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100+ Free FCA(SA) Part I Practice Questions

Pass your CMSA FCA(SA) Part I Primary Examination in Anaesthesia exam on the first try — instant access, no signup required.

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Key Facts: FCA(SA) Part I Exam

3 Core Domains

Tested across Pharmacology, Physiology/Biochemistry, and Physics/Equipment Safety

CMSA College of Anaesthetists Syllabus

4 Written Papers

Integrated structure of 2 Short Answer Question (SAQ) and 2 Single Best Answer (SBA) papers

CMSA FCA(SA) Part I Regulations

Cohen Method

Criterion-referenced standard setting used to calculate aggregated pass mark

CMSA Examination Standards

R 12,150

Written examination fee (inclusive of 15% VAT)

CMSA Fee Structure

HPCSA Registered

Mandatory medical practitioner registration requirement for candidates

CMSA Eligibility Rules

100 MCQs

Original SBA practice questions provided in this study adaptation bank

OpenExamPrep

The FCA(SA) Part I is the official primary examination for anaesthesiology specialist trainees in South Africa, governed by the CMSA College of Anaesthetists. It features four integrated written papers (2 SAQ and 2 SBA) testing Pharmacology (~35%), Physiology & Biochemistry (~35%), and Physics, Clinical Measurement & Equipment Safety (~30%). Candidates must meet HPCSA registration requirements and achieve an aggregated score set via the Cohen standard-setting method. The current written exam fee is R 12,150. These 100 practice MCQs serve as an English-language study adaptation designed to reinforce core basic science concepts for South African candidates.

