FCAI SAQ Autumn 2023
FCAI WRITTEN TRIAL SAQ
1. 86 years old female with NOF fracture dur to fall, plan for hemi-arthroplasty.
a) What underlying medical problem that may causes her fall? (6m)
b) Mechanism of dabigatran. (2m)
c) MOA of dabigatran and indication of the specific antidote. (2m)
d) How will you manage bleeding in this patient? (2m)
e) How to optimize pain pre-op? (5m)
f) Anatomical features of femoral nerve block relevance to performance of femoral nerve block. (8m)
2. 34 years old lady 30 weeks pregnant, presented with acute appendicitis, plan for appendicectomy.
a) Risk of GA drug to foetus. (5m)
b) Haematological changes in pregnancy. (4m)
c) GI changes in pregnancy. (2m)
d) Important information you would give during pre-anesthesia visit pertinent to this case. (4m)
e) Outline modification of general anaesthesia. (7m)
f) Drugs consider to be safe and to avoid. (3m)
3. 60 years old male, cough, intermitent hemoptysis, LOW, planned for VATS KIV lobectomy.
a) What is HPV. (1m)
b) Anaesthetic agent effect on HPV and clinical implicaƟon. (2m)
c) Discuss pulmonary blood flow distribuƟon, venƟlaƟon and shunt flow during single lung venƟlaƟon in the lateral posiƟon. (5m)
d) What are the pulmonary function values that indicate increase risk for morbidity and mortality (3m) and outline the recent changes in these values (2m).
e) IndicaƟon for SLV. (4m)
f) Possible cause of shoulder Ɵp pain. (2m)
g) List the different regional analgesic option. (2m)
h) Outline side effects, complicaƟon, and ways to minimise risk of thoracic epidural analgesia. (4m)
FCAI WRITTEN SAQ
1. Lady plan for subtotal thyroidectomy.
a) History (3m) and examination (3m) relevant to this case.
b) Vocal cord nerve supply. (4m)
c) Describe usage of neuromonitoring ETT. (3m)
d) Vocal cord position after intra-op permanent and temporary nerve injury. (2m)
e) Post-op complication and management. (4m)
2. Awake craniotomy
a) Indication of awake craniotomy.
b) Describe 2 types of anaesthesia management for awake craniotomy. (6m)
c) Absolute and relaƟve contraindicaƟon for awake craniotomy.
d) Intra-op challenges and management.
e) List 5 of the 7 nerves for scalp block.
3. Acute compartment syndrome
a) List the osteofascial compartment of leg. (4m)
b) Cardinal features for compartment syndrome.
c) 5 evolving signs for compartment syndrome.
d) Pathophysiological of compartment syndrome.
e) Two diagnosƟc method and management. (7m)
4. 26 years old, asthmaƟc, smoker, inadequate fasƟng Ɵme, sustained eye injury, planned for EUA.
a) Normal range of IOP and it’s determinant.
b) RegulaƟon of IOP
c) Concern and problem in this case.
d) Intra and post-op management to maintain or reduce IOP
5. Neonate delivered at 26w, now 12w post delivery presented with recurrent inguinal hernia
a) Define prematurity and list classification.
b) Anatomical and psychological consideraƟon for prematurity.
c) What is corrected gestational age for this baby, and how it influence management in daycare vs inpatient surgery.
d) IntraoperaƟve management.
6. Phantom limb pain (PLP).
a) Define PLP. (2m)
b) Pathophysiology of PLP. (7m)
c) Differential diagnosis for PLP. (4m)
d) Pre- and intra-op mx to reduce PLP. (8m)
e) Describe usage of ultrasound in epidural placement. (4m)
7. Mitral stenosis
a) Sign (3m) and symptoms (3m).
b) Common causes.
c) Picture of ECG, describe. (P mitrale)
d) Treatment option. (2m)
8. 28 years old, insulin dependent, 30 weeks pregnant, anxious. Injured two tendon during cuƫting avocado. Patient request for regional.
a) what information to tell patient. (3m)
b) Risk and benefit of regional in this case.
c) To perform brachial plexus block, what probe shape and frequency? (2m)
d) What seƫng at ultrasound machine to improve image? (3m)
e) If reduce frequency, what will happen to image resoluƟon and depth of penetraƟon? (2m)
f) What is the concern for block in this parƟcular paƟent?
9. CXR of right lobar pneumonia (CAP).
a) Describe CXR and possible diagnosis. (2m)
b) List the common organism, anƟbioƟc class and main MOA of the abx.
c) If paƟent develop this pneumonia aŌer 10 days in hospital, what is the common organism, list the abx class and main MOA.
d) What is lung protecƟve strategy, what kind of lung trauma can occur? (4m)
e) InterpretaƟon of ABG 7.28 / Pao2 57 / Pco2 43 / 18 / -8.1 on Fio2 0.6
10. 60 years old male with pre-existing hypertension under GP, on T. Amlodipine 10mg OD. Planned for elective cholecystectomy, at clinic noted BP 178/105.
a) Describe the physiological determinant of BP. (2m)
b) List how BP is regulated. (2m)
c) List the 4 categories of hypertension with BP range according to NICE.
d) How you assess cardiac risk via history and physical examination (3m), functional status (3m).
e) List the component of Goldmann cardiac risk index.
f) Will you proceed with surgery? (1m) List the recommendaƟon in guideline as backup. (4m)