ANZCA FINALS PAST MCQ 2025 QUESTIONS
AND 100% CORRECT ANSWERS |A+ GRADE
MULTPLE CHOICES
Q. 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......Correct Ans ANSWER B
Q. 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......Correct Ans ANSWER E
ISSUES
1. GORD and gastritis
2. Early satiety and delayed gastric emptying
3. High, narrow palate and dental crowding
4. Peridontal disease (friability, gingivitis, gum recession)
1
ANZCA FINALS PAST MCQ @2025
,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.
Q. 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......Correct Ans ANSWER C
Q. 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......Correct Ans ANSWER C
A - WRONG: "Although widely practiced, prophylactic erythrocyte transfusion remains a treatment with
appreciable complications whose potential benefits have 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)
2
ANZCA FINALS PAST MCQ @2025
,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
Q. 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......Correct Ans ANSWER A
ABSOLUTE CONTRAINDICATIONS
* 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
3
ANZCA FINALS PAST MCQ @2025
, Q. 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......Correct Ans ANSWER A
Q. 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......Correct Ans 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"
Q. Petit mal epilepsy - Which is true? (or words to that effect)
A: Most common in child <2 years old
B: Can precipitate seizures by hyperventilating
C: Often seizures last for more than 30 seconds
4
ANZCA FINALS PAST MCQ @2025
AND 100% CORRECT ANSWERS |A+ GRADE
MULTPLE CHOICES
Q. 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......Correct Ans ANSWER B
Q. 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......Correct Ans ANSWER E
ISSUES
1. GORD and gastritis
2. Early satiety and delayed gastric emptying
3. High, narrow palate and dental crowding
4. Peridontal disease (friability, gingivitis, gum recession)
1
ANZCA FINALS PAST MCQ @2025
,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.
Q. 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......Correct Ans ANSWER C
Q. 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......Correct Ans ANSWER C
A - WRONG: "Although widely practiced, prophylactic erythrocyte transfusion remains a treatment with
appreciable complications whose potential benefits have 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)
2
ANZCA FINALS PAST MCQ @2025
,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
Q. 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......Correct Ans ANSWER A
ABSOLUTE CONTRAINDICATIONS
* 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
3
ANZCA FINALS PAST MCQ @2025
, Q. 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......Correct Ans ANSWER A
Q. 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......Correct Ans 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"
Q. Petit mal epilepsy - Which is true? (or words to that effect)
A: Most common in child <2 years old
B: Can precipitate seizures by hyperventilating
C: Often seizures last for more than 30 seconds
4
ANZCA FINALS PAST MCQ @2025
