HKCA Final MCQ case studies
HKCA Final MCQ · Put your knowledge to work in context.
The Final Fellowship Examination is the summative assessment run by The Hong Kong College of Anaesthesiologists (HKCA), the body whose website lists separate training, course and examination pathways under three headings: Anaesthesiology, Intensive Care and Pain Medicine. The exam is intended for trainees who have completed the College's specialty training in anaesthesiology and who are working towards Fellowship; the College's site also describes a Joint Syllabus in Intensive Care Medicine implemented on 1 July 2022 and notes important changes to the Final Fellowship Examination in 2018, so candidates should confirm the current syllabus and format directly with the College rather than relying on older study material. The HKCA Final MCQ case studies are 5 cases and about 3,321 words.
1Severe aortic stenosis and hip fracture surgery
An 82-year-old woman (58 kg, 155 cm) is admitted with a displaced left femoral neck fracture after a fall. She has severe aortic stenosis: transthoracic echocardiography two weeks ago showed an aortic valve area of 0.7 cm², mean gradient 48 mmHg, peak velocity 4.2 m/s, LVEF 55%, and mild mitral regurgitation.
738 words, about 4 min2Category 1 caesarean section with severe pre-eclampsia and falling platelets
A 34-year-old woman (BMI 42 kg/m²) at 36 weeks' gestation presents with severe pre-eclampsia. Blood pressure is 168/108 mmHg despite labetalol 200 mg twice daily and nifedipine 20 mg modified release.
683 words, about 3 min3Moderate ARDS not improving on high FiO2
A 56-year-old man is admitted to intensive care with severe community-acquired pneumonia and moderate ARDS. He weighs 80 kg and is 175 cm tall.
649 words, about 3 min4Septic shock after laparotomy for perforated diverticulitis
A 72-year-old woman (60 kg) is admitted with septic shock from perforated diverticulitis. She underwent emergency laparotomy and sigmoid colectomy 12 hours ago.
627 words, about 3 min5Opioid toxicity and rotation in advanced pancreatic cancer
A 58-year-old man with locally advanced pancreatic cancer has severe abdominal and back pain. He is taking oral morphine modified-release 100 mg twice daily, with immediate-release morphine 20 mg for breakthrough pain, up to four doses per day.
624 words, about 3 min