Mixed Deck — All ABA Topics Flashcards

When an anesthesiologist suspects a terminally ill patient's pain management is being under-treated due to provider opiophobia, the most ethical action is to:

Answer: Advocate for adequate analgesia consistent with palliative care standards

Advocating for adequate pain control in terminally ill patients through appropriate channels is both an ethical duty and consistent with palliative care standards.

When performing an ultrasound-guided transversus abdominis plane (TAP) block, between which muscle layers should the local anesthetic be deposited?

Answer: Internal oblique and transversus abdominis

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

During a laparoscopic procedure, end-tidal CO2 abruptly rises to 80 mmHg and SpO2 drops to 78% with decreased breath sounds on the left. The MOST likely cause is:

Answer: Pneumothorax from trocar injury

Trocar injury to the pleura during laparoscopy can cause pneumothorax, presenting with unilateral decreased breath sounds, rising ETCO2, and hypoxia.

Which principle underpins the ABA requirement that diplomates report impairment in a colleague?

Answer: Non-maleficence toward patients who may be harmed

Non-maleficence—preventing harm to patients—is the primary ethical basis for mandatory reporting of an impaired colleague.

What is the name of the clinical competency committee tool used by ACGME anesthesiology programs to assess milestone achievement?

Answer: Anesthesiology Milestone Project

The Anesthesiology Milestone Project provides a framework for programs to assess resident development across six core competency domains.

Which of the following best describes the significance of a STOP-BANG score of 5 or greater in a preoperative patient?

Answer: High risk for obstructive sleep apnea requiring perioperative precautions

A STOP-BANG score ≥ 5 indicates high risk for moderate-to-severe OSA, warranting perioperative precautions such as continuous pulse oximetry and possible CPAP use.

The LEMON mnemonic for difficult airway assessment includes all of the following EXCEPT:

Answer: Neck circumference

LEMON stands for Look, Evaluate (3-3-2 rule), Mallampati, Obstruction, and Neck mobility — neck circumference is not one of the five components.

During handoff from the OR to the PACU, which communication framework is recommended by the ABA and patient safety organizations to minimize information loss?

Answer: SBAR (Situation, Background, Assessment, Recommendation)

SBAR is the standardized handoff framework endorsed by patient safety organizations to ensure structured, complete information transfer.

In the preoperative assessment of a patient with myasthenia gravis, which factor most influences the choice of neuromuscular blocking agent?

Answer: Profound sensitivity to nondepolarizing agents requiring significantly reduced doses

Myasthenia gravis patients have reduced acetylcholine receptors at the neuromuscular junction, making them exquisitely sensitive to nondepolarizing neuromuscular blocking agents.

A patient with COPD and FEV1/FVC of 0.52 presents for elective inguinal hernia repair under neuraxial anesthesia. Which preoperative optimization step is most important?

Answer: Ensure bronchodilator therapy is optimized and the patient is at baseline pulmonary function

Optimizing bronchodilator therapy and ensuring the patient is at their best baseline pulmonary status reduces perioperative bronchospasm and respiratory complications.

Which receptor subtype mediates the analgesic effects of opioids at the spinal cord level?

Answer: Mu (μ) receptors in the dorsal horn

Mu (μ) opioid receptors in the dorsal horn of the spinal cord are the primary mediators of spinal analgesia, inhibiting pain signal transmission.

A patient with health literacy challenges nods aggressively during a consent explanation but cannot answer a single teach-back question. What should the anesthesiologist do?

Answer: Re-explain key information using plain language, visual aids, and shorter segments, then re-check comprehension

When teach-back fails, the anesthesiologist must re-educate using simplified language and alternative methods before consent is complete.

Under ABA standards, what is the anesthesiologist's duty when they identify an unreported adverse event that occurred during a previous colleague's case?

Answer: Report it through the facility's adverse event reporting system

Adverse event reporting is both an ethical and regulatory obligation that must occur through the institution's formal reporting system.

An attending anesthesiologist is simultaneously supervising four CRNAs in separate rooms. A complication arises in one room. Ethically, the attending must:

Answer: Physically respond to the emergency room while ensuring the other cases are safely covered

The attending must personally respond to the emergency while arranging adequate coverage for the other supervised cases.

During a laparoscopic procedure, the surgeon notes CO2 gas entering the vascular system. What is the hallmark hemodynamic finding of venous gas embolism?

Answer: Sudden increase in end-tidal CO2 followed by a decrease

Venous gas embolism causes an initial transient rise then a precipitous fall in EtCO2 as gas obstructs pulmonary blood flow and reduces CO2 delivery to the lungs.

Why is continuing medical education (CME) essential for anesthesiologists?

Answer: To stay updated on patient safety and medical advancements

The field of medicine, particularly anesthesiology, is constantly evolving with new research, technologies, and best practices. Continuing Medical Education (CME) ensures that anesthesiologists remain current with these advancements, including new drugs, techniques, and patient safety protocols. This ongoing learning is crucial for delivering the highest standard of care and adapting to changes that improve patient outcomes.

What is the primary focus of patient safety in anesthesiology?

Answer: Minimizing risks and ensuring optimal care

Patient safety is the cornerstone of anesthesiology, as the administration of anesthesia inherently carries risks. The primary focus is to proactively identify, mitigate, and manage these risks to prevent adverse events and ensure the best possible outcomes for patients. This involves meticulous planning, continuous monitoring, adherence to protocols, and a culture of vigilance throughout the perioperative period.

During a root-cause analysis (RCA) of an adverse event, which tool BEST helps identify contributing system factors rather than individual blame?

Answer: Ishikawa (fishbone) cause-and-effect diagram

The Ishikawa fishbone diagram systematically maps contributing causes across categories (equipment, people, process, environment), focusing on system factors rather than individual blame.

When counseling a patient about postoperative pain management options, the anesthesiologist notes the patient has strong objections to opioids. What is the most appropriate response?

Answer: Explore the reasons for objection and collaboratively develop a multimodal analgesia plan that minimizes or eliminates opioids

Exploring objections and offering multimodal non-opioid alternatives respects patient values while providing effective pain control.

Why is airway management a critical skill in anesthesiology?

Answer: Ensures ventilation and prevents hypoxia

Airway management is paramount in anesthesiology because it directly ensures that the patient can breathe adequately and receive sufficient oxygen, preventing hypoxia (lack of oxygen). Anesthesiologists must be proficient in various techniques to secure and maintain a patent airway, as any compromise can lead to severe brain damage or death. This skill is foundational for patient survival and safe anesthetic delivery.