Practice Test Geeks(ABA) ASA (American Society of Anesthesiologists) Board Certification Practice Test
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Anesthesia Principles & Practices Flashcards

7 cards from real ABA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. Which mechanism best explains the MAC-sparing effect of nitrous oxide when combined with volatile anesthetics?

    Answer: Competitive NMDA receptor antagonism reduces overall anesthetic requirement

    Nitrous oxide's NMDA antagonism provides additive analgesia and sedation, reducing the MAC requirement of co-administered volatile agents.

  2. A patient with severe mitral stenosis presents for elective surgery. Which hemodynamic goal is MOST important during anesthetic management?

    Answer: Maintain sinus rhythm and avoid tachycardia

    Mitral stenosis limits diastolic filling; tachycardia reduces diastolic time further, causing acute pulmonary edema, so rate control and sinus rhythm are paramount.

  3. The phenomenon of 'diffusion hypoxia' after nitrous oxide discontinuation is primarily caused by:

    Answer: Rapid outward diffusion of N2O diluting alveolar oxygen

    Large volumes of N2O rapidly diffuse from blood into alveoli, diluting both oxygen and CO2, necessitating supplemental oxygen at emergence.

  4. Which property of a local anesthetic MOST determines its duration of action?

    Answer: Protein binding percentage

    Higher protein binding correlates with prolonged duration because the drug remains sequestered at the sodium channel protein, delaying redistribution.

  5. During one-lung ventilation, hypoxemia persists despite 100% FiO2. The MOST effective next intervention is:

    Answer: Apply CPAP (5-10 cmH2O) to the non-ventilated lung

    Low-level CPAP to the non-dependent lung maintains partial alveolar recruitment while still allowing surgical access, improving V/Q matching.

  6. Neostigmine reversal of neuromuscular blockade is contraindicated when the train-of-four (TOF) count is:

    Answer: 0 (no twitches present)

    With no twitches present, there is near-complete receptor occupancy by the blocking agent; neostigmine cannot overcome this and may cause paradoxical weakness via muscarinic effects.

  7. Which volatile anesthetic is MOST associated with nephrotoxicity due to inorganic fluoride production?

    Answer: Methoxyflurane

    Methoxyflurane undergoes extensive hepatic metabolism releasing high serum fluoride levels, historically causing high-output renal failure ('methoxyflurane nephrotoxicity').