100+ Free Facharzt FMH Anästhesiologie Practice Questions

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2026 Statistics

Key Facts: Facharzt FMH Anästhesiologie Exam

EDAIC + SSAPM

Exam Format

SIWF / SSAPM Examination Regulations

120

Written EDAIC MCQs

ESAIC / SSAPM Examination Committee

5 Years

Postgraduate Training

SIWF Weiterbildungsprogramm

180 min

Written Exam Duration

EDAIC Part 1 Standard

Lifetime

FMH Title Validity

Swiss Medical Association (FMH)

100

Practice Questions

OpenExamPrep

The Facharzt FMH Anästhesiologie credential certifies specialist anesthesiologists in Switzerland through SIWF and SSAPM. Examination assessment comprises the written European EDAIC Part 1 examination (120 MCQs) and the SSAPM structured oral clinical board, covering anesthetic pharmacology, subspecialty anesthesia, difficult airway management, critical care, and crisis protocols.

Sample Facharzt FMH Anästhesiologie Practice Questions

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

1A 45-year-old patient is undergoing general anesthesia maintained with desflurane in an oxygen/air mixture. Which of the following physical and pharmacological properties is characteristic of desflurane compared to sevoflurane and isoflurane?

A.Lowest blood:gas partition coefficient (~0.42), resulting in the fastest alveolar wash-in and wash-out kinetics

B.Highest oil:gas partition coefficient, resulting in the lowest minimum alveolar concentration (MAC)

C.High boiling point of 58.5°C, allowing administration through standard unheated tec vaporizers

D.Absence of airway irritation when administered in high concentrations during mask induction

Explanation: Desflurane has a very low blood:gas partition coefficient of approximately 0.42 (compared to ~0.65 for sevoflurane and ~1.4 for isoflurane), which confers rapid induction and emergence kinetics. Because of its high vapor pressure and boiling point near room temperature (22.8°C), desflurane requires a specialized heated, pressurized vaporizer (Tec 6 / D-Vapor). It is pungent and causes airway irritation, making it unsuitable for inhalational induction.

2A 58-year-old male with severe ischemic cardiomyopathy (LVEF 22%) presents for urgent bowel obstruction repair. The anesthesiologist selects etomidate for induction of general anesthesia. What is the primary endocrine consideration associated with even a single induction dose of etomidate?

A.Immediate suppression of thyroid-stimulating hormone (TSH) secretion lasting 48 hours

B.Reversible inhibition of 11-beta-hydroxylase, leading to transient adrenocortical suppression

C.Profound stimulation of aldosterone synthase, causing acute hyperkalemia and metabolic acidosis

D.Irreversible destruction of the adrenal cortex, requiring lifelong mineralocorticoid replacement

Explanation: Etomidate is an imidazole derivative that provides exceptional cardiovascular stability but causes dose-dependent, reversible inhibition of 11-beta-hydroxylase (the enzyme converting 11-deoxycortisol to cortisol and 11-deoxycorticosterone to corticosterone). A single induction dose can suppress the adrenocortical stress response for 6 to 24 hours.

3During elective laparoscopic cholecystectomy in a 70 kg patient, neuromuscular monitoring is performed using quantitative acceleromyography on the adductor pollicis muscle. After administering 40 mg of rocuronium, the surgeon finishes earlier than anticipated. Quantitative train-of-four (TOF) monitoring displays 2 twitches (moderate neuromuscular block). What is the recommended dose of sugammadex to achieve complete reversal (TOF ratio ≥0.9)?

A.0.5 mg/kg based on ideal body weight

B.1.0 mg/kg based on lean body mass

C.2.0 mg/kg based on actual body weight

D.16.0 mg/kg based on total blood volume

Explanation: According to ESAIC and international neuromuscular monitoring guidelines, the recommended dose of sugammadex for routine reversal of a moderate block (reappearance of T2 in train-of-four stimulation) is 2.0 mg/kg of actual body weight. A dose of 4.0 mg/kg is required for deep block (1–2 post-tetanic counts, no TOF twitches), and 16.0 mg/kg is reserved for immediate rescue reversal after high-dose rocuronium (1.2 mg/kg).

