This chapter is a question and answer style article that contains past FRCA paper examples related to neurosurgery, neuroradiology and neurocritical care. It also guides trainees on the most effective manner in which to approach these questions. The chapter presents the case study of a 9-year-old child with Down's syndrome is scheduled for an adenotonsillectomy. The discussion covers the following: airway/respiratory (30%), cardiovascular (10%) and neurological (10%) features of the syndrome relevant to the anaesthetist; and the general principles involved in the preoperative (15%), intraoperative (25%) and postoperative (10%) management of this patient with Down's syndrome.