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Question 1

Primary Topic: Trauma – Obstetric Patient

Subtopics: Trauma – Pregnant Patient, Fetal Monitoring, Tocodynamometry, Fetal Effects of Ionizing Radiation, Ketamine, Hypovolemic Resuscitation / Rhesus Isosensitization / Pregnancy – NSAIDS Use, Fetal Heart Rate Variability, Fetal Effects of Ketamine / Head Injury – Hyperventilation / Spinal Bifida – Occulta vs. Cystica, Meningocele vs. Myelomeningocele, Spinal Dysraphism, Neuraxial Anesthesia / Magnesium – Seizure Prophylaxis, Toxicity / Neuraxial Anesthesia – Spina Bifida, Coagulopathy, Hypovolemia, Brain Stem Herniation / Difficult Airway Management / Emergency Cesarean Section – Anesthetic Choice, Maternal Optimization / Pulseless Electrical Activity (PEA) / Tension Pneumothorax / Omphalocele – Difference from Gastroschisis, Medical Management, Monitoring, Intubation Options, Nitrous Oxide Use, Right-to-Left Shunting vs. Abdominal Compartment Syndrome, Staged Closure, Extubation / Beckwith-Wiedemann Syndrome / Retinopathy of Prematurity

Question 2

Primary Topic: Pediatrics – Scoliosis

Subtopics: Scoliosis – Cobb Angle, Preoperative Evaluation, Duchenne’s Muscular Dystrophy (DMD), Physiologic Effects, Intraoperative Monitoring, Blood Loss, Postoperative Pain Management / DMD – Volatile Agent Exposure / Neurologic Monitoring – Wake-up Test, SSEPs, MEPs, EMGs, Ankle Clonus Test, Anesthetic Effects on Evoked Potentials, Anesthetic Management / Prone Position / Pulmonary Artery Catheter / Deliberate Hypotension – Risks, Technique / Venous Air Embolism – Diagnosis, Management / Extubation – Criteria for, Rapid Shallow Breathing Index

Question 3

Primary Topic: Pediatrics – Strabismus Surgery

Subtopics: Strabismus Surgery – Risk of Postoperative Nausea and Vomiting, Oculogastric Reflex, Oculocardiac Reflex, Forced Duction Test, Association with Malignant Hyperthermia / Upper Respiratory Tract Infection – Preoperative Evaluation, Delaying Elective Surgery, Perioperative Risks, LMA vs. ETT / Asthma – Preoperative IV Anticholinergic / Pediatric Patient – Succinylcholine-Induced Hyperkalemia / Malignant Hyperthermia (MH) – Associated Disorders, “MH-Like” Events, Variable Expressivity, Caffeine Halothane Contracture Test, MHAUSE Recommendations, Treatment, Prophylactic Dantrolene, Cleaning the Anesthesia Machine, Arterial Blood Gas Interpretation, Mixed Venous Blood Gas, Complications (e.g. renal failure, DIC) / Masseter Muscle Rigidity (MMR) – Definitions, Association with MH, Cancelling vs. Proceeding with the Case, Post-Event Monitoring, MHAUS Recommendations / Oculocardiac Reflex – Neural Pathway, Treatment

Question 4

Primary Topic: Neuro – Acute Cervical Spinal Cord Injury

Subtopics: Acute Cervical Spine Injury – Pathophysiology, Neurogenic Pulmonary Edema, Complications, Steroid Administration, Airway Management, Spinal Shock, Proliferation of Cholinergic Receptors, Succinylcholine Administration, Intraoperative Positioning / Neurological Monitoring – SSEPs, MEPs / Head Injury – Hyperventilation / PVCs – R-on-T Phenomenon, Treatment / Vaporizer Spill / Coronary Stents – Timing of Elective Surgery, Drug-Eluting vs Bare Metal, ACC AHA Guidelines / Chronic Cervical Spinal Cord Injury – Long-Term Complications, Preoperative Assessment, Baclofen, Autonomic Hyperreflexia, / Autonomic Hyperreflexia –Pathophysiology, Regional vs General Anesthesia, Proliferation of Cholinergic Receptors, Succinylcholine Administration, Treatment / Central Oxygen Supply Failure

Question 5

Primary Topic: Orthopedics – Spinal Surgery

Subtopics: Acute Spinal Cord Injury – Steroid Administration, Spinal Cord Monitoring, Airway Management, Postoperative Complications / Spinal Cord Monitoring – SSEPs, MEPs, Wake-up Test, Anesthetic Effects, Interpretation, Management / Spinal Cord Blood Supply / Tobacco Use – COPD, Preoperative Cessation, PFTs / COPD – Diagnosis, Optimization / PFTs – Information Provided, Interpretation / Chronic Alcohol Abuse – Systemic Manifestations, Withdrawal / Diabetes Mellitus – Perioperative Glucose Management, Perioperative Complications, Preoperative Assessment, Autonomic Neuropathy / Delayed Emergence – Differential / ABG – Interpretation, Anion Gap / Metabolic Acidosis – ABG, Differential, Treatment / Bicarbonate Therapy – For Metabolic Acidosis, Potential Complications / Post-operative Vision Loss – Postoperative Ischemic Optic Neuropathy, Risk Factors, Risk Reduction, Management

Question 6

Primary Topic: ENT – Submandibular Abscess

Subtopics: Submandibular Abscess – Sepsis, Airway Management / Down Syndrome – Cervical Spine Instability, Difficult Airway Management / Wolff Parkinson White – Reentrant and Non-reentrant arrhythmias / Aspiration– Risk Reduction, In the Setting of Tracheostomy, Aspiration Pneumonitis, Management, Steroid and Antibiotic Administration / Uncooperative Patient – IV Access, Difficult Airway Management / Difficult Airway – Preparations, Intubating Options / Subglottic Stenosis – Down Syndrome vs. Submandibular Abscess, Airway Access / Bronchospasm – Risk Factors, Causes, Treatment / Tracheostomy Tube –Management when Dislodged, Aspiration Risk / Medical Legal – Medical Malpractice, Standard of Care, Risk Reduction

