BCA Obstetric Anesthesia & Analgesia 2

Question 1

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

Accepted Answer

Uteroplacental blood flow is pressure-dependent with no autoregulation

Answer

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

Question 2

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

Accepted Answer

Ketamine 1-1.5 mg/kg

Answer

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.

Question 3

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

Accepted Answer

Interruption of pain-mediated sympathetic activation

Answer

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

Question 4

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

Accepted Answer

Chloroprocaine 3%

Answer

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.

Question 5

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

Accepted Answer

Phenylephrine 100 mcg IV bolus

Answer

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

(BCA) Board of Certification in Anesthesiology Practice Test

(BCA) Board of Certification in Anesthesiology Practice Test

BCA Obstetric Anesthesia & Analgesia 2