Practice Test Geeks(BCA) Board of Certification in Anesthesiology Practice Test
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Cardiovascular Anesthesia Flashcards

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

Read the first 7 Cardiovascular Anesthesia flashcards as text

  1. Which vasopressor is CONTRAINDICATED in a patient with severe mitral stenosis and atrial fibrillation with rapid ventricular response?

    Answer: Epinephrine

    Epinephrine's beta-1 chronotropic effects further increase heart rate, worsening the transmitral gradient and pulmonary congestion in mitral stenosis with AF.

  2. The cerebral metabolic rate for oxygen (CMRO2) is reduced by approximately how much for each 1°C decrease in temperature during hypothermic CPB?

    Answer: 6-7%

    CMRO2 decreases by approximately 6-7% per degree Celsius of cooling, following the Q10 relationship (metabolic rate roughly halves for every 10°C decrease).

  3. A patient develops acute pulmonary edema immediately after mitral valve repair is completed. TEE shows systolic anterior motion. The BEST initial medical management is:

    Answer: Phenylephrine and IV fluid bolus

    SAM-induced LVOT obstruction is worsened by hypovolemia and vasodilation; phenylephrine increases afterload and fluid increases preload, both reducing SAM severity.

  4. Which statement about del Nido cardioplegia compared to standard blood cardioplegia is CORRECT?

    Answer: del Nido provides arrest for approximately 60-90 minutes per dose

    del Nido cardioplegia's formulation (with lidocaine, MgSO4, and mannitol) provides sustained arrest for 60-90 minutes, reducing the need for frequent redosing.

  5. Which condition is MOST likely to produce a 'V-wave' on the pulmonary artery wedge pressure tracing?

    Answer: Acute severe mitral regurgitation

    Acute severe MR causes large V-waves as the regurgitant volume rapidly elevates left atrial pressure during ventricular systole, transmitted to the PAWP tracing.

  6. During off-pump CABG (OPCAB), which stabilizer position for the circumflex territory most commonly causes hemodynamic compromise?

    Answer: Lateral wall (Cx territory) with vertical displacement

    Lateral wall exposure requires cardiac displacement that rotates the heart, compresses the RV, and distorts the tricuspid valve, causing significant hemodynamic instability.

  7. Tranexamic acid reduces bleeding in cardiac surgery primarily by:

    Answer: Competitively blocking plasminogen lysine-binding sites

    Tranexamic acid is a lysine analogue that competitively inhibits plasminogen activation by blocking its lysine-binding sites, thereby preventing fibrinolysis.