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Final ANZCA
Final ANZCA Exam 100% Verified
Questions & Answers | Grade A |
Latest 2026/2027
1. Heart Failure Mx: Investigation - ECG, CXR, ECHO, Bloods, Coronary
angiography Classify
Monitoring
Goals - eliminate oedema, maintain MAP, improve end organ perfusion
Optimise preload
Optimise afterload
Inotropic support
2. Severe Hypothermia Mx: Vasopressors only when T>30oC
'not dead until warm and dead' (30-32⁰C)
Passive warming
Peripheral active warming
Central active warming
Final ANZCA
, 2
Final ANZCA
Supportive care and monitoring
3. SvO2: mixed venous blood saturation, from pulm A sampled with PAC -
can be measured continuously.
SvO2 > 70% could indicate peripheral hypoxia and inability to extract
oxygen
SvO2 < 70% could indicate increased oxygenation extraction,
hypoperfusion, anaemia, hypoxaemia
4. Neuroleptic Malignant Syndrome: FEVERS
Dopamine depletion
Diagnosis - clinical, biochemical, proximity to antipsychotic
Mx: Supportive, Cooling, Biochemical, Pharmacological, Plasmapheresis
Anaesthetic implications
5. Malignant Hyperthermia: acute life-threatening disturbance of skeletal
muscle calcium homeostasis following exposure to triggering agent
(e.g. volatiles, suxamethonium, etc)
ABCD
Dantrolene: 2.5mg/kg then repeat as necessary up to 10mg/kg
Final ANZCA
, 3
Final ANZCA
Direct treatment - hyperthermia, hyperkalemia, acidosis, rhabdomyolysis
HDU/ICU monitoring of all above for 24hrs
6. Seizures: ABC
A- patent airway
B - hyperventilation
C- secure large bore IV, blood tests
Pharmacological treatment: benzodiazepine=> phenytoin =>GA
7. Epilepsy: Pre-op
- History: childhood, recent precipitation
- Ix: blood levels, screen
- continue AED up to the day
Intra-op
- induction: inhaled or IV; NMB - avoid sux, atrac or ciastrac
- maintenance: inhalation or TIVA
Post-op
- restart AED
- monitor carefully
Final ANZCA
, 4
Final ANZCA
8. Organ donation and Anaesthesia: Maintain 'normea'
Anaesthetic technique
Monitors
Optimise organs for transplant
Drugs - muscle relaxant, methylprednisolone, broad spectrum antibiotics,
heparin, chlopromazine, prostacyclin
9. PK and PD in critical illness: PD - more susceptible to
toxicity PK
A - altered GI absorption
D - increased capillary leak, decreased plasma proteins
M - change in metabolism liver, plasma, renal
E - decreased clearance
10. Brain Death: 4hrs since GCS 3
Patient must be normal biochemically
Cranial nerve reflexes tested
(optional) brain perfusion study
11. Critical Illness Neuropathy: Upregulation of AChR
Final ANZCA
Final ANZCA
Final ANZCA Exam 100% Verified
Questions & Answers | Grade A |
Latest 2026/2027
1. Heart Failure Mx: Investigation - ECG, CXR, ECHO, Bloods, Coronary
angiography Classify
Monitoring
Goals - eliminate oedema, maintain MAP, improve end organ perfusion
Optimise preload
Optimise afterload
Inotropic support
2. Severe Hypothermia Mx: Vasopressors only when T>30oC
'not dead until warm and dead' (30-32⁰C)
Passive warming
Peripheral active warming
Central active warming
Final ANZCA
, 2
Final ANZCA
Supportive care and monitoring
3. SvO2: mixed venous blood saturation, from pulm A sampled with PAC -
can be measured continuously.
SvO2 > 70% could indicate peripheral hypoxia and inability to extract
oxygen
SvO2 < 70% could indicate increased oxygenation extraction,
hypoperfusion, anaemia, hypoxaemia
4. Neuroleptic Malignant Syndrome: FEVERS
Dopamine depletion
Diagnosis - clinical, biochemical, proximity to antipsychotic
Mx: Supportive, Cooling, Biochemical, Pharmacological, Plasmapheresis
Anaesthetic implications
5. Malignant Hyperthermia: acute life-threatening disturbance of skeletal
muscle calcium homeostasis following exposure to triggering agent
(e.g. volatiles, suxamethonium, etc)
ABCD
Dantrolene: 2.5mg/kg then repeat as necessary up to 10mg/kg
Final ANZCA
, 3
Final ANZCA
Direct treatment - hyperthermia, hyperkalemia, acidosis, rhabdomyolysis
HDU/ICU monitoring of all above for 24hrs
6. Seizures: ABC
A- patent airway
B - hyperventilation
C- secure large bore IV, blood tests
Pharmacological treatment: benzodiazepine=> phenytoin =>GA
7. Epilepsy: Pre-op
- History: childhood, recent precipitation
- Ix: blood levels, screen
- continue AED up to the day
Intra-op
- induction: inhaled or IV; NMB - avoid sux, atrac or ciastrac
- maintenance: inhalation or TIVA
Post-op
- restart AED
- monitor carefully
Final ANZCA
, 4
Final ANZCA
8. Organ donation and Anaesthesia: Maintain 'normea'
Anaesthetic technique
Monitors
Optimise organs for transplant
Drugs - muscle relaxant, methylprednisolone, broad spectrum antibiotics,
heparin, chlopromazine, prostacyclin
9. PK and PD in critical illness: PD - more susceptible to
toxicity PK
A - altered GI absorption
D - increased capillary leak, decreased plasma proteins
M - change in metabolism liver, plasma, renal
E - decreased clearance
10. Brain Death: 4hrs since GCS 3
Patient must be normal biochemically
Cranial nerve reflexes tested
(optional) brain perfusion study
11. Critical Illness Neuropathy: Upregulation of AChR
Final ANZCA
