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ABA Pediatric Anesthesiology Exam Content Outline
Pediatric Anesthesiology Examination
Revised – November 2019


American Board of Anesthesiology


Pediatric Anesthesiology Examination Content Outline
The Content Outline for the Pediatric Anesthesiology Examination reflects the subject matter for the
(October 2, 2012)
Pediatric Anesthesiology subspecialty. It is divided into five sections including Basic Science, Organ
Based Basic and Clinical Sciences, Clinical Subspecialties, Clinical Science of Anesthesia, and Special
Problems or Issues. The examination covers material from all of these sections. The outline reflects
disease states, management considerations, and issues relatively unique to the pediatric patient. The
subspecialty board certified pediatric anesthesiologist is expected to have knowledge within each of
these categories and topics.


[https://www.theaba.org/pdfs/PA_Content_Outline.pdf Pediatric Anesthesiology Examination Content Outline]
(November 2019)


As appropriate, items should be considered to include the changes that occur throughout the growth and development of the pediatric patient.
As appropriate, items should be considered to include the changes that occur throughout the growth and development of the pediatric patient.


==I. BASIC SCIENCE==
==I. BASIC SCIENCE==
A. Anatomy
A. Anatomy
:1. General Development
:1. General Development
::a) Airway
::a. Airway
::b) Body habitus
::b. Body habitus
::c) [[Water, volume, and blood composition]]
::c. Water, volume, and blood composition
:2. Anatomy for Procedures
:2. Anatomy for Procedures
::a) Airway management
::a. Airway management
::b) Central neuraxial blockade
::b. Central neuraxial blockade
::c) Peripheral nerve blockade
::c. Peripheral nerve blockade
::d) Vascular cannulation
::d. Vascular cannulation
B. Physics and Anesthesia Equipment
B. Physics and Anesthesia Equipment
:1. Respiration
:1. Respiration
::a) <b>[[Breathing circuits]]</b>
::a. Breathing circuits
::b) Ventilation devices and techniques
::b. Ventilation devices and techniques
:2. Methods for Monitoring
:2. Methods for Monitoring
::a) Brain, spinal cord, and neuromuscular function
::a. Brain, spinal cord, and neuromuscular function
::b) Cardiac rhythm and vascular pressures
::b. Cardiac rhythm and vascular pressures
::c) Oxygenation, gas concentration, and ventilation
::c. Oxygenation, gas concentration, and ventilation
::d) Temperature
::d. Temperature
C. Anesthetic Pharmacology: Physiologic States, Pathophysiologic States and Adverse Effects
:3. Ultrasound: Physics and Clinical applications
C. Anesthetic Pharmacology: Physiologic States, Pathophysiologic States and
Adverse Effects, Development Pharmacology
:1. Pharmacokinetics and Pharmacodynamics
:1. Pharmacokinetics and Pharmacodynamics
::a) Blood-brain barrier
::a. Blood-brain barrier
::b) Drug absorption
::b. Drug absorption
::c) Drug distribution
::c. Drug distribution
::d) Neuromuscular system
::d. Neuromuscular system
::e) Biotransformation and excretion
::e. Biotransformation and excretion
::f) Pharmacogenetics
::f. Pharmacogenetics
:2. Non-opioid Analgesics
:2. Non-opioid Analgesics
:3. Opioid Analgesics
:3. Opioid Analgesics
Line 47: Line 55:
:9. Sympathetic and Parasympathetic Agents
:9. Sympathetic and Parasympathetic Agents
:10. Agents Affecting Coagulation
:10. Agents Affecting Coagulation
==II. ORGAN-BASED BASIC AND CLINICAL SCIENCES==
==II. ORGAN-BASED BASIC AND CLINICAL SCIENCES==
A. Respiratory System
A. Respiratory System
:1. Anatomy and Physiology
:1. Anatomy and Physiology
::a) Prenatal and postnatal development
::a. Prenatal and postnatal development
::b) Respiratory mechanics, ventilation, and lung volumes
::b. Respiratory mechanics, ventilation, and lung volumes
::c) Oxygen transport
::c. Oxygen transport
::d) Surfactant, surface activity, and lung mechanics
::d. Surfactant, surface activity, and lung mechanics
::e) Lung physiology
::e. Lung physiology
:::(1) surfactant and surface tension
 