4A 32-year-old patient undergoing knee arthroscopy receives an ultrasound-guided femoral nerve block with 20 mL of 0.5% bupivacaine. Five minutes after injection, the patient develops perioral numbness, metallic taste, sudden generalized tonic-clonic seizures, and wide-complex ventricular tachycardia. Which molecular mechanism explains the heightened cardiotoxicity of bupivacaine compared to lidocaine?

A.Selective blockade of L-type calcium channels without affecting myocardial sodium conduction

B.Rapid dissociation from open voltage-gated potassium channels during the cardiac action potential

C.Selective agonism of central alpha-2 adrenoceptors causing massive sympathetic outflow

D.Slow dissociation kinetics from cardiac voltage-gated sodium channels during diastole ('fast-in, slow-out')

Explanation: Bupivacaine is highly lipid-soluble and binds avidly to inactivated/open myocardial voltage-gated sodium channels (Nav1.5). Unlike lidocaine, which dissociates rapidly during diastole ('fast-in, fast-out'), bupivacaine exhibits 'fast-in, slow-out' kinetics, remaining bound during diastole. This leads to profound conduction slowing, refractory re-entrant ventricular arrhythmias, electromechanical dissociation, and decreased myocardial contractility.

5A continuous target-controlled infusion (TCI) of remifentanil is administered during a 6-hour craniotomy. Why does remifentanil maintain a virtually constant context-sensitive half-time of 3 to 5 minutes regardless of the duration of infusion?

A.Rapid metabolism via non-specific esterases in blood and tissues into a weakly active metabolite

B.Extensive pulmonary first-pass uptake followed by rapid renal excretion unchanged in urine

C.Ultra-fast hepatic clearance mediated exclusively by cytochrome P450 CYP3A4 enzymes

D.Immediate irreversible binding to plasma alpha-1-acid glycoprotein preventing tissue accumulation

Explanation: Remifentanil contains a methyl ester linkage that makes it susceptible to rapid hydrolysis by non-specific plasma and tissue esterases to remifentanil acid, which possesses 1/4600th the potency of the parent drug. Because it is not reliant on organ-dependent clearance (hepatic or renal) or redistribution for offset, its context-sensitive half-time remains 3–5 minutes even after prolonged infusions.

6During mechanical ventilation of an anesthetized, paralyzed adult patient in the supine position, which of the following changes in respiratory physiology is expected compared to the awake, upright state?

A.An increase in Functional Residual Capacity (FRC) by approximately 30%

B.A decrease in FRC by approximately 15–20% below closing capacity, predisposing to atelectasis

C.A shift of the diaphragm caudally due to unopposed positive thoracic airway pressure

D.A marked reduction in anatomical dead space with preserved alveolar dead space

Explanation: Induction of general anesthesia and muscle relaxation causes cranial displacement of the diaphragm by abdominal contents, loss of chest wall tone, and a 15–20% reduction in FRC (approximately 400–500 mL). In many supine patients, FRC drops below the closing capacity, leading to airway closure, micro-atelectasis in dependent lung regions, and intrapulmonary shunt.

7An anesthesiologist is managing a closed-circuit circle system with carbon dioxide absorption using desiccated barium hydroxide or sodalime absorbent. When sevoflurane is passed over completely dry, strong base absorbent at elevated temperatures, what is the primary toxic degradation product formed, and what clinical complication does it cause?

A.Carbon monoxide, causing severe tissue carboxyhemoglobinemia

B.Phosgene gas, causing acute non-cardiogenic pulmonary edema

C.Compound A (fluoromethyl-2,2-difluoro-1-[trifluoromethyl]vinyl ether), causing dose-dependent nephrotoxicity in animal models

D.Formaldehyde, causing severe intraoperative bronchospasm and laryngeal edema

Explanation: Sevoflurane reacts with the strong base absorbents (potassium and sodium hydroxide) to produce Compound A, a haloalkene that has demonstrated proximal tubular nephrotoxicity in rat models. To minimize Compound A accumulation, fresh gas flow should be maintained at ≥1–2 L/min when using sevoflurane. Conversely, dry absorbents reacting with desflurane or isoflurane produce carbon monoxide.

