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 WRITTEN EXAMINATION TOPICS LIST
The following is a list of topics to prepare for the Written Examination. This list is extensive but in no way exclusive. The
information can be found in most textbooks.
I. PHYSIOLOGICAL SCIENCES
A. PHYSIOLOGY
1. Respiration: Lung Functions and Cellular Processes
 Lung Mechanics
 Ventilation – Perfusion
 Diffusion
 Blood Gas Transport
 Regulation of Ventilation
 Non-Respiratory Functions of Lungs
2. Physiology of the Cardiovascular System
 Cardiac Cycle
 Ventricular Function
 Venous Return
 Blood Pressure
 Microcirculation
 Organ Perfusion
 Regulation of Circulation and Blood Volume
3. Central and Peripheral Nervous Systems
 Brain
 Spinal Cord
 Cerebrospinal Fluid
 Neuromuscular and Synaptic transmission
 Skeletal Muscle Contractions
 Pain Mechanism and Pathways
 Autonomic Nervous System
4. Hepatic Function
 Dual blood supply and its regulation
 Metabolic and synthetic functions
 Excretory functions
 Mechanisms of drug metabolism and excretion
 Liver function tests
5. Renal Function
 Blood flow
 Glomerular filtration
 Tubular reabsorption and secretion
 Renal function tests
 Hormonal regulation of extracellular fluid
 Hormonal regulation of osmolality
 Regulation of acid-base balance
 Drug excretion
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6. Endocrine Function
 Pituitary
 Thyroid and parathyroid
 Adrenal medulla
 Adrenal cortex
 Pancreas
7. Temperature Regulation
 Temperature sensing - central, peripheral
 Temperature regulating centers - concept of set
point
 Heat production and conservation
 Heat loss – mechanisms
 Body temperature measurements – sites, gradients
 Special pediatric considerations
8. Aging: Physiological and Pharmacological Implications
B. PHARMACOLOGY
1. General Concepts
 Pharmacokinetics
 Protein binding
 Partition coefficients
 pKa
 Ionization
 Tissue uptake
 Elimination
 Biotransformation
 Termination of action
2. Anesthetics: Gases and Vapors
 Physical properties
 Mechanism of action
 Effects on CNS, circulation, respiration,
neuromuscular function, renal function, hepatic
function, hematologic and immune systems
 Biotransformation – toxicity
 Minimal alveolar concentration
 Trace concentrations
 O.R. pollution
 Personnel hazards
3 Anesthetics: Intravenous (Opioid and Non-opioid
Induction and Anesthetic Agents)
 Mechanism of action
 Pharmacokinetics and pharmacodynamics
 Metabolism and excretion
 Effect on circulation
 Effect on respiration
 Effect on other organs
 Adverse effects
4. Anesthetics: Local
 Mode of action
 Biotransformation and excretion
 Comparison of drugs and chemical groups
 Prolongation of action
 Toxicity
5. Muscle Relaxants (Depolarizing, Non-depolarizing)
 Mechanism of action
 Non-relaxant side effects
 Abnormal responses
 Biotransformation and excretion
 Prolongation of action, termination of action
 Antagonism
 Drug interactions, antibiotics, H2 blockers,
magnesium
6. Autonomic Drugs
 Sympathetic
 Parasympathetic
7. Cardiovascular Drugs
 Digitalis - actions and toxicity
 Positive inotropes
 Antiarrhythmics
 Antianginal drugs
 Vasodilators
 Electrolytes (cardiac effects)
 Vasoconstrictors
8. Central Nervous System Drugs (Major actions,
comparison of drugs; effects on circulation, respiration;
adverse effects)
 Pre- and post- anesthetic medications
 Antidepressants
 Antiparkinson drugs
 Ethyl alcohol
 Hypnotics - barbiturate and non-barbiturate
 Anticonvulsants
 Antieleptics
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Physostigmine
Benzodiazepine antagonists
Antiemetics - phenothiazines; butyrophenones;
metoclopramide; anticholinergics
Antihistamines (H1, H2, Mixed).
Drug abuse and addiction, tolerance, dependence.
