BCA BCA Neuroanesthesia & Neurosurgical Procedures

Question 1

Which anesthetic agent is MOST commonly used for neurosurgical procedures due to its ability to decrease cerebral metabolic rate?

Accepted Answer

Propofol

Answer

Propofol reduces cerebral metabolic rate of oxygen (CMRO2) and decreases intracranial pressure, making it a preferred agent for neurosurgical procedures.

Question 2

During craniotomy, a sudden bradycardia with hypertension (Cushing's triad) most likely indicates:

Accepted Answer

Raised intracranial pressure

Answer

Cushing's triad (hypertension, bradycardia, irregular respirations) is a classic sign of critically elevated intracranial pressure threatening brainstem herniation.

Question 3

Which position is MOST associated with venous air embolism risk during neurosurgery?

Accepted Answer

Sitting (beach chair)

Answer

The sitting position places surgical sites above the heart level, creating negative venous pressure that dramatically increases the risk of venous air embolism.

Question 4

The BEST method to detect venous air embolism intraoperatively is:

Accepted Answer

Precordial Doppler ultrasound

Answer

Precordial Doppler ultrasound is the most sensitive noninvasive monitor for detecting venous air embolism, able to detect as little as 0.05 mL of air.

Question 5

Hyperventilation is used in neurosurgery primarily to:

Accepted Answer

Decrease PaCO2 to cause cerebral vasoconstriction

Answer

Hyperventilation lowers PaCO2, inducing cerebral vasoconstriction that reduces cerebral blood volume and intracranial pressure, creating better surgical conditions.

(BCA) Board of Certification in Anesthesiology Practice Test

(BCA) Board of Certification in Anesthesiology Practice Test

BCA BCA Neuroanesthesia & Neurosurgical Procedures