:::(2) metabolism
:::1. surfactant and surface tension
:::(3) ventilation / perfusion matching
:::2. metabolism
:::3. ventilation / perfusion matching
:2. Clinical Sciences
:2. Clinical Sciences
::a) Obstructive disease
::a. Obstructive disease
:::(1) upper airway
:::1. upper airway
:::(2) tracheobronchial
:::2. tracheobronchial
:::(3) parenchymal
:::3. parenchymal
::b) Restrictive disease
::b. Restrictive disease
:::(1) pleural
:::1. pleural
:::(2) neurologic
:::2. neurologic
:::(3) musculoskeletal
:::3. musculoskeletal
::c) Anesthesia for thoracic procedures
::c. Anesthesia for thoracic procedures
:::(1) one lung ventilation
:::1. one lung ventilation
:::(2) video-assisted thoracoscopy
:::2. video-assisted thoracoscopy
:::(3) mediastinal masses
:::3. mediastinal masses
:::(4) chest wall surgery / reconstruction
:::4. chest wall surgery / reconstruction
:::5. lung Transplantation
B. Cardiovascular System
B. Cardiovascular System
:1. Anatomy and Physiology
:1. Anatomy and Physiology
::a) Prenatal and postnatal development
::a. Prenatal and postnatal development
::b) Fetal, transitional, and adult circulation
::b. Fetal, transitional, and adult circulation
::c. Benign heart murmur
:2. Clinical Science
:2. Clinical Science
:a) General considerations
::a. General considerations
:::(1) cardiovascular effects on anesthetic uptake and delivery
:::1. cardiovascular effects on anesthetic uptake and delivery
:::(2) anesthetic effects on the cardiovascular system
:::2. anesthetic effects on the cardiovascular system
:::(3) vasoactive medications
:::3. vasoactive medications
::b) Disease states
::b. Disease states
:::(1) acyanotic lesions
:::1. acyanotic lesions
:::(2) cyanotic lesions
:::2. cyanotic lesions
:::(3) palliative procedures
:::3. palliative procedures
:::(4) pulmonary hypertension
:::4. pulmonary hypertension
:::(5) infectious diseases
:::5. infectious diseases
:::(6) cardiomyopathies
:::6. cardiomyopathies
:::(7) pericardial disease
:::7. pericardial disease
:::(8) intracardiac masses
:::8. intracardiac masses
:::(9) arrhythmic lesions
:::9. arrhythmic lesions
:::(10) heart transplantation
:::10. heart transplantation
::c) Anesthesia for cardiac procedures
::c. Anesthesia for cardiac procedures
:::(1) complete anatomic and physiological repairs
:::1. complete anatomic and physiological repairs
:::(2) single ventricle procedures
:::2. single ventricle procedures
:::(3) palliation surgery
:::3. palliation surgery
:::(4) management and consequences of cardiopulmonary bypass
:::4. management and consequences of cardiopulmonary bypass
:::(5) deep hypothermic circulatory arrest
:::5. deep hypothermic circulatory arrest
:::(6) anesthesia for pacemaker / implantable cardiac defibrillator insertion and replacement
:::6. anesthesia for pacemaker / implantable cardiac defibrillator insertion and
:::(7) anesthesia for diagnostic, interventional and electrophysical procedures
replacement
:d) Anesthesia for the adult with congenital heart disease
:::7. anesthesia for diagnostic, interventional and electrophysical procedures
:e) Cardiopulmonary resuscitation
:d. Anesthesia for the adult with congenital heart disease
:e. Cardiopulmonary resuscitation
:f. Anesthesia for non-cardiac procedures in child with congenital heart disease
C. Central and Peripheral Nervous Systems
C. Central and Peripheral Nervous Systems
:1. Anatomy and Physiology
:1. Anatomy and Physiology
::a) Prenatal and postnatal development
::a. Prenatal and postnatal development
:::(1) brain, fontanelles, cranial sutures, and spinal cord
:::1. brain, fontanelles, cranial sutures, and spinal cord
:::(2) myelinization, autonomic nervous systems, and pain pathways
:::2. myelinization, autonomic nervous systems, and pain pathways
:::(3) Neurodegenerative changes after anesthesia
:::3. neurodegenerative changes after anesthesia
::b) Neurophysiology
::b. Neurophysiology
:2. Clinical Science
:2. Clinical Science
::a) General considerations
::a. General considerations
:::(1) intracranial pressure and blood flow
:::1. intracranial pressure and blood flow
:::(2) pharmacology of diuretics, steroids, and anticonvulsant medications
:::2. pharmacology of diuretics, steroids, and anticonvulsant medications,
::b) Disease states
::b. Disease states
:::(1) autism, developmental delay, and attention-deficit hyperactivity disorder
:::1. autism, developmental delay, and attention-deficit hyperactivity disorder
:::(2) hydrocephalus
:::2. hydrocephalus
:::(3) tumors
:::3. tumors
:::(4) seizure disorders
:::4. seizure disorders
:::(5) cerebrovascular disorders
:::5. cerebrovascular disorders
:::(6) open and closed head injuries
:::6. open and closed head injuries
:::(7) spinal cord disorders
:::7. spinal cord disorders
:::(8 neurodegenerative disorders
:::8. neurodegenerative disorders
:::(9) spasticity
:::9. spasticity
:::(10) Chiari malformations
:::10. Chiari malformations
