ABA Perioperative Patient Management 2

Question 1

A patient with severe aortic stenosis (valve area 0.6 cm²) requires emergent hip fracture repair. Which hemodynamic goal is MOST important intraoperatively?

Accepted Answer

Maintain heart rate 80–100 bpm and avoid hypotension

Answer

Severe AS requires maintaining normal-to-slow heart rate and adequate preload/afterload to preserve coronary perfusion pressure across the fixed obstruction.

Question 2

Which of the following best describes the anesthetic consideration for a patient on chronic clonidine therapy undergoing major surgery?

Accepted Answer

Continue clonidine perioperatively to prevent rebound hypertension

Answer

Abrupt clonidine withdrawal can cause severe rebound hypertension; it should be continued perioperatively or a patch applied if oral intake is not possible.

Question 3

During a laparoscopic cholecystectomy, end-tidal CO₂ rises from 38 to 58 mmHg over 20 minutes despite unchanged ventilator settings. The MOST likely cause is:

Accepted Answer

Subcutaneous CO₂ absorption from insufflation

Answer

Peritoneal CO₂ insufflation is rapidly absorbed, and subcutaneous emphysema further increases systemic CO₂ load, raising ETCO₂.

Question 4

A 72-year-old patient undergoing radical prostatectomy develops oliguria (15 mL/hr) despite 2L of crystalloid. CVP is 12 mmHg. The next best step is:

Accepted Answer

Assess cardiac output and systemic vascular resistance

Answer

With adequate filling pressure but persistent oliguria, functional hemodynamic monitoring is needed to distinguish low output from high SVR states before further therapy.

Question 5

Which neuromuscular monitoring pattern indicates adequate reversal with neostigmine before extubation?

Accepted Answer

Train-of-four ratio ≥ 0.9 by acceleromyography

Answer

A quantitative TOF ratio ≥ 0.9 measured by acceleromyography is the accepted threshold for adequate neuromuscular recovery before extubation.

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

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

ABA Perioperative Patient Management 2