a tourniquet present in this situation, and how might they be minimised?

1999

2

10