How to prepare for the Primary FRCA MCQ/SBA paper: the exam format, a syllabus breakdown across pharmacology, physiology, physics and clinical measurement, sample questions with explanations, and a 4,000+ question bank mapped to the Royal College syllabus.
What the exam covers
Pharmacology, physiology, physics and clinical measurement as applied to anaesthetic practice.
Applied basic sciences relevant to safe anaesthetic and perioperative care.
Statistics and evidence-based practice as tested in the SBA paper.
Exam format
Multiple-choice question (MCQ) paper with single-best-answer questions.
Delivered as a computer-based exam via the Royal College of Anaesthetists.
A pass requires meeting the standard set for that diet, followed by the OSCE/SOE components.
How Examrix helps you pass Primary FRCA
A Primary FRCA SBA question bank of 4,000+ questions covering the full Royal College syllabus.
Detailed explanations with references, focused on pharmacology, physiology, physics and clinical measurement.
Timed exam and tutor modes matched to the real SBA paper structure.
Per-topic analytics and peer benchmarking to target the highest-yield gaps.
Topic coverage
PharmacologyRespiratory physiologyCardiovascular physiologyRenal physiologyClinical measurementPhysicsStatisticsAnatomyPharmacokineticsPain and its management
Primary FRCA syllabus breakdown
Pharmacology
Pharmacokinetics, compartment models and context-sensitive half-time
Intravenous and inhalational anaesthetic agents
Neuromuscular blockers and their reversal
Local anaesthetics and toxicity
Analgesics, including opioids and NSAIDs
Cardiovascular and autonomic drugs
Physiology and biochemistry
Respiratory physiology: ventilation, gas exchange and V/Q relationships
Cardiovascular physiology: cardiac cycle, pressure–volume loops and regulation
Renal physiology, acid–base balance and fluid compartments
Neurophysiology, cerebral blood flow and intracranial pressure
Maternal, neonatal and paediatric physiology
Physics and clinical measurement
Gas laws, flow, humidification and vaporisers
Pressure and flow measurement, and the anaesthetic breathing systems
Capnography, pulse oximetry and gas analysis
Electrical safety, diathermy and defibrillation
Ultrasound principles and Doppler
Anatomy and statistics
Airway, respiratory and cardiovascular anatomy
Vertebral column and regional block anatomy
Data types, distributions and error
Study design, sensitivity, specificity and predictive values
Sample Primary FRCA questions
Three example single-best-answer questions in the style of the Primary FRCA bank, with the reasoning behind the correct answer.
Question 1
Which property of sevoflurane best explains its rapid onset of anaesthesia compared with isoflurane?
A.Higher oil:gas partition coefficient
B.Lower blood:gas partition coefficient
C.Higher saturated vapour pressure
D.Lower minimum alveolar concentration
E.Greater molecular weight
Answer: Lower blood:gas partition coefficient
Speed of onset depends on how quickly alveolar partial pressure rises. A low blood:gas partition coefficient (sevoflurane ≈ 0.65 vs isoflurane ≈ 1.4) means less agent is taken up into blood, so alveolar and brain partial pressures equilibrate faster. The oil:gas coefficient predicts potency, not speed.
Question 2
A patient's capnograph shows a normal waveform shape but the end-tidal CO₂ has fallen abruptly from 4.8 kPa to 1.5 kPa with unchanged ventilation. What is the most likely cause?
A.Bronchospasm
B.Pulmonary embolism
C.Malignant hyperthermia
D.Rebreathing
E.Oesophageal intubation
Answer: Pulmonary embolism
A sudden fall in end-tidal CO₂ with a preserved waveform indicates an abrupt increase in alveolar dead space — classically pulmonary embolism or another cause of reduced pulmonary blood flow. Bronchospasm produces a sloping upstroke, malignant hyperthermia raises end-tidal CO₂, and rebreathing raises the baseline.
Question 3
Which statement about the oxyhaemoglobin dissociation curve is correct?
A.A rise in 2,3-DPG shifts the curve to the left
B.Fetal haemoglobin shifts the curve to the right
C.A fall in pH shifts the curve to the right
D.Hypothermia shifts the curve to the right
E.Carboxyhaemoglobin shifts the curve to the right
Answer: A fall in pH shifts the curve to the right
The Bohr effect: acidosis (and hypercapnia, pyrexia and raised 2,3-DPG) reduces haemoglobin's oxygen affinity and shifts the curve right, favouring tissue offloading. Fetal haemoglobin, hypothermia and carboxyhaemoglobin all shift the curve left.
