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100+ Free AOBA Anesthesiology Practice Questions

Pass your AOBA Anesthesiology Certifying Examination exam on the first try — instant access, no signup required.

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~91.3% (5-yr aggregate) Pass Rate
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Which induction agent is most likely to suppress adrenocortical function via 11-beta-hydroxylase inhibition?

A
B
C
D
to track
2026 Statistics

Key Facts: AOBA Anesthesiology Exam

320

MCQs on Written Exam

AOBA Written Exam blueprint

500/800

Scaled Passing Score

AOBA scoring policy

$3,500

Total Exam Fees (W+O+C)

AOBA 2026 fee schedule

~91.3%

5-Yr Aggregate Pass Rate (Written)

AOBA published rate

42%

Physiologic Sciences (Largest Block)

AOBA Table of Specifications

300-500 hrs

Average Study Time

Anesthesia residents

AOBA's Primary Written Exam is one of three components (Written, Oral, Clinical) required for AOA board certification in anesthesiology. Of the ~320 MCQs, physiology and pharmacology dominate at 42% combined; clinical disease states and procedures at 33%; physics, anatomy, biochem, and math at 24%; and a small (1%) OPP component. AOBA's 5-year aggregate pass rate on the written exam is ~91.3%. Fees total ~$3,500 ($500 W + $1,000 O + $2,000 C). Continuous certification is via annual Longitudinal Assessment ($210/yr) on a 10-year cycle.

Sample AOBA Anesthesiology Practice Questions

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

1A healthy 35-year-old undergoes elective laparoscopic cholecystectomy under general anesthesia with sevoflurane. What is the approximate MAC value for sevoflurane in a healthy adult?
A.1.15%
B.2.0%
C.6.0%
D.104%
Explanation: The MAC (minimum alveolar concentration) of sevoflurane in 100% oxygen for a healthy adult is approximately 2.0%. MAC is the alveolar concentration at which 50% of patients fail to move to a standard surgical stimulus.
2Which of the following factors INCREASES MAC?
A.Pregnancy
B.Hypothermia
C.Chronic alcoholism
D.Acute opioid administration
Explanation: Chronic alcoholism increases MAC due to upregulation of GABA receptors and cross-tolerance. Acute alcohol intoxication, by contrast, decreases MAC.
3A 60-year-old man develops bradycardia and hypotension after rocuronium reversal. The intensivist gave neostigmine without glycopyrrolate. What is the primary mechanism of this adverse response?
A.Nicotinic blockade
B.Muscarinic stimulation
C.Histamine release
D.Direct beta-receptor inhibition
Explanation: Neostigmine inhibits acetylcholinesterase, increasing acetylcholine at both nicotinic and muscarinic receptors. Unopposed muscarinic stimulation causes bradycardia, salivation, bronchoconstriction, and miosis. Glycopyrrolate or atropine must be co-administered.
4What is the recommended sugammadex dose for reversal of profound rocuronium block (no train-of-four twitches, post-tetanic count 1-2)?
A.2 mg/kg
B.4 mg/kg
C.8 mg/kg
D.16 mg/kg
Explanation: Sugammadex 16 mg/kg is recommended for immediate reversal of profound rocuronium-induced blockade (e.g., 'cannot intubate, cannot ventilate' rescue). 4 mg/kg is used for deep block (PTC 1-2 with no TOF twitches in routine reversal); 2 mg/kg for moderate (TOF count 2+).
5A patient develops seizures and ventricular arrhythmias after a femoral nerve block with bupivacaine. What is the FIRST-line definitive treatment?
A.Lidocaine bolus
B.Amiodarone 300 mg IV
C.20% Intralipid 1.5 mL/kg bolus
D.Phenytoin loading dose
Explanation: This is local anesthetic systemic toxicity (LAST). ASRA recommends 20% lipid emulsion (Intralipid) 1.5 mL/kg bolus followed by 0.25 mL/kg/min infusion. Lipid scavenges lipophilic bupivacaine from cardiac sodium channels. Standard ACLS modifications apply: avoid lidocaine, reduce epinephrine to <1 mcg/kg.
6Which volatile anesthetic has the LOWEST blood-gas partition coefficient and therefore the fastest onset/offset?
A.Isoflurane
B.Sevoflurane
C.Desflurane
D.Halothane
Explanation: Desflurane has the lowest blood-gas partition coefficient (~0.42), giving it the fastest induction and emergence. Lower blood solubility means faster equilibration between alveolar and brain partial pressures.
7A 28-year-old develops masseter rigidity and rapidly rising end-tidal CO2 after succinylcholine + sevoflurane induction. Temperature is 39.5C. What is the appropriate dose of dantrolene?
A.0.5 mg/kg IV
B.2.5 mg/kg IV
C.10 mg/kg IV
D.20 mg/kg IV
Explanation: This is malignant hyperthermia. Initial dantrolene dose is 2.5 mg/kg IV, repeated every 5-10 minutes (up to 10 mg/kg total) until symptoms resolve. Discontinue triggering agents, hyperventilate with 100% O2, cool the patient, and treat hyperkalemia and acidosis.
8Which induction agent is most likely to suppress adrenocortical function via 11-beta-hydroxylase inhibition?
A.Propofol
B.Etomidate
C.Ketamine
D.Midazolam
Explanation: Etomidate inhibits 11-beta-hydroxylase, suppressing cortisol synthesis. A single dose can cause adrenal suppression for 24-48 hours and is associated with increased mortality in septic shock. It is otherwise hemodynamically stable.
9What is the most common cardiovascular effect of propofol induction in a hemodynamically stable adult?
A.Hypertension and tachycardia
B.Hypotension and bradycardia
C.Reflex tachycardia and hypotension
D.No significant change
Explanation: Propofol causes hypotension primarily from systemic vasodilation (decreased SVR) and modest myocardial depression. Unlike other agents, propofol blunts the baroreceptor reflex, so reflex tachycardia is attenuated or absent.
10A 24-year-old G1P0 at 37 weeks presents for cesarean delivery under spinal anesthesia. Which dermatome level is the MINIMUM acceptable block height to ensure adequate surgical anesthesia?
A.T10
B.T8
C.T6
D.T4
Explanation: Adequate spinal block for cesarean delivery requires sensory anesthesia to T4 (nipple level) to cover peritoneal traction and uterine exteriorization. T10 is sufficient only for vaginal delivery.