::c) Anesthesia for neurosurgical procedures
::c. Anesthesia for neurosurgical procedures
:::(1) seizure surgery
:::1. seizure surgery
:::(2) intracranial tumors and vascular lesions
:::2. intracranial tumors and vascular lesions
:::(3) craniofacial reconstruction / cranioplasty
:::3. craniofacial reconstruction / cranioplasty
:::(4) meningomyelocele / spinal surgery
:::4. meningomyelocele / spinal surgery
:::(5) neurologic imaging
:::5. neurologic imaging
D. Gastrointestinal System
D. Gastrointestinal System
:1. Anatomy and Physiology
:1. Anatomy and Physiology
::a) Prenatal and postnatal development
::a. Prenatal and postnatal development
:2. Clinical Science
:2. Clinical Science
::a) Esophageal, stomach and intestine disorders
::a. Esophageal, stomach and intestine disorders
:::(1) abdominal wall defects
:::1. abdominal wall defects
:::(2) intestinal rotation defects
:::2. intestinal rotation defects
:::(3) atresias, stenoses and webs
:::3. atresias, stenoses and webs
:::(4) inflammatory states
:::4. inflammatory states
:::(5) duplications and cysts
:::5. duplications and cysts
:::(6) hernias
:::6. hernias
:::(7) necrotizing enterocolitis
:::7. necrotizing enterocolitis
::b) Liver, biliary tract and spleen disorders
::b. Liver, biliary tract and spleen disorders
::c) Anorectal disorders
::c. Anorectal disorders
::d) Morbid obesity / bariatric surgery
::d. Morbid obesity / bariatric surgery
::e) Gastrointestinal endoscopy
::e. Gastrointestinal endoscopy
::f) Esophageal / gastrointestinal foreign bodies
::f. Esophageal / gastrointestinal foreign bodies
::g) Organ transplantation
::g. Liver, intestinal, and multivisceral transplantation
E. Renal / Urinary
E. Renal/Urinary
:1. Anatomy and Physiology
:1. Anatomy and Physiology
::a) Prenatal and postnatal development
::a. Prenatal and postnatal development
::b) [[Homeostasis functions]]
::b. Homeostasis functions
:2. Clinical Science
:2. Clinical Science
::a) Renal failure
::a. Renal failure
::b) Phimosis and hypospadias
::b. Phimosis and hypospadias
::c) Ureteropelvic junction obstruction
::c. Ureteropelvic junction obstruction
::d) Vesicoureteral reflux
::d. Vesicoureteral reflux
::e) Bladder exstrophy
::e. Bladder exstrophy
::f) Renal transplantation
::f. Renal transplantation
F. Endocrine/Metabolic
F. Endocrine/Metabolic
:1. Anatomy and Physiology
:1. Anatomy and Physiology
::a) Prenatal and postnatal development
::a. Prenatal and postnatal development
::b) Puberty and variants
::b. Puberty and variants
:2. Clinical Science
:2. Clinical Science
::a) Adrenal disorders
::a. Adrenal disorders
::b) Diabetes mellitus
::b. Diabetes mellitus
::c) Diabetes insipidus
::c. Diabetes insipidus
::d) Disorders of sodium regulation
::d. Disorders of sodium regulation
::e) Pheochromocytoma
::e. Pheochromocytoma
::f) Thyroid disorders
::f. Thyroid disorders
::g) DiGeorge syndrome
::g. 22q.11 deletion syndrome (DiGeorge)
G. Hematology/Oncology
G. Hematology/Oncology
:1. Anatomy and Physiology
:1. Anatomy and Physiology
::a) Prenatal and postnatal development
::a. Prenatal and postnatal development
:2. Clinical Science
:2. Clinical Science
::a) Hematology
::a. Hematology
:::(1) anemias
:::1. anemias
:::(2) coagulation disorders
:::2. coagulation disorders
::b) Oncology
::b. Oncology
:::(1) leukemia
:::1. leukemia
:::(2) neuroblastoma
:::2. neuroblastoma
:::(3) retinoblastoma
:::3. retinoblastoma
:::(4) sarcomas / osteosarcomas
:::4. sarcomas / osteosarcomas
:::(5) Wilms tumor
:::5. Wilms tumor
::c) Chemotherapeutic agents and side effects
::c. Chemotherapeutic agents and side effects
::d) Radiotherapy
::d. Radiotherapy
::e) Bone marrow and stem cell transplants
::e. Bone marrow and stem cell transplants
:::(1) graft versus host disease
:::1. graft versus host disease
::f) Immunologic disorders (congenital and acquired)
::f. Immunologic disorders (congenital and acquired)
H. Genetics
H. Genetics
:1. Anatomy and Physiology
:1. Anatomy and Physiology
:2. Clinical Sciences
:2. Clinical Sciences
::a) Chromosomal abnormalities
::a. Chromosomal abnormalities
::b) Craniofacial syndromes
::b. Craniofacial syndromes
::c) Effects of environmental agents
::c. Effects of environmental agents
::d) Endocrine disorders
::d. Endocrine disorders
::e) Immunologic disorders
::e. Immunologic disorders
::f) Inborn errors of metabolism
::f. Inborn errors of metabolism
::g) Malignant hyperthermia
::g. Malignant hyperthermia
::h) Mitochondrial myopathies
::h. Mitochondrial myopathies
::i) Myopathic disorders
::i. Myopathic disorders
::j) Myotonias
::j. Myotonias
::k) Muscular dystrophies
::k. Muscular dystrophies
::l) Neurologic disorders
::l. Neurologic disorders
::m) Overgrowth syndromes
::m. Overgrowth syndromes
::n) Osteochondrodysplastic syndromes
::n. Osteochondrodysplastic syndromes
::o) Skin and connective tissue disorders
::o. Skin and connective tissue disorders
 