8A 24-year-old trauma patient with an acute open femur fracture is scheduled for emergency surgery. He ate a large meal 1 hour prior to the accident. Rapid sequence induction (RSI) is planned. Why is succinylcholine contraindicated in a patient with a known history of malignant hyperthermia?

A.It causes profound histamine release leading to unmanageable bronchospasm

B.It binds to plasma pseudocholinesterase, depleting circulating enzyme stores

C.It competitively inhibits non-depolarizing relaxants, preventing airway protection

D.It acts as a potent triggering agent causing sustained calcium release from the sarcoplasmic reticulum

Explanation: Succinylcholine and all volatile inhalational anesthetics (sevoflurane, desflurane, isoflurane) are absolute triggers of malignant hyperthermia (MH). In MH-susceptible individuals harboring mutations in the RYR1 or CACNA1S genes, these agents trigger uncontrolled intracellular calcium release from the sarcoplasmic reticulum, causing hypermetabolism, sustained muscle rigidity, and rhabdomyolysis.

9A 42-year-old woman undergoing total intravenous anesthesia (TIVA) with propofol and remifentanil receives a continuous infusion of propofol for 5 hours. Which pharmacokinetic model parameter dictates the prolonged recovery time after discontinuation of a long propofol infusion compared to a short 30-minute bolus case?

A.Context-sensitive half-time, which increases with infusion duration due to cumulative saturation of peripheral fat compartments

B.Elimination half-life (t1/2 beta), which remains fixed at 2 minutes regardless of duration

C.Clearance rate, which decreases exponentially as hepatic blood flow increases

D.Central compartment volume (V1), which expands tenfold during steady-state anesthesia

Explanation: The context-sensitive half-time is the time required for the central compartment drug concentration to decrease by 50% after stopping a steady-state infusion of a given duration ('context'). For propofol, as the infusion duration extends to multiple hours, peripheral compartments (muscle and fat) fill, decreasing the net concentration gradient from blood to tissues, which prolongs the context-sensitive half-time.

10Which physicochemical property of a local anesthetic agent is the primary determinant of its onset of action?

A.Lipid solubility (octanol:water partition coefficient)

B.Acid dissociation constant (pKa) relative to physiological tissue pH (7.4)

C.Plasma protein binding percentage (alpha-1-acid glycoprotein)

D.Molecular weight and chemical linkage (ester vs amide)

Explanation: The pKa of a local anesthetic determines the proportion of the drug that exists in the uncharged (non-ionized, lipid-soluble base) form at physiological pH (7.4) according to the Henderson-Hasselbalch equation. Only the uncharged base form can penetrate the neural lipid membrane to reach the intracellular receptor site; therefore, agents with a pKa closer to 7.4 (e.g., lidocaine pKa 7.9) have a faster onset of action than agents with higher pKa (e.g., bupivacaine pKa 8.1).

About the Facharzt FMH Anästhesiologie Exam

The Facharzt FMH für Anästhesiologie (Specialist in Anesthesiology FMH) is the Swiss Federal specialist title granting full independent practice rights in anesthesia, perioperative medicine, intensive care, emergency medicine, and pain management across Switzerland. Governed by the SIWF (Swiss Institute for Postgraduate and Continuous Medical Training) and the SSAPM (Swiss Society of Anaesthesiology and Perioperative Medicine), board qualification requires passing the written EDAIC Part 1 examination (European Diploma in Anaesthesiology and Intensive Care) as the official Swiss written component, followed by the national SSAPM oral-practical board examination. The curriculum covers basic sciences (pharmacology of hypnotics, opioids, muscle relaxants, local anesthetics; respiratory, cardiovascular, and neurophysiology; equipment and physics), clinical subspecialties (obstetric, pediatric, neuro, cardiothoracic, vascular, and regional anesthesia), perioperative medicine, crisis resource management (difficult airway CICO algorithms, malignant hyperthermia, anaphylaxis, local anesthetic toxicity LAST), intensive care, trauma resuscitation, and acute/chronic pain. Note on format and language: While the official written EDAIC Part 1 examination is available in multilingual formats (English, German, French) and the SSAPM oral examination is conducted in Swiss national languages or English, this question bank is an English-language multiple-choice study adaptation created by OpenExamPrep—not an official SSAPM/ESAIC examination release—specifically designed to train high-yield clinical decision-making, physiological concepts, and guideline-based crisis management.