About the AOBA Anesthesiology Exam

The AOBA Anesthesiology Certifying Examination is the primary written component of AOA osteopathic board certification in anesthesiology. The written exam consists of 320 multiple-choice questions over four 90-minute sections, covering Physiologic Sciences (42%), Physical Sciences (24%), Clinical Sciences (33%), and Osteopathic Principles & Practice (1%). Passing the Written, Oral, and Clinical exams is required for primary certification. Candidates must complete the Clinical Base Year and CA-1 of an accredited anesthesiology residency before sitting for the written exam.

Questions

320 scored questions

Time Limit

6 hours testing (four 90-minute sections) plus ~30 minutes of breaks

Passing Score

Scaled score 500/800 on each component (Written, Oral, Clinical)

Exam Fee

$500 Written + $1,000 Oral + $2,000 Clinical (AOBA 2026) (American Osteopathic Board of Anesthesiology (AOBA))

AOBA Anesthesiology Exam Content Outline

22%

Pharmacology

IV induction (propofol, etomidate, ketamine), volatile MAC values, NMBA pharmacology and sugammadex (16 mg/kg deep block, 4 mg/kg moderate, 2 mg/kg reappearance T2), opioid PK, local anesthetic toxicity (LAST: 20% Intralipid 1.5 mL/kg bolus + 0.25 mL/kg/min), MH and dantrolene 2.5 mg/kg, anticoagulants for neuraxial (ASRA guidelines).

20%

Physiology

Cardiac output determinants, oxyhemoglobin curve shifts (Bohr), V/Q mismatch and shunt physiology, CPP = MAP - ICP, autoregulation, autonomic reflexes (Bainbridge, oculocardiac), neuromuscular junction, fluid compartments, acid-base (Henderson-Hasselbalch, anion gap), renal handling of K+/Mg2+/Ca2+.

