BCA Anesthesia Complications & Management 2

Question 1

A patient develops sudden hypotension, bronchospasm, and urticaria 10 minutes after antibiotic administration. What is the first-line treatment?

Accepted Answer

IV epinephrine 0.1–0.5 mg

Answer

Epinephrine is the first-line treatment for anaphylaxis due to its alpha and beta adrenergic effects that counteract vasodilation, bronchospasm, and mast cell mediator release.

Question 2

Which finding is most characteristic of malignant hyperthermia compared to other causes of intraoperative hyperthermia?

Accepted Answer

Rising end-tidal CO2 despite increased minute ventilation

Answer

Rapidly rising end-tidal CO2 that cannot be controlled by increasing ventilation is the earliest and most sensitive sign of malignant hyperthermia, reflecting massively increased skeletal muscle metabolism.

Question 3

A patient on rocuronium has incomplete reversal with neostigmine. Train-of-four shows 2 twitches. What is the best next step?

Accepted Answer

Administer sugammadex 16 mg/kg

Answer

Sugammadex 16 mg/kg is indicated for immediate reversal of profound neuromuscular blockade (1–2 twitches on TOF) caused by rocuronium or vecuronium.

Question 4

During spinal anesthesia, a patient complains of difficulty breathing and becomes unresponsive. Blood pressure is 60/40. This presentation is most consistent with:

Accepted Answer

Total spinal anesthesia

Answer

Total spinal anesthesia results from intrathecal spread of local anesthetic to cervical and brainstem levels, causing hypotension, respiratory paralysis, and loss of consciousness.

Question 5

A patient develops ST-segment depression and new regional wall motion abnormalities intraoperatively. After confirming adequate oxygenation, what is the most appropriate initial intervention?

Accepted Answer

Correct hemodynamic abnormalities (BP, HR)

Answer

Correcting hemodynamic derangements (optimizing oxygen supply-demand balance by addressing hypotension, tachycardia, or anemia) is the first priority in managing intraoperative myocardial ischemia.

(BCA) Board of Certification in Anesthesiology Practice Test

(BCA) Board of Certification in Anesthesiology Practice Test

BCA Anesthesia Complications & Management 2