100+ Free ABA Pediatric Anesthesiology Practice Questions

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Compared with an adult, where is the larynx located in a neonate?

At the level of C6-C7

At the level of C4-C5 (same as adult)

At the level of C3-C4 (more cephalad)

At the level of T1

to track

2026 Statistics

Key Facts: ABA Pediatric Anesthesiology Exam

200

Exam Items

ABA Pediatric Anesthesiology exam specifications

4 hrs

Exam Time

ABA Pediatric Anesthesiology exam page

$1,900

Standard Fee (2026)

ABA 2026 Exam Fee Schedule

Oct 10, 2026

2026 Exam Date

ABA Pediatric Anesthesiology exam page

12 mo

ACGME Fellowship Required

ABA Eligibility Policy

10 yr

Certification Cycle

ABA Continuing Certification (MOCA) program

The ABA Pediatric Anesthesiology exam is a 200-item computer-based test delivered in a 4-hour session at Pearson VUE. The 2026 standard registration fee is $1,900 (retake $1,615); late registration (Aug 13-27, 2026) is $2,400. The 2026 exam date is October 10, 2026. Candidates must hold ABA primary certification and have completed a 12-month ACGME-accredited pediatric anesthesiology fellowship. The exam uses a criterion-referenced passing standard set by content experts.

Sample ABA Pediatric Anesthesiology Practice Questions

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

1Compared with an adult, where is the larynx located in a neonate?

A.At the level of C6-C7

B.At the level of C4-C5 (same as adult)

C.At the level of C3-C4 (more cephalad)

D.At the level of T1

Explanation: The neonatal larynx sits at C3-C4, which is more cephalad than the adult position of C4-C5. This higher position, combined with a larger tongue and shorter neck, makes direct laryngoscopy more challenging and favors a straight (Miller) blade to lift the omega-shaped epiglottis.

2In a child younger than 10 years, what is the narrowest portion of the upper airway?

A.The glottic opening (vocal cords)

B.The cricoid cartilage

C.The oropharynx

D.The trachea at the level of the carina

Explanation: Traditionally taught as the functional narrowest point in children under 10, the cricoid ring is a complete, nonexpandable ring of cartilage. In adults the glottis is the narrowest point. This classic teaching guides ETT selection (to avoid mucosal pressure at the cricoid) even though modern MRI data show the glottis is also narrow in children.

3Using the Cole formula, what is the appropriate uncuffed endotracheal tube size for a 4-year-old child?

A.4.0 mm ID

B.4.5 mm ID

C.5.0 mm ID

D.5.5 mm ID

Explanation: Uncuffed ETT size = (age/4) + 4 = (4/4) + 4 = 5.0 mm internal diameter. For a cuffed tube, use (age/4) + 3.5 = 4.5 mm. Always have a size larger and smaller available, and confirm an appropriate leak at 20-25 cm H2O for uncuffed tubes.

4What is the estimated oxygen consumption (VO2) of a healthy neonate per kilogram per minute compared with an adult?

A.2 mL/kg/min vs 3.5 mL/kg/min in adults

B.3.5 mL/kg/min vs 6 mL/kg/min in adults

C.6 mL/kg/min vs 3.5 mL/kg/min in adults

D.10 mL/kg/min vs 6 mL/kg/min in adults

Explanation: Neonatal VO2 is approximately 6 mL/kg/min, nearly double the adult value of 3.5 mL/kg/min. Combined with a smaller functional residual capacity, this explains the rapid desaturation of infants during apnea and the need for meticulous preoxygenation.

5Which statement about closing capacity (CC) and functional residual capacity (FRC) in children is correct?

A.CC is always less than FRC throughout life

B.CC exceeds FRC during normal tidal breathing until approximately age 6

C.CC equals FRC at all ages

D.CC is only greater than FRC in adolescents

Explanation: In young children, closing capacity exceeds FRC during tidal breathing until about age 6, leading to airway closure, atelectasis, and ventilation-perfusion mismatch. This explains why infants and young children desaturate more rapidly during apnea despite breathing 100% oxygen.

