SCFHS Anesthesia Exam MCQs 2026

Saudi Anesthesia Prometric Exam Overview

The Saudi Commission for Health Specialties (SCFHS) conducts this computer-based examination for specialist physicians seeking professional classification as an Anesthesia Registrar or Senior Registrar in hospitals, surgical day centers, and emergency trauma units across the Kingdom of Saudi Arabia. The test evaluates clinical decision-making, intraoperative hemodynamic management, perioperative critical care, difficult airway stabilization, and resuscitation. Once qualification reviews and DataFlow primary source verification are completed, candidates receive testing eligibility through the SCFHS Mumaris+ platform to book their Prometric test.

Exam Parameter	Details
Exam Title	Saudi Anesthesia Prometric Exam (SMLE Anesthesia Specialist / Registrar)
Authority	Saudi Commission for Health Specialties (SCFHS)
Delivery Mode	Prometric Computer-Based Test (CBT)
Exam Code	ANE-REG / ANES
Question Format	Multiple-Choice (Single Best Answer)
Number of MCQs	200 questions (split into 2 clinical blocks)
Exam Duration	4 hours (with a scheduled 30-minute midpoint break)
Passing Score	65% for Registrar; 70% for Senior Registrar
Negative Marking	None
Language	English
Score Result	Pass / Fail report available on the Mumaris+ portal within 7 to 10 working days
Score Validity	5 years

Detailed Syllabus & Domain Breakdown

The SCFHS Anesthesia blueprint tests applied clinical pharmacology, physiology, subspecialty surgical anesthesia, and perioperative crisis management. Questions present patient vignettes that require rapid diagnostic evaluation, invasive monitoring interpretation, drug dosing adjustments for coexisting diseases, and evidence-based emergency airway or resuscitation protocols.

Specialty Module	Core Topics	Key Focus Areas & Clinical Scenarios
Airway Assessment & Management	Preoperative airway metrics (Mallampati, thyromental distance, neck mobility), ASA and DAS difficult airway algorithms, videolaryngoscopy, fiberoptic bronchoscopy, and front-of-neck surgical access.	Managing unanticipated difficult intubation, executing "Cannot Intubate, Cannot Oxygenate" (CICO) emergency pathways, and planning safe extubation in swollen or high-risk airways.
Anesthesia Workstation, Physics & Monitoring	High- and low-pressure machine checks, gas pipeline safety, fail-safe valves, circle systems, vaporizers, capnography waveforms, invasive lines (arterial, CVP, PAC), and depth monitors (BIS).	Troubleshooting acute circuit disconnects or pressure leaks during positive pressure ventilation, reading capnographic signs of bronchospasm or pulmonary embolism, and monitoring neuromuscular recovery (TOF).
Clinical Pharmacology & Anesthetic Agents	IV induction drugs (propofol, ketamine, etomidate), volatile agents (sevoflurane, desflurane, isoflurane), neuromuscular blockers, reversal agents (sugammadex, neostigmine), inotropes, and vasopressors.	Handling altered pharmacokinetics in renal or hepatic failure, managing context-sensitive half-times in prolonged infusions, and mitigating hemodynamic collapse during rapid sequence induction (RSI).
Cardiac, Thoracic & Vascular Anesthesia	Coronary artery disease, severe valvular lesions, one-lung ventilation (double-lumen tubes, bronchial blockers), cardiopulmonary bypass separation, and aortic cross-clamping physiology.	Managing hypoxemia during one-lung ventilation, handling hemodynamic instability during cross-clamp release, and identifying intraoperative ST-segment ischemia or acute right ventricular failure.
Neurosurgical Care & Neuro-Anesthesia	Intracranial dynamics (ICP, CPP, autoregulation), craniotomy for mass lesions, cerebral aneurysms, neuro-monitoring interactions (MEPs, SSEPs), and venous air embolism.	Controlling acute intracranial hypertension, choosing brain relaxation techniques during tumor resection, and emergency intervention for sudden venous air embolism during sitting-position surgery.
Obstetric & Gynecological Anesthesia	Physiological changes in pregnancy, labor analgesia (epidural, CSE, remifentanil PCA), emergency cesarean section, preeclampsia/eclampsia, and peripartum hemorrhage.	Managing total or high spinal blocks, navigating the obstetric difficult airway, initiating massive transfusion protocols for uterine atony, and newborn resuscitation principles.
Pediatric & Neonatal Anesthesia	Neonatal anatomy and physiology, pediatric fluid calculations, fasting intervals, congenital defects (TEF, congenital diaphragmatic hernia), and outpatient ENT/strabismus procedures.	Responding to severe laryngospasm on extubation, precise weight-based dosing for pediatric emergencies, and sizing cuffed vs. uncuffed endotracheal tubes.
Regional Anesthesia & Acute Pain Management	Neuraxial anatomy (spinal, epidural), ultrasound-guided peripheral nerve blocks (brachial plexus, femoral, sciatic), truncal blocks (TAP, ESP, rectus sheath), and multimodal post-operative pain protocols.	Prompt recognition and treatment of Local Anesthetic Systemic Toxicity (LAST) with 20% lipid emulsion, post-dural puncture headache workup, and adhering to ASRA guidelines for anticoagulated patients.
Critical Care, Trauma & Coexisting Diseases	Damage-control resuscitation, permissive hypotension, burn shock fluid formulas (Parkland), fat embolism syndrome, bone cement shock (BCIS), and endocrine emergencies (pheochromocytoma, thyroid storm).	Cervical spine in-line stabilization during rapid intubation, viscoelastic testing (TEG/ROTEM) to guide transfusion in coagulopathy, and crisis control of intraoperative pheochromocytoma blood pressure surges.
OR Safety, Crisis Protocols & Medical Ethics	Perioperative ACLS algorithms, acute anaphylaxis management, malignant hyperthermia diagnosis and dantrolene dosing, WHO Surgical Safety Checklist, informed consent, and SCFHS regulations.	Rapid multidisciplinary coordination during intraoperative cardiac arrest, preventing syringe mislabeling and medication errors, and handling informed consent and DNR conflicts under Saudi law.

SCFHS Anesthesia Exam MCQs