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ANZCA Part 1 SAQs

Health & Fitness

Activity Overview

Episode publication activity over the past year

Episodes

Warfarin reversal

06 Aug 2022

Contributed by Lukas

Hard for me cos I’m bad at haem

Pharmacokinetics of chronic kidney disease

06 Aug 2022

Contributed by Lukas

Hit the headings and use loads of examples with some detail about the examples (as per examiners report)

Respiratory responses to hypoxaemia

06 Aug 2022

Contributed by Lukas

Should probably have a line or two about HPV for the awake patient

How a pulse oximeter works

06 Aug 2022

Contributed by Lukas

Errors is a separate question don’t @me

NMB at larynx, diaphragm, adductor pollicis

05 Aug 2022

Contributed by Lukas

Cool graph on ketamine nightmares that is worth drawing

Afterload

05 Aug 2022

Contributed by Lukas

Table at the start

Time to awakening after propofol TCI

04 Aug 2022

Contributed by Lukas

Draw compartment model. PK/PD structure. PK needs to include accumulation and elimination.

IPPV and CO

04 Aug 2022

Contributed by Lukas

More than just a valsalva but similar principles. Don’t forget frank starling graph and indirect effects.

Perioperative hypothermia

04 Aug 2022

Contributed by Lukas

Classify into mild and mod-severe

CVS effects in pregnancy

04 Aug 2022

Contributed by Lukas

Pretty neat

Hyperventilation reducing intracranial pressure

02 Aug 2022

Contributed by Lukas

The buffering part is hard to get my head around

Protective and regulatory functions of the liver

02 Aug 2022

Contributed by Lukas

Protective: RID (reservoir, immunological, drugs). Regulatory: SEAMS (storage, endocrine, acid base, metabolic, synthesis)

Ageing and the respiratory system

02 Aug 2022

Contributed by Lukas

Weirdly not put into a section of its own in Nunn’s or West’s. Ended up using deranged physiology for most of it. Use a graph for FRC and CC.

CO2 carriage in the blood

02 Aug 2022

Contributed by Lukas

Brandis very good again. Do a graph at the end with arterial and venous lines showing Haldane effect.

Safe delivery of oxygen

02 Aug 2022

Contributed by Lukas

Acronym for machine features is POP (pressure, oxygen, power)

Renal hormones (produced within or activated by)

02 Aug 2022

Contributed by Lukas

Had to look in different parts of different books for this one 😡 inefficient but done

Foetal and adult Hb

02 Aug 2022

Contributed by Lukas

Brandis is my pick for this question. Graphs I’ve talked about are from there too.

Preload

02 Aug 2022

Contributed by Lukas

Filling pressure, compliance, afterload. Then section on IPPV/SV for showing off.

Work of breathing

28 Jul 2022

Contributed by Lukas

Hasn’t come up in 10 years and poor pass rate, core topic

Respiratory system compliance

28 Jul 2022

Contributed by Lukas

A hard one. Can exclude certain parts for questions specifically on lung compliance.

Platelets and their role in haemostasis

28 Jul 2022

Contributed by Lukas

So much rote learning that means nothing

O2 and CO2 transfer at the placenta

27 Jul 2022

Contributed by Lukas

Maternal (uterine artery) O2 = 105mmHg, CO2 = 30mmHg. Foetal (umbilical artery) O2 = 20mmHg, CO2 = 50mmHg.

Lower Oesophageal Sphincter

24 Jul 2022

Contributed by Lukas

Very short, if you know the content you can get a pass pretty quickly

CO2 absorbers and risks

24 Jul 2022

Contributed by Lukas

Amsorb sounds pretty good

Pneumotachograph

24 Jul 2022

Contributed by Lukas

Not been asked for a while, much easier to approach and understand this question once you have a good grasp of viscosity/density and laminar/turbulent...

Renal handling of glucose, physiological consequences of glycosuria

24 Jul 2022

Contributed by Lukas

Graph with glucose flux on y axis and plasma glucose on x axis

Aldosterone and cortisol

24 Jul 2022

Contributed by Lukas

Also asked as mineralocorticoids and glucocorticoids

Oral hypoglycaemic drugs

24 Jul 2022

Contributed by Lukas

There are probably more but this is enough for me

How LAs prevent conduction of action potentials

24 Jul 2022

Contributed by Lukas

Lots of different terminology for the states of VDNaC and the gates. Voltage = M gate (outer gate). Time = H gate (inner gate). Resting = closed M ope...

PaCO2 and ETCO2 difference

23 Jul 2022

Contributed by Lukas

Almost complete credit to Stan Tay at adrenaline memories.

