Practice Test Geeks(BCA) Board of Certification in Anesthesiology Practice Test
← All BCA Flashcard Decks

Obstetric Anesthesia & Analgesia 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 Obstetric Anesthesia & Analgesia flashcards as text

  1. Which uteroplacental circulation characteristic makes the fetus vulnerable to maternal hypotension during neuraxial anesthesia?

    Answer: Uteroplacental blood flow is pressure-dependent with no autoregulation

    Uteroplacental blood flow lacks autoregulation and is directly dependent on maternal perfusion pressure, making the fetus vulnerable to maternal hypotension.

  2. A parturient at 38 weeks gestation requires emergency cesarean delivery under general anesthesia. Which agent is MOST appropriate for rapid sequence induction?

    Answer: Ketamine 1-1.5 mg/kg

    Ketamine 1–1.5 mg/kg is preferred for RSI in obstetrics when propofol is avoided; it maintains hemodynamics and is safe for the fetus.

  3. What is the primary mechanism by which epidural labor analgesia reduces maternal catecholamine levels?

    Answer: Interruption of pain-mediated sympathetic activation

    Pain relief from epidural analgesia interrupts the sympathoadrenal reflex arc, reducing pain-driven catecholamine release and improving uteroplacental blood flow.

  4. During labor epidural top-up for emergency cesarean, which local anesthetic produces the fastest surgical anesthesia onset?

    Answer: Chloroprocaine 3%

    Chloroprocaine 3% has the fastest onset (2–5 minutes) of all epidural local anesthetics due to its high pKa offset by high concentration and rapid hydrolysis.

  5. A term parturient develops high spinal block after epidural catheter migration. Which hemodynamic intervention is FIRST-LINE?

    Answer: Phenylephrine 100 mcg IV bolus

    Phenylephrine is the first-line vasopressor for spinal-induced hypotension in obstetrics as it restores SVR with less fetal acidosis than ephedrine.

  6. Which parameter BEST guides the adequacy of a spinal block before cesarean delivery?

    Answer: Loss of cold sensation to T4 bilaterally

    Cold sensation testing to T4 (nipple line) is the standard clinical assessment ensuring adequate block height for uterine manipulation and peritoneal stimulation.

  7. Intrathecal morphine 0.1-0.2 mg after cesarean delivery primarily provides analgesia by acting on which receptors?

    Answer: Mu opioid receptors in the substantia gelatinosa of the dorsal horn

    Intrathecal morphine binds mu opioid receptors in the spinal cord dorsal horn, producing prolonged neuraxial analgesia lasting 12–24 hours.