Local Anesthetics (MSQ DRILL 178)

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1/37 Questions

At low concentration of local anesthetics sodium channels are blocked. True or false?
- True
- False

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2.

In order for anesthetics to work they have to block the action potential. How do they do this?
- By blocking pottassium channels
- By blocking sodium channels
- By blocking release of acetylcholine from the presynaptic neuron
- By blocking chloride channels
Correct Answer

A. By blocking sodium channels
3.

If you block calcium channels because of a high concentration of a local anesthetic you will have increased or decreased conduction?
- Increased conduction
- Decreased conduction
Correct Answer

A. Decreased conduction
4.

In other words coccaine can act as a local anesthetic since it blocks sodium channels?
- Yes
- No
Correct Answer

A. Yes
5.

Is there a possibility that a patient who has taken coccaine might develop arrythmias
- Yes
- No
Correct Answer

A. Yes
6.

Is coccaine an amide or an ester?
- Amide
- Ester
Correct Answer

A. Ester
7.

What types of anesthetics should be used for long precedures?
- Longer acting anesthetics
- Shorter acting anesthetics
Correct Answer

A. Longer acting anesthetics
8.

In general local anesthetics can cause central nervous system side effects. True or false?
- True
- False
Correct Answer

A. True
9.

Which local anesthetics are hepatically metabolized and should therefore be used cautiously in paitients with hepatic impairment?
- Esters
- Amides
Correct Answer

A. Amides
10.

Which anesthetics should be used for a long procedure?
- Water soluble
- Lipophilic
Correct Answer

A. Lipophilic

Explanation

Water soluble anesthetics have a shorter duration.

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11.

Would you use procaine for a long or a short procedure?
- Long procedure
- Short procedure
Correct Answer

A. Short procedure

Explanation

Because it is hydrophilic and therefore has a shorter duration of action.

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12.

In other words a low dose of a local anesthetic can block sodium channels, and lead to hyper or hypo excitalbility of cardiac muscle?
- Hyper excitability
- Hypo excitability
Correct Answer

A. Hyper excitability
13.

Which of the following is a sodium channel blocker that also inhibits the reuptake of dopamine and norepi?
- Heroin
- Cannabis
- Coccaine
- Methamphetamine
Correct Answer

A. Coccaine
14.

You should use epinephrine in distal, perfusion limited sites such as the tip on of the nose, toes and fingers. True or false?
- True
- False
Correct Answer

A. False

Explanation

You should NEVER use epinephrine in perfusion limited areas.

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15.

Which molecules would have a faster onset?
- Lipophilic molecules
- Hydrophilic molecules
Correct Answer

A. Lipophilic molecules
16.

Between audio-visual disturbances and convulsions, which one occurs at high concentations?
- Audio-visual disturbances
- Convulsions
Correct Answer

A. Convulsions
17.

Which local anesthetics are structurally and immunologically related to p-aminobenzoic acid (PABA?)
- Esters
- Amides
Correct Answer

A. Esters

Explanation

PABA is an intermediate in the bacterial synthesis of
folate. Sulfonamide drugs are structurally similar to PABA, and their antibacterial activity is due to their ability to interfere with the conversion of PABA to folate by the enzyme dihydropteroate synthetase. Thus, bacterial growth is limited through folate deficiency without effect on human cells.

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18.

Which organs will quickly feel the effects of a local anesthetic?
- Organs with high perfusion
- Organs with low perfusion
Correct Answer

A. Organs with high perfusion
19.

What are the two structural classes of local anesthetics?
- Esters
- Amines
- Amides
- Carboxylic acids
- Purines
Correct Answer(s)

A. Esters
A. Amides
20.

Local anesthetics that have one "i" in their name are esters or amides?
- Esters
- Amides
Correct Answer

A. Esters
21.

Esters are preferable for patients with hepatic dysfunction. What enzyme degrades esters?
- Acetylcholinestarase
- Mono amine oxidase
- Plasma cholinesterase
- Synaptic cholinesterase
Correct Answer

A. Plasma cholinesterase
22.

Calcium channels are blocked by a high conentration of a local anesthetics resulting in decreased conduction. Would this lead to high or low blood pressure?
- High blood pressure - hypertension
- Low blood pressure - hypotension
Correct Answer

A. Low blood pressure - hypotension
23.

If a patient has a PABA allergy, do you use an amide or an ester?
- Amide
- Ester
Correct Answer

A. Amide
24.

If you add epinephrine to a local anesthetic, does this increase or decrease absorption?
- Increases absorption of local anesthetic
- Decreases absoption of local anesthetic
Correct Answer

A. Decreases absoption of local anesthetic
25.

All local anesthetics are __________ connected to an aromatic ring.
- Weak acids
- Strong acids
- Weak bases
- Stog bases
Correct Answer

A. Weak bases
26.

Do you need a high concentration of a local anesthetic in order to induce sedation in a patient?
- Yes
- No
Correct Answer

A. No
27.

If oxidation of Fe2+ occurs as a result of a local anesthetics what will happen to the patient's respiratory status?
- Shortness of breath
- Hypoventiation
- No change in respiratory status
Correct Answer

A. Shortness of breath
28.

Death is most definitiely resultant of a high concentration of a local anesthetic, what about nystagmus, do you need a high or a low concentration?
- Nystagmus occurs at high concentrations
- Nystagmus occurs at low concentrations
Correct Answer

A. Nystagmus occurs at high concentrations
29.

Lidocaine, mepivaciane and procaines (novocain) are lipophilic or water soluble?
- Lipophilic
- Water soluble
Correct Answer

