Pediatric Anesthesiology Examination

ABAPediatricAnesthesiologyExaminationThe Content Outline for the Pediatric Anesthesiology Examination reflects the subject matter for thePediatric Anesthesiology subspecialty. It is divided into five sections including Basic Science, OrganBased Basic and Clinical Sciences, Clinical Subspecialties, Clinical Science of Anesthesia, and SpecialProblems or Issues. The examination covers material from all of these sections. The outline reflectsdisease states, management considerations, and issues relatively unique to the pediatric patient. Thesubspecialty board certified pediatric anesthesiologist is expected to have knowledge within each ofthese categories and topics.Revised – November 2019

I.A.BASIC SCIENCEAnatomy1.General Developmenta.Airwayb.Body habitusc.Water, volume, and blood composition2.a.b.c.d.B.1.Physics and Anesthesia EquipmentRespirationa.Breathing circuitsb.Ventilation devices and techniques2.a.b.c.d.3.C.A.Methods for MonitoringBrain, spinal cord, and neuromuscular functionCardiac rhythm and vascular pressuresOxygenation, gas concentration, and ventilationTemperatureUltrasound: Physics and Clinical applicationsAnesthetic Pharmacology: Physiologic States, Pathophysiologic States andAdverse Effects, Development Pharmacology1.Pharmacokinetics and Pharmacodynamicsa.Blood-brain barrierb.Drug absorptionc.Drug distributiond.Neuromuscular systeme.Biotransformation and natomy for ProceduresAirway managementCentral neuraxial blockadePeripheral nerve blockadeVascular cannulationNon-opioid AnalgesicsOpioid AnalgesicsSedative and Anxiolytic AgentsAnti-emeticsInhalation AnestheticsLocal AnestheticsNeuromuscular Blocking and Reversal AgentsSympathetic and Parasympathetic AgentsAgents Affecting CoagulationORGAN-BASED BASIC AND CLINICAL SCIENCESRespiratory System1.Anatomy and Physiologya.Prenatal and postnatal developmentb.Respiratory mechanics, ventilation, and lung volumesc.Oxygen transportd.Surfactant, surface activity, and lung mechanicse.Lung physiology1

1.2.3.2.a.b.Clinical SciencesObstructive disease1.upper airway2.tracheobronchial3.parenchymalRestrictive .3.4.5.B.1.surfactant and surface tensionmetabolismventilation / perfusion matchingAnesthesia for thoracic proceduresone lung ventilationvideo-assisted thoracoscopymediastinal masseschest wall surgery / reconstructionlung TransplantationCardiovascular SystemAnatomy and Physiologya.Prenatal and postnatal developmentb.Fetal, transitional, and adult circulationc.Benign heart murmur2.a.Clinical ScienceGeneral considerations1.cardiovascular effects on anesthetic uptake and delivery2.anesthetic effects on the cardiovascular system3.vasoactive sease statesacyanotic lesionscyanotic lesionspalliative procedurespulmonary hypertensioninfectious diseasescardiomyopathiespericardial diseaseintracardiac massesarrhythmic lesionsheart transplantationAnesthesia for cardiac procedurescomplete anatomic and physiological repairssingle ventricle procedurespalliation surgerymanagement and consequences of cardiopulmonary bypassdeep hypothermic circulatory arrestanesthesia for pacemaker / implantable cardiac defibrillator insertion andreplacement2

7.C.1.d.e.Anesthesia for the adult with congenital heart diseaseCardiopulmonary resuscitationf.Anesthesia for non-cardiac procedures in child with congenital heart diseaseCentral and Peripheral Nervous SystemsAnatomy and Physiologya.Prenatal and postnatal development1.brain, fontanelles, cranial sutures, and spinal cord2.myelinization, autonomic nervous systems, and pain pathways3.neurodegenerative changes after anesthesiab.2.NeurophysiologyClinical Sciencea.General considerations1.intracranial pressure and blood flow2.pharmacology of diuretics, steroids, and anticonvulsant medications,b.Disease states1.autism, developmental delay, and attention-deficit hyperactivity disorder2.hydrocephalus3.tumors4.seizure disorders5.cerebrovascular disorders6.open and closed head injuries7.spinal cord disorders8.neurodegenerative disorders9.spasticity10.Chiari malformationsc.1.2.3.4.5.D.1.anesthesia for diagnostic, interventional and electrophysical proceduresAnesthesia for neurosurgical proceduresseizure surgeryintracranial tumors and vascular lesionscraniofacial reconstruction / cranioplastymeningomyelocele / spinal surgeryneurologic imagingGastrointestinal SystemAnatomy and Physiologya.Prenatal and postnatal development2.a.b.c.Clinical ScienceEsophageal, stomach and intestine disorders1.abdominal wall defects2.intestinal rotation defects3.atresias, stenoses and webs4.inflammatory states5.duplications and cysts6.hernias7.necrotizing enterocolitisLiver, biliary tract and spleen disordersAnorectal disorders3

