100+ Free ABA Critical Care Practice Questions

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Question 1

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A patient in the ICU has a cardiac index of 2.0 L/min/m2, CVP of 18 mmHg, SVR of 1800 dyn·s/cm5, and cool extremities. Which type of shock is most consistent with this hemodynamic profile?

Cardiogenic shock

Distributive (septic) shock

Hypovolemic shock

Neurogenic shock

to track

2026 Statistics

Key Facts: ABA Critical Care Exam

200

Exam Questions

ABA 2026

4 hours

Exam Duration

ABA 2026

$1,900

Standard Registration Fee

ABA 2026

~85-90%

First-Attempt Pass Rate

ABA Assessment Results

12 months

ACCM Fellowship Required

ACGME

Oct 3, 2026

Next Exam Date

ABA 2026

The ABA Critical Care Medicine subspecialty exam certifies anesthesiologists to practice as adult intensivists. It consists of 200 single-best-answer (A-type) multiple-choice questions and is administered over 4 hours at Pearson VUE testing centers. The 2026 exam is scheduled for October 3, 2026, with standard registration June 10-August 5. The registration fee is $1,900 standard or $2,400 late, with a retake fee of $1,615. Eligibility requires completion of an ACGME-accredited ACCM fellowship (12 months) plus active ABA primary certification or candidacy. The same exam content is taken by ABIM, ABEM, and ABS CCM candidates under ABMS reciprocity. Topic blueprint emphasizes shock, sepsis (Surviving Sepsis 2021), ARDS (Berlin criteria and lung-protective ventilation), AKI, neurocritical care, and end-of-life practice.

Sample ABA Critical Care Practice Questions

Try these sample questions to test your ABA Critical Care exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A patient in the ICU has a cardiac index of 2.0 L/min/m2, CVP of 18 mmHg, SVR of 1800 dyn·s/cm5, and cool extremities. Which type of shock is most consistent with this hemodynamic profile?

A.Cardiogenic shock

B.Distributive (septic) shock

C.Hypovolemic shock

D.Neurogenic shock

Explanation: Cardiogenic shock is characterized by low cardiac output (CI <2.2 L/min/m2), high filling pressures (CVP >15 mmHg, PCWP >18 mmHg), and high SVR due to compensatory vasoconstriction. Cool, clamped extremities reflect poor perfusion. Distributive shock shows low SVR and typically high or normal CO. Hypovolemic shock shows low CVP. Neurogenic shock shows low SVR from loss of sympathetic tone.

2Which finding best distinguishes distributive shock from hypovolemic shock on bedside hemodynamic assessment?

A.Low systemic vascular resistance with warm extremities

B.Low CVP

C.Elevated lactate

D.Tachycardia

Explanation: Distributive shock (sepsis, anaphylaxis, neurogenic) is defined by pathologic vasodilation — low SVR with typically preserved or elevated cardiac output producing warm, well-perfused extremities despite hypotension. Hypovolemic shock produces high SVR and cool extremities. Low CVP, elevated lactate, and tachycardia occur in both.

3According to the Surviving Sepsis Campaign 2021 1-hour bundle, which of the following is required for a patient with septic shock and lactate of 5 mmol/L?

A.30 mL/kg IV crystalloid plus broad-spectrum antibiotics within 1 hour

B.Immediate initiation of norepinephrine before fluid resuscitation

C.Central venous pressure target of 8-12 mmHg

D.Transfuse to hemoglobin >10 g/dL

Explanation: The SSC 2021 1-hour bundle for septic shock or sepsis-induced hypoperfusion (lactate ≥4 or hypotension) requires: measure lactate, obtain blood cultures before antibiotics, administer broad-spectrum antibiotics within 1 hour, administer 30 mL/kg crystalloid within 3 hours for hypotension or lactate ≥4, and start vasopressors for MAP ≥65 if hypotension persists. CVP-guided resuscitation and restrictive Hgb (7 g/dL, not 10) are not current standards.

4A patient with septic shock remains hypotensive (MAP 58 mmHg) on norepinephrine 0.5 mcg/kg/min. What is the next most appropriate step per SSC 2021?