A. Water soluble
30.

Oxdiation of FE2t to Fe3t with eventual cyanosis as a result of a local anesthetic will lead to cyanosis and shortness of breath. This can also be referred to:
- Chocolate blood
- Thick blood
- Thin blood
- Black blood
Correct Answer

A. Chocolate blood
31.

Smaller lipophilic molecules have a faster onet. Do they also have a long duration?
- Yes
- No
Correct Answer

A. Yes
32.

Local anesthetics can cause cyanosis due to the oxidation of Fe2+ to Fe3+. What is this process all known as?
- Methylhemoglobinemia
- Methomoglobinemia
- Methylmyoglobiuria
Correct Answer

A. Methomoglobinemia
33.

If sodium channels are blocked because of a LOW concentration of a local anesthetic the cardiac tissue will experience increased or decreased automaticity?
- Increased automaticity
- Decreased automaticity
Correct Answer

A. Increased automaticity
34.

So if someone has taken coccaine and they are thus euphoric which of the following may you observe?
- CNS depression
- CNS stimulation
- Bradycardia
- Tachycardia
- Hypertension
Correct Answer(s)

A. CNS stimulation
A. Tachycardia
A. Hypertension

Explanation

The hypertension is from an increased level of dopamine and norepi because of the reduced reuptake.

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35.

In terms of cardiovascular side effects, what channels are blocked when a high concentration of local anesthetics is administered?
- Sodium channels
- Calcium channels
- Pottasium channels
- Chloride channels
Correct Answer

A. Calcium channels
36.

A dose >10mg/kg of procaine is being prepared to be administered on patient. You walk in and state the following:
- The patient will becone cyanotic because of the oxidation of hemoglobin
- The patient will become cyanotic because of the oxidation of myoglobin
- The patient will becone cyanotic because of the oxidation of iron Fe2+
- The patient will become cynotic because of the reduction of Fe3+
Correct Answer

A. The patient will becone cyanotic because of the oxidation of iron Fe2+
37.

A patient who has received an local anesthetic complains of a metallic taste in their mouth and a feeling of numbness around their mouth (cirumoral numbing). Are these symptoms reflective of a high or a low concentration of the local anesthetic?
- High dose
- Low dose
Correct Answer

A. Low dose

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Quiz Edited by
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Apr 26, 2010

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Local Anesthetics (Msq Drill 178)

At low concentration of local anesthetics sodium channels are blocked. True or false?

Quiz Preview

In order for anesthetics to work they have to block the action potential. How do they do this?

If you block calcium channels because of a high concentration of a local anesthetic you will have increased or decreased conduction?

In other words coccaine can act as a local anesthetic since it blocks sodium channels?

Is there a possibility that a patient who has taken coccaine might develop arrythmias

Is coccaine an amide or an ester?

What types of anesthetics should be used for long precedures?

In general local anesthetics can cause central nervous system side effects. True or false?

Which local anesthetics are hepatically metabolized and should therefore be used cautiously in paitients with hepatic impairment?

Which anesthetics should be used for a long procedure?

Would you use procaine for a long or a short procedure?

In other words a low dose of a local anesthetic can block sodium channels, and lead to hyper or hypo excitalbility of cardiac muscle?

Which of the following is a sodium channel blocker that also inhibits the reuptake of dopamine and norepi?

You should use epinephrine in distal, perfusion limited sites such as the tip on of the nose, toes and fingers. True or false?

Which molecules would have a faster onset?

Between audio-visual disturbances and convulsions, which one occurs at high concentations?

Which local anesthetics are structurally and immunologically related to p-aminobenzoic acid (PABA?)

Which organs will quickly feel the effects of a local anesthetic?

What are the two structural classes of local anesthetics?

Local anesthetics that have one "i" in their name are esters or amides?

Esters are preferable for patients with hepatic dysfunction. What enzyme degrades esters?

Calcium channels are blocked by a high conentration of a local anesthetics resulting in decreased conduction. Would this lead to high or low blood pressure?

If a patient has a PABA allergy, do you use an amide or an ester?

If you add epinephrine to a local anesthetic, does this increase or decrease absorption?

All local anesthetics are __________ connected to an aromatic ring.

Do you need a high concentration of a local anesthetic in order to induce sedation in a patient?

If oxidation of Fe2+ occurs as a result of a local anesthetics what will happen to the patient's respiratory status?

Death is most definitiely resultant of a high concentration of a local anesthetic, what about nystagmus, do you need a high or a low concentration?

Lidocaine, mepivaciane and procaines (novocain) are lipophilic or water soluble?

Oxdiation of FE2t to Fe3t with eventual cyanosis as a result of a local anesthetic will lead to cyanosis and shortness of breath. This can also be referred to:

Smaller lipophilic molecules have a faster onet. Do they also have a long duration?

Local anesthetics can cause cyanosis due to the oxidation of Fe2+ to Fe3+. What is this process all known as?

If sodium channels are blocked because of a LOW concentration of a local anesthetic the cardiac tissue will experience increased or decreased automaticity?

So if someone has taken coccaine and they are thus euphoric which of the following may you observe?

In terms of cardiovascular side effects, what channels are blocked when a high concentration of local anesthetics is administered?

A dose >10mg/kg of procaine is being prepared to be administered on patient. You walk in and state the following:

A patient who has received an local anesthetic complains of a metallic taste in their mouth and a feeling of numbness around their mouth (cirumoral numbing). Are these symptoms reflective of a high or a low concentration of the local anesthetic?