Question7

Primary Topic: ENT – Bleeding Tonsil

Subtopics: Tonsillectomy – Preoperative Evaluation, Flexible LMA, Narcotic-induced Respiratory Depression in Children with OSA, Risk of PONV / Obstructive Sleep Apnea – Screening, Opioids and Respiratory Depression / Hemophilia – Types, Laboratory Assessment, Desmopressin Use, Preoperative Optimization, Transfusion, Postoperative Factor VIII Administration / Medical Ethics – Children and Decision-Making Capacity / LMA – Use for Tonsillectomy, Extubation in Children / Bleeding Tonsil – Preoperative Management, Assessment of Volume Status, Extubation / Citrate Toxicity – Signs and Symptoms / Adrenal Insufficiency – Addisonian Crisis, Pathophysiology, Signs and Symptoms, Steroid Replacement Regimens, Treatment of Addisonian Crisis / Postoperative Nausea and Vomiting (PONV) – Prevention, Opioid Sparing Drugs

Question 8

Primary Topic: Trauma & Burn

Subtopics: Trauma – Primary vs. Secondary vs. Tertiary Survey / Burn – Fluid Resuscitation, Parkland Formula, Burn Injury Classification, Burn Shock, Airway Management, Inhalational Injury, Cardiovascular Effects, Carbon Monoxide Poisoning, Succinylcholine Administration, ETT Exchange, Hypermetabolic Response to Thermal Injury, Nutritional Support / Acidosis – Sodium Bicarbonate / Carbon Monoxide Poisoning – Pulse Oximetry, Pathophysiology, Treatment, Delayed Neurologic Sequelae / Cyanide Toxicity – Diagnosis, Treatment / Limb Compartment Syndrome – Diagnosis, Distinguishing from Vascular Trauma, Indication for Fasciotomy / Laryngospasm – Pathophysiology, Management / Transfusion – Estimated Blood Volume, Estimated Allowable Blood Loss / Burn Excision – – Anesthesia Management, Tangential vs Fascial Excision / Jet Ventilation – Initial Setting, Complications, Subglottic vs. Supraglottic, Relative Contraindications / Myoglobinuria – Differentiating from Hemoglobinuria, Diagnosis, Treatment / Abdominal Compartment Syndrome – Signs and Symptoms, Diagnosis, Systemic Effects

Question 9

Primary Topic: Cardiovascular – Thoracic Aortic Dissection

Subtopics: Thoracic Aortic Dissection – Perioperative Complications, Classification, Aorta Anatomy, Aortic Regurgitation, Aneurysm Rupture and Propagation, β-blocker and Vasodilator Therapy, Preoperative Initiation of β-blocker Therapy, Preoperative Assessment of Pulmonary Function, Monitoring, Postoperative Respiratory Failure, Anticoagulation for Bypass, Neuromonitoring, Potential Blood Loss, Anesthesia Maintenance, Hypothermia, Rewarming, Post-Cross Clamp Hypotension, Protamine Administration, Extubation, Postoperative Neurological Deficit / Coronary Stent – Thienopyridine Therapy, Bridging Therapy, Perioperative Management / Spinal Cord Perfusion / Lumbar Drain – CSF Drainage, Complications, Traumatic Placement Prior to Bypass, ASRA Guidelines / Epidural Catheter – ASRA Guidelines, Risks and Benefits / Neuromonitoring / Acute Normovolemic Hemodilution – Method, Limitations, Contraindications / Central Venous Pressure Monitoring / Evoked Potential Monitoring – Effects of Anesthesia, Interpretation / Temperature Monitoring – Core vs Peripheral / Pulmonary Artery Catheter – Signs of Myocardial Ischemia / Spinal Cord Protection – Spinal Cord Blood Supply, Hypothermia, Lumbar Drain, Interventions that Reduce the Risk of Spinal Cord Injury, Neuromonitoring / Ventilator Modes / Hypothermia – Spinal Cord Protection, Inducing Coagulopathy / Thromboelastography

Question 10

Primary Topic: Neuro – Cerebral Aneurysms

Subtopics: Cerebral Aneurysm – Monitoring, Hunt and Hess Classification, Deliberate Hypotension, Neuroprotection / Ruptured Cerebral Aneurysm – Management / Hypothermia – Neuroprotection, Complications / Elevated ICP – Signs and Symptoms / Difficult Airway – Evaluation / Central Line Placement – Carotid Artery Puncture, Subclavian Approach / Modes of Ventilation / Postoperative Vasospasm – Diagnosis, Management / Neurogenic Pulmonary Edema – Pathophysiology, Treatment / SIADH vs CSWS

Question 11

Primary Topic: Pediatrics – Tracheoesophageal Fistula

Subtopics: TEF – Diagnosis, Initial Airway Management, Types of TEF, Associated Congenital Anomalies (VACTERL), Preoperative Management, Monitoring, Induction and Intubation, Gastrostomy Tube, Intraoperative Ventilation, Extubation, Postoperative Ventilator Settings, Postoperative Pain Management, Postoperative and Long Term Complications / Prematurity – Associated Complications / Cuffed vs Uncuffed ETT / Pediatric Fluid Management / Neonatal Thermal Regulation – Mechanism of Heat Production, Complications of Hypothermia, Warming Methods / Neonatal Transfusion / Post-Intubation Croup – Risk Factors, Treatment / Tracheomalacia

Question 12

Primary Topic: Pediatrics – CDH & Prematurity

Subtopics: Congenital Diaphragmatic Hernia – Presentation, Pathophysiology, Persistent Fetal Circulation (Shunting), Alveolar-Arterial Gradient, Medical Management, Mask Ventilation, Mechanic Ventilation, Pulmonary Hypertension, ECMO, Intravenous Access, Monitoring, Preductal vs. Postductal Oxygen Saturation, Risk of Barotrauma, Expansion of the Hypoplastic Lung, Abdominal Compartment Syndrome, Extubation, Heart Failure, Pneumothorax / Umbilical Vein Catheterization – Method, Central vs. Peripheral Line, Hepatic Injury, Complications / Umbilical Artery Catheterization – Complications, Utilization / Retinopathy of Prematurity – Pathophysiology, Risk Factors, Prevention / Persistent Fetal Circulation – Fetal Shunts, Pulmonary Hypertension, Management of Right-to-Left Shunting / Pneumothorax – Needle Thoracentesis / Hypothermia – Complications, Prevention, Treatment