Sample FCA(SA) Part I Practice Questions

Try these sample questions to test your FCA(SA) Part I exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1Propofol clearance exceeds hepatic blood flow in adult surgical patients. Which mechanism accounts for this extrahepatic elimination?
A.Renal excretion of unchanged drug
B.Luminescent degradation in circulation
C.Pulmonary metabolism and uptake
D.Plasma cholinesterase hydrolysis
Explanation: Propofol has a high metabolic clearance rate (1.5–2.2 L/min) that exceeds normal hepatic blood flow (~1.5 L/min). Extrahepatic clearance occurs predominantly in the lungs, where propofol undergoes first-pass uptake and glucuronidation, as well as minor renal metabolism.
2Which intravenous anesthetic agent exhibits a context-sensitive half-time that remains essentially flat (< 10 minutes) even after an infusion lasting several hours?
A.Thiopental
B.Fentanyl
C.Midazolam
D.Remifentanil
Explanation: Remifentanil is rapidly hydrolysed by non-specific blood and tissue esterases. Its context-sensitive half-time is 3 to 5 minutes regardless of the duration of continuous infusion because its elimination does not depend on organ clearance or redistribution from peripheral tissue stores.
3What primary physical chemical property explains the ultra-rapid onset of hypnosis following an intravenous bolus of thiopental?
A.Low volume of distribution
B.High lipid solubility and high un-ionized fraction
C.Low plasma protein binding
D.Rapid renal clearance
Explanation: Thiopental has high lipid solubility and a pKa of 7.6, meaning approximately 60% of the drug is un-ionized at physiological pH (7.4). The combination of high lipid solubility and a large un-ionized fraction allows rapid penetration across the blood-brain barrier within one arm-brain circulation time.
4Induction of anesthesia with etomidate is associated with transient adrenocortical suppression. Which enzyme is inhibited by etomidate?
A.11-beta-hydroxylase
B.21-hydroxylase
C.Aromatase
D.5-alpha-reductase
Explanation: Etomidate contains an imidazole ring that reversibly inhibits 11-beta-hydroxylase (and to a lesser extent 17-alpha-hydroxylase), blocking the conversion of 11-deoxycortisol to cortisol and 11-deoxycorticosterone to aldosterone in the adrenal cortex.
5Ketamine produces dissociative anesthesia primarily through which central nervous system receptor interaction?
A.Competitive antagonism of GABA-A receptors
B.Non-competitive antagonism of N-methyl-D-aspartate (NMDA) receptors
C.Agonism of mu-opioid receptors
D.Irreversible blockade of voltage-gated sodium channels
Explanation: Ketamine binds non-competitively to the phencyclidine site inside the channel ionophore of the N-methyl-D-aspartate (NMDA) receptor, blocking glutamatergic excitatory neurotransmission and uncoupling the thalamocortical and limbic systems.
6Remimazolam is an ultra-short-acting intravenous benzodiazepine. What structural feature renders its metabolism independent of organ clearance?
A.Phenolic structure hydrolysed by pseudo-cholinesterase
B.Carboxylic acid ester linkage susceptible to tissue esterases
C.Quaternary amine structure eliminated by Hofmann degradation
D.Nitro group reduced by hepatic microsomal enzymes
Explanation: Remimazolam is designed with an ester linkage incorporated into the benzodiazepine nucleus. It undergoes rapid organ-independent hydrolysis by non-specific tissue esterases (primarily carboxylesterase-1) to an inactive carboxylic acid metabolite (CNS 7054).
7According to the Meyer-Overton hypothesis, what physical chemical property correlates most strongly with the anesthetic potency (1/MAC) of volatile anesthetics?
A.Boiling point at 1 atm
B.Oil:gas partition coefficient
C.Blood:gas partition coefficient
D.Molecular weight
Explanation: The Meyer-Overton hypothesis demonstrates a direct linear correlation between lipid solubility (measured as the oil:gas partition coefficient) and anesthetic potency (inversely proportional to minimum alveolar concentration [MAC]). Agents with higher oil:gas solubility have lower MAC values.
8Which volatile anesthetic has the lowest blood:gas partition coefficient at 37°C, resulting in the most rapid rise of alveolar partial pressure (FA/FI)?
A.Isoflurane
B.Sevoflurane
C.Desflurane
D.Halothane
Explanation: Desflurane has a blood:gas partition coefficient of 0.42 (compared to nitrous oxide 0.47, sevoflurane 0.65, isoflurane 1.4, and halothane 2.4). Less anesthetic dissolves in pulmonary blood, allowing FA to approach FI rapidly.
9Desflurane requires a specialized vaporizing system (TEC 6) because of which physical property at sea level room temperature?
A.Vapor pressure of 669 mmHg and boiling point of 22.8°C
B.High oil:gas partition coefficient of 220
C.Instability when exposed to ambient fluorescent light
D.Tendency to polymerize in copper kettles
Explanation: Desflurane has a high vapor pressure of 669 mmHg (at 20°C) and a boiling point near room temperature (22.8°C). Standard variable-bypass vaporizers would boil desflurane, causing uncontrolled output and wild concentration fluctuations. The TEC 6 heats desflurane to 39°C (vapor pressure ~1500 mmHg) to inject vapor into the fresh gas stream.
10Degradation of sevoflurane by dry carbon dioxide absorbents containing sodium and potassium hydroxide produces which potentially nephrotoxic degradation product?
A.Carbon monoxide
B.Compound A (fluoromethyl-2,2-difluoro-1-[trifluoromethyl]vinyl ether)
C.Phosgene gas
D.Formaldehyde
Explanation: Sevoflurane degrades in warm, dry alkaline CO2 absorbents (especially those containing high NaOH/KOH content) to form Compound A. In rat models, Compound A causes renal proximal tubular necrosis, leading to clinical recommendations to maintain fresh gas flow ≥ 1–2 L/min.

About the FCA(SA) Part I Exam

The Fellowship of the College of Anaesthetists of South Africa Part I — FCA(SA) Part I — is the primary specialist barrier examination administered by the Colleges of Medicine of South Africa (CMSA). It evaluates a registrar's foundational knowledge of the basic medical sciences and physical principles underpinning safe anaesthetic practice. The assessment consists of four integrated written papers: two SAQ papers and two SBA papers covering Applied Pharmacology, Applied Physiology & Biochemistry, and Physics, Clinical Measurement & Equipment Safety. This 100-question practice set provides an English-language study adaptation featuring single-best-answer questions with detailed rationales for every option, structured according to the official CMSA content weightings.

Assessment

Modernized four-paper integrated written assessment comprising two Short Answer Question (SAQ) papers and two Single Best Answer (SBA) papers across Pharmacology, Physiology/Biochemistry, and Physics/Equipment Safety.

Time Limit

Multiple timed written paper sessions scheduled over the CMSA examination week.

Passing Score

Aggregated passing threshold determined using the Cohen criterion-referenced standard-setting method across all four written papers.

