Anesthesia oral board cases

Malignant Hyperthermia Crisis

Intra-Op MH · Mid-Case Recognition

A healthy 24-year-old presents for shoulder arthroscopy and deteriorates mid-case. The scenario begins as a routine anaesthetic and becomes a crisis, so the examiner is watching when you recognise it rather than only what you do afterwards. Masseter rigidity at induction is available early, and a rising end-tidal CO₂ precedes the temperature change.

Can't Intubate, Can't Oxygenate

Emergency Cricothyrotomy · Failed Airway

An elective laparoscopic Nissen becomes an unanticipated failed airway after rapid sequence induction in a 45-year-old with a BMI of 47. Three laryngoscopy attempts have failed, bag-mask ventilation is impossible, and a supraglottic device has not rescued it. Saturation is 68% and falling, which puts the entire case under a hard time limit.

Cardiac Tamponade

Pericardial Effusion · Ketamine Induction · Preload Preservation

A 55-year-old with a malignant pericardial effusion presents compensated but with tamponade physiology on echocardiography. Anaesthesia is consulted for two possible plans — echo-guided pericardiocentesis under sedation, or a surgical window requiring general anaesthesia — and the examiner will make you defend the choice.

Severe Aortic Stenosis · Emergent Hip Fracture

Geriatric · Critical AS · Anticoagulated

An 82-year-old with critical aortic stenosis needs an emergent hip hemiarthroplasty. She last took apixaban 18 hours ago and has borderline baseline cognition. Nothing here is a crisis yet, which is the point — the examiner is assessing judgement rather than reflexes.

Venous Air Embolism — Sitting Craniotomy

Posterior Fossa Tumor · Mill-Wheel Murmur · Durant's Maneuver

A 52-year-old undergoing a posterior fossa craniotomy in the sitting position has a sudden end-tidal CO₂ crash with a mill-wheel murmur on precordial Doppler. A preoperative echocardiogram found a PFO, which the examiner included deliberately.

STAT Cesarean — Severe Preeclampsia

Failed Epidural · Difficult Airway · HELLP

A 32-year-old at 36 weeks with severe preeclampsia and HELLP needs an immediate caesarean for fetal bradycardia. Her epidural is patchy, her platelet count is 78k, and her airway is oedematous — three problems that constrain each other, which is precisely why the case is set up this way.

Amniotic Fluid Embolism

Peripartum Cardiovascular Collapse · DIC

A 27-year-old in active labour at 38 weeks collapses suddenly with profound hypoxia, hypotension, and fetal bradycardia. AFE is a diagnosis of exclusion, so the examiner is testing how you reason toward it while resuscitating, not whether you can name it.

Postpartum Hemorrhage

Uterine Atony · Massive Transfusion · MTP Activation

A 29-year-old has lost 2,400 mL within 30 minutes after vaginal delivery, with a boggy uterus and falling blood pressure. The case escalates while you manage it, so the examiner is assessing whether your resuscitation keeps pace with the bleeding.

Pediatric Tonsillectomy & Adenoidectomy

Severe OSA · Post-Tonsillectomy Hemorrhage

A 6-year-old with polysomnography-confirmed severe OSA presents for tonsillectomy and adenoidectomy, then returns to theatre bleeding. The parent declines premedication, so the case tests communication as well as clinical management, and the second half is effectively a full-stomach emergency.

Local Anesthetic Systemic Toxicity

Bupivacaine LAST · Interscalene Block · Cardiac Arrest

A 52-year-old receives a high-volume interscalene block before shoulder arthroplasty, reports perioral tingling, seizes, and arrests within about 90 seconds. The case turns on recognising that this is not a routine arrest and that standard resuscitation needs modification.