d.e.f.g.E.1.2.F.1.Renal/UrinaryAnatomy and Physiologya.Prenatal and postnatal developmentb.Homeostasis functionsClinical Sciencea.Renal failureb.Phimosis and hypospadiasc.Ureteropelvic junction obstructiond.Vesicoureteral refluxe.Bladder exstrophyf.Renal transplantationEndocrine/MetabolicAnatomy and Physiologya.Prenatal and postnatal developmentb.Puberty and variants2.a.b.c.d.e.f.g.G.1.Morbid obesity / bariatric surgeryGastrointestinal endoscopyEsophageal / gastrointestinal foreign bodiesLiver, intestinal, and multivisceral transplantationClinical ScienceAdrenal disordersDiabetes mellitusDiabetes insipidusDisorders of sodium regulationPheochromocytomaThyroid disorders22q.11 deletion syndrome (DiGeorge)Hematology/OncologyAnatomy and Physiologya.Prenatal and postnatal development2.a.Clinical ScienceHematology1.anemias2.coagulation roblastomaretinoblastomasarcomas / osteosarcomasWilms tumorChemotherapeutic agents and side effectsRadiotherapyBone marrow and stem cell transplants1.graft versus host diseaseImmunologic disorders (congenital and acquired)Genetics4

1.2.III.A.Anatomy and PhysiologyClinical Sciencesa.Chromosomal abnormalitiesb.Craniofacial syndromesc.Effects of environmental agentsd.Endocrine disorderse.Immunologic disordersf.Inborn errors of metabolismg.Malignant hyperthermiah.Mitochondrial myopathiesi.Myopathic disordersj.Myotoniask.Muscular dystrophiesl.Neurologic disordersm.Overgrowth syndromesn.Osteochondrodysplastic syndromeso.Skin and connective tissue disordersCLINICAL SUBSPECIALTIESFetal1.General Considerationsa.Fetal oxygenationb.Fetal pain and stressc.Fetal monitoring2.a.b.B.1.Clinical ScienceFetal surgeryEx utero intrapartum treatment (EXIT) procedureNeonatalGeneral Considerationsa.Apgar scoringb.Post conceptional age and organ system maturityc.Effects of anesthesia and surgery on cognitive developmentd.Stress responsee.Transport medicinef.Neonatal resuscitation2.a.Clinical ScienceSurgical disease states1.amniotic bands2.congenital cystic adenomatoid malformation3.congenital diaphragmatic hernia4.duodenal atresia5.hernia6.hypertrophic pyloric stenosis7.myelomeningocele8.necrotizing enterocolitis9.neonatal lobar emphysema10.omphalocele and gastroschisis11.sacrococcygeal teratoma12.tracheo-esophageal fistula13.vein of Galen malformation5

b.1.2.3.4.5.6.7.8.9.10.C.Medical disease statesapnea and bradycardiaanemiabronchopulmonary dysplasiafailure to thriveintraventricular hemorrhagekernicteruspersistent pulmonary hypertensionpersistent fetal circulationretinopathy of prematurityneonatal abstinence syndromePainful Disease States1.Pathophysiologya.Procedural, postoperative, and posttraumatic painb.Pain in the neonatec.Chronic pain states2.a.b.c.D.1.OtolaryngologyAirway Proceduresa.Bronchoscopic proceduresb.Tonsillectomy, adenoidectomy, and abscess drainagec.Tracheotomyd.Choanal atresia repaire.Laryngotracheal reconstructionf.Laser procedures2.a.b.E.1.a.b.c.d.e.f.g.1.Otologic ProceduresMyringotomy and tubesCochlear implant, tympanoplasty, and mastoidectomyPlastic and Oral-Maxillary Facial SurgeryCoexisting Diseasesa.Craniofacial syndromesb.Congenital heart diseasec.Increased intracranial pressured.Obstructive sleep apnea2.F.TreatmentRegional analgesiaPharmacologic and non-pharmacologic techniques of pain managementComplementary and alternative pain managementClinical ScienceCraniosynostosis repairsCleft repairsHypoplasia repairsSyndactyly repairsTissue flaps and tissue expandersVascular malformationsMandibular repairsOphthalmologyGeneral Considerations6