Exam Fee

R 12,150 (inclusive of 15% VAT) (College of Anaesthetists of South Africa (CMSA))

FCA(SA) Part I Exam Content Outline

35%

Applied Pharmacology in Anaesthesia

Pharmacokinetics (absorption, distribution, metabolism, elimination, context-sensitive half-time), pharmacodynamics, intravenous hypnotics, volatile and gaseous anesthetics, local anesthetics, neuromuscular blockers and reversal agents, opioids, autonomic drugs, cardiovascular resuscitation drugs, antiemetics, and drug toxicity.

35%

Applied Physiology & Biochemistry

Cardiovascular dynamics, respiratory mechanics and gas exchange, neurophysiology and intracranial pressure, renal function and fluid-electrolyte balance, hepatic function, hematology and coagulation cascades, acid-base regulation, and cellular bioenergetics.

30%

Physics, Clinical Measurement & Equipment Safety

Fundamental gas laws, fluid dynamics and laminar/turbulent flow, vaporizer design and compensation, gas supplies and manifolds, breathing circuits, mechanical ventilation principles, physiological measurement (capnography, pulse oximetry, invasive blood pressure), electrical safety, macroshock/microshock prevention, and equipment hazard reduction.

How to Pass the FCA(SA) Part I Exam

What You Need to Know

  • Passing score: Aggregated passing threshold determined using the Cohen criterion-referenced standard-setting method across all four written papers.
  • Assessment: Modernized four-paper integrated written assessment comprising two Short Answer Question (SAQ) papers and two Single Best Answer (SBA) papers across Pharmacology, Physiology/Biochemistry, and Physics/Equipment Safety.
  • Time limit: Multiple timed written paper sessions scheduled over the CMSA examination week.
  • Exam fee: R 12,150 (inclusive of 15% VAT)

Keys to Passing

  • Complete 500+ practice questions
  • Score 80%+ consistently before scheduling
  • Focus on highest-weighted sections
  • Use our AI tutor for tough concepts

FCA(SA) Part I Study Tips from Top Performers

1Integrate basic science principles directly with clinical anaesthetic practice, focusing on mechanism of action, physical principles, and physiological responses.
2Master pharmacokinetic modeling principles, including three-compartment models, clearance, volume of distribution, and context-sensitive half-times.
3Focus heavily on gas laws, fluid mechanics (Poiseuille and Bernoulli principles), vaporizer mechanics, and breathing circuit performance.
4Review acid-base interpretation, blood-gas analysis, oxygen delivery equations (DO2, VO2), and respiratory mechanics (compliance, resistance, dead space).
5Understand electrical safety principles, including isolated power supplies, line isolation monitors, and microshock mechanisms in cardiac catheterization and invasive monitoring.
6Practice single-best-answer questions under timed conditions to refine decision-making speed and clinical reasoning across all three syllabus domains.

Frequently Asked Questions

What is the FCA(SA) Part I examination?

The FCA(SA) Part I is the primary specialist qualification exam administered by the College of Anaesthetists of the Colleges of Medicine of South Africa (CMSA), testing applied basic sciences essential for anaesthetic practice.

What is the structure of the FCA(SA) Part I written examination?

The modernized examination format consists of four integrated written papers: two Short Answer Question (SAQ) papers and two Single Best Answer (SBA) papers covering Pharmacology, Physiology & Biochemistry, and Physics & Equipment Safety.

How is the passing score determined for the CMSA FCA(SA) Part I?

Scores across all four written papers are aggregated, and the overall pass mark is determined using the Cohen criterion-referenced standard-setting method.

What is the current examination fee for the FCA(SA) Part I?

The written examination fee for recent CMSA sittings is R 12,150 (inclusive of 15% VAT). Candidates should verify current fees on the official CMSA portal prior to registration.

Are supplementary examinations offered for FCA(SA) Part I?

No. Under current CMSA regulations for the integrated four-paper format, supplementary examinations are not offered. Candidates who do not meet the pass mark must retake all four papers at a subsequent official sitting.

Are these official CMSA examination questions?

No. This question bank is an independent English-language study adaptation created for self-assessment and exam preparation. Official past papers and syllabus blueprints are published directly by the Colleges of Medicine of South Africa (CMSA).