Question 13

Primary Topic: Obstetrics – Laparoscopic Appendectomy

Subtopics: Nonobstetric Surgery for the Pregnant Patient – Fetal Neurotoxicity, Maternal and Fetal Risks, Timing of Semi-elective Surgery, Steroids for Fetal Lung Maturation, Tocolytic Administration, Fetal Monitoring (Continuous vs. Preoperative and Postoperative), Tocodynamometry, Aspiration Risk, Maternal-fetal Oxygen Tension Gradient, NSAID Administration / Teratogenesis / Laparoscopic Surgery – Risk of PONV, Risks in Pregnancy, Complications Associated with Pneumoperitoneum Creation (e.g. Capnothorax, CO2 Emphysema, Mainstem Intubation) / Diabetes Mellitus – Diabetic Scleroderma / Diabetic Ketoacidosis (DKA) – Diagnosis, Treatment, ABG and Anion Gap, Perioperative Risks / Postoperative Nausea and Vomiting (PONV) – Risk Factors, Prevention and Treatment, Drugs Avoided in Pregnancy / Electroconvulsive Therapy (ECT) – Risks for Pregnant Patient, Contraindications, Physiologic Effects, Anesthetic Management, Airway Management, Post-ECT Myalgia, Postictal Agitation

Question 14

Primary Topic: Pulmonary – Pneumonectomy

Subtopics: Pneumonectomy – Pre-Thoracotomy Assessment, Pulmonary Function Testing, Cardiovascular Assessment, Monitoring, Double-Lumen Tube Placement and Management, One-Lung Ventilation, Extubation, Postoperative Pain Management, Post-pneumonectomy Complications (Cardiac Herniation, Right Heart Failure, Supraventricular Tachycardia) / COPD – Chronic Bronchitis vs. Emphysema, Digital Clubbing / Arterial Blood Gas – Interpretation / CVP – Options for Access

Question 15

Primary Topic: ENT – UPPP / Obstructive Sleep Apnea

Subtopics: UPPP Surgery – Endotracheal Tube Selection, Anesthesia Maintenance / Obstructive Sleep Apnea (OSA) – Diagnosis, Polysomnography (sleep study), Apnea-Hypopnea Index, Airway Management, Postoperative Pain Management, Candidacy for Outpatient Surgery, Postoperative Discharge Criteria, Cardiovascular Effects, Sensitivity to CNS Depressants, Obstructive Sleep Hypopnea Syndrome (OSH), Obesity Hypoventilation Syndrome (OHS), Pickwickian Syndrome / Obesity – Coexisting Disease, Drug Distribution, Hydrophilic vs. Lipophilic Drugs, Induction vs. Maintenance Dosing / Coronary Artery Disease – Preoperative Assessment / Difficult Airway Management – Awake Fiberoptic Intubation, Recent Weight Gain, OSA, Cricothyroidotomy, Tracheostomy / LASER – FiO2 Reduction / Circuit Leak – Management / ETT Cuff Leak – Management, ETT Exchange / Atrial Fibrillation – Management, Electrical vs. Pharmacologic Conversion / Negative Pressure Pulmonary Edema – Management

Question 16

Primary Topic: Pediatrics – Ligation of Patent Ductus Arteriosus

Subtopics: Fetal Circulation – Transition at Birth, Fetal Shunts / Respiratory Distress Syndrome (RDS) – Pathophysiology, Presentation, Prevention and Treatment / Patent Ductus Arteriosus – Pharmacologic Treatment, Pathophysiology / Ligation of PDA – Preoperative Evaluation, Perioperative Complications, Monitoring, Maintenance of Anesthesia, Right-to-Left Shunting, Postoperative Hypertension / Neonatal Glucose Homeostasis / Retinopathy of Prematurity – Prevention, Risk Factors / Neonatal Transfusion – Target Hematocrit, Estimated Blood Volume / Neutral Temperature / Neonatal Thermal Regulation – Pathophysiology, Prevention of Hypothermia / Neonatal Seizure – Differential, Treatment

Question 17

Primary Topic: Endocrine – Pheochromocytoma

Subtopics: Pheochromocytoma – Pathophysiology, Associated Complications, Diagnosis, Preoperative Preparation, Clonidine Suppression Test, α-Blockade, α-methylparatyrosine, Fluid Management, Monitoring, Medications to be Avoided, Perioperative Hypertensive, Perioperative Hypotension, Postoperative Hypoglycemia / Laparoscopic Surgery – Gastric Decompression, Venostasis, Risk of Postoperative Nausea and Vomiting, General vs Regional Anesthesia, Subcutaneous Emphysema, Capnothorax, CO2 Embolism, Oliguria / Malignant Hyperthermia – Prophylactic Dantrolene / Subcutaneous Emphysema – Diagnosis, Management

Question 18

Primary Topic: Renal – Chronic Renal Failure

Subtopics: Chronic Renal Failure – Preoperative Work-up, Mechanism of Anemia, Transfusion, Cardiac Effects, Drugs to Avoid, Fluid Management / Dialysis – Volume Status, / Hyperkalemia – Preoperative Management, Signs and Symptoms, Treatment / Capnography – Use in the Diagnosis of Hypoxia / Aspiration – Perioperative Management / Postoperative Hypoxia – Differential / Narcotic Dependence – Perioperative Management / Neuraxial Blockade – Consideration in CRF, ASRA Guidelines Concerning SQ Heparin