6A 2-month-old former 32-week-premature infant is scheduled for inguinal hernia repair. What is the most important postoperative consideration?

A.Immediate discharge after recovery to minimize hospital exposure

B.Monitoring for at least 12-24 hours for apnea given postconceptual age <60 weeks

C.No special monitoring required

D.Mandatory postoperative mechanical ventilation

Explanation: Ex-premature infants younger than 60 weeks postconceptual age are at high risk for postoperative apnea and should be admitted for continuous apnea/bradycardia monitoring for 12-24 hours. Caffeine (10 mg/kg IV) may reduce apnea risk. Spinal anesthesia does not eliminate the risk.

7A 3-year-old with tetralogy of Fallot develops a Tet spell intraoperatively with cyanosis and hypotension. Which treatment is FIRST-line?

A.Nitroglycerin to decrease preload

B.Phenylephrine to increase systemic vascular resistance

C.Furosemide to decrease pulmonary edema

D.Epinephrine to increase inotropy

Explanation: Tet spells are caused by increased right-to-left shunting through the VSD when SVR drops or RVOT obstruction increases. Treatment: 100% O2, volume, knee-to-chest position, phenylephrine (to raise SVR and reverse the shunt), beta-blockade (esmolol) for RVOT spasm, and opioid or ketamine for sedation. Inotropes that increase contractility can worsen dynamic obstruction.

8Which stage of single-ventricle palliation for hypoplastic left heart syndrome is typically performed at 4-6 months of age?

A.Norwood procedure (Stage 1)

B.Bidirectional Glenn (Stage 2)

C.Fontan procedure (Stage 3)

D.Orthotopic heart transplant

Explanation: The bidirectional Glenn anastomoses the SVC to the pulmonary artery at 4-6 months, shifting from a Norwood shunt (BT or Sano) to a passive SVC-to-PA flow. The Fontan (IVC-to-PA) typically follows at 2-4 years once pulmonary vascular resistance is low enough to support completely passive flow.

9A 12-year-old develops masseter spasm, hypercarbia, and rising end-tidal CO2 shortly after receiving succinylcholine and sevoflurane. What is the FIRST-line treatment?

A.Dantrolene 2.5 mg/kg IV

B.Epinephrine 1 mg IV

C.Sodium bicarbonate 1 mEq/kg

D.Naloxone 0.4 mg IV

Explanation: Malignant hyperthermia treatment begins with dantrolene 2.5 mg/kg IV bolus, repeated to a total of 10 mg/kg or until the episode resolves. Simultaneously: stop triggers (sevoflurane, succinylcholine), hyperventilate with 100% O2 at high flows, cool the patient, treat hyperkalemia and acidosis, and call the MHAUS hotline (1-800-644-9737).

10Mutations in which gene are most commonly associated with malignant hyperthermia susceptibility?

A.SCN5A

B.RYR1 (ryanodine receptor 1)

C.LMNA

D.MYH7

Explanation: RYR1 mutations account for more than 70% of MH cases. A smaller proportion involve CACNA1S (L-type calcium channel). MH is autosomal dominant with variable penetrance. MH-associated myopathies include central core disease, multiminicore disease, and King-Denborough syndrome.

About the ABA Pediatric Anesthesiology Exam

The ABA Pediatric Anesthesiology Subspecialty Certification Exam certifies anesthesiologists with fellowship-level expertise in the perioperative care of neonates, infants, and children. The 200-item multiple-choice exam delivered at Pearson VUE covers neonatal airway and physiology, congenital heart disease, pediatric pharmacology, regional anesthesia, malignant hyperthermia, surgical emergencies (pyloric stenosis, CDH, NEC), NPO and fluid guidelines, pain assessment, and FDA neurotoxicity considerations.

