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Practice cases for the oral board

192 anaesthesia cases, each a patient, the examiner's questions and an answer to say aloud. Start with the Core: 80 cases, one for each core topic, so every part of the exam comes up once. Today mixes new cases with cases from memory: a patient you have met, a few days later, with the diagnosis and the notes hidden. Your marks stay on this device.

Start the CoreIschaemic heart disease for rectal cancer surgery

Today

8 new

  1. New · CardiacIschaemic heart disease for rectal cancer surgery
  2. New · Airway and respiratoryObesity hypoventilation for emergency laparotomy
  3. New · Thoracic and vascularAnterior mediastinal mass with SVC obstruction for node biopsy
  4. New · NeuroanaesthesiaMyasthenia gravis for emergency laparotomy
  5. New · Obstetric anaesthesiaSevere preeclampsia with HELLP for labour epidural
  6. New · Paediatric anaesthesiaActive URI and asthma for MRI under GA
  7. New · Medical and endocrine diseaseUndiagnosed phaeochromocytoma unmasked at laryngoscopy
  8. New · ICU and traumaSevere ARDS for bedside percutaneous tracheostomy

The cases, by domain

Each domain opens to its Core cases, with why each one is core, and to every case in it. New cases on Today come from the Core first; choose All cases in Settings to open the rest.

