Airway Assessment, Sleep-Disordered Breathing, Frailty, and Ambulatory Surgical Suitability — WACS Viva & Clinical Scenarios (Pre-Op & Pain Clinic Rotation)

Exam-style airway assessment, sleep-disordered breathing, frailty, and ambulatory surgical suitability viva scenarios with examiner probes and model answers…

Scenarios covered

• SCENARIO 1: A 52-year-old male with a BMI of 42 kg/m² and severe habitual snoring presents for elective open umbilical hernia repair. On pre-anaesthetic airway examination, he has an inter-incisor gap of 3.0 cm, modified Mallampati Class III, thyromental distance of 5.8 cm, neck circumference of 47 cm, and cannot bite his upper lip with his lower incisors (ULBT Class III). His STOP-BANG score is 6. How would you systematically assess his airway and sleep apnoea risk, formulate an intubation strategy, and determine his postoperative disposition?
• SCENARIO 2: An 81-year-old male with mild dementia, severe osteoporosis, and osteoarthritis of both knees is booked for elective transurethral resection of the prostate (TURP) under the assumption of a 23-hour ambulatory pathway. His Clinical Frailty Scale (CFS) is 6. He lives alone in a rural community 50 km from the hospital. What specific tools will you use to evaluate his frailty, delirium risk, and suitability for day-case surgical discharge, and what is your overall perioperative management plan?
• SCENARIO 3: A 36-year-old female with long-standing, severe, deforming rheumatoid arthritis is scheduled for elective total knee arthroplasty. On assessment, she has limited cervical spine extension, a fixed flexion deformity of the neck, temporomandibular joint pain with an inter-incisor distance of 2.2 cm, and mild hoarseness of voice. Outline your step-by-step pre-anaesthetic airway, radiological, and systemic evaluation, and defend your airway management strategy.
• SCENARIO 4: A 28-year-old male is evaluated in the day-surgery pre-op assessment clinic for an elective diagnostic knee arthroscopy. He is an active cigarette smoker (10 pack-years), has mild well-controlled asthma, and lives with his brother who will drive him home. Detail your institutional selection criteria for ambulatory anaesthesia in a West African tertiary hospital, his discharge criteria (e.g., PADSS), and instructions regarding postoperative recovery.