ANZCA FINALS PAST MCQ 2025
QUESTIONS AND ANSWERS
Acromegaly due to excess of growth hormone. Why is it difficult to do a direct
laryngoscopy?
A: Distorted facial anatomy
B: Macroglossia
C: Glottic stenosis
D: Prognathe mandible
E: Arthritis of the neck - ....ANSWER☑️☑️...-ANSWER B
Ehlers-Danlos syndrome. Most important to specifically do all EXCEPT:
A: Avoid hyperextension of the neck
B: Damage to the teeth
C: Avoid joint hypermobility
D: Gastro oesophageal reflex
E: Strict temperature regulation - ....ANSWER☑️☑️...-ANSWER E
ISSUES
1. GORD and gastritis
2. Early satiety and delayed gastric emptying
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,3. High, narrow palate and dental crowding
4. Peridontal disease (friability, gingivitis, gum recession)
5. Joint laxity. Subluxations and dislocations are common and represent the major
manifestation of the condition. All sites can be involved, including the extremities,
vertebral column, costo-vertebral and costo-sternal joints, clavicular articulations,
and temporomandibular joints.
An 85y.o for open AAA repair. Refuses blood because of risk of vCJD. You tell him
you won't anaesthetise him as the risk is too high. This is an example of:
A: Autonomy
B: Beneficence
C: Malevolence
D: Coercion
E: Paternalism - ....ANSWER☑️☑️...-ANSWER C
A 35yr old African-American with sickle cell and fractured ankle for ORIF. Hb 90,
Haematocrit 0.3.
A: Transfuse 2 units packed cells (?pre-op)
B: Let him cool passively to low/normal temperature
C: Spinal is safe
D: Avoid thiopentone
E: Tourniquet is absolutely contra-indicated - ....ANSWER☑️☑️...-ANSWER C
A - WRONG: "Although widely practiced, prophylactic erythrocyte transfusion
remains a treatment with appreciable complications whose potential benefits have
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,not been clearly demonstrated by a prospective, randomized clinical trial". Also a
study in orthopaedic patients "did not detect a prophylactic effect from preoperative
transfusion" (Sickle Cell Disease and Anesthesia. Anesthesiology 2004; 101:766-85)
B - WRONG: "Although hypothermia would tend to retard sickling because of a left
shift of the oxygen dissociation curve, hypothermia is often identified as a precipitant
of perioperative SCD complications". "avoidance of patient hypothermia is a basic
objective for most anesthetics" (Same reference)
C - CORRECT: "The use of regional anesthesia therefore does not appear to be
contraindicated in SCD" (Same reference) and OHA p202 agrees
D - ??? but seems unlikely
E - WRONG according to OHA p202 -JC
Absolute contraindication to sitting position for posterior fossa craniotomy for
meningioma
A: Prescence of patent ventriculo-atrial drain/shunt
B: 0.5mm PFO
C: Oesophageal stricture so transoesophageal echo placement is out
D: History of TIA
E: Aortic stenosis - ....ANSWER☑️☑️...-ANSWER A
ABSOLUTE CONTRAINDICATIONS
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, * Patent ventriculo-atrial shunt
* Severe cardiovascular disease
* Large patent foramen ovale or other pulmonary-systemic shunt
* Cerebral ischaemia when upright and awake
* Anaesthesia or surgical team not familiar with the position
ECG- which does NOT have abnormal Q waves:
A: Digoxin toxicity
B: Anterior myocardial infartion
C: Previous AMI
D: LBBB
E: Wolff-Parkinson-White syndrome - ....ANSWER☑️☑️...-ANSWER A
Long stem about an old #NOF patient with aortic stenosis. What is a sign/
investigation/ symptom that shows the most severity? (ie Which one of these would
indicate that the lesion was severe?)
A: Thrill in Aortic area
B: Murmur in lower left sternal edge
C: Murmur radiating to carotids
D: History of ischaemic heart disease or coronary artery disease
E: history of angina/ syncope - ....ANSWER☑️☑️...-ANSWER A
A - True - "A precordial thrill may be felt, especially on leaning forward in expiration.
Its presence is reasonably specific for severe aortic stenosis"
FOR STUDY PURPOSES ONLY ©️ 2025 ALL RIGHTS RESERVED 4
QUESTIONS AND ANSWERS
Acromegaly due to excess of growth hormone. Why is it difficult to do a direct
laryngoscopy?