==III. CLINICAL SUBSPECIALTIES==
==III. CLINICAL SUBSPECIALTIES==
A. Fetal
A. Fetal
:1. General Considerations
:1. General Considerations
::a) Fetal oxygenation
::a. Fetal oxygenation
::b) Fetal pain and stress
::b. Fetal pain and stress
::c) Fetal monitoring
::c. Fetal monitoring
:2. Clinical Science
:2. Clinical Science
:a) Fetal surgery
::a. Fetal surgery
:b) Ex utero intrapartum treatment (EXIT) procedure
::b. Ex utero intrapartum treatment (EXIT) procedure
B. Neonatal
B. Neonatal
:1. General Considerations
:1. General Considerations
::a) Apgar scoring
::a. Apgar scoring
::b) Post conceptional age and organ system maturity
::b. Post conceptional age and organ system maturity
::c) Effects of anesthesia and surgery on cognitive development
::c. Effects of anesthesia and surgery on cognitive development
::d) Stress response
::d. Stress response
::e) Transport medicine
::e. Transport medicine
::f) Neonatal resuscitation
::f. Neonatal resuscitation
:2. Clinical Science
:2. Clinical Science
::a) Surgical disease states
::a. Surgical disease states
::(1) amniotic bands
:::1. amniotic bands
::(2) congenital cystic adenomatoid malformation
:::2. congenital cystic adenomatoid malformation
::(3) congenital diaphragmatic hernia
:::3. congenital diaphragmatic hernia
::(4) duodenal atresia
:::4. duodenal atresia
::(5) hernia
:::5. hernia
::(6) hypertrophic pyloric stenosis
:::6. hypertrophic pyloric stenosis
::(7) myelomeningocele
:::7. myelomeningocele
::(8) necrotizing enterocolitis
:::8. necrotizing enterocolitis
::(9) neonatal lobar emphysema
:::9. neonatal lobar emphysema
::(10) omphalocele and gastroschisis
:::10. omphalocele and gastroschisis
::(11) sacrococcygeal teratoma
:::11. sacrococcygeal teratoma
::(12) tracheo-esophageal fistula
:::12. tracheo-esophageal fistula
::(13) vein of Galen malformation
:::13. vein of Galen malformation
:b) Medical disease states
::b. Medical disease states
::(1) apnea and bradycardia
:::1. apnea and bradycardia
::(2) anemia
:::2. anemia
::(3) bronchopulmonary dysplasia
:::3. bronchopulmonary dysplasia
::(4) failure to thrive
:::4. failure to thrive
::(5) intraventricular hemorrhage
:::5. intraventricular hemorrhage
::(6) kernicterus
:::6. kernicterus
::(7) persistent pulmonary hypertension
:::7. persistent pulmonary hypertension
::(8) persistent fetal circulation
:::8. persistent fetal circulation
::(9) retinopathy of prematurity
:::9. retinopathy of prematurity
:::10. neonatal abstinence syndrome
C. Painful Disease States
C. Painful Disease States
:1. Pathophysiology
:1. Pathophysiology
::a) Procedural, postoperative, and posttraumatic pain
::a. Procedural, postoperative, and posttraumatic pain
::b) Pain in the neonate
::b. Pain in the neonate
::c) Chronic pain states
::c. Chronic pain states
:2. Treatment
:2. Treatment
::a) Regional analgesia
::a. Regional analgesia
::b) Pharmacologic and non pharmacologic techniques of pain management
::b. Pharmacologic and non-pharmacologic techniques of pain management
::c) Complementary and alternative pain management
::c. Complementary and alternative pain management
D. Otolaryngology
D. Otolaryngology
:1. Airway Procedures
:1. Airway Procedures
::a) Bronchoscopic procedures
::a. Bronchoscopic procedures
::b) Tonsillectomy, adenoidectomy, and abscess drainage
::b. Tonsillectomy, adenoidectomy, and abscess drainage
::c) Tracheotomy
::c. Tracheotomy
::d) Choanal atresia repair
::d. Choanal atresia repair
::e) Laryngotracheal reconstruction
::e. Laryngotracheal reconstruction
::f) Laser procedures
::f. Laser procedures
:2. Otologic Procedures
:2. Otologic Procedures
::a) Myringotomy and tubes
::a. Myringotomy and tubes
::b) Cochlear implant, tympanoplasty, and mastoidectomy
::b. Cochlear implant, tympanoplasty, and mastoidectomy
E. Plastic and Oral-Maxillary Facial Surgery
E. Plastic and Oral-Maxillary Facial Surgery
:1. Coexisting Diseases
:1. Coexisting Diseases
::a) Craniofacial syndromes
::a. Craniofacial syndromes
::b) Congenital heart disease
::b. Congenital heart disease
::c) Increased intracranial pressure
::c. Increased intracranial pressure
::d) Obstructive sleep apnea
::d. Obstructive sleep apnea
:2. Clinical Science
:2. Clinical Science
::a) Craniosynostosis repairs
::a. Craniosynostosis repairs
::b) Cleft repairs
::b. Cleft repairs
::c) Hypoplasia repairs
::c. Hypoplasia repairs
::d) Syndactyly repairs
::d. Syndactyly repairs
::e) Tissue flaps and tissue expanders
::e. Tissue flaps and tissue expanders
::f) Vascular malformations
::f. Vascular malformations
::g) Mandibular repairs
::g. Mandibular repairs
F. Ophthalmology
F. Ophthalmology
:1. General Considerations
:1. General Considerations
::a) Physiology
::a. Physiology
::b) Pharmacology of ophthalmologic medications
::b. Pharmacology of ophthalmologic medications
:2. Clinical Science
:2. Clinical Science
::a) Enucleations
::a. Enucleations
::b) Retinopathy of prematurity
::b. Retinopathy of prematurity
::c) Trauma
::c. Trauma
::d) Tear duct probing
::d. Tear duct probing
::e) Strabismus repair
::e. Strabismus repair
G. Orthopedic Surgery
G. Orthopedic Surgery
:1. Coexisting Diseases
:1. Coexisting Diseases
::a) Cardiopulmonary disease
::a. Cardiopulmonary disease
::b) Congenital malformations
::b. Congenital malformations
::c) Myopathic disease
::c. Myopathic disease
::d) Neuromuscular disease
::d. Neuromuscular disease
::e) Oncologic disease
::e. Oncologic disease
::f) Systemic disease
::f. Systemic disease
:2. Clinical Science
:2. Clinical Science
::a) Anterior, posterior, and combined spine fusion
::a. Anterior, posterior, and combined spine fusion
::b) Chest wall reconstruction
::b. Chest wall reconstruction
::c) Tourniquet management
::c. Tourniquet management
H. Trauma and Burns
H. Trauma and Burns
:1. Trauma
:1. Trauma
::a) Age-related mechanisms and associated injuries
::a. Age-related mechanisms and associated injuries
::b) Incidence, patterns, implications of abuse
::b. Incidence, patterns, implications of abuse
::c) Management of the polytrauma victim
::c. Management of the polytrauma victim
::d) Hypothermia and submersion injury
::d. Hypothermia and submersion injury
:2. Burns
:2. Burns
::a) Types, mechanisms, locations and implications of injuries
::a. Types, mechanisms, locations and implications of injuries
::b) Inhalation injuries/airway management
::b. Inhalation injuries/airway management
::c) Fluid resuscitation and calculating burn surface area
::c. Fluid resuscitation and calculating burn surface area
::d) Anesthetic and pain management of the burn patient
::d. Anesthetic and pain management of the burn patient
 
