ANZCA Final MCQs 2025 Questions and Answers Fully Solved
You are called to see a 30 year old man with rapidly deteriorating asthma. Following appropriate
medical management an endotracheal tube is inserted and he is ventilated with a mechanical ventilator
with a tidal volume of 600ml and a rate of 12 breaths per minute. Five minutes later the blood pressure
is unrecordable and external cardiac massage is commenced. Arterial blood is taked and shows ph 7.08,
pCO2 96 mmHg, pO2 36 mmHg, SpO2 46% and bicarbonate 27 mmol/L. He is administered adrenaline,
salbutamol, pancuronium, bicarbonate and calcium gluconate. The ECG shows sinus rhythm at a rate of
60 beats per minute. The patient remains pulseless and cyanosed with fixed dilated pupils and distended
neck veins. The most appropriate management is to
A. cease resuscitation
B. administer further adrenaline
C. insert bilateral intercostal drains
D. cease ventilation for 30 seconds and resume at a slower rate
E. incre - Answers ANSWER D
A 42 year old lady presents for right pneumonectomy with a left sided double-lumen tube. She is 132kg
and 160cm. What depth, measured at the incisors, is likely to give the ideal position?
A. 24cm
B. 26cm
C. 28cm
D. 30cm
E. 32cm - Answers ANSWER C
Millers formula:
Depth= 12 + (pt height cms/10)
therefore 28 in this case.
Features of severe pre-eclampsia include all except:
A. Foetal growth retardation
,B. Peripheral oedema
C. Systolic BP more than 160
D. Thrombocytopenia
E. Severe proteinuria - Answers ANSWER B
A 20 year old man was punched in the throat 3 hours ago at a party. He is now complaining of severe
pain, difficulty swallowing, has a hoarse voice and had has some haemoptysis. What is your next step in
his management?
A. Awake Fibreoptic Intubation
B. CT scan for laryngeal fractures
C. Direct laryngoscopy after topicalising with local anaesthetic
D. Nasopharyngoscopy by an ENT surgeon
E. Soft tissue xray of the neck - Answers ANSWER D
A 60 year old man with normal LV function is having coronary artery bypass grafting. After separation
from the bypass machine he becomes hypotensive with ST elevation in leads II and aVF. The Swan Ganz
Catheter showed a PCWP of 25 and CVP of 15 with normal PVR and SVR. The TOE is likely to show:
A. Early mitral inflow > inflow during atrial systole
B. Inferior wall hypokinesis
C. Severe MR
D. TR and RV dilatation
E. LV cavity obliteration at the end of systole - Answers ANSWER B
What is the test is decreased in Iron deficiency anaemia?
A. microcytosis
B. serum ferritin
C. serum iron
,D. transferrin
E. total iron binding capacity - Answers ANSWER B
serum ferritin
Serum Iron is also low but is low in Anaemia Chronic Disease too, whereas ferritin is more specific for Fe
Deficiency.
in Fe deficiency anaemia transferrin/Total Iron Binding Capacity is increased, as total body stores of iron
are low and the carrier molecule (transferrin) is being underutilised. Therefore Transferrin SATURATION
will be low also.
A full size C oxygen cyclinder (size A in New Zealand) has pressure regulated from
A. 16000kpa to 400kpa
B. 16000kpa to 240kpa
C. 11000kpa to 400kpa
D. 11000kpa to 240kpa
E. 7600kpa to 240kpa - Answers ANSWER A
BOC website
MRI Telsa 3, least likely to cause harm
A. Cochlear implant
B. mechanical heart valve
C. Implanted intrathecal pump
D. Recently placed aortic stent
E. shrapnel fragment - Answers ANSWER B
, not D as recently placed so not endotheliolised
What happens when you place a magnet over a biventricular internal cardiac defibrillator
A. Switch to asynchronous pacing
B. Damage the internal programming
C. Nothing
D. Switch off antitachycardia function
E. Switch of rate responsiveness - Answers ANSWER D
but retains PPM functions.
depends on the device
Electrocardiogram in the Cs5 configuration. What are you looking at when monitoring lead I.
A. anterior ischaemia
B. atrial
C. inferior
D. lateral
E. septal - Answers ANSWER A
The central subclavicular (CS5) lead is particularly well suited for the detection of anterior myocardial
wall ischemia. The right arm (RA) electrode is placed under the right clavicle, the left arm (LA) electrode
is placed in the V5 position, and the left leg electrode is in its usual position to serve as a ground.
Lead I is selected for detection of anterior wall ischemia, and
lead II can be selected for monitoring inferior wall ischemia or for the detection of arrhythmias. If a
unipolar precordial electrode is unavailable, this CS5 bipolar lead is the best and easiest alternative to a
true V5 lead for monitoring myocardial ischemia.
Thys DM, Kaplan JA: The ECG in Anesthesia and Critical Care. New York, Churchill Livingstone, 1987.
