Anesthesia Emergencies Practice Questions for AA Boards
Train the first minutes of an anesthesia emergency: recognize the pattern, remove the trigger, choose the immediate treatment, and avoid the distractors that delay definitive care.
Built for current AA students practicing rapid recognition and management of high-stakes intraoperative crises.
What you will practice
Local anesthetic systemic toxicity
Anaphylaxis and refractory hypotension
Venous air embolism
Severe bronchospasm
Malignant hyperthermia
Cardiac arrest and crisis resource management
What this resource helps you do
Recognize crisis patterns from short clinical stems
Prioritize the first definitive intervention
Expose emergency algorithms that need immediate review
Practice questions from this topic
A 60-kg adult develops severe cardiovascular instability from local anesthetic systemic toxicity. According to the ASRA 2020 checklist, what is the approximate initial IV bolus volume of 20% lipid emulsion?
30 mL
60 mL
90 mL
180 mL
Correct answer: C
For a patient under 70 kg, the ASRA checklist uses an initial 20% lipid emulsion bolus of approximately 1.5 mL/kg over 2–3 minutes: 60 × 1.5 = 90 mL. An infusion of approximately 0.25 mL/kg/min follows (15 mL/min here). Persistent instability may require another bolus and an increased infusion rate under the checklist. Lipid therapy accompanies airway support and modified resuscitation; it is not the entire treatment. The stated checklist maximum total lipid dose is 12 mL/kg.
An adult develops sudden hypoxemia and hypotension after air enters an open central venous catheter hub. The hub is immediately occluded. Which inspired-gas strategy is appropriate for suspected life-threatening venous air embolism?
Administer 100% oxygen and discontinue nitrous oxide if it is being used
Add nitrous oxide to accelerate bubble absorption
Reduce inspired oxygen to room air to avoid increasing bubble size
Withhold supplemental oxygen until embolism is confirmed by imaging
Correct answer: A
Administering 100% oxygen supports oxygenation and promotes nitrogen washout from air bubbles. Nitrous oxide can diffuse into and enlarge gas bubbles and should be stopped. Prevent further air entry, support circulation, and obtain expert help. The 2025 AHA guidance supports level positioning rather than routine head-down positioning; position must also allow effective CPR if arrest occurs. Hyperbaric oxygen evaluation is appropriate for life-threatening gas embolism.
Source: American Heart Association. 2025 Guidelines, Part 10: Adult and Pediatric Special Circumstances of Resuscitation, Gas Embolism. https://cpr.heart.org/en/resuscitation-science/cpr-and-ecc-guidelines/adult-and-pediatric-special-circumstances-of-resuscitation ; Association of Anaesthetists. Quick Reference Handbook, section 3-5 Circulatory embolus. https://anaesthetists.org/Portals/0/PDFs/QRH/QRH_complete_June_2023.pdf
An adult develops bronchospasm, urticaria, and hypotension shortly after an IV antibiotic. The antibiotic is stopped, help is called, oxygen and airway support are provided, and epinephrine treatment is underway. Blood pressure remains 70/40 mmHg and only a small maintenance volume of IV fluid has been given. Which additional intervention most directly addresses the circulatory problem?
Nebulized albuterol
IV diphenhydramine
IV methylprednisolone
A rapid IV crystalloid bolus with reassessment and further fluid as needed
Correct answer: D
Anaphylaxis causes vasodilation and rapid movement of fluid out of the circulation. Give IV crystalloid promptly alongside epinephrine; adult guidance describes an initial 500–1,000 mL bolus followed by reassessment and additional fluid according to response. Continue airway and circulatory support and escalate epinephrine treatment if shock persists. Albuterol can supplement treatment of bronchospasm but does not reverse shock. Antihistamines do not treat airway or circulatory compromise, and corticosteroids are not recommended routinely for acute anaphylaxis.
Source: Resuscitation Council UK. Emergency treatment of anaphylaxis (2021), fluid resuscitation and adjuncts. https://www.resus.org.uk/sites/default/files/2021-05/Emergency%20Treatment%20of%20Anaphylaxis%20May%202021_0.pdf ; RCUK FAQs: Anaphylaxis. https://www.resus.org.uk/professional-library/faqs/faqs-anaphylaxis
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Which anesthesia emergencies should AA students know cold?
Prioritize malignant hyperthermia, local anesthetic systemic toxicity, anaphylaxis, difficult ventilation, bronchospasm, venous air embolism, massive hemorrhage, equipment failure, and perioperative cardiac arrest.
Are these emergency questions from the Anesthesia Review question bank?
Yes. These previews are selected practice-bank questions with their original answer choices, explanations, and references.
What is the best way to study anesthesia crises?
Practice each crisis as a sequence: recognition clues, immediate actions, definitive treatment, dose or equipment details, team communication, and the next step if the patient does not improve.