BCSE Principles of Anesthesia 5

Question 1

A patient develops tachycardia, hyperthermia, muscle rigidity, and rhabdomyolysis after sevoflurane exposure. Temperature is 41°C. What is the immediate treatment?

Accepted Answer

Administer dantrolene 2.5 mg/kg IV immediately

Answer

Malignant hyperthermia requires immediate dantrolene (2.5 mg/kg IV, repeat up to 10 mg/kg), discontinuation of triggers, and aggressive cooling.

Question 2

Which monitoring modality is most useful for detecting intraoperative myocardial ischemia?

Accepted Answer

Five-lead ECG with continuous ST-segment monitoring (leads II and V5)

Answer

Combined monitoring of leads II and V5 detects approximately 96% of intraoperative ST-segment changes, covering both inferior and anterior/lateral territory.

Question 3

Opioid-induced hyperalgesia is BEST managed by which strategy?

Accepted Answer

Opioid rotation and multimodal analgesia with NMDA antagonists

Answer

Opioid rotation plus NMDA antagonists (ketamine, methadone) targets central sensitization underlying opioid-induced hyperalgesia.

Question 4

A patient has a T4 spinal cord injury. During urinary catheter insertion the patient develops hypertension, bradycardia, and diaphoresis. What is occurring?

Accepted Answer

Autonomic dysreflexia

Answer

Autonomic dysreflexia occurs in SCI above T6 when noxious stimuli below the lesion trigger uncontrolled sympathetic discharge without supraspinal inhibition.

Question 5

Which agent used for controlled hypotension in neuroanesthesia directly donates nitric oxide to produce vasodilation?

Accepted Answer

Sodium nitroprusside

Answer

Sodium nitroprusside spontaneously releases nitric oxide, activating guanylyl cyclase and producing rapid, titratable vasodilation.

BCSE - Basic and Clinical Sciences Examination Practice Test

BCSE - Basic and Clinical Sciences Examination Practice Test

BCSE Principles of Anesthesia 5