==IV. CLINICAL SCIENCE OF ANESTHESIA==
==IV. CLINICAL SCIENCE OF ANESTHESIA==
A. Evaluation and Preoperative Preparation of the Pediatric Patient (See Specific Disease States)
A. Evaluation and Preoperative Preparation of the Pediatric Patient (See Specific
Disease States)
:1. Normal developmental milestones
:1. Normal developmental milestones
:2. Evaluation of Coexisting Disease
:2. Evaluation of Coexisting Disease
::a) Cerebral palsy
::a. Cerebral palsy
::b) Cystic fibrosis
::b. Cystic fibrosis
::c) Down syndrome
::c. Down syndrome
::d) Gastro-esophageal reflux
::d. Gastro-esophageal reflux
::e) Latex allergy
::e. Latex allergy
::f) Mediastinal masses
::f. Mediastinal masses
::g) Reactive airway disease
::g. Reactive airway disease
::h) Upper respiratory tract infections
::h. Upper respiratory tract infections
::i) Congenital heart disease
::i. Congenital heart disease
::j) Autism spectrum disorders
::j. Autism spectrum disorders
:3. Physical Examination
:3. Physical Examination
:4. Laboratory Testing
:4. Laboratory Testing
Line 347: Line 359:
C. Regional Anesthesia and Analgesia
C. Regional Anesthesia and Analgesia
:1. Pharmacology and Toxicity of Local Anesthetics
:1. Pharmacology and Toxicity of Local Anesthetics
:2. Central Neuraxial Blockade: Indications, Contraindications, Techniques, Adjuvants, and Controversies
:2. Central Neuraxial Blockade: Indications, Contraindications, Techniques, Adjuvants,
:3. Peripheral Nerve Blockade: Indications, Contraindications, Techniques, Adjuvants, and Controversies
and Controversies
:3. Peripheral Nerve Blockade: Indications, Contraindications, Techniques, Adjuvants,
and Controversies
D. General Anesthesia
D. General Anesthesia
:1. Stages and Signs of Anesthesia
:1. Stages and Signs of Anesthesia
:2. Induction Techniques
:2. Induction Techniques
:3. Airway Management
:3. Airway Management
::a) Indications, techniques, limitations, and devices for mask ventilation
::a. Indications, techniques, limitations, and devices for mask ventilation
::b) Indications, techniques, limitations, and devices for endotracheal intubation
::b. Indications, techniques, limitations, and devices for endotracheal intubation
::c) Management of the difficult airway
::c. Management of the difficult airway
::d) Methods for single lung ventilation and lung separation
::d. Methods for single lung ventilation and lung separation
E. Complications of Anesthesia
E. Complications of Anesthesia
:1. Airway Obstruction
:1. Airway Obstruction
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:4. Management of the Post Anesthetic Care Unit
:4. Management of the Post Anesthetic Care Unit
H. Monitored Anesthesia Care and Sedation
H. Monitored Anesthesia Care and Sedation
I. Acute and Chronic Pain Management
==V. SPECIAL PROBLEMS OR ISSUES==
==V. SPECIAL PROBLEMS OR ISSUES==
A. Conjoined Twins, Including Preoperative Planning, Staging Procedures, Surgical Separation, Anesthetic Considerations and Physical Impact of Separation
A. Special Surgical Procedures