Question 19

Primary Topic: Neuro – Cerebellar Tumor

Subtopics: Craniotomy (Cerebellar Tumor) – Evoked Potential Monitoring, Venous Air Embolism, Induction of Anesthesia, Reduction of Brain Swelling, Extubation, Tension Pneumocephalus / von Willebrand’s Disease – Types, Pathophysiology, Diagnosis, Prophylactic Desmopressin / Intracranial Hypertension – Methods of Reducing Intracranial Pressure, Hyperventilation, Blood Pressure Management, Cerebral Perfusion, Lumbar Drainage of CSF, Sedative and Opioid Administration, Steroid Administration, succinylcholine Administration / Mitral Valve Prolapse with Mitral Valve Regurgitation – Diagnosis, Preoperative Assessment, Antibiotic Prophylaxis, Factors that Worsen Mitral Regurgitation in the Setting of Mitral Valve Prolapse / Infective Endocarditis Prophylaxis – Indications / Venous Air Embolism – Monitoring, Central Line Placement / Central Line Placement – Options for Access, Treatment of Air Embolism, Intravascular Electrocardiography for Placement / Delayed Emergence – Differential, Management / Peripheral Neuropathy – Diagnosis, Risk Factors, Prevention, Treatment

Question 20

Primary Topic: Pediatrics – Laryngeal Papillomatosis

Subtopics: Pediatric Anesthesia – Parental Presence in the OR, Pre-Induction Intravenous Access, Succinylcholine Use / Laryngeal Papillomatosis – Causes, Treatment, Airway Evaluation, Risk of Airway Obstruction, Airway Management vs. Surgical Access (Intermittent Extubation with or without Spontaneous Ventilation, Intermittent Jet Ventilation) / Jet Ventilation – Technique, Complications / LASER – Types, Injury, Airway Fire / Airway Fire – Management, Risk Reduction, Post-Fire Airway Management / Malignant Hyperthermia – Genetic Inheritance, Susceptibility, Succinylcholine, Postoperative Monitoring of the Susceptible Patient, Signs and Symptoms, Treatment / Laryngospasm – Treatment

Question 21

Primary Topic: Obstetrics – Sickle Cell Disease

Subtopics: Sickle Cell Disease – Hydroxyurea, Pathophysiology, Sickling in Venous Blood, Aplastic Crisis, Vaso-Occlusive Crisis, Acute Chest Syndrome, Splenic Sequestration Crisis, Hemolytic Crisis, Preoperative Assessment, Systemic Effects, Sickle Cell Lung Disease, Exchange Transfusion, Neuraxial Anesthesia, Factors that Reduce Sickling, Seizure, Tourniquet Use / Neuraxial Anesthesia – Coagulopathy, Epidural or Spinal Hematoma, For Cesarean Section, Catheter Management in the Coagulopathic Patient, Infection at Catheter Site / Epidural or Spinal Hematoma – Signs and Symptoms, Prevention / Preeclampsia – Spinal vs. Epidural, Eclampsia / Local Anesthetic Toxicity – CNS Effects, Treatment / Amniotic Fluid Embolism – Signs and Symptoms / Uterine Atony / Retinal Detachment – Intra-vitreal Bubble, Nitrous Oxide Administration, Air vs. Sulfur Hexafluoride vs. Perfluoropropane / Hypocalcemia – Citrate Toxicity, Signs and Symptoms / Opioid Dependence – Postoperative Pain Management, Epidural Morphine, Withdrawal / Acute Chest Syndrome – Signs and Symptoms, Treatment / Pulmonary Edema – Transfusion Related Acute Lung Injury vs. Transfusion Associated Circulatory Overload vs. Transfusion Associated Dyspnea / Pregnancy Testing

Question 22

Primary Topic: Pulmonary – Mediastinoscopy

Subtopics: Paraneoplastic Syndromes / Lambert-Eaton Myasthenic Syndrome – Pathophysiology, Presentation, Treatment, Muscle Relaxants / Hyponatremia – SIADH vs Diuretic Use, Delaying Elective Surgery, Perioperative Risk / Carotid Artery Disease – Risks During Mediastinoscopy / Mediastinoscopy – Contraindications, Complications, Monitoring, Innominate Artery Compression, General vs Local Anesthesia, Pneumothorax, Nitrous Oxide, Bleeding, Deliberate Hypotension / Hypertension – Perioperative Risks, Delaying Elective Surgery, Signs of End-organ Injury / ACE Inhibitor – Perioperative Hypotension / Superior Vena Cava Syndrome – Signs and Symptoms, Diagnosis, Complications / Recurrent Laryngeal Nerve Injury – Complete vs Partial Injury, Management / Cardiac Tamponade – Diagnosis, Treatment

Question 23

Primary Topic: Pulmonary – Cystic Fibrosis

Subtopics: Cystic Fibrosis – Pathophysiology, Preoperative Evaluation, Preoperative Optimization, Pulmonary Function Testing (PFTs), Medical Treatment, Regional vs General Anesthesia / Laparoscopic Surgery – Pneumoperitoneum Insufflation, Vasovagal Response, Right Mainstem Intubation, Capnothorax, Pneumothorax / Thoracic Epidural – Postoperative Pain Control, Coagulopathy / Emergence Delirium – Treatment, Prevention, Risk Factors / Extra Pyramidal Symptoms – Types, Pathophysiology, Treatment

Question 24

Primary Topic: Cardiovascular – Carotid Endarterectomy

Subtopics: Carotid Endarterectomy – Preoperative Work-up, Indications for Pre-procedural Revascularization, General vs. Regional, Monitoring, Carbon Dioxide Management, Manipulation of the Carotid Sinus / Deep and Superficial Cervical Plexus Blocks – Technique, Complications / Neurophysiologic Monitoring – Monitoring Options, Anesthetic Effects, Management, Cerebral Ischemia vs Cardiac Ischemia / Coronary Artery Disease – Preoperative Assessment (ACC/AHA Guidelines), Ketamine / Myocardial Preconditioning / Delayed Emergence – Differential, Management / Post-CEA Respiratory Distress / Cerebral Hyperperfusion Syndrome – Pathophysiology, Signs and Symptoms / Postoperative Dyspnea – Differential / Postoperative Hypertension – Management / cNeck Hematoma – Management