A.Add vasopressin 0.03 U/min

B.Add phenylephrine 0.5 mcg/kg/min

C.Switch to dopamine

D.Add dobutamine

Explanation: The Surviving Sepsis Campaign 2021 recommends adding vasopressin (fixed dose 0.03 U/min) as the second-line agent when norepinephrine alone is insufficient to maintain MAP ≥65 mmHg. Vasopressin spares catecholamines and acts via V1 receptors. Epinephrine is typically added third if MAP remains inadequate. Dopamine is no longer preferred because of increased arrhythmia risk. Dobutamine is an inotrope for suspected cardiac dysfunction, not a first-line vasopressor.

5A patient with septic shock on norepinephrine 0.6 mcg/kg/min and vasopressin 0.03 U/min remains hypotensive. When should hydrocortisone 200 mg/day be started per SSC 2021?

A.When norepinephrine ≥0.25 mcg/kg/min has been required for at least 4 hours

B.Only after a positive ACTH stimulation test

C.Routinely in all septic shock patients at diagnosis

D.Only if serum cortisol is <5 mcg/dL

Explanation: SSC 2021 suggests IV hydrocortisone 200 mg/day (either 50 mg every 6 hours or continuous infusion) for adult patients with septic shock requiring ongoing vasopressor therapy — typically when norepinephrine ≥0.25 mcg/kg/min has been required for at least 4 hours to maintain MAP ≥65 mmHg. ACTH stimulation testing is not required before initiation, and routine use in all septic shock patients is not recommended.

6According to the Berlin definition, moderate ARDS is defined by which PaO2/FiO2 ratio (with PEEP ≥5 cmH2O)?

A.100-200

B.200-300

C.50-100

D.<50

Explanation: The Berlin definition classifies ARDS severity by PaO2/FiO2 ratio with PEEP ≥5 cmH2O: mild (200-300), moderate (100-200), and severe (≤100). All categories require bilateral infiltrates, respiratory failure not fully explained by cardiac failure, and onset within 1 week of insult.

7A 70-kg patient with ARDS is being ventilated. What tidal volume target reflects lung-protective ventilation based on ideal body weight?

A.280-420 mL (4-6 mL/kg IBW)

B.490-560 mL (7-8 mL/kg IBW)

C.700-840 mL (10-12 mL/kg IBW)

D.850-1000 mL

Explanation: Lung-protective ventilation in ARDS uses tidal volumes of 4-6 mL/kg of ideal body weight (IBW, not actual weight). For a patient with IBW of 70 kg, this is 280-420 mL. Plateau pressures should be kept ≤30 cmH2O. This strategy reduces ventilator-induced lung injury and mortality, as shown in the ARDSNet trial.

8A patient with severe ARDS (PF 80) is being mechanically ventilated. Which intervention is most strongly supported by evidence for improving mortality?

A.Prone positioning for 12-16 hours per day

B.Inhaled nitric oxide

C.High-dose corticosteroids

D.High-frequency oscillatory ventilation (HFOV)

Explanation: The PROSEVA trial demonstrated that prone positioning for 12-16 hours per day in patients with severe ARDS (PF <150) significantly reduces mortality. Inhaled nitric oxide improves oxygenation transiently but has no mortality benefit. HFOV (OSCILLATE/OSCAR trials) was harmful. Corticosteroids have mixed evidence and are not standard of care for all ARDS.

9Which plateau pressure target should not be exceeded during lung-protective ventilation in ARDS?

A.30 cmH2O

B.35 cmH2O

C.40 cmH2O

D.45 cmH2O

Explanation: Plateau pressure should be kept ≤30 cmH2O during lung-protective ventilation to minimize alveolar overdistension and ventilator-induced lung injury. Plateau pressure is measured during an end-inspiratory hold when flow is zero and reflects alveolar distension. Higher plateau pressures (>30) are associated with increased mortality.

10Per KDIGO criteria, stage 2 acute kidney injury requires which of the following?