A: Distorted facial anatomy
B: Macroglossia
C: Glottic stenosis
D: Prognathe mandible
E: Arthritis of the neck - ....ANSWER☑️☑️...-ANSWER B
Ehlers-Danlos syndrome. Most important to specifically do all EXCEPT:
A: Avoid hyperextension of the neck
B: Damage to the teeth
C: Avoid joint hypermobility
D: Gastro oesophageal reflex
E: Strict temperature regulation - ....ANSWER☑️☑️...-ANSWER E
ISSUES
1. GORD and gastritis
2. Early satiety and delayed gastric emptying
FOR STUDY PURPOSES ONLY ©️ 2025 ALL RIGHTS RESERVED 1
,3. High, narrow palate and dental crowding
4. Peridontal disease (friability, gingivitis, gum recession)
5. Joint laxity. Subluxations and dislocations are common and represent the major
manifestation of the condition. All sites can be involved, including the extremities,
vertebral column, costo-vertebral and costo-sternal joints, clavicular articulations,
and temporomandibular joints.
An 85y.o for open AAA repair. Refuses blood because of risk of vCJD. You tell him
you won't anaesthetise him as the risk is too high. This is an example of:
A: Autonomy
B: Beneficence
C: Malevolence
D: Coercion
E: Paternalism - ....ANSWER☑️☑️...-ANSWER C
A 35yr old African-American with sickle cell and fractured ankle for ORIF. Hb 90,
Haematocrit 0.3.
A: Transfuse 2 units packed cells (?pre-op)
B: Let him cool passively to low/normal temperature
C: Spinal is safe
D: Avoid thiopentone
E: Tourniquet is absolutely contra-indicated - ....ANSWER☑️☑️...-ANSWER C
A - WRONG: "Although widely practiced, prophylactic erythrocyte transfusion
remains a treatment with appreciable complications whose potential benefits have
FOR STUDY PURPOSES ONLY ©️ 2025 ALL RIGHTS RESERVED 2
,not been clearly demonstrated by a prospective, randomized clinical trial". Also a
study in orthopaedic patients "did not detect a prophylactic effect from preoperative
transfusion" (Sickle Cell Disease and Anesthesia. Anesthesiology 2004; 101:766-85)
B - WRONG: "Although hypothermia would tend to retard sickling because of a left
shift of the oxygen dissociation curve, hypothermia is often identified as a precipitant
of perioperative SCD complications". "avoidance of patient hypothermia is a basic
objective for most anesthetics" (Same reference)
C - CORRECT: "The use of regional anesthesia therefore does not appear to be
contraindicated in SCD" (Same reference) and OHA p202 agrees
D - ??? but seems unlikely
E - WRONG according to OHA p202 -JC
Absolute contraindication to sitting position for posterior fossa craniotomy for
meningioma
A: Prescence of patent ventriculo-atrial drain/shunt
B: 0.5mm PFO
C: Oesophageal stricture so transoesophageal echo placement is out
D: History of TIA
E: Aortic stenosis - ....ANSWER☑️☑️...-ANSWER A
ABSOLUTE CONTRAINDICATIONS
FOR STUDY PURPOSES ONLY ©️ 2025 ALL RIGHTS RESERVED 3
, * Patent ventriculo-atrial shunt
* Severe cardiovascular disease
* Large patent foramen ovale or other pulmonary-systemic shunt
* Cerebral ischaemia when upright and awake
* Anaesthesia or surgical team not familiar with the position
ECG- which does NOT have abnormal Q waves:
A: Digoxin toxicity
B: Anterior myocardial infartion
C: Previous AMI
D: LBBB
E: Wolff-Parkinson-White syndrome - ....ANSWER☑️☑️...-ANSWER A
Long stem about an old #NOF patient with aortic stenosis. What is a sign/
investigation/ symptom that shows the most severity? (ie Which one of these would
indicate that the lesion was severe?)
A: Thrill in Aortic area
B: Murmur in lower left sternal edge
C: Murmur radiating to carotids
D: History of ischaemic heart disease or coronary artery disease
E: history of angina/ syncope - ....ANSWER☑️☑️...-ANSWER A
A - True - "A precordial thrill may be felt, especially on leaning forward in expiration.
Its presence is reasonably specific for severe aortic stenosis"
FOR STUDY PURPOSES ONLY ©️ 2025 ALL RIGHTS RESERVED 4