B. Professional Issues
B. Professional Issues
:1. [[Ethical and Legal Obligations of Pediatric Anesthesia Care and Research]]
:1. Ethical and Legal Obligations of Pediatric Anesthesia Care and Research
:2. Teaching, Supervision, and the Anesthesia Care Team
:2. Teaching, Supervision, and the Anesthesia Care Team
:3. Practice-based Learning and Improvement
:3. Practice-based Learning and Improvement
:4. Continuous Quality Improvement
:4. Continuous Quality Improvement
C. Principles of Biostatistics and Pediatric Study Design


C. Principles of Biostatistics and Study Design
D. Substance Abuse

Revision as of 21:59, 19 March 2021

Pediatric Anesthesiology Examination Revised – November 2019


The Content Outline for the Pediatric Anesthesiology Examination reflects the subject matter for the Pediatric Anesthesiology subspecialty. It is divided into five sections including Basic Science, Organ Based Basic and Clinical Sciences, Clinical Subspecialties, Clinical Science of Anesthesia, and Special Problems or Issues. The examination covers material from all of these sections. The outline reflects disease states, management considerations, and issues relatively unique to the pediatric patient. The subspecialty board certified pediatric anesthesiologist is expected to have knowledge within each of these categories and topics.

Pediatric Anesthesiology Examination Content Outline (November 2019)

As appropriate, items should be considered to include the changes that occur throughout the growth and development of the pediatric patient.

I. BASIC SCIENCE

A. Anatomy

1. General Development
a. Airway
b. Body habitus
c. Water, volume, and blood composition
2. Anatomy for Procedures
a. Airway management
b. Central neuraxial blockade
c. Peripheral nerve blockade
d. Vascular cannulation

B. Physics and Anesthesia Equipment

1. Respiration
a. Breathing circuits
b. Ventilation devices and techniques
2. Methods for Monitoring
a. Brain, spinal cord, and neuromuscular function
b. Cardiac rhythm and vascular pressures
c. Oxygenation, gas concentration, and ventilation
d. Temperature
3. Ultrasound: Physics and Clinical applications

C. Anesthetic Pharmacology: Physiologic States, Pathophysiologic States and Adverse Effects, Development Pharmacology

1. Pharmacokinetics and Pharmacodynamics
a. Blood-brain barrier
b. Drug absorption
c. Drug distribution
d. Neuromuscular system
e. Biotransformation and excretion
f. Pharmacogenetics
2. Non-opioid Analgesics
3. Opioid Analgesics
4. Sedative and Anxiolytic Agents
5. Anti-emetics
6. Inhalation Anesthetics
7. Local Anesthetics
8. Neuromuscular Blocking and Reversal Agents
9. Sympathetic and Parasympathetic Agents
10. Agents Affecting Coagulation

II. ORGAN-BASED BASIC AND CLINICAL SCIENCES

A. Respiratory System

1. Anatomy and Physiology
a. Prenatal and postnatal development
b. Respiratory mechanics, ventilation, and lung volumes
c. Oxygen transport
d. Surfactant, surface activity, and lung mechanics
e. Lung physiology
1. surfactant and surface tension
2. metabolism
3. ventilation / perfusion matching
2. Clinical Sciences
a. Obstructive disease
1. upper airway
2. tracheobronchial
3. parenchymal
b. Restrictive disease
1. pleural
2. neurologic
3. musculoskeletal
c. Anesthesia for thoracic procedures
1. one lung ventilation
2. video-assisted thoracoscopy
3. mediastinal masses
4. chest wall surgery / reconstruction
5. lung Transplantation

B. Cardiovascular System

1. Anatomy and Physiology
a. Prenatal and postnatal development
b. Fetal, transitional, and adult circulation
c. Benign heart murmur
2. Clinical Science
a. General considerations
1. cardiovascular effects on anesthetic uptake and delivery
2. anesthetic effects on the cardiovascular system
3. vasoactive medications
b. Disease states
1. acyanotic lesions
2. cyanotic lesions
3. palliative procedures
4. pulmonary hypertension
5. infectious diseases
6. cardiomyopathies
7. pericardial disease
8. intracardiac masses
9. arrhythmic lesions
10. heart transplantation
c. Anesthesia for cardiac procedures
1. complete anatomic and physiological repairs
2. single ventricle procedures
3. palliation surgery
4. management and consequences of cardiopulmonary bypass
5. deep hypothermic circulatory arrest
6. anesthesia for pacemaker / implantable cardiac defibrillator insertion and

replacement

7. anesthesia for diagnostic, interventional and electrophysical procedures
d. Anesthesia for the adult with congenital heart disease
e. Cardiopulmonary resuscitation
f. Anesthesia for non-cardiac procedures in child with congenital heart disease