22%

Disease States

CAD/valves (severe AS Vmax >=4, HCM, MR), reactive airways and OSA (STOP-BANG), diabetes (DKA, perioperative GLP-1), pregnancy physiology + preeclampsia, end-stage renal/hepatic, obesity ramped position, trauma (massive transfusion 1:1:1), sepsis (vasopressor choice), MG/MD/myotonia, peds syndromes (Down, T21), and increased ICP.

13%

Physics & Equipment

Anesthesia machine checkout, variable-bypass vaporizers (desflurane heated), Mapleson circuit efficiencies (D for controlled, A for spontaneous), CO2 absorber chemistry (compound A, carbon monoxide), scavenging, electrosurgery and pacemaker interference, ultrasound physics for blocks/lines, MAC and partition coefficients.

11%

Procedures & Regional Techniques

ASA difficult airway algorithm, awake fiberoptic, video laryngoscopy, neuraxial dermatomes (T4 for C-section, T10 for vaginal delivery), brachial plexus blocks (interscalene -> shoulder/sparing ulnar; supraclavicular -> arm; infraclavicular; axillary), TAP/QL/ESP, ankle block branches, OB epidural (test dose 3 mL 1.5% lido + epi).

8%

Subspecialty (OB, Peds, Cardiac, Neuro)

Maternal physiologic changes (CO +50%, MAC -30%, FRC -20%), preeclampsia mag sulfate (1-2 g/hr), peds airway (cuffed ETT formula (age/4)+3.5), MH triggers in peds, cardiac (CPB, protamine reaction), one-lung ventilation, neuro (volatile cap at 1 MAC, mannitol 0.25-1 g/kg).

3%

ICU, Pain & OMM

ARDS lung-protective (Vt 4-8 mL/kg PBW, plateau <30, PEEP), sepsis 1-hour bundle, vasopressor selection, chronic pain (multimodal, ketamine/dexmedetomidine, neuropathic pain pharmacology), interventional pain basics, and OPP/OMM in PACU (rib raising for atelectasis, sub-occipital release for PDPH).

How to Pass the AOBA Anesthesiology Exam

What You Need to Know

  • Passing score: Scaled score 500/800 on each component (Written, Oral, Clinical)
  • Exam length: 320 questions
  • Time limit: 6 hours testing (four 90-minute sections) plus ~30 minutes of breaks
  • Exam fee: $500 Written + $1,000 Oral + $2,000 Clinical (AOBA 2026)

Keys to Passing

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

AOBA Anesthesiology Study Tips from Top Performers

1Master MAC and pharmacokinetics: MAC values (Iso 1.15, Sevo 2.0, Des 6.0, N2O 104), MAC modifiers (age -6%/decade above 40, opioids/benzos/hypothermia/pregnancy decrease MAC; chronic alcohol/red hair increase MAC). Drill induction agent doses, NMBA reversal (sugammadex 16 mg/kg deep, 4 mg/kg moderate, 2 mg/kg T2 reappearance vs neostigmine + glyco).
2Memorize LAST treatment (20% Intralipid 1.5 mL/kg bolus then 0.25 mL/kg/min for >=10 min, max 12 mL/kg), MH protocol (dantrolene 2.5 mg/kg IV q5-10 min, cool, treat hyperK), and ASRA neuraxial-anticoagulation intervals (unfractionated SQ heparin no delay; LMWH prophylactic 12h, therapeutic 24h; rivaroxaban 72h; warfarin INR <=1.5).
3Drill regional anesthesia anatomy: interscalene block covers shoulder but spares ulnar (C8-T1), supraclavicular = arm + risk of pneumothorax, infraclavicular = elbow/forearm, axillary = forearm/hand (spares musculocutaneous unless coracobrachialis injection), TAP covers T10-L1 anterior abdominal wall, ankle block 5 nerves (deep peroneal, superficial peroneal, sural, saphenous, posterior tibial).
4Internalize OB anesthesia high-yield: maternal CO +50%, MAC -30%, FRC -20%, full stomach by 18 weeks; spinal C-section level T4; epidural test dose 3 mL 1.5% lidocaine + 1:200K epi (HR rise = intravascular, motor block = intrathecal); preeclampsia magnesium 4-6 g load + 1-2 g/hr; HELLP platelets and neuraxial; pediatric ETT (age/4)+3.5 cuffed, (age/4)+4 uncuffed.
5Practice the anesthesia machine + circuits: variable-bypass vaporizer principles (desflurane is heated/pressurized due to low BP), Mapleson D efficient for controlled ventilation, Mapleson A for spontaneous, compound A risk with sevo + dry CO2 absorber, CO production with desflurane + dry barium hydroxide lime, electrical safety (LIM line isolation monitor, microshock 0.1 mA into heart), and ultrasound physics (higher MHz = better resolution, less depth).
6Don't skip OPP/OMM (~1%) - it's free points. Know rib-raising for post-op atelectasis/ileus, suboccipital decompression and venous sinus drainage for PDPH, lymphatic pump for ileus and immune support, paraspinal inhibition for back pain, and somatic dysfunction at viscerosomatic levels (T1-T4 cardiac, T2-T7 pulmonary, T10-L2 renal/GU).

