[I passed!] A review of the 2022 Cardiovascular Anesthesiology Specialist Exam and study materials

Introduction

Hello. I am an anesthesiologist in my 10th year of practice.
The other day, or rather just today, I took the Cardiovascular Anesthesiology Specialist Exam.

So, I will leave a brief review and some self-made materials here.
As I mention later, I missed the mark significantly due to a lack of research, so I hope my failure serves as a reference. Everyone, please step over my dead body (tears).

By the way, regarding exam preparation, it is not about reading the Orange Book ("Anesthesia for Cardiac Surgery") or reading the guidelines.There is only one way to prepare: "By any means necessary, search until the very last minute for 'reproduced past exam questions' sold somewhere on the internet."That is the only way to solve those problems. It is too much of an impossible game.

Question Format

The exam format is CBT.
There is a 120-minute time limit for 80 questions, so there wasn't much time to spare. (After solving them once and checking them a second time, there were already only about 10 minutes left.)

The questions are probably the same for everyone? The order might be different.
The results will be notified by email in late December and displayed on the academic society's My Page.

2022 Exam Questions

I couldn't remember the details (there was too little time & I can't remember such a large number of questions), but I will write down the genres to the extent that I remember them.

• Frozen Elephant Trunk technique for aortic dissection

• iFR and FFR

• What is Carpentier classification IIIb?

• Transposition of the great arteries, corrected transposition of the great arteries (clinical problems)

• Anesthesia management for a patient with a giant uterine fibroid, DVT, and PE

• Anesthesia for pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension

• Treatment of pediatric JET (Junctional Ectopic Tachycardia)

• Surgical indications for TR

• Surgical indications for MR (left atrial diameter and left ventricular diameter)

• Anesthetic management after congenital heart disease surgery

• A question like: A patient with left pulmonary artery occlusion experiences respiratory distress and a drop in SpO2 while attempting ablation from the SVC. What do you do?

• MEP has decreased, what do you do?

• During descending aortic replacement, when should you pay attention to MEP? (At what timing: proximal to the aneurysm, at the aneurysm, or distal to the aneurysm? Two answers required)

• IE with AR, cerebral infarction, and pulmonary edema. Indications and contraindications for emergency surgery

• Sudden heart failure in a patient after AVR. Did the A-valve detach? What do you do? (Fluoroscopic image showing something that looks like it in the abdominal aorta, and no prosthetic valve in the aortic root)

• Regarding graft blood flow measurement using a transit-time flowmeter, such as PI

• A case of abdominal compartment syndrome caused by ruptured AAA. Do you administer muscle relaxants? Do you aspirate gastric contents? Do you perform drainage? Do you perform surgical intervention if bladder pressure is 15 mmHg or higher?

• COVID-19 positivity discovered during emergency surgery. What do you do? Can you use a cell saver, etc.?

• Changes in hemodynamics during pregnancy and postpartum (SVR, etc.)

• Circulatory effects of oxytocin

• Does FFP contain Factor XIII?

• Timing for non-cardiac surgery after placing a bare-metal stent

I had heard that 'questions come from the pre-exam lecture!', so I looked at the materials from the Japanese Society of Cardiovascular Anesthesiology specialist lectures for three years (2020, 2021, 2022), but they didn't appear as much as I thought. In particular, I thought Andexanet would definitely be on the exam since it was just approved this year, but it didn't come up at all. I don't think perioperative brain injury appeared either.

Self-made past question collection (somewhat old)

I don't think this will be very helpful, but I'm leaving here the materials I made while studying.
This is a self-made collection of answers and explanations for past questions circulating on the internet (partially cited).
Since these are questions from 2015-2019, they are a bit old.
Please note that there may be some errors.

1. Based on the Anestation blog
The order of the questions from 2015-2019 has been shuffled.

2. Based on Dr. Near's blog
Reproduced questions from 2016-2018.

Sites I referred to

● Anestation blog

The questions in the first PowerPoint file were cited from here.
Some answers and explanations are also cited.

I realized after the exam was over that the 2020 questions had also been released. There were several questions that appeared on the 2022 exam, so I wish I had checked them.

https://anesthalpha.com/心臓血管麻酔専門医試験㉒/

● Dr. Near's blog

There are reproduced questions from 2015-2018.

● Ane-chan sensei's note

● Bonus (flea market sites)

Regarding past questions, they sometimes circulate on flea market sites.
There were also reproduced questions from 2021, but I didn't notice them because they were listed 2 months before the exam. To make matters worse, I realized they were listed the day after the exam. When I noticed, I was so shocked (even though the exam was already over) that I couldn't sleep for a while. It was painful.

Orange Book "Anesthesia for Cardiac Surgery" Mind Maps

As part of my exam study, I summarized the Orange Book "Anesthesia for Cardiac Surgery" into mind maps chapter by chapter (because I forget things if I just read them). I don't know if it was useful, but I was able to use it to quickly look through things right before the exam.

In conclusion

As I wrote at the beginning, I have absolutely no idea why I was able to pass. There were no recent past exam questions, few people with experience, and nothing available other than information found on the internet. I managed to pass somehow using the Blue Book (Cardiovascular Anesthesia Pocket Manual) and past exam questions found online.

The way to pass is, above all, "Find the past exam questions!" Good luck to all the examinees. I am rooting for you.