BCSE Principles of Anesthesia 4

Question 1

Which inhalational agent is CONTRAINDICATED in patients with a history of renal insufficiency due to nephrotoxic fluoride metabolite production?

Accepted Answer

Methoxyflurane

Answer

Methoxyflurane undergoes extensive hepatic metabolism releasing high levels of inorganic fluoride, causing polyuric renal failure.

Question 2

During general anesthesia, a patient's end-tidal CO2 suddenly rises while peak airway pressure increases. What is the most likely cause?

Accepted Answer

Bronchospasm

Answer

Bronchospasm causes increased airway resistance leading to rising peak pressures and CO2 retention due to impaired exhalation.

Question 3

Which local anesthetic is MOST associated with cardiovascular toxicity due to its high lipid solubility and slow sodium channel dissociation?

Accepted Answer

Bupivacaine

Answer

Bupivacaine has high lipid solubility and slow dissociation from cardiac sodium channels, making ventricular arrhythmias difficult to resuscitate.

Question 4

A patient undergoing thyroidectomy is found to have a high-riding innominate artery. What is the anesthetic implication?

Accepted Answer

Increased risk of arterial bleeding during tracheostomy

Answer

A high-riding innominate artery overlies the trachea at or above the sternal notch, creating significant hemorrhage risk during emergency tracheostomy.

Question 5

What is the effect of hyperventilation on cerebral blood flow during neuroanesthesia?

Accepted Answer

Decreases CBF by causing cerebral vasoconstriction via hypocapnia

Answer

Hypocapnia from hyperventilation causes cerebral vasoconstriction, reducing cerebral blood flow and intracranial pressure.

BCSE - Basic and Clinical Sciences Examination Practice Test

BCSE - Basic and Clinical Sciences Examination Practice Test

BCSE Principles of Anesthesia 4