BCA BCA Thoracic & Vascular Anesthesia 2

Question 1

During carotid endarterectomy (CEA) under general anesthesia, the primary purpose of intraoperative EEG monitoring is to detect:

Accepted Answer

Cerebral ischemia during carotid cross-clamping

Answer

EEG monitoring detects ipsilateral cortical ischemia during carotid cross-clamp, prompting placement of a carotid shunt to maintain cerebral perfusion.

Question 2

The MOST common indication for insertion of an intra-aortic balloon pump (IABP) in the perioperative setting is:

Accepted Answer

Cardiogenic shock or failure to wean from cardiopulmonary bypass

Answer

The IABP augments diastolic coronary perfusion and reduces afterload (systolic unloading), making it the primary mechanical support for cardiogenic shock and post-bypass ventricular failure.

Question 3

During cardiopulmonary bypass (CPB), systemic hypothermia is used primarily to:

Accepted Answer

Reduce whole-body oxygen consumption and provide organ protection

Answer

Hypothermia decreases metabolic rate and oxygen demand proportionally, extending safe ischemia time for the heart and other organs during cardiac surgical procedures.

Question 4

Heparin dosing for cardiopulmonary bypass is monitored using:

Accepted Answer

Activated clotting time (ACT)

Answer

The ACT is the standard point-of-care test for monitoring heparin anticoagulation during CPB; a target ACT of ≥ 480 seconds is typically required before initiating bypass.

Question 5

Protamine sulfate is administered after CPB to reverse heparin. A severe adverse reaction to protamine is MOST associated with:

Accepted Answer

History of fish allergy or vasectomy

Answer

Patients with fish allergy or prior vasectomy (anti-protamine antibodies) are at elevated risk for severe protamine reactions including anaphylaxis and pulmonary vasoconstriction.

(BCA) Board of Certification in Anesthesiology Practice Test

(BCA) Board of Certification in Anesthesiology Practice Test

BCA BCA Thoracic & Vascular Anesthesia 2