Dexmedetomidine

17 Jul 2022

Contributed by Lukas

Most of this answer is in PD

ACEi/ARB therapeutic and adverse effects

17 Jul 2022

Contributed by Lukas

Draw the flowchart from angiotensinogen onwards

Metabolic acidosis in hypovolaemic shock

17 Jul 2022

Contributed by Lukas

Breadth over depth

Tissue demand for O2 and cardiac output

17 Jul 2022

Contributed by Lukas

Adrenaline memories answer very good. I changed some of the headings to simplify it with how I understand it. The key is understanding the difference ...

Ultrasound

12 Jul 2022

Contributed by Lukas

A hard one to do in 10 mins but thankfully examiners report says Doppler and CO measurement are “extra marks” rather than pass marks.

Viscosity and density

12 Jul 2022

Contributed by Lukas

Learn those formulas and effect of temperature (common MCQ)

Skin antiseptic agents

12 Jul 2022

Contributed by Lukas

Povidine iodine and alcoholic chlorhexidine. This is a 2-3/5 answer. Apart from knowing that I shouldn’t inject chlorhex into someone’s spinal cor...

500ml of 20% mannitol: CNS/CVS/renal effects

12 Jul 2022

Contributed by Lukas

This is a good starting point and probably a pass as per examiners reports, but if you get time then add more detail (e.g. baroreceptor reflexes to vo...

Structure and function of the NMDA receptor

12 Jul 2022

Contributed by Lukas

Get the headings down and the rest will follow

How the body handles a metabolic acidosis

10 Jul 2022

Contributed by Lukas

Renal and acid base will be the death of me

Blood brain barrier

10 Jul 2022

Contributed by Lukas

Na+ transport passive as per Power and Kam. Doesn’t make sense to me but it’s a recommended text so going to run with it 👍🏽

LV myocardial O2 supply and demand

09 Jul 2022

Contributed by Lukas

Hard one to do in 10 mins, practice practice practice

Respiratory changes in obesity

09 Jul 2022

Contributed by Lukas

Keep it simple stupid

Right lateral position ventilation and perfusion

09 Jul 2022

Contributed by Lukas

Graph from ketamine nightmares is elite for understanding but not sure I would have time to draw three graphs. Could do the full table for VQ at dead ...

Cerebral effects of prolonged anaesthesia in steep head down

08 Jul 2022

Contributed by Lukas

Model answers not ideal so came up with my own, tried to keep it simple

EEG awake features and quantitative monitors (BIS and entropy)

08 Jul 2022

Contributed by Lukas

Mainly from Stan Tay at Adrenaline Memories

Humidification by respiratory system and HME

08 Jul 2022

Contributed by Lukas

Makeup question by ex chair of examiners. Answer based off a friend’s answer (Matt Avery) that she gave a 5/5 to!

ROTEM physiology and hyperfibrinolysis

07 Jul 2022

Contributed by Lukas

Graph very important. TEG probably simpler but I chose ROTEM because it’s what they actually use at work and this exam is all about becoming a bette...

Right internal jugular CVC anatomy

06 Jul 2022

Contributed by Lukas

Has been asked both as a written SAQ and with a booklet containing images and shorter questions

Paracetamol mechanism, metabolism, toxicity

06 Jul 2022

Contributed by Lukas

Serotonergic, COX3, endogenous cannabinoids. Management of toxicity to be covered in another episode.

Hypothalamus

06 Jul 2022

Contributed by Lukas

At the start I think it’s worth putting abbreviations to denote A for anterior, P for posterior, M for medial, L for lateral

O2 and CO2 Hb dissociation curves

06 Jul 2022

Contributed by Lukas

Look up a diagram. Best one I could find was Ketamine Nightmares (had both on same axes and content rather than saturation %). Also correction that bi...

CVS and respiratory effects of CO2 pneumoperitoneum

06 Jul 2022

Contributed by Lukas

Pretty rude of the surgeons to impose this on us, don’t you think?

Physiological effects of 2L CSL

29 Jun 2022

Contributed by Lukas

Minor error where I said Cl content increases the strong ion difference but actually it decreases it… my bad (Stewart approach 🤦‍♂️). But s...

PK for onset and offset of local anaesthetics

29 Jun 2022

Contributed by Lukas

An annoyingly broad question that asked for the onset and offset, also didn’t specify topical or subcutaneous or nerve block. A narrower scope would...

CVS effects of central neuraxial blockade

29 Jun 2022

Contributed by Lukas

A good one to practice. Those CVS reflexes at the end are tricky.