CardiacCore 0 / 8, All 0 / 22
  1. Ischaemic heart disease for rectal cancer surgeryIschaemic heart disease: the stepwise cardiac risk-assessment walk applied to one patient
  2. Severe HFrEF for emergency laparotomyHeart failure with reduced ejection fraction: induction and inotrope choice in an emergency
  3. Severe mitral regurgitation for free-flap surgeryRegurgitant valve: keep it fast, full and vasodilated; AF with shock
  4. Severe PAH on epoprostenol for hysteroscopyPulmonary hypertension: protecting the right ventricle, the transferable RV failure framework
  5. Unrepaired tetralogy of Fallot for MRICyanotic congenital lesion: balancing shunt flow with systemic and pulmonary resistance
  6. Pacing-dependent ICD patient for neck surgeryImplanted device: pacing dependence, diathermy interference and reprogramming plan
  7. WPW with pre-excited AF after intubationRhythm problem: pre-excited AF and the unstable tachycardia algorithm
  8. Severe symptomatic AS for urgent laparoscopyStenotic valve: fixed output, the rate, preload and afterload rules
  9. All 22 Cardiac cases
Airway and respiratoryCore 0 / 6, All 0 / 12
  1. Obesity hypoventilation for emergency laparotomyObesity and hypoventilation: RSI, ventilation and postoperative obstruction in the obese
  2. Brittle asthma for ankle fixation, with bronchospasm at inductionReactive airway: asthma optimisation, anaphylaxis and severe bronchospasm with gas trapping
  3. Subglottic stenosis for laser and dilation with jet ventilationShared airway: laser safety, jet ventilation and airway fire drill
  4. Ludwig angina with trismus: awake tracheal intubationAnticipated difficult airway: awake tracheal intubation step by step
  5. Rheumatoid neck for emergency surgery: failed intubation at RSIUnanticipated failed intubation at RSI: the full DAS plan A to D
  6. Retrosternal goitre with tracheal compression for thyroidectomyCompressed trachea: goitre airway plan, nerve palsy and neck haematoma
  7. All 12 Airway and respiratory cases
Thoracic and vascularCore 0 / 5, All 0 / 11
  1. Anterior mediastinal mass with SVC obstruction for node biopsyAnterior mediastinal mass: keeping spontaneous breathing and rescue positions
  2. Ruptured AAA for emergency EVAR under local anaesthesiaRuptured aneurysm: permissive hypotension and haemorrhage control under local anaesthesia
  3. Aortoiliac occlusion for aortobifemoral bypass with coronary diseaseOpen aortic surgery: clamp and unclamp physiology, epidural and coronary disease
  4. Symptomatic carotid stenosis for endarterectomy under cervical plexus blockCarotid surgery: awake neuromonitoring, clamp ischaemia and neck haematoma
  5. Lung cancer for pneumonectomy: one-lung hypoxaemia and AFLung resection: fitness assessment, one-lung hypoxaemia and postoperative AF
  6. All 11 Thoracic and vascular cases
NeuroanaesthesiaCore 0 / 6, All 0 / 14
  1. Myasthenia gravis for emergency laparotomyMyasthenia gravis: relaxant dosing, full-stomach induction and cholinergic versus myasthenic crisis
  2. Head injury with haemorrhagic shock for laparotomyHead injury with bleeding: cerebral perfusion versus haemorrhage control priorities
  3. Poor-grade subarachnoid haemorrhage for coilingSubarachnoid haemorrhage: transmural pressure control and neurogenic pulmonary oedema
  4. Prone multilevel spinal fusion: arrest and visual lossProne positioning: arrest when prone and postoperative visual loss
  5. Acute cervical cord injury with neurogenic shockAcute cervical cord injury: neck-safe airway, neurogenic shock and bradycardia
  6. Awake craniotomy for a glioma near the motor stripCraniotomy framework: awake technique, sedation airway loss and intraoperative seizure
  7. All 14 Neuroanaesthesia cases
Obstetric anaesthesiaCore 0 / 7, All 0 / 17
  1. Severe preeclampsia with HELLP for labour epiduralPreeclampsia with HELLP: neuraxial timing, pulmonary oedema and magnesium toxicity
  2. Failed intubation for retained placentaObstetric failed intubation: the obstetric difficult airway algorithm and wake-or-proceed
  3. Amniotic fluid embolism with arrest during vacuum deliveryAmniotic fluid embolism: maternal arrest, uterine displacement, delivery and DIC
  4. Cord prolapse at full dilatationCategory 1 caesarean: extending the epidural versus general, against the clock
  5. Atonic PPH with coagulopathy for laparotomyPostpartum haemorrhage: massive obstetric bleeding, coagulopathy and transfusion lung injury
  6. Preterm birth on magnesium with neonatal resuscitationPreterm delivery: neonatal resuscitation algorithm from ventilation to compressions
  7. Failed epidural extension, then high block at caesareanNeuraxial caesarean: failed block options and managing a high block
  8. All 17 Obstetric anaesthesia cases
Paediatric anaesthesiaCore 0 / 7, All 0 / 17
  1. Active URI and asthma for MRI under GAChild with a cold: proceed or postpone, laryngospasm and paediatric bradycardia
  2. Post-tonsillectomy bleed with von Willebrand diseaseBleeding tonsil: hypovolaemic child, full stomach of blood, bleeding disorder
  3. Infantile hypertrophic pyloric stenosisInfant physiology: fluid and electrolyte correction first, then infant RSI
  4. Ex-premature infant for retinopathy laserEx-premature infant: apnoea risk, retinopathy laser and neonatal ventilation
  5. Duchenne muscular dystrophy for tendon surgeryMuscular dystrophy: volatile-induced hyperkalaemic arrest and paediatric life support
  6. Inhaled foreign body in a child with asthmaInhaled foreign body: shared airway, spontaneous versus controlled ventilation
  7. Acute epiglottitis in an unimmunised childInfective upper airway obstruction in a child: gas induction and surgical backup
  8. All 17 Paediatric anaesthesia cases
Medical and endocrine diseaseCore 0 / 8, All 0 / 30
  1. Undiagnosed phaeochromocytoma unmasked at laryngoscopyCatecholamine crisis: recognising phaeochromocytoma, blockade before surgery and pressor storm
  2. Type 2 diabetes on a GLP-1 agonist and SGLT2 inhibitor for laparoscopic colectomyDiabetes: GLP-1 aspiration risk, SGLT2 ketoacidosis and autonomic neuropathy
  3. Thyroid storm after urgent trauma surgery in unrecognised hyperthyroidismThyroid storm: recognition after surgery and the ordered drug treatment
  4. Cushing's disease for transsphenoidal pituitary surgeryPituitary surgery: Cushing physiology, shared airway, diabetes insipidus after resection
  5. Frail 89-year-old for emergency laparotomyFrailty in an emergency: risk, shared decisions and postoperative delirium
  6. Child-Pugh B cirrhosis for urgent laparoscopic cholecystectomyLiver disease: Child-Pugh risk, coagulopathy, bleeding and encephalopathy