Assessment

Two-part qualifying examination: 1) The written EDAIC Part 1 Examination consisting of two 90-minute multiple-choice papers (Paper A: Basic Sciences; Paper B: Clinical Anesthesia & Intensive Care), and 2) The SSAPM national oral-practical board examination consisting of standardized clinical scenario stations evaluated by Swiss senior anesthesiologists.

Time Limit

180 minutes written examination (two 90-minute sessions) plus approximately 60–90 minutes structured oral examination

Passing Score

Criterion-referenced standard passing score on the written EDAIC Part 1 MCQ examination (typically ~65–70% raw score) and a structured passing evaluation across all clinical stations assessed by the SSAPM examination committee

Exam Fee

EDAIC Part 1 fee CHF 325 (Swiss registered candidates) / CHF 450–510; SSAPM Oral Examination fee CHF 750; SIWF FMH Title Application fee CHF 1,000–2,500 (Schweizerisches Institut für ärztliche Weiter- und Fortbildung (SIWF / FMH) and Schweizerische Gesellschaft für Anästhesiologie und Perioperative Medizin (SSAPM / SGAR), utilizing the EDAIC examination system)

Facharzt FMH Anästhesiologie Exam Content Outline

22%

Basic Sciences, Pharmacology & Physics

Pharmacokinetics and pharmacodynamics of intravenous hypnotics (propofol, etomidate, ketamine, dexmedetomidine, context-sensitive half-times), inhalational anesthetics (MAC, blood:gas partition coefficients, vaporizers, compound A/carbon monoxide), neuromuscular blocking agents and reversal (rocuronium, succinylcholine, train-of-four monitoring, sugammadex, neostigmine), local anesthetics (pKa, protein binding, lipophilicity, LAST pathophysiology and 20% lipid emulsion therapy), opioids and adjuvants (remifentanil, sufentanil, fentanyl, naloxone), and cardiovascular, respiratory, and neurophysiology.

28%

Clinical & Subspecialty Anesthesia

Evidence-based management of obstetric anesthesia (labor neuraxial analgesia, spinal hypotension and phenylephrine/ephedrine, post-dural puncture headache, preeclampsia/magnesium, emergency cesarean section, amniotic fluid embolism), pediatric anesthesia (airway anatomy, laryngospasm management, caudal epidural dosing, cuffed ETTs, fasting guidelines), neuroanesthesia (ICP dynamics, cerebral perfusion pressure, TBI management, venous air embolism in sitting craniotomies, intraoperative neuromonitoring), cardiothoracic and vascular anesthesia (one-lung ventilation, CPB weaning, aortic cross-clamping hemodynamics, TEE views), regional anesthesia (interscalene, supraclavicular, infraclavicular, axillary, femoral, sciatic, adductor canal, ESP, TAP blocks, ultrasound guidance), and ambulatory/geriatric care.

16%

Perioperative Medicine, Coagulation & Monitoring

Preoperative evaluation and risk stratification (ASA physical status, Revised Cardiac Risk Index RCRI, STOP-BANG for OSA, metabolic equivalents METs), patient blood management and viscoelastic testing (ROTEM/TEG interpretation, reversal of DOACs with idarucizumab/andexanet alfa, 4-factor PCC, fibrinogen concentrate, tranexamic acid, massive transfusion protocols), goal-directed fluid therapy (dynamic preload indices SVV/PPV, arterial line waveform analysis, balanced crystalloids vs saline), and enhanced recovery after surgery (ERAS pathways, Apfel score, multimodal antiemetic prophylaxis, postoperative hypothermia prevention).

