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BCA Thoracic & Vascular Anesthesia Flashcards

6 cards from real BCA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. A patient on chronic beta-blocker therapy undergoing vascular surgery should:

    Answer: Continue beta-blockers perioperatively to reduce cardiac events

    Abrupt beta-blocker withdrawal causes rebound sympathetic activation; continuing therapy perioperatively prevents tachycardia and reduces myocardial ischemia risk in vascular patients.

  2. The gold standard for confirming correct placement of a double-lumen tube (DLT) after patient positioning is:

    Answer: Fiberoptic bronchoscopy

    Repositioning the patient for surgery frequently displaces a DLT; fiberoptic bronchoscopy directly visualizes the carina and tube position, confirming adequate lung isolation.

  3. During repair of a ruptured abdominal aortic aneurysm (AAA), sudden loss of femoral pulses after aortic clamping MOST likely indicates:

    Answer: Aortic dissection extending below the clamp

    Loss of distal pulses after clamping can signal clamp-induced retrograde aortic dissection extending into the iliac or femoral vessels, requiring immediate surgical reassessment.

  4. Which drug is MOST appropriate for treating rebound hypertension after carotid endarterectomy?

    Answer: Labetalol or nicardipine

    Labetalol (combined alpha/beta blockade) or nicardipine (calcium channel blocker) effectively controls post-CEA hypertension without causing reflex tachycardia or cerebral vasodilation.

  5. Endovascular aortic repair (EVAR) requires anesthesia considerations related to:

    Answer: Contrast nephropathy risk and groin access site management

    EVAR uses fluoroscopic contrast, creating nephrotoxicity risk especially in patients with baseline renal impairment; femoral arteriotomy access also requires monitoring for hematoma or distal ischemia.

  6. In thoracic surgery, the MAXIMUM safe duration of one-lung ventilation before significant ischemia-reperfusion injury to the non-ventilated lung becomes a concern is generally accepted as:

    Answer: Varies primarily with FiO2 delivered to the ventilated lung

    Tolerance of OLV varies widely based on FiO2, PEEP strategy, and patient reserve; there is no fixed safe limit — continuous SpO2 monitoring and willingness to recruit or reinflate the lung guide management.