BCA Cardiovascular Anesthesia 2

Question 1

Which volatile anesthetic best preserves cardiac output in patients with severe left ventricular dysfunction?

Accepted Answer

Sevoflurane

Answer

Sevoflurane causes less myocardial depression and provides cardioprotection via preconditioning, making it preferred in severe LV dysfunction.

Question 2

A patient on cardiopulmonary bypass develops ST elevation in lead II. The most likely cause is:

Accepted Answer

Air embolism to right coronary artery

Answer

Air entrainment preferentially affects the right coronary artery (most anterior), causing RCA territory ischemia manifesting as inferior ST elevation.

Question 3

The gold standard for assessing myocardial viability in a patient with chronic ischemic cardiomyopathy prior to CABG is:

Accepted Answer

PET scanning with FDG

Answer

FDG-PET identifies hibernating myocardium with high sensitivity and specificity, making it the gold standard for viability assessment.

Question 4

During aortic valve replacement, the aortic cross-clamp time is most directly associated with:

Accepted Answer

Degree of myocardial ischemia

Answer

Cross-clamp time directly correlates with the duration of global myocardial ischemia despite cardioplegia, affecting postoperative ventricular function.

Question 5

Protamine reversal of heparin can cause pulmonary hypertension via:

Accepted Answer

Thromboxane A2 release from pulmonary macrophages

Answer

Heparin-protamine complexes activate complement and stimulate pulmonary macrophages to release thromboxane A2, causing severe pulmonary vasoconstriction.

(BCA) Board of Certification in Anesthesiology Practice Test

(BCA) Board of Certification in Anesthesiology Practice Test

BCA Cardiovascular Anesthesia 2