Dynamik and I met up to take the 293 today, I will let him post his results but I can happily say that I passed with a 790.  Of course my pass was not without the usual prometric stesses.  I finished question 34 of 43 and saw the usual pause before a simulation.  My blood pressure went through the roof when an error briefly popped up and I saw "Stopping Engine" dialog box appear in its place.  The engine returned to the initial log on screen and I called the proctor over to assist, the engine would not reopen because it said there was already a test in progress.  I wish that were the case.  Thankfully, I was able to simply move spots and log in to the exact spot it crashed on me  

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My findings
I found more NLB and Clustering questions that I had assumed there would be, be ready to get alot of questions on those two.  It was only covered in 1/6 of the syngress book but the questions seemed more frequent.
Plenty on PKI/CA and IPSEC, spend most of your time on these, know them well.
Less similarity with the 291 than I expected DNS, RRAS, WSUS, and IPs were only briefly touched upon.  If you are fresh of the 291 you should be fine with a brief review, I think I spent too much time rereading these topics looking to learn something new.
I felt this was the trickiest MS exam I have taken, it appeared that extra time was put in to make one or two words change everything (least effort, only, cannot, quickest, etc)  At the end I had more questions than normal marked for review due to tricky wording.
43 Questions and 3 sims for me on this one.
Tread lightly and take your time.