BCA BCA Neuroanesthesia & Neurosurgical Procedures 2

Question 1

Which volatile anesthetic is MOST likely to increase intracranial pressure at concentrations above 1 MAC?

Accepted Answer

All volatile agents have similar ICP effects above 1 MAC

Answer

All volatile anesthetic agents cause dose-dependent cerebral vasodilation and ICP elevation above 1 MAC; the effect is dose-dependent rather than agent-specific.

Question 2

In a patient with a traumatic brain injury (TBI), the TARGET mean arterial pressure (MAP) to maintain cerebral perfusion pressure (CPP) of at least 60 mmHg with an ICP of 20 mmHg is:

Accepted Answer

80 mmHg

Answer

CPP = MAP − ICP; to achieve CPP ≥ 60 mmHg with ICP of 20 mmHg, MAP must be ≥ 80 mmHg.

Question 3

Mannitol reduces intracranial pressure primarily by:

Accepted Answer

Creating an osmotic gradient that draws water from brain parenchyma

Answer

Mannitol establishes an osmotic gradient across the blood–brain barrier, drawing free water from brain tissue into the intravascular space and reducing brain volume.

Question 4

Which neuromuscular blocking agent is CONTRAINDICATED in patients with acute denervation injury (e.g., spinal cord injury within 72 hours)?

Accepted Answer

Succinylcholine

Answer

Succinylcholine causes massive potassium release from upregulated acetylcholine receptors in denervated muscle, risking fatal hyperkalemic cardiac arrest.

Question 5

During awake craniotomy for brain mapping, the anesthetic technique that best allows intraoperative neurological testing while maintaining patient comfort is:

Accepted Answer

Asleep-awake-asleep technique with dexmedetomidine/propofol

Answer

The asleep-awake-asleep technique using dexmedetomidine and/or propofol provides sedation during opening/closing while allowing an awake, cooperative patient for cortical mapping.

(BCA) Board of Certification in Anesthesiology Practice Test

(BCA) Board of Certification in Anesthesiology Practice Test

BCA BCA Neuroanesthesia & Neurosurgical Procedures 2