ANZCA Final Exam case studies
ANZCA Final Exam · Put your knowledge to work in context.
The ANZCA Final Exam is the summative assessment taken by trainees in the anaesthesia training program of the Australian and New Zealand College of Anaesthetists, the body that describes itself as the foremost authority on anaesthesia, pain medicine and perioperative medicine in Australia and New Zealand. The college frames its education and training around three clinical areas - anaesthesia, pain medicine and perioperative medicine - and the final examination sits at the end of the anaesthesia training program, alongside compulsory elements such as the simulation-based Effective Management of Anaesthetic Crises (EMAC) course. The ANZCA Final Exam case studies are 5 cases and about 2,756 words.
1Postoperative breathlessness after major abdominal surgery in a patient with obesity
A 58-year-old man (BMI 41, OSA on CPAP, type 2 diabetes) is day 2 after an open right hemicolectomy. He has an epidural running bupivacaine 0.125% at 6 mL/h with good analgesia (rest pain 2/10).
577 words, about 3 min2Rapid atrial fibrillation in a patient with severe aortic stenosis presenting for emergency surgery
A 79-year-old woman (weight 52 kg) presents at 22:00 with a displaced distal radius fracture requiring manipulation under anaesthesia. She has severe aortic stenosis (echo 3 months ago: valve area 0.8 cm2, mean gradient 42 mmHg, EF 55%) and permanent atrial fibrillation.
555 words, about 3 min3Opioid-tolerant patient with chronic pain and acute surgical abdomen
A 44-year-old woman with chronic pancreatitis and a history of opioid use disorder (currently on buprenorphine 16 mg daily, stable for 2 years) presents with 18 hours of severe epigastric pain, vomiting and distension. She is tachycardic at 118, BP 132/78, afebrile, with a rigid upper abdomen and no bowel sounds.
538 words, about 3 min4Shared decision-making about neuraxial analgesia in a patient with thrombocytopenia and pre-eclampsia
A 31-year-old primigravida at 34 weeks presents with BP 168/108, 3+ proteinuria, headache and visual disturbance. Platelets are 88 x 10^9/L and falling (was 130 two days ago), ALT 140, creatinine 95, and she has brisk reflexes with clonus.
533 words, about 3 min5Unexpected difficult airway in a remote setting
You are the anaesthetist on call for a small district hospital. At 02:00 you are asked to anaesthetise a 68-year-old man (weight 120 kg, neck circumference large, beard, limited mouth opening, Mallampati 3, previous radiotherapy to the neck) for incision and drainage of a deep neck abscess with impending airway compromise.
553 words, about 3 min