a.b.2.a.b.c.d.e.G.a.b.c.H.1.Clinical ScienceAnterior, posterior, and combined spine fusionChest wall reconstructionTourniquet managementTrauma and BurnsTraumaa.Age-related mechanisms and associated injuriesb.Incidence, patterns, implications of abusec.Management of the polytrauma victimd.Hypothermia and submersion injury2.a.b.c.d.A.Clinical ScienceEnucleationsRetinopathy of prematurityTraumaTear duct probingStrabismus repairOrthopedic Surgery1.Coexisting Diseasesa.Cardiopulmonary diseaseb.Congenital malformationsc.Myopathic diseased.Neuromuscular diseasee.Oncologic diseasef.Systemic disease2.IV.PhysiologyPharmacology of ophthalmologic medicationsBurnsTypes, mechanisms, locations and implications of injuriesInhalation injuries/airway managementFluid resuscitation and calculating burn surface areaAnesthetic and pain management of the burn patientCLINICAL SCIENCE OF ANESTHESIAEvaluation and Preoperative Preparation of the Pediatric Patient (See SpecificDisease States)1.Normal developmental milestones2.Evaluation of Coexisting Diseasea.Cerebral palsyb.Cystic fibrosisc.Down syndromed.Gastro-esophageal refluxe.Latex allergyf.Mediastinal massesg.Reactive airway diseaseh.Upper respiratory tract infectionsi.Congenital heart diseasej.Autism spectrum disorders3.Physical Examination7

4.5.6.7.8.9.B.C.Laboratory TestingPsychosocial Preparation of the Patient and FamilyParental Presence and Pharmacologic Preparation for Anesthetic InductionFasting RequirementsAge-Related Differences in Anesthetic RiskInformed ConsentGeneral Considerations of the Perioperative Period1.Fluid, Electrolyte, and Glycemic sion Therapy and Blood Conservation TechniquesRegional Anesthesia and AnalgesiaPharmacology and Toxicity of Local AnestheticsCentral Neuraxial Blockade: Indications, Contraindications, Techniques, Adjuvants,and Controversies3.Peripheral Nerve Blockade: Indications, Contraindications, Techniques, Adjuvants,and General AnesthesiaStages and Signs of AnesthesiaInduction TechniquesAirway Managementa.Indications, techniques, limitations, and devices for mask ventilationb.Indications, techniques, limitations, and devices for endotracheal intubationc.Management of the difficult airwayd.Methods for single lung ventilation and lung separationComplications of AnesthesiaAirway ObstructionInadequate Vascular AccessIatrogenic trauma / positioning injuryHypotensionHypertensionDysrhythmiasCardiac ArrestAnaphylactic and Anaphylactoid ReactionsAwareness and Recall Under AnesthesiaPsychosocial ComplicationsSpecial Techniques and Situations1.Controlled Hypotension2.Controlled Hypothermia3.Surgery on ECMO4.Management of Laparoscopic Surgery5.Anesthesia for Satellite and Remote Locations6.Perioperative Management of the Intensive Care Unit PatientG.1.2.3.4.Postoperative PeriodManagement and Diagnosis of Pain, Anxiety and Emergence AgitationRespiratory, Cardiovascular, and Neurologic Consequences of AnesthesiaPost Operative Nausea and VomitingManagement of the Post Anesthetic Care Unit8

H.Monitored Anesthesia Care and SedationI.V.Acute and Chronic Pain ManagementSPECIAL PROBLEMS OR ISSUESA.Special Surgical ProceduresB.1.2.3.4.Professional IssuesEthical and Legal Obligations of Pediatric Anesthesia Care and ResearchTeaching, Supervision, and the Anesthesia Care TeamPractice-based Learning and ImprovementContinuous Quality ImprovementC.Principles of Biostatistics and Pediatric Study DesignD.Substance Abuse9

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 relativ