Question 25

Primary Topic: Renal – Arterial Venous Fistula

Subtopics: AV Fistula Revision – Anesthetic Options, Patient Positioning, Blood Pressure Cuff Application / Chronic Renal Failure – Assessing Volume Status, Hemodialysis, Systemic Effects, Hyponatremia, Succinylcholine Administration, Effects on Drug Pharmacokinetics and Pharmacodynamics, Uremic Pericarditis, Intravenous Access, Regional Anesthesia, Using a Temporary Dialysis Catheter for Intravenous Access / Hyponatremia – Signs and Symptoms, Associated Risks, Delaying Elective Surgery, Intramuscular Injections / Uremic Pericarditis – Cardiac Tamponade / Nondepolarizing Neuromuscular Blockers – Antibiotic Potentiation of Blockade / Inadequate Nondepolarizer Reversal – Factors that Interfere with Reversal, Management, Excessive Neostigmine, Combining Anticholinesterases / Interscalene Block – Pneumothorax, Phrenic Nerve Blockade (Ipsilateral Diaphragmatic Paresis) / Discharge Criteria for Same Day Surgery – PADSS and Aldrete

Question 26

Primary Topic: Cardiovascular – Endovascular Repair Aortic Aneurysm

Subtopics: Aortic Aneurysm – Complications, Difference from Aortic Dissection, Crawford Classification / Hypertension – Risk of Aneurysmal Propagation or Rupture, Management, β-Blocker and Vasodilator Timing / Endovascular Repair Aortic Aneurysm – Perioperative Complications, Spinal Cord Preservation Strategies, Endoleaks, General vs. Neuraxial Anesthesia, Creating a Hemodynamically “Still” Field (Adenosine or Transvenous Pacing or Right Atrial Flow Occlusion), Post-Implantation Syndrome / Open Surgical Repair Aortic Aneurysm – Clamp and Sew Technique, Hypothermia for Spinal Cord and Renal Preservation, Postoperative Complications / Postoperative Renal Dysfunction – Risk Factors and Causes, Preservation Strategies, Suprarenal vs. Intrarenal Cross Clamp Application, Acute Tubular Necrosis, Evaluation / Endoleaks – Types, Management / Aortic Cross Clamp Application – Physiologic Effects, Management of Hypertension / Aortic Cross Clamp Release – Preparing for Cross Clamp Release, Treatment Hypotension / Cyanide Toxicity – Sodium Nitroprusside, Pathophysiology, Treatment

Question 27

Primary Topic: Obstetrics – Ischemic Cardiomyopathy

Subtopics: Ischemic Cardiomyopathy – Preoperative Assessment, Chest X-Ray Findings, Echocardiography, Preoperative Optimization, Preoperative β-Blocker Therapy, Cesarean Section vs. Labor, Magnesium Sulfate, Neuraxial Anesthesia / Myocardial Infarction – ECG Interpretation / Preoperative Assessment of Left Ventricular Function – Indications / Preeclampsia – Magnesium Sulfate (Indications and Contraindications) / Magnesium Toxicity – Signs and Symptoms, Treatment / Neuraxial Anesthesia – Preeclampsia, Coagulopathy, Ischemic Cardiomyopathy, Catheter Management in the Coagulopathic Patient / Asystole – ACLS Protocol, Atropine and Pacing, Causes (5 “H’s” and 5 “T’s”), Pregnant Patient / ACLS – Asystole, Pregnant Patient, Delivery of the Baby / Ventricular Tachycardia – ACLS Protocol / Transfusion – Average Blood Volume, Estimated Allowable Blood Loss / Neonatal Respiratory Distress – Differential

Question 28

Primary Topic: Neuro – Transphenoidal Hypophysectomy

Subtopics: Transphenoidal Hypophysectomy – Complications, Monitoring, Patent Foramen Ovale and Air Embolism, Visual Evoked Potentials, Cocaine Injection for Topicalization, Extubation, Adrenal Insufficiency / Endocrinologic Conditions / Pituitary Tumor – Symptomatology, Mass Effects, Systemic Effects, Types of Pituitary Adenomas, Bromocriptine, Octreotide / Pituitary Gland – Physiologic Function / Acromegaly – Diagnosis, Anesthetic Concerns, Airway Management / Venous Air Embolism – Precordial Doppler, Diagnosis, Treatment / Obstructive Sleep Apnea – Postoperative Management, Extubation, Monitoring Following an Episode of Apnea / Diabetes Insipidus – Central vs Nephrogenic, Diagnosis, Treatment

Question 29

Primary Topic: Obstetrics – Massive Blood Loss

Subtopics: Jehovah’s Witness – Transfusion Options, Ethics / Uterine Rupture – TOLAC, / Neuraxial Anesthesia – Peripheral Neuropathy / Vaginal Delivery – Options for Analgesia, Paracervical Block, Pudendal Block / Consent / Intraosseous Access – Placement, Complications / Massive Blood Loss – Transfusion / DIC – Pathophysiology, Diagnosis, Treatment / Unintentional Needle Stick / Pulmonary Edema – TACO, ARDS, TRALI / Transfusion Related Acute Lung Injury (TRALI) – Pathophysiology, Diagnosis, Treatment / Transfusion Associated Circulatory Overload (TACO) – Diagnosis

Question 30

Primary Topic: Endocrine – Obesity

Subtopics: Obesity – Perioperative Complications, Blood Pressure Cuff Sizing / OSA – Screening, Diagnosis, Ambulatory Center Case Selection, Perioperative Risk and Complications, Drug Distribution and Dosing, Volatile Agent Distribution and Metabolism, Postoperative Pain Control, Postoperative Respiratory Depression, Postoperative Monitoring / CAD – Preoperative Workup for Noncardiac Surgery (ACC/AHA Guidelines) / Asthma – Bronchospasm / Difficult Airway Management / Closing Capacity