Questions

200 scored questions

Time Limit

4 hours

Passing Score

Criterion-referenced (content-expert standard)

Exam Fee

$1,900 standard (Retake $1,615); Late $2,400 (ABA / Pearson VUE)

ABA Pediatric Anesthesiology Exam Content Outline

20%

Neonatal & Infant Anesthesia

Airway anatomy (larynx at C3-C4, cricoid narrowest in children <10 yr), ETT sizing (age/4+4 uncuffed, age/4+3.5 cuffed), short trachea, closing capacity > FRC until age 6, higher O2 consumption (6 mL/kg/min vs 3.5 adult), immature neuromuscular junction, and post-op apnea in ex-premature infants <60 weeks postconceptual age

18%

Congenital Heart Disease Anesthesia

Single-ventricle physiology (HLHS Norwood/Glenn/Fontan staging), tetralogy of Fallot with Tet spell management (phenylephrine to increase SVR, not just fluid), transposition of the great arteries, coarctation, atrioventricular canal, balanced Qp:Qs, and inhalational vs IV induction in CHD

14%

Pediatric Pharmacology & Agents

Sevoflurane as the most common inhalational induction agent, propofol infusion syndrome in prolonged high-dose pediatric sedation, ketamine for hemodynamically unstable patients, emergence delirium incidence and treatment, dexmedetomidine, MAC variation with age, and neuromuscular blocker pharmacokinetics

10%

Pediatric Regional Anesthesia

Caudal epidural block (0.5-1 mL/kg of 0.2% ropivacaine) for below-umbilicus surgery, ultrasound-guided peripheral nerve and fascial plane blocks, TAP blocks, spinal anesthesia in ex-premature infants, local anesthetic systemic toxicity dosing limits in children, and post-caudal motor weakness assessment

10%

Congenital & Pediatric Surgical Emergencies

Pyloric stenosis (hyperchloremic hypokalemic metabolic alkalosis requiring preoperative correction — it is a medical emergency, not a surgical one), necrotizing enterocolitis in premature neonates, congenital diaphragmatic hernia (permissive hypercapnia, avoid high peak airway pressures), gastroschisis, omphalocele, and tracheoesophageal fistula

10%

Pediatric Airway & Difficult Airway

Larger tongue-to-mouth ratio, cephalad larynx, omega-shaped epiglottis, short neck; Pierre Robin sequence, Treacher Collins, Goldenhar, Crouzon, and mucopolysaccharidoses; LMA use, video laryngoscopy, pediatric fiberoptic intubation, and differentiation of croup from epiglottitis

Malignant Hyperthermia & Inherited Disorders

Dantrolene 2.5 mg/kg IV bolus, repeat to a total of 10 mg/kg; RYR1 and CACNA1S gene mutations; remove triggers, hyperventilate with 100% O2, treat hyperkalemia and acidosis, contact the MHAUS hotline; MH-associated myopathies (central core disease, King-Denborough syndrome)

Pediatric Fluids, Blood & NPO

4-2-1 maintenance rule, avoidance of routine hypotonic maintenance fluids (hospital-acquired hyponatremia risk), D5LR for neonates requiring glucose, massive transfusion thresholds in children, and 2017 ASA fasting guidelines (2 h clear liquids, 4 h breast milk, 6 h formula/nonhuman milk/light meal, 8 h fatty meal)

Pediatric Pain Assessment & PACU

FLACC scale (2 months to 7 years), Faces pain scale (3-7 years), numeric rating scale (NRS) for age 7 and up with scores of 7 or more indicating moderate-to-severe pain, multimodal analgesia, opioid dosing, PONV prophylaxis, and differentiating emergence delirium from pain

Neurotoxicity, Ethics & Special Topics

FDA 2017 Drug Safety Communication on anesthetic and sedation drugs in children under 3 years for more than 3 hours; reassuring human cohort data from the GAS, PANDA, and MASK trials (SmartTots consortium); informed consent and assent, child abuse recognition, and pediatric advanced life support (PALS)

