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

A nine year old child with spina bifida presenting for a tendon transfer procedure is said to have multiple allergies including latex and antibiotics. How would you decide whether or not the child has latex allergy?

1999

2

11

A nine year old child with spina bifida presenting for a tendon transfer procedure is said to have multiple allergies including latex and antibiotics. If the child does have latex allergy, describe the precautions that should be taken peri-operatively to prevent this child developing a latex reaction?

1999

2

12

A nine year old child with spina bifida presenting for a tendon transfer procedure is said to have multiple allergies including latex and antibiotics. What would you advise the parents regarding the risks that latex allergy adds to the peri-operative period?

1999

2

13

What is the role for radionuclide imaging in the assessment of ischaemic heart disease prior to general anaesthesia for non-cardiac surgery?

1999

2

14

Draw a circle breathing system and give reasons for the location in the circle of the one way valves and the Adjustable Pressure Limiting (APL or pop-off) valve.

1999

2

15

What is micro-shock? Outline methods designed to prevent it occurring in the operating theatre.

1999

1

1

A 52 year old man, height 1.75m, weighing 130 kg presents for laparoscopic cholecystectomy under general anaesthesia.  History and examination reveal no other abnormality. How does this patient’s obesity influence your management of his anaesthetic up to the time of the first incision?

1999

1

2

A 52 year old man, height 1.75m, weighing 130 kg presents for laparoscopic cholecystectomy under general anaesthesia.  History and examination reveal no other abnormality. Explain the physiological effects of a carbon dioxide pneumoperitoneum in this man.

1999

1

3

A 52 year old man, height 1.75m, weighing 130 kg presents for laparoscopic cholecystectomy under general anaesthesia.  History and examination reveal no other abnormality. Open cholecystectomy becomes necessary.  The surgeon requests that you place an epidural catheter for postoperative analgesia.  Outline the issues which should be considered in responding to this request.

1999

1

4

A 4 year old boy weighing 15 kg presents for day surgery repair of a left inguinal hernia for which you plan general anaesthesia and a caudal block.  He has no significant past history, and is well. Describe how you would perform a caudal injection for this child.

1999

1

5

A 4 year old boy weighing 15 kg presents for day surgery repair of a left inguinal hernia for which you plan general anaesthesia and a caudal block.  He has no significant past history, and is well. Justify your choice of agent(s) for caudal injection for this child.

1999

1

6

A 4 year old boy weighing 15 kg presents for day surgery repair of a left inguinal hernia for which you plan general anaesthesia and a caudal block.  He has no significant past history, and is well. If his parents express concern about caudal analgesia, what alternative analgesia options would you offer?  Include a brief comment on their particular advantages and disadvantages.

1999

1

7

A 55 year old adult is to have nasal polypectomy under general anaesthesia.  The patient has nocturnal oesophageal reflux and extensive fixed upper dental prostheses. How would you reduce the risk of peri-operative dental damage?

1999

1

8

A 55 year old adult is to have nasal polypectomy under general anaesthesia.  The patient has nocturnal oesophageal reflux and extensive fixed upper dental prostheses. How can problems associated with the use of vasoconstrictors in nasal surgery be prevented?

1999

1

9

A 55 year old adult is to have nasal polypectomy under general anaesthesia.  The patient has nocturnal oesophageal reflux and extensive fixed upper dental prostheses. Describe the management of systemic toxicity resulting from the use of vasoconstrictors in nasal surgery.

1999

1

10

Describe the anatomy of the brachial plexus relevant to risks associated with supraclavicular block.

1999

1

11

Describe the use of a nerve stimulator to monitor neuromuscular blockade during general anaesthesia for intracranial surgery.

1999

1

12

What is the role of non-steroidal anti-inflammatory drugs for postoperative analgesia in adult day surgery patients?

1999

1

13

A severely depressed 60 year old man presents for electroconvulsive therapy. His history includes controlled hypertension and stable ischaemic heart disease.  He is taking the monoamine oxidase inhibitor phenelzine for depression.  What are the implications of his phenelzine therapy of relevance to general anaesthesia for ECT?

1999

1

14

A severely depressed 60 year old man presents for electroconvulsive therapy. His history includes controlled hypertension and stable ischaemic heart disease.  He is taking the monoamine oxidase inhibitor phenelzine for depression.  Describe the physiological effects of electroconvulsive therapy relevant to his anaesthetic management. Omit any considerations concerning phenelzine

1999

1

15

A severely depressed 60 year old man presents for electroconvulsive therapy. His history includes controlled hypertension and stable ischaemic heart disease.  He is taking the monoamine oxidase inhibitor phenelzine for depression.  Discuss your choice of induction agent for this procedure.

1998

2

1

A patient was scheduled for elective repair of an abdominal aortic aneurysm. During preparation for anaesthesia, the 8.5 French Gauge introducer sheath intended for the internal jugular vein was inserted into the carotid artery. How could the risk of this incident occurring be minimised?

1998

2

2

A patient was scheduled for elective repair of an abdominal aortic aneurysm. During preparation for anaesthesia, the 8.5 French Gauge introducer sheath intended for the internal jugular vein was inserted into the carotid artery. When the problem has been recognised, what is the appropriate management?

1998

2

3

A patient was scheduled for elective repair of an abdominal aortic aneurysm. During preparation for anaesthesia, the 8.5 French Gauge introducer sheath intended for the internal jugular vein was inserted into the carotid artery. Discuss the choice of the internal jugular vein as the initial site to attempt central vein cannulation in this patient.

1998

2

4

A 35 year old man had a heart transplant 4 years ago. He is now troubled by pain from avascular necrosis of the head of femur, and requires surgery. He is on cyclosporin, azathioprine and prednisolone. What are the implications of his immunosuppressive treatment for perioperative anaesthesia care?