Question 31

Primary Topic: Trauma – Pediatric Patient

Subtopics: Trauma – Hypotension Differential, Induction and Intubation / Pseudotumor Cerebri – Definition, Signs and Symptoms, Treatment, Steroid Administration / Interosseous Access – Technique for Placement / Cervical Spine Injury – imaging, clearance, SCIWORA, PECARN & NEXUS criteria, pseudosubluxation / Head Injury – Glasgow Coma Scale (modified for pediatric patients), Pediatric Trauma Score, Airway Management, Hyperventilation / Intracranial Hypertension – Treatment, Hyperventilation, Lumbar Puncture for CSF Drainage / FAST Exam – Indications, Evaluation of the Trauma Patient, FAST Exam vs. CT vs. Diagnostic Peritoneal Lavage / Abdominal Compartment Syndrome – Pathophysiology, Diagnosis, Systemic Effects, Treatment, Hypotension Following Laparotomy / Transfusion Medicine – Rh(D) Typing, Platelet Typing (Apheresis vs. Whole Blood Derived), FFP Universal Donor Typing / Hypocalcemia – Citrate Toxicity, Signs and Symptoms, Trousseaus Sign, Chvostek’s Sign, Treatment / Propofol Infusion Syndrome – Risk Factors, Pathophysiology, Treatment / Child Abuse – Ethics, Evaluation, Management / Ventriculoperitoneal Shunt Revision – External Ventricular Drain / Slit Ventricle Syndrome

Question 32

Primary Topic: Endocrine – Carcinoid Syndrome

Subtopics: Carcinoid Syndrome – Pathophysiology, Carcinoid Triad, Signs and Symptoms, Diagnosis, Cardiac Effects, Carcinoid Crisis, Preoperative Management, Succinylcholine Use, Epinephrine Use, Delayed Emergence / Carcinoid Crisis – Signs and Symptoms, Inciting Factors, Risk Reduction, Treatment / Vaporizers – Agent Specificity, Effects of Potency and Vapor Pressure / Bowel Resection for Obstruction – Monitoring, Induction of Anesthesia, Aspiration Risk, Nitrous Oxide Use / Cricoid Pressure – Technique, Effectiveness, Active Vomiting / Difficult Airway Management / Airway Blocks – Risk of Aspiration / Anaphylaxis – Treatment, Penicillin and Cephalosporin Cross-Reactivity / CVP Wave Form – Tricuspid Regurgitation / Aspiration – Airway Blocks, Bowel Obstruction, Pathophysiology of Aspiration Pneumonitis, Prophylactic Antibiotics / Line Isolation Monitor

Question 33

Primary Topic: Pediatrics – Pyloric Stenosis

Subtopics: Pyloric Stenosis – Presentation, Metabolic and Electrolyte Abnormalities, Diagnosis, Medical vs. Surgical Emergency, Medical Management, Fluid Management, Aspiration Risk, Induction of Anesthesia, Succinylcholine, Extubation, Pain Control / Osteogenesis Imperfecta – Pathophysiology, Airway Changes and Management, Monitoring, Regional and Neuraxial Anesthesia, Succinylcholine Administration, Intraosseous Line Placement / Pediatric Equipment – Breathing Circuits, Precordial Stethoscope / Postextubation Croup – Risk Factors, Treatment / Bronchospasm – Treatment, Extubation / Postoperative Apnea in Neonates – Risk Factors, Postoperative Patient Monitoring

Question 34

Primary Topic: Obstetrics – Aortic Stenosis

Subtopics: Aortic stenosis – Classification, Pathophysiology, Transvalvular Gradient, Neuraxial vs General Anesthesia, Pulmonary Artery Catheter Placement, Atrial Fibrillation / Bacterial Endocarditis Prophylaxis – Indications / Neuraxial Anesthesia – Aortic Stenosis, Fever, Multiple Sclerosis, Thrombocytopenia, ASRA Guidelines / Enoxaparin – Anti-Xa Level, Protamine Reversal, ASRA Guidelines / Atrial Fibrillation – Ventricular Filling, Treatment, Causes / Post-Dural Puncture HA – Prevention, Signs and Symptoms, Treatment Options / Adrenal Suppression – Perioperative Steroid Supplementation / Emergency Cesarean Section – Anesthetic Options / Multiple Sclerosis – Signs and Symptoms, Spinal vs Epidural Anesthesia, Local Anesthetic Concentration, Succinylcholine / Uterine Atony – Management, Uterotonic Agents / Epidural Spinal Hematoma – Signs and Symptoms, Evaluation, Treatment / Pulmonary Thromboembolism – Diagnosis, Signs and Symptoms, Treatment / Post-partum HA – Differential

Question 35

Primary Topic: Orthopedics – Shoulder Surgery / Beach Chair

Subtopics: Shoulder Surgery – Regional vs General Anesthesia / Obesity – Preoperative Work-up / Obstructive Sleep Apnea (OSA) – Screening, Ambulatory Surgery, Postoperative Pain Management / Beach Chair Position – Physiologic Effects, Bezold-Jarisch Reflex, Monitoring, Deliberate Hypotension / Cerebral Perfusion – Autoregulation, Effects of Chronic Hypertension / Tobacco Use – Smoking Cessation, Preoperative Work-up / Autonomic Neuropathy – Pathophysiology, Preoperative Evaluation, Systemic Effects / β-Blocker Administration – Preoperative Administration, ACC AHA Guidelines / Tension Pneumothorax – Diagnosis, Management / Aspiration – Management, Cricoid Pressure, Aspiration Pneumonitis, Aspiration Pneumonia / Corneal Abrasion – Prevention, Presentation, Treatment

Question 36

Primary Topic: Obstetrics – Preeclampsia/Eclampsia

Subtopics: Unwitnessed Loss of Consciousness – Differential / Preeclampsia – Diagnosis / Seizure – Airway Management, Treatment / Difficult Airway Management / CT Scan – Transport, Delaying Therapy for / Emergency Cesarean Section – Anesthetic Choices / Neuraxial Blockade – HIV, Coagulopathy, Complications / Elevated Intracranial Pressure – Monitoring, Cushing Response, Methods of Reducing ICP, Signs of Uncal Herniation / Delayed Emergence / G6PD Deficiency – Pathophysiology, Diagnosis, Anesthetic Management, Hemolytic Anemia / Methemoglobinemia – Pulse-oximetry, Benzocaine Administration, Diagnosis, Treatment / Magnesium Toxicity – Presentation, Treatment / Pulseless Electrical Activity (PEA) / Post-Cardiac Arrest Care – Therapeutic Hypothermia / HIV & Needle Stick