  7. HbSS sickle cell disease: elective laparoscopic cholecystectomySickle cell disease: preoperative transfusion, avoiding triggers, acute crisis
  8. Missed dialysis and hyperkalaemia for urgent hernia repairRenal failure: dialysis timing, hyperkalaemia and hyperkalaemic arrest
  9. All 30 Medical and endocrine disease cases
ICU and traumaCore 0 / 6, All 0 / 13
  1. Severe ARDS for bedside percutaneous tracheostomyARDS: lung-protective ventilation and a tracheostomy in a hypoxaemic patient
  2. Septic shock from Fournier gangrene for debridementSeptic shock: urgent debridement, induction in shock and vasopressor and inotrope escalation
  3. Pelvic fracture haemorrhage for angioembolisationMajor trauma: primary survey, damage control resuscitation and massive transfusion
  4. Child with major burns and inhalation injury for excisionBurns: inhalation injury, fluid resuscitation and excision blood loss in a child
  5. Bilateral femoral fractures and fat embolismLong-bone fractures: fat embolism, intraoperative collapse and the later syndrome
  6. Brain-dead donor for multi-organ retrievalOrgan donation: brain-death physiology, diabetes insipidus and donor optimisation
  7. All 13 ICU and trauma cases
Intra-operative crisesCore 0 / 8, All 0 / 21
  1. Ventricular tachycardia in the beach-chair positionBroad-complex tachycardia with a pulse, then shockable arrest: two algorithms
  2. Massive pulmonary embolism for catheter thrombectomyMassive pulmonary embolism: RV failure support, non-shockable arrest and thrombolysis
  3. TURP syndrome under spinal anaesthesiaIrrigation fluid absorption: hyponatraemia, seizures and safe sodium correction
  4. Malignant hyperthermia during laparoscopic hernia repairMalignant hyperthermia: early recognition, the dantrolene drill and hyperkalaemia management
  5. Complete heart block before an urgent ureteric stentComplete heart block: bradycardia algorithm, pacing and failure to capture
  6. Delayed LAST after bilateral TAP cathetersLocal anaesthetic toxicity: delayed onset, lipid emulsion and modified arrest drugs
  7. Chlorhexidine anaphylaxis with arrest in an asthmaticAnaphylaxis to arrest: IM then IV adrenaline, the asthmatic twist, glucagon
  8. Bone cement implantation syndrome with aortic stenosisBone cement implantation syndrome: RV failure at cementing in a frail patient
  9. All 21 Intra-operative crises cases
Pain and regional anaesthesiaCore 0 / 5, All 0 / 13
  1. Headache after a day-case spinal, and the headache that isn't PDPHPost-dural puncture headache: diagnosis, blood patch and dangerous differentials
  2. Buprenorphine maintenance for spinal fusionOpioid-tolerant patient: buprenorphine continuation, multimodal analgesia and opioid overdose
  3. Pancreatic cancer pain: neurolytic coeliac plexus blockCancer pain: neurolytic coeliac plexus block, consent and complications
  4. Multiple rib fractures in an older man with COPDRib fractures: analgesia choice to prevent respiratory failure in the elderly
  5. Below-knee amputation on dual antiplatelets, and phantom painAntiplatelets with regional anaesthesia, and phantom versus stump pain
  6. All 13 Pain and regional anaesthesia cases
OSCE: actor and procedure stationsCore 0 / 14, All 0 / 22
  1. Telling a wife her husband died during ruptured aneurysm repairActor: breaking bad news of an intraoperative death
  2. Disclosing a syringe swap: paralysed before she was asleepActor: open disclosure of a drug error and apology
  3. Jehovah's Witness refusing blood before revision hipActor: refusal of blood, advance decision and blood-sparing options
  4. Consent for a labour epiduralActor: informed consent for a labour epidural under time pressure
  5. Capacity and refusal of urgent laparotomyActor: assessing capacity in a confused patient refusing surgery
  6. Family history of malignant hyperthermia before hernia repairActor: counselling a frightened patient about inherited anaesthetic risk
  7. Ventilation and ceiling of care before emergency laparotomy in severe COPDActor: postoperative ventilation and ceiling-of-care discussion with patient and family
  8. Failed epidural and an angry patient after laparotomyActor: angry patient with failed analgesia, then opioid over-sedation
  9. Needlestick from a patient with HIV: advising a colleagueActor: advising a colleague after a high-risk needlestick injury
  10. DOPS: bronchial blocker in a difficult airway, and a blocker that slipsDOPS: bronchial blocker placement in a difficult airway, and dislodgement
  11. DOPS: ultrasound-guided internal jugular line, wire ectopy and air embolismDOPS: ultrasound-guided internal jugular line, wire ectopy and air embolism
  12. DOPS: scalpel front-of-neck access in CICODOPS: scalpel-bougie-tube front-of-neck access when you cannot intubate or oxygenate
  13. DOPS: fibreoptic intubation through a supraglottic airway, and laryngospasmDOPS: fibreoptic intubation through a working supraglottic airway, and laryngospasm
  14. DOPS: ultrasound-guided popliteal sciatic blockDOPS: ultrasound-guided popliteal sciatic block and intraneural injection
  15. All 22 OSCE: actor and procedure stations cases
Scan stations20 images
How it works
  1. New: the full case with its notes. Read Know this first, then answer each question aloud before you press Show.
  2. From memory: the same patient days later, named by the patient, with the diagnosis and the notes hidden. Answer aloud, then press Show.
  3. Mark Got it only if you said every point. Again brings the case back tomorrow; Got it brings it back in 3, then 7, 14 and 30 days.
  4. Each question's label says what kind of question it is, in the sheets' colours:
    • Consider what it is
    • PreparePlanPerform what to do
    • Crisis what now
    • OpenExplainRespondClose an actor station's parts
  5. The fatal mistakes sit in a red block marked with crosses: red there means wrong, not a class.
  6. An answer names its layer where the layer changes: the patient, the stem trigger, the disease, the surgery, the airway, the crisis or after surgery.
  7. OSCE stations use their own parts: Open, Explain, Respond and Close for actor stations; Prepare, Perform and Crisis for procedures. Their lines are what you say to the actor (Communication) or the steps in order (Procedure step).
Settings

From 0 to 30. Reviews from memory always show, from every domain, so nothing you learned is skipped.

New cases come from
Order of new cases
Which cases

To add one case to today, open it and press Add to today. Settings are saved on this device. Reset puts them back and keeps the cases you added today.

Every answer names the books it was checked against. Each scan image carries its own credit.