ANZCA MCQS Final Exam (Latest 2026/ 2027 Update) Review| 100% Verified Questions & Answers | Grade A

ANZCA MCQS Final Exam (Latest 2026/ 2027 Update) Review| 100% Verified Questions & Answers | Grade A QUESTION What equipment do we commonly place down an ETT? Answer: EQUIPMENT THROUGH ETT · Bronchoscope: o 3.2 mm o 4 mm → Use for placing DLT & intubating via LMA o 5.2 mm → 7.5 ETT · Cook Frova Bougie (Blue): o 14 Fr (4.7 mm) o Compatible with ≥ 6 ETT o Not compatible with DLT (shearing end of bougie) · Cook exchange catheter (green/purple): o 11 Fr (3.7 mm) → Compatible 4 ETT or 35 Fr DLT o 14 Fr (4.7 mm) → Compatible 5 ETT or 39 Fr DLT · Aintree intubating catheter: o 19 Fr (6.3 mm) → Compatible 7 ETT o Internal diameter 4.7 → Compatible 4 mm scope QUESTION What concurrent diseases do obese patients have that affect airway management? Answer: OSA: 70% of pts with BMI 35 will have OSA or OHVS (20% of pts with OSA) These pts are likely to require HDU DM (gastroparesis) GORD HH QUESTION What are the classes of obesity? Answer: QUESTION Why is BMV/Facemask ventilation such a problem with the morbidly obese? Answer: Obesity and OSA are predictors of difficult BMV if there is any concern about ability to BMV - careful consideration should be given to intubating AWAKE QUESTION Why is LMA insertion such a problem with the morbidly obese? Answer: ↓ chest compliance - difficult ventilation via LMA In pts with BMI 35 - LMA's are unreliable as rescue devices QUESTION What are the concerns with intubation of morbidly obese patients? Answer: In pts with BMI 35 intubation should be the default means of managing the airway LMAs are unreliable Use of a SGA should be restricted to extreme cases where: the pt can SV, the procedure is short and the pt can be ramped for the entire time - to enable quick, easy intubation Predictors of difficult laryngoscopy: - Neck circumference - Pre-tracheal soft tissue 2.5cm predictor of difficult airway Morbid obesity is a weak predictor of failed intubation Aspiration risk: obesity is a risk fx for reflux, HH, diabetes (gastroparesis), gastric banding - these all ↑ the risk of aspiration RSI should be performed in obese pts with risk fx for aspiration in addition to obesity if there is any concern about ability to intubate successfully - careful consideration should be given to intubating AWAKE QUESTION What is your approach to the intra-operative airway management of morbidly obese? Answer: Positioning for intubation Ramped - sternum + EAM level Improves preox / FRC ↓ reflux risk ↓ risk of difficult intubation Keep in this position throughout the case - so long as it does not interfere with surgical access preoxygenation Needs to be perfect b/c the time to desaturation in the obese pt is very short Ideally use apnoeic oxygenation during airway securement as well Extubation Pre-oxygenate in ramped position Have patient awake reversed (TOF 0.9) upright: with pillows under arms to support them bite block - to prevent neg pressure pulmonary oedema Airway adjuncts NPA useful Regional anaesthesia Should be strongly considered BUT there needs to be a clear plan to manage the airway should the RA technique fail before or during OT If RA unlikely to be effective - safer just to go with GA from the outset QUESTION Airway scenario: 60 y/o M post XRT SCC P/W resp distress d/t B/L VC palsy. What are your considerations and approach? Answer: Previous neck dissection: Easy BMV Easy gd 1 larynx Nasendoscopy shows clear view of cords but small glottis opening d/t B/L VC palsy For microlaryngoscopy Actual plan: TIVA Roc Jet vent via surgical laryngoscopy LMA post laser QUESTION 42 y/o F burns to face / eyes / lips neck For debridement and cleaning of burns prev GA uneventful What are your considerations and approach? Answer: Hx / Ex Hx: confined space etc Examine for: carbonaceous sputum / singed nasal hair Ix: ABG CO / cyanide - err on the side of giving O2 Approach Co-operative pt AFOI Uncooperative pt RSI +/- surgical airway ICU post op QUESTION 42 presented to ED blunt trauma to anterior neck. alert / oriented / blunt trauma / stridor / unable to speak. What are your considerations and approach? Answer: Concerns trauma concerns re other injury Airway Laryngeal injury concern Risk of other injury to tracheobronchial tree - sub cut emphysema acute, evolving obstruction ↑ airway trauma on attempting to intubate PPV - ↑ risk of sub cut emphysema Approach If stable Nasendoscopy CT - to view injury to lower airway AFOI Double set up surgical trache What actually happened RSI surgical tracheostomy QUESTION 67 y/o M 15 hrs after uneventful total thyroidectomy haematoma of neck with neck opened on the ward What is your plan? Answer: Plan When opening the neck - the neck is opened to the trachea Plan: RSI - videolaryngoscopy + FOI with double set up (be prepared for airway grade to be slightly worse) unlikely to tolerate anything awake back up - surgeons do a trache what actually happened AFOI Drugs ready to go for GA Pt intubated - ICU haematoma - compression of venous return - ↑ swelling airway swelling