Frequently Asked Questions

Who is eligible for the AOBA Anesthesiology certifying examination?

Candidates must be DO or MD graduates of an accredited medical school, hold an unrestricted state medical license, and have completed (or be in the final year of) an accredited anesthesiology residency. The written exam can be taken after completing the Clinical Base Year and the CA-1 year. Program directors must attest to satisfactory clinical competence. Passing all three components (Written, Oral, Clinical) is required for primary certification.

How is the AOBA Anesthesiology Written Exam structured?

The written exam consists of 320 single-best-answer multiple-choice questions delivered in four ~80-question sections of 90 minutes each (6 hours of testing, ~30 minutes of breaks). It is offered annually (typically August) via remote proctoring. The blueprint allocates 42% to Physiologic Sciences (physiology 20%, pharmacology 22%), 24% to Physical Sciences (anatomy 8%, biochemistry 1%, physics 13%, math 2%), 33% to Clinical Sciences (procedures/techniques 11%, disease states 22%), and 1% to Osteopathic Principles & Practice.

What is the fee for the AOBA Anesthesiology exam?

The AOBA Primary Written Exam fee is $500. The Oral Exam is $1,000, and the Clinical Exam is $2,000 - totaling approximately $3,500 in AOBA fees for primary certification (2026 rates; confirm current fees with AOBA). A 30% late surcharge applies to applications received after the first deadline. Continuous certification via Longitudinal Assessment is $210 per year.

What is the passing score on the AOBA Written Exam?

AOBA uses a 200-800 scaled score system. A scaled score of 500 or higher is required to pass the written exam, and the same threshold applies to the Oral and Clinical components. The standard is criterion-referenced (Angoff-based), so the passing scaled score corresponds to a fixed level of competency rather than a fixed percentile.

What is the pass rate on the AOBA Written Exam?

AOBA publishes a five-year aggregate first-attempt pass rate of approximately 91.3% on the Primary Written Exam. Rates for the Oral and Clinical components vary; the Oral exam in particular has historically had a lower first-attempt rate. Repeat candidates have markedly lower rates, so robust first-attempt prep is strongly encouraged.

How long should I study for the AOBA Anesthesiology Written Exam?

Most candidates report 300-500 hours of dedicated prep across the CA-1 and CA-2 years. A typical plan allocates ~40% to physiology/pharmacology, ~25% to physics/equipment/anatomy, ~25% to disease states and procedures (regional, OB, peds, cardiac, ICU), and ~10% to mixed timed practice. Daily question-bank practice (50-100/day in the final 8 weeks) correlates strongly with passing.

How is continuous certification maintained after passing AOBA boards?

AOBA replaced the traditional 10-year recertification exam with the Longitudinal Assessment (LA) - an annual untimed online question set delivered each year of a 10-year cycle. The LA fee is $210 per year. Diplomates also complete the four-component Osteopathic Continuous Certification (OCC) program (licensure, lifelong learning/CME, cognitive assessment, performance in practice).

How much does the AOBA exam emphasize Osteopathic Principles & Practice (OPP/OMM)?

Only ~1% of the AOBA Written Exam is dedicated explicitly to Osteopathic Principles & Practice. High-yield OMM topics relevant to anesthesia include rib-raising for postoperative atelectasis, suboccipital decompression and venous sinus techniques for post-dural-puncture headache, lymphatic pump for ileus, and somatic dysfunction recognition in chronic pain patients. Don't ignore it - it's only a few questions but they are easy points.