Practice Test Geeks(BCA) Board of Certification in Anesthesiology Practice Test
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BCA Thoracic & Vascular Anesthesia Flashcards

6 cards from real BCA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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

    Answer: Cerebral ischemia during carotid cross-clamping

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

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

    Answer: Cardiogenic shock or failure to wean from cardiopulmonary bypass

    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.

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

    Answer: Reduce whole-body oxygen consumption and provide organ protection

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

  4. Heparin dosing for cardiopulmonary bypass is monitored using:

    Answer: Activated clotting time (ACT)

    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.

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

    Answer: History of fish allergy or vasectomy

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

  6. Which anesthetic technique is MOST associated with reduced blood loss during spine and major vascular surgery?

    Answer: Deliberate controlled hypotension

    Deliberate controlled hypotension reduces perfusion pressure at surgical sites, significantly decreasing intraoperative blood loss during procedures with large raw surface areas.