C. Central and Peripheral Nervous Systems

1. Anatomy and Physiology
a. Prenatal and postnatal development
1. brain, fontanelles, cranial sutures, and spinal cord
2. myelinization, autonomic nervous systems, and pain pathways
3. neurodegenerative changes after anesthesia
b. Neurophysiology
2. Clinical Science
a. General considerations
1. intracranial pressure and blood flow
2. pharmacology of diuretics, steroids, and anticonvulsant medications,
b. Disease states
1. autism, developmental delay, and attention-deficit hyperactivity disorder
2. hydrocephalus
3. tumors
4. seizure disorders
5. cerebrovascular disorders
6. open and closed head injuries
7. spinal cord disorders
8. neurodegenerative disorders
9. spasticity
10. Chiari malformations
c. Anesthesia for neurosurgical procedures
1. seizure surgery
2. intracranial tumors and vascular lesions
3. craniofacial reconstruction / cranioplasty
4. meningomyelocele / spinal surgery
5. neurologic imaging

D. Gastrointestinal System

1. Anatomy and Physiology
a. Prenatal and postnatal development
2. Clinical Science
a. Esophageal, stomach and intestine disorders
1. abdominal wall defects
2. intestinal rotation defects
3. atresias, stenoses and webs
4. inflammatory states
5. duplications and cysts
6. hernias
7. necrotizing enterocolitis
b. Liver, biliary tract and spleen disorders
c. Anorectal disorders
d. Morbid obesity / bariatric surgery
e. Gastrointestinal endoscopy
f. Esophageal / gastrointestinal foreign bodies
g. Liver, intestinal, and multivisceral transplantation

E. Renal/Urinary

1. Anatomy and Physiology
a. Prenatal and postnatal development
b. Homeostasis functions
2. Clinical Science
a. Renal failure
b. Phimosis and hypospadias
c. Ureteropelvic junction obstruction
d. Vesicoureteral reflux
e. Bladder exstrophy
f. Renal transplantation

F. Endocrine/Metabolic

1. Anatomy and Physiology
a. Prenatal and postnatal development
b. Puberty and variants
2. Clinical Science
a. Adrenal disorders
b. Diabetes mellitus
c. Diabetes insipidus
d. Disorders of sodium regulation
e. Pheochromocytoma
f. Thyroid disorders
g. 22q.11 deletion syndrome (DiGeorge)

G. Hematology/Oncology

1. Anatomy and Physiology
a. Prenatal and postnatal development
2. Clinical Science
a. Hematology
1. anemias
2. coagulation disorders
b. Oncology
1. leukemia
2. neuroblastoma
3. retinoblastoma
4. sarcomas / osteosarcomas
5. Wilms tumor
c. Chemotherapeutic agents and side effects
d. Radiotherapy
e. Bone marrow and stem cell transplants
1. graft versus host disease
f. Immunologic disorders (congenital and acquired)

H. Genetics

1. Anatomy and Physiology
2. Clinical Sciences
a. Chromosomal abnormalities
b. Craniofacial syndromes
c. Effects of environmental agents
d. Endocrine disorders
e. Immunologic disorders
f. Inborn errors of metabolism
g. Malignant hyperthermia
h. Mitochondrial myopathies
i. Myopathic disorders
j. Myotonias
k. Muscular dystrophies
l. Neurologic disorders
m. Overgrowth syndromes
n. Osteochondrodysplastic syndromes
o. Skin and connective tissue disorders

III. CLINICAL SUBSPECIALTIES

A. Fetal

1. General Considerations
a. Fetal oxygenation
b. Fetal pain and stress
c. Fetal monitoring
2. Clinical Science
a. Fetal surgery
b. Ex utero intrapartum treatment (EXIT) procedure

B. Neonatal

1. General Considerations
a. Apgar scoring
b. Post conceptional age and organ system maturity
c. Effects of anesthesia and surgery on cognitive development
d. Stress response
e. Transport medicine
f. Neonatal resuscitation
2. Clinical Science
a. Surgical disease states
1. amniotic bands
2. congenital cystic adenomatoid malformation
3. congenital diaphragmatic hernia
4. duodenal atresia
5. hernia
6. hypertrophic pyloric stenosis
7. myelomeningocele
8. necrotizing enterocolitis
9. neonatal lobar emphysema
10. omphalocele and gastroschisis
11. sacrococcygeal teratoma
12. tracheo-esophageal fistula
13. vein of Galen malformation
b. Medical disease states
1. apnea and bradycardia
2. anemia
3. bronchopulmonary dysplasia
4. failure to thrive
5. intraventricular hemorrhage
6. kernicterus
7. persistent pulmonary hypertension
8. persistent fetal circulation
9. retinopathy of prematurity
10. neonatal abstinence syndrome