1998

2

5

A 35 year old man had a heart transplant 4 years ago. He is now troubled by pain from avascular necrosis of the head of femur, and requires surgery. He is on cyclosporin, azathioprine and prednisolone. How does the history of him having a heart transplant influence your anaesthetic management?

1998

2

6

Describe the strategies which should be employed to minimise the risk of sepsis associated with his peripheral venous cannula.

1998

2

7

A healthy 34 year old man requires colonoscopy under intravenous sedation because of a strong family history of bowel cancer. Describe the composition and effects of bowel preparation solutions commonly used before colonoscopy.

1998

2

8

A healthy 34 year old man requires colonoscopy under intravenous sedation because of a strong family history of bowel cancer. Soon after colonoscopy begins his pulse rate falls to 40 beats/minute and blood pressure to 60/40 mmHg. Describe your management

1998

2

9

A healthy 34 year old man requires colonoscopy under intravenous sedation because of a strong family history of bowel cancer. What criteria need be met before he can be discharged home from the day procedure facility?

1998

2

10

How may the spread of blood borne viral infectious agents from patient to health care worker be minimised in anaesthesia?

1998

2

11

Compare propofol with sevoflurane as the sole general anaesthesia agent for a three year old child requiring insertion of drainage tubes for chronic otitis media.

1998

2

12

Describe the anatomy of the trigeminal nerve and its branches relevant to providing anaesthesia of the teeth and gums.

1998

2

13

A 34 year old woman requires repeat lower section caesarean section. Last time she had a caesarean section her post operative course was complicated by post dural puncture headache (following dural puncture with a 16 G needle), as well as a deep venous thrombosis. She won’t have general anaesthesia. How would you minimise the problem of post dural puncture headache on this occasion?

1998

2

14

A 34 year old woman requires repeat lower section caesarean section. Last time she had a caesarean section her post operative course was complicated by post dural puncture headache (following dural puncture with a 16 G needle), as well as a deep venous thrombosis. She won’t have general anaesthesia. Describe and justify the regional anaesthesia technique you would choose for this woman.

1998

2

15

A 34 year old woman requires repeat lower section caesarean section. Last time she had a caesarean section her post operative course was complicated by post dural puncture headache (following dural puncture with a 16 G needle), as well as a deep venous thrombosis. She won’t have general anaesthesia. Describe and justify your prophylaxis against deep venous thrombosis for her. (Begin your answer by briefly stating in just a word or two the regional anaesthesia technique you have chosen.)

1998

1

1

What are the desirable features of a breathing circuit filter for adult anaesthesia use?

1998

1

2

Use of at least 30% oxygen in the inspired gas has been traditional practice in anaesthesia for healthy adults. Is this practice valid?

1998

1

3

How may physiological control of temperature regulation in adults be altered by general anaesthesia?

1998

1

4

A 59 year old patient presents for the first time with a subacute bowel obstruction requiring laparotomy in the next two or three days. You are asked by the surgeon to review the patient because on admission his blood pressure is 210/120. Hypertension has not been previously diagnosed in this man and he is on no medications. Describe your assessment of his hypertension by history and examination.

1998

1

5

A 59 year old patient presents for the first time with a subacute bowel obstruction requiring laparotomy in the next two or three days. You are asked by the surgeon to review the patient because on admission his blood pressure is 210/120. Hypertension has not been previously diagnosed in this man and he is on no medications. How would you proceed with investigation of his hypertension if no cause was apparent from the assessment described above?

1998

1

6

A 59 year old patient presents for the first time with a subacute bowel obstruction requiring laparotomy in the next two or three days. You are asked by the surgeon to review the patient because on admission his blood pressure is 210/120. Hypertension has not been previously diagnosed in this man and he is on no medications. How would you manage his blood pressure in the peri-operative period if no cause had been found for this hypertension?

1998

1

7

A 50 year old man with gastro-oesophageal reflux and occasional nocturnal pharyngeal reflux is to have knee arthroscopy under general anaesthesia. What are the methods which could be used to minimise the risk of aspiration of gastric contents?

1998

1

8

A 50 year old man with gastro-oesophageal reflux and occasional nocturnal pharyngeal reflux is to have knee arthroscopy under general anaesthesia. What are the adverse effects of the pharmacological agents which could be used for this purpose (to minimise the risks of aspiration of gastric contents)? Exclude any considerations of anaesthetic agents or muscle relaxants.

1998

1

9

A 50 year old man with gastro-oesophageal reflux and occasional nocturnal pharyngeal reflux is to have knee arthroscopy under general anaesthesia. Despite your best management the patient does regurgitate and aspirate at induction. How would you manage this?

1998

1

10

An otherwise well 20 year old requires circumcision. Describe the anatomy of the penis relevant to providing regional anaesthesia for circumcision in an adult.

1998

1

11

An otherwise well 20 year old requires circumcision. The patient becomes unconscious after injection of a total of 10mls of bupivacaine 5mg/ml for penile block. Describe your initial assessment.

1998

1

12

An otherwise well 20 year old requires circumcision. The patient is found to be in ventricular fibrillation. The patient becomes unconscious after injection of a total of 10mls of bupivacaine 5mg/ml for penile block. Describe your management of this situation.

1998

1

13

An obese 40 year old man with a history of snoring presents for septoplasty and cautery of turbinates. At the pre-anaesthetic assessment consultation, what clinical features on history and examination would suggest to you that he may have sleep apnoea?

1998

1

14

An obese 40 year old man with a history of snoring presents for septoplasty and cautery of turbinates. Discuss your plan for intra operative airway management of this patient.

1998

1

15

An obese 40 year old man with a history of snoring presents for septoplasty and cautery of turbinates. How would sleep apnoea influence your post-operative management including provision of analgesia?

1997