18%

Resuscitation, Airway & Crisis Management

Difficult airway algorithms (DAS/ASA unanticipated difficult intubation, video laryngoscopy, supraglottic rescue devices, 'cannot intubate, cannot oxygenate' CICO emergency front-of-neck access / surgical cricothyroidotomy, awake fiberoptic intubation), malignant hyperthermia (ryanodine receptor RYR1 pathophysiology, ETCO2 elevation, masseter spasm, dantrolene preparation and dosing, activated charcoal filters), perioperative anaphylaxis (grading, immediate epinephrine titration, serum mast cell tryptase testing, sugammadex reversal for rocuronium-induced anaphylaxis), acute bronchospasm, and ERC/AHA advanced life support guidelines in the operating theater.

16%

Intensive Care, Trauma & Pain Medicine

ICU mechanical ventilation and ARDS (Berlin definition, lung-protective ventilation 6 mL/kg PBW, driving pressure, prone positioning criteria, neuromuscular blockade), sepsis and septic shock (Sepsis-3 definitions, SOFA scoring, 1-hour resuscitation bundle, norepinephrine, vasopressin, dobutamine, stress-dose hydrocortisone), trauma resuscitation (ATLS principles, lethal triad of trauma, damage control resuscitation, permissive hypotension), and acute/chronic pain management (multimodal analgesia, intravenous lidocaine infusions, ketamine NMDA antagonism, neuropathic pain regimens, neuraxial opioids and delayed respiratory depression monitoring).

How to Pass the Facharzt FMH Anästhesiologie Exam

What You Need to Know

Passing score: Criterion-referenced standard passing score on the written EDAIC Part 1 MCQ examination (typically ~65–70% raw score) and a structured passing evaluation across all clinical stations assessed by the SSAPM examination committee
Assessment: Two-part qualifying examination: 1) The written EDAIC Part 1 Examination consisting of two 90-minute multiple-choice papers (Paper A: Basic Sciences; Paper B: Clinical Anesthesia & Intensive Care), and 2) The SSAPM national oral-practical board examination consisting of standardized clinical scenario stations evaluated by Swiss senior anesthesiologists.
Time limit: 180 minutes written examination (two 90-minute sessions) plus approximately 60–90 minutes structured oral examination
Exam fee: EDAIC Part 1 fee CHF 325 (Swiss registered candidates) / CHF 450–510; SSAPM Oral Examination fee CHF 750; SIWF FMH Title Application fee CHF 1,000–2,500

Keys to Passing

Work through all 100 available questions
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Facharzt FMH Anästhesiologie Study Tips from Top Performers

1Master Pharmacokinetics & Pharmacodynamics: Understand context-sensitive half-times (e.g., remifentanil's ultra-short 3–5 min half-time due to non-specific tissue and blood esterase metabolism vs fentanyl's prolonged context-sensitive half-time after long infusions), MAC alterations (hypothermia, pregnancy, age, acute vs chronic ethanol use), and receptor mechanisms.

2Know Neuromuscular Monitoring & Sugammadex Dosing: Understand qualitative and quantitative train-of-four (TOF) monitoring, post-tetanic count (PTC), and exact sugammadex dosing based on actual body weight (2 mg/kg for moderate block with ≥2 twitches on TOF, 4 mg/kg for deep block with 1–2 PTC, and 16 mg/kg for immediate rescue reversal 3 minutes after 1.2 mg/kg rocuronium).

3Memorize Crisis Dosing & Protocols: Commit to memory the precise initial doses for emergency resuscitation: Dantrolene 2.5 mg/kg IV bolus repeated up to 10 mg/kg for malignant hyperthermia; Intralipid 20% 1.5 mL/kg IV bolus followed by 0.25 mL/kg/min (max 12 mL/kg) for LAST; Epinephrine 10–50 mcg IV boluses for Grade 2/3 perioperative anaphylaxis, and 1 mg IV for cardiac arrest.