9. Diuretics
 Mechanism of action
 Comparison of drugs
 Adverse effects
 Effect on electrolyte and acid-base balance
 Ultrafiltration
10. Immunosuppressive and anti-Rejection Drugs
11. Drug Interactions
 Protein binding
 pH effect
 Enzyme induction and inhibition
12. Pharmacogenetics
 Malignant hyperthermia (including diagnosis and
therapy)
 Pseudocholinesterase deficiency
13. Drug Reactions (Anaphylactoid, Anaphylaxis)
II. PHYSICAL SCIENCES
A. ANATOMY
1. Topographical Anatomy as Landmarks
 Neck
 Chest
 Abdomen
 Pelvis
 Extremities
2. Radiological Anatomy
 Chest
 Spine
3. Respiratory System
 Nose
 Pharynx
 Larynx
 Trachea
 Lungs
 Muscles of respiration
4. Cardiovascular System
 Normal anatomy of heart and major vessels
 Heart conduction system
 External innervations
 Coronary circulation
 Blood supply of other major organs
5. Nervous System
 Brain
 Spinal cord and spine
 Meninges
 Autonomic nervous system
6. Regional Anesthesia: Main Nerve Blocks
 Autonomic
 Head and neck
 Extremities
 Trunk
 Spine
B. BIOCHEMISTRY
1. Normal Body Metabolism
 Carbohydrates
 Proteins
 Concerning specific organ metabolism
2. Acid-Base Regulation: Buffer Systems, Effects of
Imbalance on Electrolytes and Organ Perfusion
3. Water and Electrolytes: Distribution and Balance,
Compartments
C. PHYSICS
1. Mechanics
 Pressure measurements of gases, liquids
 Transducers, regulators, medical gas cylinders
2. Flow Velocity
 Viscosity – density
 Laminar – turbulent
 Flowmeters
 Rotameter
 Electromagnetic
 Ultrasonic
 Pneumotachogram
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3. Properties of Liquids, Gases and Vapors
 Diffusion of gases
 Solubility coefficient
 Relative and absolute humidity
 Critical temperature, critical pressure
4. Gas Laws
5. Vaporizers
 Vapor pressure, calculation of anesthetic
concentrations
 Vaporizer types
6. Uptake and Distribution of Inhalation Agents
 Uptake & elimination curves - effect of ventilation,
circulation, anesthetic systems
 Concentration effect
 Second gas effect
 Nitrous Oxide and closed spaces
7. Design of Anesthesia Machines
8. Physics of Breathing Systems
 Principles
 Components
 Characteristics
 Oxygen supply systems
 Waste gas evacuation systems
 Fail safe and other safety features
9. Monitoring Methods
 Vascular pressures
 Head function
 Brain and spinal cord function
 Neuromuscular function
 Ventilation
 Gas concentrations
 Temperature
 Oxygen
10. Monitoring Instrumentation
 Blood gases
 Gas concentrations
 Cardiac output
 Pressure transducers
 Doppler
 Oscillometry
 Blood warmers, cell savers
 Echocardiography
 Coagulation monitors
11. Ventilators
 Classifications
 Principles of action
 Nebulizers
 Humidifiers
12. Alarms
 Operating room, electrical
 Anesthesia machine, ventilators, and oxygen
13. Defibrillators
 Internal, external, implantable; energy,
cardioversion; paddle size and position
III. CLINICAL SCIENCES
A. ANESTHESIA PROCEDURES, METHODS AND
TECHNIQUES
1. Evaluation of the Patient and Preoperative Preparation
 Physical status
 Pre-medication
 NPO Recommendation
2. Regional Anesthesia
 General
 Spinal
 Epidural and caudal
 Peripheral and autonomic nerve blocks
 IV regional
14. Pacemakers
 Temporary, permanent, transcutaneous
 Types - fixed rate, synchronized, ventricular, atrial, 3. General Anesthesia
 Stages and signs of anesthesia
A-V sequential
 Awareness under anesthesia
 Standard nomenclature
 Airway management – intubation, fiberoptic
 Reasons for failure or malfunction
 Techniques for difficult intubation
15. Electrical: Fire and Explosion Hazards
 Endobronchial intubation
 Source of ignition
 Complications
