ABA Anesthesia Principles & Practices 3

Question 1

In a patient receiving a remifentanil infusion for total intravenous anesthesia (TIVA), the MOST important consideration at emergence is:

Accepted Answer

Transition to longer-acting analgesia before stopping infusion

Answer

Remifentanil's ultra-short half-life causes acute opioid offset; without bridging analgesia, patients awaken in severe pain.

Question 2

A patient develops masseter muscle rigidity after succinylcholine administration. The MOST appropriate immediate action is:

Accepted Answer

Proceed cautiously, monitor for signs of malignant hyperthermia

Answer

Isolated masseter spasm after succinylcholine may be a normal variant or early MH sign; vigilant monitoring for tachycardia, hypercapnia, and temperature rise guides management.

Question 3

The volume of distribution (Vd) of a drug is MOST influenced by:

Accepted Answer

Degree of tissue and plasma protein binding

Answer

Vd reflects how extensively a drug distributes into tissues versus remaining in plasma, heavily dependent on both tissue and plasma protein binding.

Question 4

Which patient population has the GREATEST increase in sensitivity to non-depolarizing neuromuscular blocking agents?

Accepted Answer

Patients with myasthenia gravis

Answer

Myasthenia gravis reduces functional acetylcholine receptors at the NMJ, so far fewer receptors need blocking to achieve neuromuscular block.

Question 5

Cerebral autoregulation maintains constant cerebral blood flow over a MAP range of approximately:

Accepted Answer

50–150 mmHg

Answer

In neurologically intact adults, cerebral autoregulation maintains CBF across MAPs of roughly 50–150 mmHg; outside this range, CBF becomes pressure-passive.

(ABA) ASA (American Society of Anesthesiologists) Board Certification Practice Test

(ABA) ASA (American Society of Anesthesiologists) Board Certification Practice Test

ABA Anesthesia Principles & Practices 3