How to Pass the ABA Pediatric Anesthesiology Exam

What You Need to Know

Passing score: Criterion-referenced (content-expert standard)
Exam length: 200 questions
Time limit: 4 hours
Exam fee: $1,900 standard (Retake $1,615); Late $2,400

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 Pediatric Anesthesiology Study Tips from Top Performers

1Weight your study to the blueprint: neonatal and infant anesthesia (20%) plus congenital heart disease (18%) account for nearly 40% of the exam — master these first

2Memorize key pediatric formulas cold: ETT size (age/4+4 uncuffed, age/4+3.5 cuffed), maintenance fluids (4-2-1 rule), dantrolene dosing (2.5 mg/kg, to 10 mg/kg total), and caudal volume (0.5-1 mL/kg)

3Build an airway anatomy framework comparing infant vs adult: larynx at C3-C4 vs C4-C5, cricoid as narrowest point until age 10, larger tongue, omega-shaped epiglottis, and short trachea

4Drill single-ventricle staging (HLHS: Norwood, Glenn, Fontan) and Tet spell management (phenylephrine increases SVR — not fluid alone) until pattern recognition is instant

5Know the 2017 ASA NPO guidelines and D5LR rationale for neonates, and understand why routine hypotonic fluids cause hospital-acquired hyponatremia in children

6Use high-yield resources: Cote's Practice of Anesthesia for Infants and Children, the SPA review course, MHAUS guidelines, and the ABA sample questions PDF on theaba.org

Frequently Asked Questions

How many questions are on the ABA Pediatric Anesthesiology exam?

The ABA Pediatric Anesthesiology subspecialty exam is a 200-item multiple-choice test administered in a single 4-hour session at Pearson VUE test centers.

What score do I need to pass the ABA Pediatric Anesthesiology exam?

The ABA uses a criterion-referenced passing standard set by content experts who define the minimum competency required. There is no fixed percentage threshold published — the standard reflects the difficulty of the items on each form.

How much does the ABA Pediatric Anesthesiology exam cost in 2026?

Standard registration (June 17 to August 12, 2026) is $1,900 for first-time candidates and $1,615 for retakes. Late registration (August 13 to August 27, 2026) is $2,400 for first-time candidates and $2,115 for retakes.

What are the prerequisites for the ABA Pediatric Anesthesiology exam?

Candidates must hold active ABA primary certification in Anesthesiology (or be completing it in the same cycle), have completed a 12-month ACGME-accredited Pediatric Anesthesiology fellowship, and hold a valid unrestricted medical license in the U.S. or Canada with a program director attestation of competence.

When is the 2026 ABA Pediatric Anesthesiology exam?

The 2026 ABA Pediatric Anesthesiology subspecialty exam is offered on October 10, 2026, at Pearson VUE test centers across the U.S. and Canada.

What topics are tested on the ABA Pediatric Anesthesiology exam?

The blueprint emphasizes neonatal and infant anesthesia (airway, physiology), congenital heart disease, pediatric pharmacology, regional anesthesia, malignant hyperthermia, surgical emergencies (pyloric stenosis, CDH, NEC), NPO and fluid management, pain assessment, and FDA neurotoxicity guidance.

How much study time do pediatric anesthesiologists need for the ABA subspecialty exam?

Most fellowship graduates spend 200 to 300 hours over 4 to 8 months after fellowship completion, combining blueprint review (e.g., Cote's Practice of Anesthesia for Infants and Children), question banks, and SPA/ABA sample items.

Is the ABA Pediatric Anesthesiology exam the same as the primary anesthesiology boards?

No. This is a subspecialty certification offered after ABA primary certification. The primary anesthesiology pathway is the BASIC, ADVANCED, and APPLIED (OSCE + SOE) exams. Pediatric Anesthesiology is a separate 200-item subspecialty exam with its own blueprint.