Anesthesiology APPLIED Exam › Exam skills and answer structure

The additional-topics block: three minutes per topic

Exam skills and answer structure·~5 min read· Physician-reviewed✓ Sourced · 2

Stem

Twenty-five minutes into the session, the examiner closes the main case on an elderly man's hip fracture and says, "Let's move to some additional topics." Without a pause, she reads the first one: a 4-year-old, two hours after tonsillectomy, is now bleeding from the mouth in recovery. Ten minutes remain on the clock, and two more unrelated scenarios are waiting on her page.

Question

How do you handle this topic and the two that follow, so that all three get answered well?

Ideal answer

HeadlineEach topic is a self-contained 3-minute case, hard reset first. I restate it, "A 4-year-old, two hours after tonsillectomy, now bleeding," then give the priority.

While she reads: patient, setting, the one abnormal fact. Restating it shows I have the right patient.
Priority and two or three actions, with reasons, life threats first: oxygen, call for help, the surgeon applies pressure. Then the one finding that would change my plan; stop.
Follow-ups in the same shape: she almost always asks one or two, one level deeper.
"Let's move on" means letting the case go completely: a breath, then the next scenario as if the session had just started; no carrying the bleeding child's frame, no arguing to finish a sampled point.

Watch for: the clock: with 90 seconds left, I compress to the priority and one action.

Breaking down the answer

Three cold cases in ten minutes — in the ABA sample, each 35-minute session ends with 10 minutes of three unrelated mini-cases: pre-eclampsia, post-CABG tamponade and hypothermia in one; tracheoesophageal fistula, outpatient epidural wet tap, and anaphylaxis in radiology in the other.¹
Why it is hard — topics arrive with no stem to review and no time to settle, so the block samples breadth and tests adaptability in its purest form; I treat this block as where a slow start costs most. Three topics, three resets, no carryover.
Why restate — it buys two seconds, confirms I heard the scenario, and lets the examiner correct a misheard detail before I build a plan on it. A plan for the wrong patient scores nothing.
Why the abnormal fact — every detail in a short scenario is deliberate: a full stomach, a pacemaker, a platelet count of 60,000, a Jehovah's Witness. The abnormal fact is the question, so I build around it rather than reciting a generic anesthetic.
Lead with the safety-critical action — the scenario often drops me into an active event; I name what threatens life first, act, then explain etiology.
Hold depth in reserve; the examiner drives the clock — the consultant-level summary, depth when chosen. Front-loading every detail leaves nothing for the follow-up and burns the next topic's time. Being cut off is the schedule, not failure.
Reset physically — I pause, sit back and listen. Carrying the hemodynamic frame of a bleeding tonsil into a neonate with a tracheoesophageal fistula is a common, avoidable error.

Follow-up question

The second topic is a rare syndrome you have never managed. You start answering, and 90 seconds in the examiner adds a complication. What do you say?

Follow-up answer

HeadlineRecall is not what is being scored now; judgment is. I state the governing principle, the safe default and my resource, then stop.

"I would treat this as a difficult airway with a full stomach and confirm the drug interaction with pharmacy before induction." Three attributes survive even without recall. When the complication arrives, I run recognize, communicate, treat, reassess in two sentences, because the block is too short for anything longer: I name what changed, tell the surgeon, give the first action, and say what I will check next. Then I stop and let the examiner move on. Composure counts here, so the next topic gets my full reset.

Pitfalls that cost points

Asking for information the examiner has already given; it signals that I was not listening.
Opening with a differential diagnosis when the scenario describes an active crisis that needs an action.

Rapid-fire

Q: Are the additional topics related to the stem? A: No. In the ABA sample they are independent mini-cases from other subspecialties, so I prepare breadth, not depth on the stem.¹

Q: How many topics are in the block? A: Plan for three in 10 minutes, about three minutes each; the examiner controls the exact number and pace.

Q: What if the examiner moves on before I finish? A: I let it go. The examiner has sampled what they needed, and returning to it costs time on the next topic.

Q: Should I ask clarifying questions? A: Only one, and only if the answer changes my first action; otherwise I state my assumption and proceed.

Q: The examiner says "one more topic" with 90 seconds left. What changes? A: I compress to the priority and one action, because a short complete answer scores better than a long incomplete one.

Numbers to know

Item	Value
Additional-topics block	10 min at the end of each session¹
Topics per block	3 in the ABA sample¹
Session length	35 min, tone at the end²
Time per topic	~3 min
Opening restatement	1 sentence, under 5 s
Target first answer	Headline ~10 s; under 60 s in all

Sources

1.Sample Standardized Oral Exam Questions · ABA · theaba.orgPublic sample; block names and minutes are taken from the sample sessions.
2.What to Expect for Your APPLIED Exam (APPLIED Exam Manual) · ABA, 2026 · theaba.orgRevised July 2026.

Facts on this page were checked against these sources on Oct 14, 2026. Guidelines change; confirm doses against current institutional protocols.