C. Painful Disease States

1. Pathophysiology
a. Procedural, postoperative, and posttraumatic pain
b. Pain in the neonate
c. Chronic pain states
2. Treatment
a. Regional analgesia
b. Pharmacologic and non-pharmacologic techniques of pain management
c. Complementary and alternative pain management

D. Otolaryngology

1. Airway Procedures
a. Bronchoscopic procedures
b. Tonsillectomy, adenoidectomy, and abscess drainage
c. Tracheotomy
d. Choanal atresia repair
e. Laryngotracheal reconstruction
f. Laser procedures
2. Otologic Procedures
a. Myringotomy and tubes
b. Cochlear implant, tympanoplasty, and mastoidectomy

E. Plastic and Oral-Maxillary Facial Surgery

1. Coexisting Diseases
a. Craniofacial syndromes
b. Congenital heart disease
c. Increased intracranial pressure
d. Obstructive sleep apnea
2. Clinical Science
a. Craniosynostosis repairs
b. Cleft repairs
c. Hypoplasia repairs
d. Syndactyly repairs
e. Tissue flaps and tissue expanders
f. Vascular malformations
g. Mandibular repairs

F. Ophthalmology

1. General Considerations
a. Physiology
b. Pharmacology of ophthalmologic medications
2. Clinical Science
a. Enucleations
b. Retinopathy of prematurity
c. Trauma
d. Tear duct probing
e. Strabismus repair

G. Orthopedic Surgery

1. Coexisting Diseases
a. Cardiopulmonary disease
b. Congenital malformations
c. Myopathic disease
d. Neuromuscular disease
e. Oncologic disease
f. Systemic disease
2. Clinical Science
a. Anterior, posterior, and combined spine fusion
b. Chest wall reconstruction
c. Tourniquet management

H. Trauma and Burns

1. Trauma
a. Age-related mechanisms and associated injuries
b. Incidence, patterns, implications of abuse
c. Management of the polytrauma victim
d. Hypothermia and submersion injury
2. Burns
a. Types, mechanisms, locations and implications of injuries
b. Inhalation injuries/airway management
c. Fluid resuscitation and calculating burn surface area
d. Anesthetic and pain management of the burn patient

IV. CLINICAL SCIENCE OF ANESTHESIA

A. Evaluation and Preoperative Preparation of the Pediatric Patient (See Specific Disease States)

1. Normal developmental milestones
2. Evaluation of Coexisting Disease
a. Cerebral palsy
b. Cystic fibrosis
c. Down syndrome
d. Gastro-esophageal reflux
e. Latex allergy
f. Mediastinal masses
g. Reactive airway disease
h. Upper respiratory tract infections
i. Congenital heart disease
j. Autism spectrum disorders
3. Physical Examination
4. Laboratory Testing
5. Psychosocial Preparation of the Patient and Family
6. Parental Presence and Pharmacologic Preparation for Anesthetic Induction
7. Fasting Requirements
8. Age-Related Differences in Anesthetic Risk
9. Informed Consent

B. General Considerations of the Perioperative Period

1. Fluid, Electrolyte, and Glycemic Management
2. Positioning
3. Thermoregulation
4. Transfusion Therapy and Blood Conservation Techniques

C. Regional Anesthesia and Analgesia

1. Pharmacology and Toxicity of Local Anesthetics
2. Central Neuraxial Blockade: Indications, Contraindications, Techniques, Adjuvants,

and Controversies

3. Peripheral Nerve Blockade: Indications, Contraindications, Techniques, Adjuvants,

and Controversies D. General Anesthesia

1. Stages and Signs of Anesthesia
2. Induction Techniques
3. Airway Management
a. Indications, techniques, limitations, and devices for mask ventilation
b. Indications, techniques, limitations, and devices for endotracheal intubation
c. Management of the difficult airway
d. Methods for single lung ventilation and lung separation

E. Complications of Anesthesia

1. Airway Obstruction
2. Inadequate Vascular Access
3. Iatrogenic trauma / positioning injury
4. Hypotension
5. Hypertension
6. Dysrhythmias
7. Cardiac Arrest
8. Anaphylactic and Anaphylactoid Reactions
9. Awareness and Recall Under Anesthesia
10. Psychosocial Complications

F. Special Techniques and Situations

1. Controlled Hypotension
2. Controlled Hypothermia
3. Surgery on ECMO
4. Management of Laparoscopic Surgery
5. Anesthesia for Satellite and Remote Locations
6. Perioperative Management of the Intensive Care Unit Patient

G. Postoperative Period

1. Management and Diagnosis of Pain, Anxiety and Emergence Agitation
2. Respiratory, Cardiovascular, and Neurologic Consequences of Anesthesia
3. Post Operative Nausea and Vomiting
4. Management of the Post Anesthetic Care Unit

H. Monitored Anesthesia Care and Sedation I. Acute and Chronic Pain Management

V. SPECIAL PROBLEMS OR ISSUES

A. Special Surgical Procedures

B. Professional Issues

1. Ethical and Legal Obligations of Pediatric Anesthesia Care and Research
2. Teaching, Supervision, and the Anesthesia Care Team
3. Practice-based Learning and Improvement
4. Continuous Quality Improvement

C. Principles of Biostatistics and Pediatric Study Design

D. Substance Abuse