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A comprehensive revision guide, Get Through Final FRCA: Single Best Answers provides candidates with a definitive resource to aid passing their challenging Final FRCA written examination. $16.49   Add to cart

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A comprehensive revision guide, Get Through Final FRCA: Single Best Answers provides candidates with a definitive resource to aid passing their challenging Final FRCA written examination.

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  • FRCA
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  • FRCA

A comprehensive revision guide, Get Through Final FRCA: Single Best Answers provides candidates with a definitive resource to aid passing their challenging Final FRCA written examination. This latest edition contains 180 new SBA questions along with detailed answer justifications. The questions ...

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  • August 21, 2024
  • 164
  • 2024/2025
  • Exam (elaborations)
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 PRACTICE PAPER 1:
QUESTIONS

Question 1
Following an infusion of intravenous paracetamol over 15 minutes, which of the
following best describes the pharmacokinetics?
A. Analgesic effect starts within 5 minutes, peaks at 1 hour and lasts 4 hours.
B. Analgesic effect starts within 30 minutes, peaks at 3 hours and lasts 6 hours.
C. Analgesic effect starts within 60 minutes, peaks at 3 hours and lasts 6 hours.
D. Analgesic effect starts within 15 minutes, peaks at 1 hour and lasts 6 hours.
E. Analgesic effect starts within 15 minutes, peaks at 30 minutes and lasts 6 hours.

Question 2
A 26-year-old woman has had an inadvertent dural puncture during placement of
an epidural catheter for labour analgesia. She subsequently delivers 6 hours later.
She is otherwise fit and well and has no drug allergies.
The best management of a headache that develops 12 hours post-delivery is
A. Bed rest, IV fluids, paracetamol and diclofenac
B. Paracetamol and diclofenac
C. Blood patch
D. Sumatriptan, paracetamol and diclofenac
E. Caffeine supplements, IV fluids, paracetamol and diclofenac

Question 3
A 21-year-old man is brought to the emergency department with a fluctuating
consciousness level, visual disturbance and vomiting. He has a respiratory rate
of 30 cycles per minute and GCS of 11 (M5, E3, V3) but other vital signs are
normal. Fundoscopy reveals retinal oedema but examination of other systems is
unremarkable. He is apyrexial. A blood gas result on air shows
pH 7.28 Na (mmol−1) 147
pCO2 (kPa) 3.6 K (mmol−1) 4.3
pO2 (kPa) 13.2 Cl (mmol−1) 102
HCO3 (mmol−1) 12.4 Glucose (mmol L−1) 12.1
Base excess (mmol L−1) –12.6
Lactate (mmol L−1) 2.26

Haematological results and liver and renal function tests are unremarkable.

1

, The most likely diagnosis is
 Practice Paper 1: Questions



A. Propylene glycol poisoning
B. Methanol poisoning
C. Tricyclic antidepressant overdose
D. Ethanol poisoning
E. Meningitis


Question 4
A 24-year-old 41-week primigravida has had rupture of membranes 4 days ago.
She presented with a temperature of 38.5°C, and antibiotics were commenced for
suspected chorioamnionitis. She is now in established labour and is requesting
analgesia. Observations include a temperature of 37.4°C, heart rate of 100 bpm and
a blood pressure of 110/80 mmHg. Blood shows a neutrophil count of 19.
The most effective analgesic strategy is
A. Nitrous oxide/oxygen (50/50)
B. Intramuscular pethidine
C. Fentanyl PCA
D. Remifentanil PCA
E. Epidural analgesia


Question 5
Following uncomplicated aortic valve replacement and coronary artery bypass
grafting, a 75-year-old man is admitted to the cardiac intensive care unit.
He is sedated, paralysed and ventilated, with a FiO2 of 0.4. On admission, he is
haemodynamically stable, with a heart rate of 75 bpm and a blood pressure of
110/50 mmHg.
His condition deteriorates over the following 2 hours, and, on further review, he
develops a tachycardia of 120 bpm, blood pressure of 85/50 mmHg and an elevated
JVP. After fairly brisk blood loss into his drains after admission (total: 350 mL),
drain output has ceased.
Which of the following diagnoses is most likely to account for his clinical
deterioration?
A. Cardiac tamponade
B. Coronary artery occlusion
C. Hypovolaemia due to blood loss
D. Air embolism
E. Acute aortic regurgitation


Question 6
A 65-year-old man presents to the emergency department with generalised
tonic–clonic seizures. He was found fitting at home by his neighbour and has
continued to fit during the 10 minute ambulance journey. He has been given 8 mg
of intravenous lorazepam in divided doses without effect.