Question 37

Primary Topic: Cardiovascular – Femoral Popliteal Bypass

Subtopics: Peripheral Vascular Disease – Ankle-brachial Index, Association with CAD and Cerebrovascular Disease / Femoral Popliteal Bypass – Cardiovascular Assessment, Preoperative Optimization, General vs. Neuraxial Anesthesia, Monitoring, Contrast Dye, Postoperative Complications and Risk Reduction / Hypertension – Perioperative Risks, Delaying Surgery, Preoperative Treatment / Left Bundle Branch Block (LBBB) – Association with Cardiac Disease, Pulmonary Artery Catheter Placement, Complicating the Diagnosis of Myocardial Infarction and SVT / Cardiac Stress Testing – Options / Balloon Angioplasty – Timing of Subsequent Surgery / Coronary Stents – Bare Metal vs. Drug-eluting, Dual Antiplatelet Therapy / Neuraxial Anesthesia – ASRA Guidelines, Systemic Heparinization, Thienopyridine Therapy, Traumatic Placement Prior to Surgery Requiring Heparinization / Contrast Dye – Adverse Reactions, Contrast-induced Nephropathy / Contrast-induced Nephropathy – Risk Factors, Prevention Strategies, Diagnosis / Fenoldopam – Renal Protection / Adverse Protamine Reactions – Types, Treatment / Acute Renal Failure – Risk Factors, Assessment, Treatment

Question 38

Primary Topic: Cardiovascular – CIED & Open Globe Injury

Subtopics: CIED (Pacemaker) – CIED Code, Preoperative Interrogation, Preoperative Programming, Electromagnetic Interference (EMI), Electrosurgical Current Return Pad Application, Effects of Magnet Placement, Failure to Capture, Indications for Postoperative Interrogation / Electrocautery – Monopolar vs. Bipolar, Burn Risk, Electrosurgical Current Return Pad Application, Electromagnetic Interference (EMI) / Open Globe Injury – Regional Anesthesia, Extrusion of Intraocular Contents, Succinylcholine Administration, Extubation / Nondepolarizer Priming Technique / Aspiration – Risk Reduction, Reverse-Trendelenburg vs. Trendelenburg Positioning, Management of Regurgitation Under Anesthesia, Extubation / Failure to Capture – Causes, Management / Ventricular Tachycardia – ACLS Protocol, Monomorphic vs. Polymorphic vs. WPW vs. Torsades vs. Uncertain Etiology, Synchronized vs. Unsynchronized Cardioversion / Ventricular Fibrillation – ACLS Protocol, Procainamide Administration / Bicarbonate Administration During ACLS

Question 39

Primary Topic: Cardiovascular – CABG & Mitral Valve Replacement

Subtopics: Cardiopulmonary Bypass Circuit – Centrifugal vs. Roller Pumps / Cardiopulmonary Bypass – Alpha-state vs. pH-stat, Activated Clotting Time (ACT), Temperature Monitoring, Decreasing Venous Reservoir Level, De-airing the Heart, Weaning from CPB, Radial Arterial vs. Central Aortic Blood Pressures Following CPB / Mitral Regurgitation – Pathophysiology, Acute vs. Chronic, Pulmonary Capillary Wedge Tracing, Intraoperative Management, Atrial Fibrillation, Left Ventricular Failure Following Valve Replacement / Atrial Fibrillation – Causes, Mitral Regurgitation, Treatment / Intra-aortic Balloon Pump – To Facilitate Weaning from CPB, Timing of Inflation and Deflation, Compatibility with Pacemakers / Modes of Ventilation / Cardiac Tamponade – Signs and Symptoms, Diagnosis, Intact vs. Disrupted Pericardium, Pulsus Paradoxus, Treatment

Question 40

Primary Topic: Endocrine – Thyroidectomy

Subtopics: Thyroidectomy – Monitoring, Anesthesia Maintenance, Extubation / Bipolar Disorder – Lithium Toxicity / Flow-Volume Loops – Intrathoracic vs. Extrathoracic Mass / Hyperthyroidism – Signs and Symptoms, Preoperative Assessment, Diagnosis, Delaying Elective Surgery, Optimization, Effect on MAC / Difficult Airway Management / Awake Fiberoptic Intubation – Airway Analgesia / Recurrent Laryngeal Nerve Injury – Types, Management / Postoperative Hypocalcemia – Evaluation, Diagnosis, Treatment / Thyroid Storm – Aspirin Use, Presentation, Thyroid Storm vs. Malignant Hyperthermia vs. Neuroleptic Malignant Syndrome, Treatment

Question 41

Primary Topic: Urology – TURP

Subtopics: TURP – Perioperative Complications, General vs Neuraxial Anesthesia, Irrigation Solutions / TURP Syndrome – Signs and Symptoms / Bladder Perforation – Signs and Symptoms, Treatment / Neuraxial Anesthesia – Local Anesthetic Choice / Diabetes – Insulin and Glucose Management, Hgb A1C / ACE Inhibitors – Perioperative Hypotension / C oronary Artery Disease – Preoperative Assessment, ACC AHA Guidelines, Recent MI, Revised Cardiac Risk Index, Major Adverse Cardiac Event (MACE) / Coronary Stent – Elective Surgery, Thienopyridine Therapy, Drug-eluting vs Bare Metal Stent / Pseudocholinesterase Deficiency – Phase II Blockade, Dibucaine Number, Management / Postoperative Vision Loss – Differential, Glycine Toxicity / Postoperative Sepsis – TURP, Potential Causes, Preoperative Antibiotics

Question 42

Primary Topic: Trauma & Critical Care – Head Injury

Subtopics: Glasgow Coma Scale / Trauma – Assessment, Airway Management / Cervical Spine Clearance / Head Injury – Glasgow Coma Scale, Airway Management, Circulatory Response, Hyperglycemia, Hyperventilation, Hypothermia, Basilar Skull Fracture / Elevated Intracranial Pressure – Ketamine, Succinylcholine, Cerebral Perfusion, Blood Pressure Management, Monitoring, Methods of Reducing ICP, Hyperventilation / Cerebral Autoregulation / Cerebral Perfusion Pressure / Hypothermia / Fat Embolism Syndrome – Diagnosis, Treatment / ARDS – Pathophysiology, Diagnosis, Treatment / SIADH & Cerebral Salt Wasting Syndrome – Diagnosis, Treatment