A.Serum creatinine increase 2.0-2.9 times baseline OR urine output <0.5 mL/kg/hr for ≥12 hours

B.Serum creatinine increase 1.5-1.9 times baseline

C.Serum creatinine increase 3.0 times baseline

D.Serum creatinine increase ≥4 mg/dL

Explanation: KDIGO AKI staging: Stage 1 — creatinine 1.5-1.9× baseline or ≥0.3 mg/dL increase, or urine output <0.5 mL/kg/hr for 6-12 hours. Stage 2 — creatinine 2.0-2.9× baseline, or urine output <0.5 mL/kg/hr for ≥12 hours. Stage 3 — creatinine 3.0× baseline, ≥4.0 mg/dL absolute, initiation of RRT, or urine output <0.3 mL/kg/hr for ≥24 hours or anuria for ≥12 hours.

About the ABA Critical Care Exam

The ABA Critical Care Medicine (CCM) exam is the subspecialty board certification for anesthesiologists who have completed an ACGME-accredited Anesthesiology Critical Care Medicine (ACCM) fellowship. The same content examination is used by ABIM, ABEM, and ABS for their respective CCM certification pathways under American Board of Medical Specialties standards. The exam covers adult ICU management across cardiovascular, pulmonary, infectious, renal, neurologic, GI, hematologic, and ethical domains.

Questions

200 scored questions

Time Limit

4 hours (computer-based)

Passing Score

Criterion-referenced scaled passing score

Exam Fee

$1,900 standard / $2,400 late (American Board of Anesthesiology (ABA))

ABA Critical Care Exam Content Outline

22%

Cardiovascular

Shock classification (distributive, cardiogenic, hypovolemic, obstructive), vasopressors, inotropes, ACLS, post-arrest TTM, mechanical circulatory support

20%

Pulmonary

ARDS (Berlin criteria), lung-protective ventilation 4-6 mL/kg IBW, plateau pressure ≤30, proning, APRV, weaning/SBT, VV-ECMO

14%

Infectious Disease & Sepsis

Surviving Sepsis 2021 1-hour bundle, vasopressor escalation, septic shock adjuncts, VAP and CLABSI bundles

10%

Renal & Acid-Base

KDIGO AKI staging, RRT indications (AEIOU), CRRT vs IHD, electrolyte emergencies, acid-base interpretation

Neurocritical Care

Elevated ICP management, TBI, stroke, status epilepticus, brain death and apnea testing

GI, Hepatic & Endocrine

Acute liver failure, pancreatitis, GI bleeding, abdominal compartment syndrome, DKA/HHS, adrenal insufficiency, glycemic control

Hematology & Transfusion

Restrictive Hgb 7 g/dL (TRICC), massive transfusion, DIC, HIT, anticoagulant reversal, VTE prophylaxis

Nutrition & Sedation

Early enteral nutrition (24-48 hr), protein 1.2-2.0 g/kg/d, analgesia-first sedation, CAM-ICU delirium, dexmedetomidine

Ethics, End-of-Life & Administration

Brain death, goals-of-care, futility, DNR/DNI, palliative transitions, ICU quality metrics

How to Pass the ABA Critical Care Exam

What You Need to Know

Passing score: Criterion-referenced scaled passing score
Exam length: 200 questions
Time limit: 4 hours (computer-based)
Exam fee: $1,900 standard / $2,400 late

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

ABA Critical Care Study Tips from Top Performers

1Memorize the Surviving Sepsis Campaign 2021 1-hour bundle cold: remeasure lactate, blood cultures before antibiotics, broad-spectrum antibiotics within 1 hour, 30 mL/kg crystalloid for hypotension or lactate ≥4, and norepinephrine for MAP ≥65 mmHg after fluid resuscitation

2Know septic shock vasopressor escalation in order: norepinephrine first, add vasopressin 0.03 U/min, add epinephrine if refractory, start hydrocortisone 200 mg/day if still requiring vasopressors — this is highest-yield on the exam

3Master the Berlin ARDS criteria (mild PF 200-300, moderate 100-200, severe <100) and lung-protective ventilation targets: TV 4-6 mL/kg ideal body weight, plateau pressure ≤30 cmH2O, prone positioning 12-16 hours for PF<150, NMB early in severe ARDS

4Differentiate the four shock categories using SvO2, lactate, CO/CVP pattern, and SVR — distributive (warm, low SVR, high CO), cardiogenic (cold, high SVR, low CO, high CVP), hypovolemic (cold, high SVR, low CO, low CVP), obstructive (cold, high CVP, tamponade/PE/tension PTX)