You are called to see a 30 year old man with rapidly deteriorating asthma. Following appropriate
medical management an endotracheal tube is inserted and he is ventilated with a mechanical ventilator
with a tidal volume of 600ml and a rate of 12 breaths per minute. Five minutes later the blood pressure
is unrecordable and external cardiac massage is commenced. Arterial blood is taked and shows ph 7.08,
pCO2 96 mmHg, pO2 36 mmHg, SpO2 46% and bicarbonate 27 mmol/L. He is administered adrenaline,
salbutamol, pancuronium, bicarbonate and calcium gluconate. The ECG shows sinus rhythm at a rate of
60 beats per minute. The patient remains pulseless and cyanosed with fixed dilated pupils and distended
neck veins. The most appropriate management is to
A. cease resuscitation
B. administer further adrenaline
C. insert bilateral intercostal drains
D. cease ventilation for 30 seconds and resume at a slower rate
E. incre - Answers ANSWER D
A 42 year old lady presents for right pneumonectomy with a left sided double-lumen tube. She is 132kg
and 160cm. What depth, measured at the incisors, is likely to give the ideal position?
A. 24cm
B. 26cm
C. 28cm
D. 30cm
E. 32cm - Answers ANSWER C
Millers formula:
Depth= 12 + (pt height cms/10)
therefore 28 in this case.
Features of severe pre-eclampsia include all except:
A. Foetal growth retardation
,B. Peripheral oedema
C. Systolic BP more than 160
D. Thrombocytopenia
E. Severe proteinuria - Answers ANSWER B
A 20 year old man was punched in the throat 3 hours ago at a party. He is now complaining of severe
pain, difficulty swallowing, has a hoarse voice and had has some haemoptysis. What is your next step in
his management?
A. Awake Fibreoptic Intubation
B. CT scan for laryngeal fractures
C. Direct laryngoscopy after topicalising with local anaesthetic
D. Nasopharyngoscopy by an ENT surgeon
E. Soft tissue xray of the neck - Answers ANSWER D
A 60 year old man with normal LV function is having coronary artery bypass grafting. After separation
from the bypass machine he becomes hypotensive with ST elevation in leads II and aVF. The Swan Ganz
Catheter showed a PCWP of 25 and CVP of 15 with normal PVR and SVR. The TOE is likely to show:
A. Early mitral inflow > inflow during atrial systole
B. Inferior wall hypokinesis
C. Severe MR
D. TR and RV dilatation
E. LV cavity obliteration at the end of systole - Answers ANSWER B
What is the test is decreased in Iron deficiency anaemia?
A. microcytosis
B. serum ferritin
C. serum iron
,D. transferrin
E. total iron binding capacity - Answers ANSWER B
serum ferritin
Serum Iron is also low but is low in Anaemia Chronic Disease too, whereas ferritin is more specific for Fe
Deficiency.
in Fe deficiency anaemia transferrin/Total Iron Binding Capacity is increased, as total body stores of iron
are low and the carrier molecule (transferrin) is being underutilised. Therefore Transferrin SATURATION
will be low also.
A full size C oxygen cyclinder (size A in New Zealand) has pressure regulated from
A. 16000kpa to 400kpa
B. 16000kpa to 240kpa
C. 11000kpa to 400kpa
D. 11000kpa to 240kpa
E. 7600kpa to 240kpa - Answers ANSWER A
BOC website
MRI Telsa 3, least likely to cause harm
A. Cochlear implant
B. mechanical heart valve
C. Implanted intrathecal pump
D. Recently placed aortic stent
E. shrapnel fragment - Answers ANSWER B
, not D as recently placed so not endotheliolised
What happens when you place a magnet over a biventricular internal cardiac defibrillator
A. Switch to asynchronous pacing
B. Damage the internal programming
C. Nothing
D. Switch off antitachycardia function
E. Switch of rate responsiveness - Answers ANSWER D
but retains PPM functions.
depends on the device
Electrocardiogram in the Cs5 configuration. What are you looking at when monitoring lead I.
A. anterior ischaemia
B. atrial
C. inferior
D. lateral
E. septal - Answers ANSWER A
The central subclavicular (CS5) lead is particularly well suited for the detection of anterior myocardial
wall ischemia. The right arm (RA) electrode is placed under the right clavicle, the left arm (LA) electrode
is placed in the V5 position, and the left leg electrode is in its usual position to serve as a ground.
Lead I is selected for detection of anterior wall ischemia, and
lead II can be selected for monitoring inferior wall ischemia or for the detection of arrhythmias. If a
unipolar precordial electrode is unavailable, this CS5 bipolar lead is the best and easiest alternative to a
true V5 lead for monitoring myocardial ischemia.
Thys DM, Kaplan JA: The ECG in Anesthesia and Critical Care. New York, Churchill Livingstone, 1987.