Morbid obesity washout of inhalational anaesthesia

29 Jun 2022

Contributed by Lukas

Numbers for equilibration of compartments refer to 3 time constants (not half lives) and are from Hemmings and Egan. Sevo 2 min FRC, 9 min VRG, 7 hrs ...

Propofol and remifentanil TCI

29 Jun 2022

Contributed by Lukas

Nail your definitions, graph, table, and learn the numbers for effect site concentrations

Safety features of vaporisers

28 Jun 2022

Contributed by Lukas

Everyone use TIVA so that this is out of the syllabus ASAP or at least only given as much importance as knowing that ether has a BGPC of 12

How inhalational anaesthetics cause loss of consciousness

28 Jun 2022

Contributed by Lukas

This is a 2/5 probably needs more examples and detail

ECG normal values and PR interval

28 Jun 2022

Contributed by Lukas

Look up a diagram

Cerebral Blood Flow

28 Jun 2022

Contributed by Lukas

A really hard one to get done in 10 mins especially if you include graphs. Focus on answering the question.

Succinylcholine adverse effects

28 Jun 2022

Contributed by Lukas

Sometimes I think study sux 😂

Immunological effects of PRBCs

27 Jun 2022

Contributed by Lukas

Breadth over depth

10xPRBC adverse effects

27 Jun 2022

Contributed by Lukas

Re alloimmunisation it’s worth adding possible future transfusion reactions as well as haemolytic disease of the newborn

Environmental effects of anaesthetics

26 Jun 2022

Contributed by Lukas

Kudos to all the TIVA divas, imagine in 20 years time if pharmacokinetics of volatiles isn’t in the syllabus 🤯

Spinal cord perfusion

26 Jun 2022

Contributed by Lukas

YouTube was helpful for learning to pronounce Adamkiewicz

O2 transport alveoli to tissues

26 Jun 2022

Contributed by Lukas

A hard one to do in 10 mins. Breadth over depth. Look up an oxygen cascade diagram for the intro if you don’t have one in your head.

CVS changes in morbid obesity

25 Jun 2022

Contributed by Lukas

99% of this from Stan Tay at adrenaline memories

Oliguria in hypovolaemic shock

25 Jun 2022

Contributed by Lukas

This one was a mouthful and I think I absolutely butchered the Starling equation

Blood groupings

25 Jun 2022

Contributed by Lukas

My blood group is B+

Sleep: CNS and respiratory effects

25 Jun 2022

Contributed by Lukas

Why do I need to know this? A) because patients think we put them to sleep so we should know what sleep is B) because we need to pass the exam and it'...

Prostaglandin effects on smooth muscle

25 Jun 2022

Contributed by Lukas

A really gross question that I might update my answer to at some point... 

Adding PEEP to IPPV

25 Jun 2022

Contributed by Lukas

If you don't set your airway pressures to multiples of five or even numbers, we cannot be friends. 

Pharmacodynamics of propofol (excluding CNS)

25 Jun 2022

Contributed by Lukas

Go to sleep but what else?

Onset of blockade of a major peripheral nerve with LA

25 Jun 2022

Contributed by Lukas

Not sure if A2 agonist/opioids actually speed up onset of block, I couldn't find a source to confirm or deny...

Neonatal airway anatomy

25 Jun 2022

Contributed by Lukas

So small and so cute but being a nose breather and having tiny nostrils is a bit silly (I would absolutely do the same to constantly feed though)

PCA morphine fentanyl

25 Jun 2022

Contributed by Lukas

When your block didn't work!

Exhaled CO2 infrared analysis

25 Jun 2022

Contributed by Lukas

Where does the capnograph come from?

CVS changes with ageing

25 Jun 2022

Contributed by Lukas

Attenuated with training, such as cycling for anaesthetists (also a great way to procrastinate study)

Circle breathing system

25 Jun 2022

Contributed by Lukas

Is it really a circle or is it more like a polygon? Look up/make sure you can draw a diagram for this one. 

ANS heart and cardiac function

25 Jun 2022

Contributed by Lukas

LubDub

Amiodarone

25 Jun 2022

Contributed by Lukas

How to get out of that MET call for AF after 2 hrs of standing around

NDMR adverse effects

25 Jun 2022

Contributed by Lukas

Stop moving

Acute to chronic pain

25 Jun 2022

Contributed by Lukas

Ouch. Thanks to Lauren Foster for suggesting this answer should include opioids increasing chronic pain by NMDA agonism, increased spinal dysnorphins,...

Acute management of HTN in pregnancy

25 Jun 2022

Contributed by Lukas

Eclampsia is bad

Cardiac action potentials

25 Jun 2022

Contributed by Lukas

Look up fast vs slow response diagram to supplement this episode