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HKCA Fellowship Final Examination - MCQ (Hong Kong)

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Sample HKCA Primary MCQ Practice Questions

Try these sample questions to review concepts for the HKCA Primary MCQ exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1Which of the following structures passes through the diaphragm at the level of the tenth thoracic vertebra (T10)?

A.Aorta

B.Esophagus

C.Inferior vena cava

D.Thoracic duct

Explanation: The esophagus, vagus nerves (anterior and posterior trunks), and esophageal branches of the left gastric vessels pass through the diaphragm at the level of the T10 vertebra. The vena caval opening is at T8, and the aortic hiatus is at T12.

2In the brachial plexus, which spinal nerves contribute to the formation of the posterior cord?

A.C5 and C6 only

B.C7 and C8 only

C.C8 and T1 only

D.C5, C6, C7, C8, and T1

Explanation: The posterior cord is formed by the posterior divisions of the superior (C5-C6), middle (C7), and inferior (C8-T1) trunks. Therefore, all spinal nerves from C5 to T1 contribute fibers to the posterior cord.

3The artery of Adamkiewicz (arteria radicularis magna) most commonly arises from the aorta on the left side between which spinal segments?

A.T3 and T5

B.T5 and T8

C.T9 and L2

D.L3 and L5

Explanation: The artery of Adamkiewicz is the largest anterior segmental medullary artery and provides the main blood supply to the lower two-thirds of the spinal cord. In approximately 75% of individuals, it arises on the left side from an intercostal or lumbar artery branching from the aorta between T9 and L2.

4Which of the following correctly defines coronary artery dominance?

A.The origin of the posterior descending artery (PDA) from either the right or left coronary artery

B.The coronary artery that supplies the majority of blood flow to the left ventricle

C.The coronary artery that gives rise to the sinoatrial (SA) nodal artery

D.The coronary artery with the largest diameter at its ostium

Explanation: Coronary artery dominance is determined by the coronary artery that gives rise to the posterior descending artery (PDA), which runs in the posterior interventricular groove and supplies the posterior third of the interventricular septum. In approximately 70-80% of individuals, this is the right coronary artery (right dominant).

5What is the typical anatomical relationship of the internal jugular vein (IJV) relative to the common carotid artery in the middle of the neck?

A.Anteromedial

B.Anterolateral

C.Posteromedial

D.Posterolateral

Explanation: In the middle of the neck, the internal jugular vein lies anterolateral to the common carotid artery. Understanding this relationship is critical for central venous cannulation, as needle redirection medially or excessive pressure can lead to accidental carotid artery puncture.

6During a retrobulbar block, the local anesthetic is injected directly into the muscle cone of the eye. Which nerve lies inside this cone and is at direct risk of injury?

A.Trochlear nerve (CN IV)

B.Facial nerve (CN VII)

C.Optic nerve (CN II)

D.Frontal nerve (branch of CN V1)

Explanation: The optic nerve (CN II), along with the oculomotor (CN III), abducens (CN VI), and nasociliary nerves (branch of CN V1), lies inside the muscle cone. Injection into this cone risks optic nerve sheath penetration or direct trauma, potentially leading to central retinal artery occlusion or brainstem anesthesia.

7What is the correct arrangement of the neurovascular bundle in the intercostal space, from superior to inferior, and its location relative to the rib?

A.Vein, Artery, Nerve (VAN) running along the lower border of the upper rib

B.Nerve, Artery, Vein (NAV) running along the lower border of the upper rib

C.Vein, Artery, Nerve (VAN) running along the upper border of the lower rib

D.Artery, Vein, Nerve (AVN) running in the middle of the intercostal space

Explanation: The intercostal neurovascular bundle consists of the intercostal vein, intercostal artery, and intercostal nerve (VAN) from superior to inferior. It runs in the costal groove along the lower border of the upper rib of the space, leaving the lower edge of the space relatively safe for needle insertion.

8The ligamentum flavum, which must be penetrated to enter the epidural space, is characterized by which anatomical feature?

A.It consists predominantly of collagen fibers, providing high tensile strength

B.It contains a high proportion of elastic fibers, giving it a yellow color and elasticity

C.It is located anterior to the dura mater and forms the anterior boundary of the vertebral canal

D.It is a thin, translucent membrane that lacks vascularity

Explanation: The ligamentum flavum consists of approximately 80% elastic fibers and 20% collagen fibers. This composition gives it a distinct yellow appearance ('flavum' means yellow in Latin) and elasticity, which helps maintain the upright posture of the spine and provides the characteristic resistance felt during epidural needle placement.

9Which nerve provides sensory innervation to the larynx above the level of the vocal cords?

A.External branch of the superior laryngeal nerve

B.Glossopharyngeal nerve (CN IX)

C.Internal branch of the superior laryngeal nerve

D.Recurrent laryngeal nerve

Explanation: Sensory innervation of the larynx above the vocal cords is supplied by the internal laryngeal nerve, which is the internal branch of the superior laryngeal nerve (a branch of CN X). The recurrent laryngeal nerve provides sensory innervation below the vocal cords and motor innervation to all intrinsic laryngeal muscles except the cricothyroid.

10What is the correct anatomical position of the femoral nerve within the femoral triangle relative to the femoral sheath and femoral artery?

A.Inside the femoral sheath, medial to the femoral artery

B.Inside the femoral sheath, lateral to the femoral artery

C.Outside the femoral sheath, medial to the femoral artery

D.Outside the femoral sheath, lateral to the femoral artery

Explanation: The femoral nerve (L2-L4) lies outside the femoral sheath and is situated lateral to the femoral artery in the femoral triangle. The femoral sheath contains the femoral artery, femoral vein, and femoral canal (containing lymphatics), but excludes the femoral nerve.

About the HKCA Primary MCQ Exam

This practice exam covers basic sciences (anatomy, physiology, pharmacology), physics, clinical measurement, statistics, and safety for the HKCA Primary Fellowship.

Exam sponsor: Hong Kong College of Anaesthesiologists. The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Assessment

100 multiple-choice questions

Time Limit

3 hours

Passing Score

60%

Exam / Certification Fees

Free

Exam sponsor website

Reported exam pass rate: ~75%. estimated pass rate This describes exam candidates, not OpenExamPrep users or results from using our resources. Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Official sources

Official HKCA Website

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

20%

Anatomy

Surgical and regional anatomy relevant to airway, blocks, and vascular access.

20%

Physiology

Systemic organ physiology, acid-base, fluid balance, and blood gas transport.

20%

Pharmacology

Pharmacokinetics, pharmacodynamics, anaesthetic agents, muscle relaxants, and local anaesthetics.

20%

Physics & Clinical Measurement

Gas laws, electrical safety, equipment calibration, and monitor physics.

20%

Statistics & Safety

Biostatistics, trial design, infection control, and clinical safety principles.

Preparing for the HKCA Primary MCQ Exam

What You Need to Know

Passing score: 60%
Assessment: 100 multiple-choice questions
Time limit: 3 hours
Exam / certification fees: Free Official sources

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Frequently Asked Questions

What is the format of the HKCA Primary MCQ exam?

The exam consists of 100 multiple-choice questions covering all five content domains.

What is the passing score for the HKCA Primary MCQ exam?

Candidates must score at least 60% to pass the exam.