5Know the elevated ICP management ladder: HOB 30°, sedation and analgesia, hypertonic saline 23.4% 30 mL bolus or mannitol 1 g/kg, CSF drainage via EVD, then decompressive craniectomy — hyperventilation only as temporizing rescue (PaCO2 30-35)

6Practice RRT indication recognition using AEIOU: Acidosis, Electrolytes (hyperkalemia), Ingestions (toxic), Overload (volume), Uremia. Know when to choose CRRT (hemodynamically unstable, elevated ICP) vs intermittent hemodialysis (stable, acute poisoning)

7Review brain death determination: prerequisite normothermia/normotension/no confounders, absent brainstem reflexes, apnea test with PaCO2 rise ≥20 mmHg (or ≥60 mmHg absolute) without spontaneous respiration — ancillary tests (EEG, cerebral angiography) only if apnea test cannot be completed

8Use the ABCDEF bundle for ICU liberation: Assess/treat pain, Both SAT and SBT, Choice of analgesia/sedation (avoid benzos, prefer dexmedetomidine or propofol), Delirium (CAM-ICU screening), Early mobility, Family engagement

Frequently Asked Questions

Who can take the ABA Critical Care Medicine exam?

Candidates must be board-eligible or board-certified anesthesiologists who have completed an ACGME-accredited Anesthesiology Critical Care Medicine (ACCM) fellowship (typically 12 months). The ABA also accepts certain combined training pathways. Physicians from internal medicine, emergency medicine, or surgery with completed CCM fellowships take the same content examination but apply through their parent board (ABIM, ABEM, or ABS).

How is the ABA CCM exam structured?

The Critical Care Medicine exam contains 200 single-best-answer (A-type) multiple-choice questions administered over 4 hours at Pearson VUE computer-based testing centers. Questions emphasize application of knowledge to clinical scenarios rather than simple recall. The 2026 exam is scheduled for October 3, 2026.

Is the ABA CCM exam the same as the ABIM Critical Care exam?

The ABA, ABIM, ABEM, and ABS all recognize Critical Care Medicine as a subspecialty under ABMS. The content examination is functionally the same across boards — qualified diplomates from the ABA and other Member Boards take the same exam for their subspecialty and are held to the same passing standard. Candidates apply through their primary certifying board.

What is the passing score for the ABA CCM exam?

The ABA uses a criterion-referenced scaled passing score set through standard-setting methodology. The passing score is not publicly disclosed as a percentage. Historical first-time pass rates are approximately 85-90% for anesthesiology CCM candidates who completed an ACGME fellowship, per published ABA annual assessment results.

How much does the ABA CCM exam cost?

The 2026 registration fee is $1,900 for standard registration (June 10 - August 5, 2026) and $2,400 for late registration (August 6-20, 2026). Retake fees are $1,615 standard and $2,115 late. Total preparation cost including review courses and textbooks typically ranges from $2,500 to $4,500.

What topics are emphasized on the ABA CCM exam?

The blueprint emphasizes Cardiovascular (22%), Pulmonary (20%), Infectious Disease & Sepsis (14%), Renal & Acid-Base (10%), Neurocritical Care (8%), GI/Hepatic/Endocrine (8%), Hematology & Transfusion (6%), Nutrition & Sedation (6%), and Ethics/End-of-Life/Administration (6%). Shock, Surviving Sepsis Campaign 2021, ARDS lung-protective ventilation, and brain death determination are high-yield topics.

How do I maintain ABA CCM certification?

ABA CCM diplomates participate in MOCA 2.0 continuous certification for the primary anesthesiology certification plus subspecialty maintenance activities including the MOCA-Minute Critical Care questions, patient safety requirements, and practice performance assessment. The subspecialty cycle is 10 years with annual activities.

How long should I study for the ABA Critical Care Medicine exam?

Most candidates study 200-400 hours over 6-12 months in parallel with their ACCM fellowship. Preparation typically combines the SCCM Comprehensive Critical Care Review course, Marino's ICU Book, Surviving Sepsis Campaign guidelines, SCCM/ACCP board review questions, and case-based bedside learning. Your ACCM clinical volume is the strongest predictor of exam success.