4Understand Obstetric & Pediatric Anesthetic Nuances: Master physiological changes in pregnancy (increased minute ventilation, decreased FRC, compensated respiratory alkalosis, decreased MAC), spinal hypotension prevention (prophylactic weight-adjusted phenylephrine infusion vs ephedrine), pediatric airway differences (larger occiput, cephalad larynx C3-C4, floppy omega-shaped epiglottis), and laryngospasm treatment (CPAP with 100% O2, Larson's maneuver, low-dose succinylcholine 0.5 mg/kg IV or propofol).

5Review ARDS Ventilation & Viscoelastic Coagulation: Be fluent in the ARDS Berlin definition, lung-protective ventilation targets (tidal volume 6 mL/kg predicted body weight, plateau pressure <30 cmH2O, driving pressure <15 cmH2O, prone positioning for PaO2/FiO2 <150), and ROTEM algorithm interpretation (EXTEM, INTEM, FIBTEM, HEPTEM, APTEM).

Frequently Asked Questions

What is the Facharzt FMH für Anästhesiologie title?

The Facharzt FMH für Anästhesiologie is the federally recognized specialist medical title awarded by the SIWF / FMH (Swiss Medical Association) upon completion of at least 5 years (60 months) of accredited postgraduate anesthesiology and intensive care training, passing both the written EDAIC Part 1 examination and the SSAPM oral board examination, and meeting all logbook requirements.

How is the Swiss Anesthesiology specialist examination structured?

The qualification requires two distinct examination components: 1) The written EDAIC Part 1 Examination (European Diploma in Anaesthesiology and Intensive Care), consisting of two 90-minute multiple-choice papers (Paper A: Basic Sciences, Paper B: Clinical Anesthesia & Intensive Care) administered in Switzerland via the SSAPM, and 2) The SSAPM oral examination, which evaluates clinical decision-making, crisis resource management, and perioperative care across structured clinical vignette stations before senior Swiss examiner pairs.

When can Swiss anesthesiology trainees sit the EDAIC Part 1 and SSAPM oral examinations?

Trainees are eligible and recommended to sit the written EDAIC Part 1 starting from their 3rd year of postgraduate residency training. Passing EDAIC Part 1 is a mandatory prerequisite for registering for the SSAPM oral board examination, which is typically taken in the 5th (final) year of residency training.

In which languages is the Swiss Anesthesiology specialist examination administered?

The written EDAIC Part 1 examination is provided in multiple European languages including English, German, and French. The SSAPM oral specialist examination can be taken in German, French, or English according to candidate preference. This OpenExamPrep study bank provides an English-language MCQ adaptation aligned with the SCOAR and ESAIC syllabus.

What are the most critical perioperative crisis management protocols tested?

Key high-yield crisis algorithms include the Difficult Airway Society / SSAPM 'cannot intubate, cannot oxygenate' (CICO) emergency front-of-neck access (eFONA) protocol, Malignant Hyperthermia management with early dantrolene (2.5 mg/kg IV initial dose), Local Anesthetic Systemic Toxicity (LAST) rescue with 20% lipid emulsion (1.5 mL/kg bolus followed by 0.25 mL/kg/min infusion), and acute perioperative anaphylaxis management with titrated intravenous epinephrine and mast cell tryptase sampling.

How does ROTEM / TEG viscoelastic testing guide massive transfusion in Swiss practice?

Viscoelastic testing (ROTEM delta or TEG 6s) enables targeted, goal-directed hemotherapy: prolonged clotting time (CT in EXTEM/INTEM) indicates coagulation factor deficiency treated with 4-factor PCC or plasma; decreased maximum clot firmness in FIBTEM indicates hypofibrinogenemia treated with fibrinogen concentrate; reduced EXTEM MCF with normal FIBTEM indicates thrombocytopenia requiring platelets; and hyperfibrinolysis (ML >15%) indicates immediate tranexamic acid administration.

100+ Free Facharzt FMH Anästhesiologie Practice Questions

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