 Prevention
4. Intravenous Fluid Therapy during Anesthesia
 Macro and micro current hazards
 Water
 Safety regulations - NFPA
 Electrolyte
 Lasers
 Glucose requirements and disposition
D. MATHEMATICS
5. Concerning Complications (Etiology, Prevention,
1. Simple Math
Treatment)
 Logarithms
 Trauma
 Graph of simple equations
 Chronic environmental exposure
 Exponential function
 Mutagenicity
 Analysis of biologic curves
 Teratogenicity
 Carcinogenicity
2. Statistics
 Scavenging
 Sample and population, probability
 Temperature
 Mean and mode
 Nausea and vomiting
 Standard deviation and error
 Bronchospasm
 T – test
 Laryngospasm
 Chi-square – correlation
 Analysis of variance
6. Special Techniques
 Controlled hypotension
3. Computers
 Controlled hypothermia
 Data handling
 Hyperbaric oxygen and anesthesia care
 Data processing
 High altitude anesthesia
 Data analysis
 Barbiturate coma
 Anesthesia applications
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7. Postoperative Period
 Pain relief
 Pharmacologic drugs, routes, risks and benefits
 Respiratory consequences of anesthesia
8. Concerning Anesthesia Record Keeping and Quality
Assurance
B. DISEASE STATES - CLINICAL PROBLEMS AND
THEIR MANAGEMENT
1. Painful Disease States
 Types of pain
 Specific pain syndromes
 Treatment
2. Respiratory System - Classification: Obstructive
Disease
 Upper Airway
 Tracheobronchial
 Parenchymal
3. Respiratory System - Classification: Respiratory
System
 Neurologic
 Musculoskeletal
 Parenchymal
 Pleural
 Mediastinal
4. Management of the Patient with Respiratory Disease
 Evaluation
 Anesthetic management
 Management of respiratory failure
6. Central Nervous System Disorders
 Seizures
 Coma
 Drug intoxication
 Paraplegia
 Quadriplegia
 Spinal shock
 Autonomic hyperreflexia
 Depolarizing relaxants
 Neuromuscular disease
 Tetanus
 Special problems of anesthesia for neurosurgery
7. Other Disease Entities
 Massive obesity
 Hepatic disease
 Diabetes mellitus
 Renal disease
 Endocrine disorders
 Intestinal obstruction
 Hematologic disorders
8. Pediatric Anesthesia
 Apparatus
 Premedication
 Agents and techniques
 Fluid therapy and blood replacement
 Physiologic anemia
 Problems in intubation
 Neonatal physiology
 Congenital heart disease
 Emergencies in the newborn
 Postoperative analgesia
9. Obstetrical Anesthesia
5. Cardiovascular Disease
 Maternal Physiology
 Ischemic heart disease
 Valvular heart disease
10. Maternal - Fetal
 Rhythm disorders and conduction defects
 Pharmacology
 Heart failure and cardiomyopathy - ischemic, viral,
 Amniotic fluid (L/S ratio)
hypertropic
 Anesthetic techniques and risks
 Cardiac tamponade and constrictive pericarditis
 Physiology of labor
 Circulatory assist
 Influence of anesthetic technique on labor
 Myocardial preservation
 Fetal monitoring
 Pulmonary embolism
 Hypertension
11. Pathophysiology and Complicated Pregnancy
 Peripheral circulatory failure
 Problems during pregnancy
 Vascular disease
 Problems of term and delivery
 Cardiopulmonary resuscitation
 Resuscitation of newborn
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12. Special Problems in:
 Endoscopy
 Microlaryngeal surgery
 Plastic surgery
 Gynecology – in-vitro fertilization
 Urology - lithotripsy
 Ophthalmology – retrobulbar block, open eye
injuries
 Orthopedics - tourniquet use
 Trauma
 Burns
 Radiology - CT scan, MRI
 Outpatient anesthesia
 Electroconvulsive treatment
 Nutrition and hyperalimentation
 Anesthetic accidents
 Risk - benefit of legal medicine
 Legal medicine
 Cost of medical care
 Critical care medicine
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