I really think AJAX may be your best answer.
You could perhaps change the background color of an answer once it is saved (and change it back if the player changes it again, until it is saved again).
This would not be hard to implement. Each button would simply send the corresponding answer to the server and change the background to indicate it had been sent.
Question: Is this on a per-person basis? That is, does each person have his/her own set of 45 answers?
An optimist sees the glass as half full.
A pessimist sees the glass as half empty.
A realist drinks it no matter how much there is.