Question 43

Primary Topic: Obstetrics – Preeclampsia / Eclampsia

Subtopics: Preeclampsia – Upper Quadrant Pain, HELLP, Volume Replacement / HELLP Syndrome – Associated Risks, Diagnosis, Signs and Symptoms, Management / Magnesium Sulfate – Fetal Neuroprotection, Seizure Prophylaxis, Toxicity / Cesarean Section – Regional vs. General Anesthesia, Management of Failed Regional Anesthesia, Emergency Cesarean Section, Difficult Airway Management, Patient Abandonment / Neuraxial Anesthesia – Coagulopathy / Neonatal Resuscitation – Resuscitation Guidelines, Calcium Administration, Pulse Oximeter Placement, Intubation, Intravenous Access / Post-Partum Hemorrhage – Differential / Uterine Atony – Management, Uterotonics / Eclamptic Seizure – Management, Decision to Intubate, Muscle Relaxant Administration / Serum Glucose – Management in the Setting of Neuronal Ischemia / Pulmonary Edema – Cardiogenic vs. Noncardiogenic, PEEP

Question 44

Primary Topic: Cardiovascular – Cardiac Ablation

Subtopics: Cardiac Ablation – Procedural Complications, Indications for the Procedure, MAC vs. General Anesthesia, Cardiac Rupture / Atrial Fibrillation – Causes, Preoperative Assessment, Treatment, Diltiazem, Concomitant β-blocker and Calcium Channel Blocker Administration / Syncope – Differential, Assessment / Tricuspid Regurgitation – Etiology, Anesthetic Management / Mitral Valve Stenosis – Grading Severity, Pathophysiology, Anesthetic Management / Pulmonary Artery Catheter – Tricuspid Regurgitation, Mitral Valve Stenosis, Coagulopathy, Interpretation in the Setting of Valvulopathy / Electrical Cardioversion – Synchronized vs. Unsynchronized Shock / Cardiac Rupture – Treatment, Cardiac Tamponade / Ambulatory Surgery Discharge Criteria – Safe Discharge Criteria, Postanesthetic Discharge Scoring System (PADS), Urinary Retention, Oral Intake, Responsible Patient Escort / Postoperative Urinary Retention – Management / Postoperative Nausea and Vomiting (PONV) – Risk Factors, Treatment

Question 45

Primary Topic: Renal – CRF & Kidney Transplant

Subtopics: Kidney Transplant – Regional vs. General Anesthesia, Monitoring, Cross-Clamp Application and Release / Chronic Renal Failure – Dialysis, Volume Assessment, Hyperkalemia, Fluid Management, Post-Transplant Oliguria / Hypertension – Classification, Preoperative Assessment, Perioperative Risk, Delaying Elective Surgery, Preoperative Optimization / Hyperkalemia – Delaying Elective Surgery, Acute vs. Chronic, Signs and Symptoms, Treatment / Sevoflurane – Nephrotoxicity / Pulmonary Edema – Assessment, PEEP / Coagulopathy – Postoperative Causes / Uremic Thrombocytopathia – Pathophysiology, Treatment / Postoperative Oliguria – Differential, Assessment, Dopamine

Question 46

Primary Topic: Hepatic – Liver Transplant

Subtopics: Liver Transplant – MELD Score, Preoperative Paracentesis, Preoperative Optimization (Coagulation Status), Contraindications, Monitoring, Veno-Venous Bypass, Epidural for Postoperative Pain Control, Aspiration Risk, Three Stages of Liver Transplantation, Postoperative Complications / Hepatopulmonary Syndrome – Definition, Diagnosis / Cirrhosis – Ascites, Coagulopathy, Portopulmonary Hypertension, Hepatic Encephalopathy, Esophageal Varices, Pseudocholinesterase Deficiency / Esophageal Varices – TEE, Orogastric Tube / Hepatorenal Syndrome (HRS) – Diagnosis, Pathophysiology / Transesophageal Echocardiography – Esophageal Varices / Hepatic Encephalopathy – Causative Factors, Pathophysiology, Management / Anhepatic Phase – Cross Clamp Application, Hyperkalemia, Citrate Toxicity / Reperfusion Phase – Cross Clamp Removal, Reperfusion Syndrome

Question 47

Primary Topic: Cardiovascular – CABG

Subtopics: β-Blocker Administration – Preoperative Administration, ACC AHA Guidelines / Myocardial Ischemia – Cardiac Enzymes, Non-ST-Segment Elevation Myocardial Infarction, Myocardial Oxygen Supply and Demand / Atelectasis / Digoxin Toxicity / TEE vs PA Catheter / Central Line Placement – In the Presence of a Carotid Bruit, Coagulation / Cardiopulmonary Bypass – Hypotension Differential, Cannula Malposition, Blood Glucose Management, Weaning off Bypass / Bradycardia – Management / Pacemaker – Failure to Capture, Alternative Pacing Options / Post-Bypass Coagulopathy – Differential, Heparin Rebound, Treatment / Intraoperative Awareness – Prevention, Explanation to Patient

Question 48

Primary Topic: Pulmonary – Mediastinal Mass

Subtopics: Mediastinal Mass – Airway Compression, Cardiovascular Compression, Myasthenia Gravis, Positional Presyncope, Risk Factors for Cardiopulmonary Complications, Preprocedural Mass Reduction, Flow Volume Loops, Difficult Airway Management, Preparations for Induction / Aspiration – Anticholinergics / Echocardiography– Evaluating Left Ventricular Function / Pulmonary Function Testing – Flow Volume Loops / Down Syndrome – Cardiac Defects, Airway Management, Bradycardia with Induction, Atlanto-axial Instability / Atlanto-axial Instability – Preoperative Screening, Signs of Cord Compression, Management / Myasthenia Gravis – Pathophysiology, Presentation, Bulbar Symptomatology, Anticholinergics, Edrophonium Test, Cholinergic Crisis / Atlanto-axial Instability / Asthma – Bronchospasm / Laryngospasm – Treatment / Cholinergic Crisis – Presentation, Treatment / Negative Pressure Pulmonary Edema