ABA Fundamentals & Core Concepts 5

Question 1

The bispectral index (BIS) monitor measures which physiologic parameter to assess depth of anesthesia?

Accepted Answer

Processed EEG waveform analysis

Answer

BIS uses a proprietary algorithm to process raw EEG data into a dimensionless number (0-100) that correlates with level of consciousness and anesthetic depth.

Question 2

Neostigmine reversal of neuromuscular blockade should always be accompanied by an anticholinergic agent because neostigmine:

Accepted Answer

Inhibits acetylcholinesterase, causing muscarinic side effects like bradycardia and increased secretions

Answer

Neostigmine inhibits acetylcholinesterase at all cholinergic synapses (both nicotinic and muscarinic), so muscarinic antagonists like glycopyrrolate are coadministered to prevent bradycardia and hypersalivation.

Question 3

Which factor primarily determines the duration of action of a single bolus dose of local anesthetic?

Accepted Answer

Protein binding

Answer

Protein binding determines duration of local anesthetic action; agents with higher protein binding (bupivacaine, ropivacaine) dissociate slowly from sodium channels and have prolonged duration.

Question 4

A patient develops ST-segment depression, hypertension, and tachycardia intraoperatively. The MOST appropriate initial intervention is:

Accepted Answer

Deepen anesthesia and consider beta-blocker or nitroglycerin

Answer

ST depression with hypertension and tachycardia suggests myocardial ischemia from increased oxygen demand; deepening anesthesia reduces sympathetic tone, and beta-blockers or nitroglycerin address the underlying supply-demand mismatch.

Question 5

The Bezold-Jarisch reflex, which can occur during spinal anesthesia, causes:

Accepted Answer

Bradycardia, hypotension, and vasodilation

Answer

The Bezold-Jarisch reflex is a paradoxical vagal reflex triggered by decreased venous return to the heart, causing bradycardia, hypotension, and systemic vasodilation.

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

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

ABA Fundamentals & Core Concepts 5