2

, The next most appropriate step would be




 Practice Paper 1: Questions
A. 2–3 mg kg−1 propofol
B. 10 mg intravenous diazepam
C. A further 4 mg lorazepam
D. Rapid sequence induction with thiopentone
E. 18 mg kg−1 phenytoin


Question 7
A 4-year-old boy, weighing 16 kg, is listed for an elective tonsillectomy for
recurrent tonsillitis. He is normally fit and well and has no allergies.
Which of the following drugs (given intravenously) would be the least
appropriate to use for perioperative analgesia?
A. Paracetamol
B. Morphine
C. Ketorolac
D. Ketamine
E. Dexamethasone


Question 8
A 45-year-old woman presents to the emergency department with a depressed
consciousness level. Her husband says that she had experienced a severe headache
minutes before collapsing. On examination, she has a Glasgow Coma Scale (GCS)
of 5. She is intubated and a CT scan shows extensive subarachnoid haemorrhage.
Which of the following is correct?
A. The underlying cause is most likely to be a basilar artery aneurysm.
B. She has World Federation of Neurosurgical Societies (WFNS) grade IV
subarachnoid haemorrhage.
C. The aneurysm should be secured within 72 hours of presentation.
D. The highest risk of vasospasm is within the first 48 hours of presentation.
E. Nimodipine reduces the risk of rebleeding.


Question 9
An 83-year-old man has been scheduled for an elective right carotid endarterectomy
after suffering a TIA. He has an 80% stenosis of his right carotid artery, and his
comorbidities include hypertension, ischaemic heart disease and COPD.
Which of the following statements regarding a local anaesthetic technique is
most accurate?
A. It has been shown to reduce the stroke rate.
B. It is associated with increased cardiac insults.
C. Only selected patients are able to tolerate this technique.
D. It removes the need for shunt placement.
E. There is no advantage in terms of mortality when compared with a general
anaesthetic technique.

3

, Question 10
 Practice Paper 1: Questions




A 35-year-old man is to undergo open fixation of the cervical spine after
sustaining bilateral C6/7 facet dislocation following a road traffic collision
5 days ago. He has no sensory deficit but significant muscle weakness below the
level of injury.
Which are the following is correct when considering anaesthesia for this
procedure?
A. This is a stable cervical spine fracture.
B. The patient is unlikely to show signs of spinal shock.
C. The patient is likely to have autonomic dysreflexia.
D. Suxamethonium is contraindicated even when there is a risk of aspiration.
E. Direct laryngoscopy is contraindicated.


Question 11
A 2-week-old neonate requires a laparotomy for suspected bowel obstruction.
Which of the following drugs should not be given at a reduced dose during the
neonatal period?
A. Suxamethonium
B. Intravenous paracetamol
C. Codeine phosphate
D. Morphine
E. Ibuprofen


Question 12
Which of the following is the most accurate statement regarding the use of spinal
anaesthesia in day surgery?
A. Bupivacaine is associated with a higher incidence of urinary retention than
lignocaine.
B. Intrathecal opiates should be avoided where possible.
C. The main risk factor for development of transient neurologic syndrome or
transient radicular irritation is the dose of bupivacaine used.
D. Urinary retention post-spinal anaesthesia requires in-patient admission.
E. Sprotte needles are associated with a higher incidence of post-dural puncture
headache than Quincke needles.


Question 13
A 65-year-old woman with a history of severe depression, hypertension
and diabetes mellitus is scheduled to undergo electroconvulsive therapy.
Her regular medications include paroxetine, amlodipine and metformin.
Anaesthesia is induced using propofol and a small dose of suxamethonium is
administered.

4

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