BCA Regional Anesthesia Techniques 2

Question 1

Which landmark is used to identify the correct interspace for a lumbar epidural in an obese patient when ultrasound is unavailable?

Accepted Answer

Iliac crest at L4-L5

Answer

The iliac crest typically crosses the L4-L5 interspace and serves as the primary surface landmark for lumbar epidural placement.

Question 2

A patient develops sudden dyspnea and decreased breath sounds on the right after a right-sided interscalene nerve block. What is the most likely complication?

Accepted Answer

Pneumothorax

Answer

Pneumothorax is a recognized complication of interscalene block due to the proximity of the lung apex, presenting with dyspnea and unilateral absent breath sounds.

Question 3

When performing a transversus abdominis plane (TAP) block, the local anesthetic is deposited in which fascial plane?

Accepted Answer

Between the internal oblique and transversus abdominis muscles

Answer

The TAP block targets the neurovascular plane between the internal oblique and transversus abdominis muscles where the T10-L1 nerves travel.

Question 4

Which of the following is the MOST appropriate management of a tourniquet pain that occurs 45 minutes into surgery under IV regional anesthesia (Bier block)?

Accepted Answer

Inflate the proximal cuff and deflate the distal cuff

Answer

For Bier block tourniquet pain, inflating the proximal cuff (over anesthetized skin) and then deflating the distal cuff reduces pain while maintaining safety.

Question 5

What is the maximum safe volume of 0.25% bupivacaine for an ultrasound-guided femoral nerve block in a 70 kg adult?

Accepted Answer

20-30 mL

Answer

For peripheral nerve blocks, 20-30 mL of 0.25% bupivacaine provides adequate spread while remaining well within the maximum dose of 2.5 mg/kg (175 mg for 70 kg).

(BCA) Board of Certification in Anesthesiology Practice Test

(BCA) Board of Certification in Anesthesiology Practice Test

BCA Regional Anesthesia Techniques 2