Block 13 Gen Anesthetics Dementia Weakness MCQ's

18 Questions | Total Attempts: 238

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Anesthetics Quizzes & Trivia

Questions and Answers
  • 1. 
    A 14 year old patient visits the dentist for a scheduled removal of his wisdom teeth. The dentist notes removal of two of the wisdom teeth will require surgery. The oral surgeon plans to use an anesthetic with good analgesic and sedative properties but which does not cause relaxation of the skeletal muscles. Which is the drug the surgeon will most likely use?
    • A. 

      Enflurane

    • B. 

      Nitrous oxide

    • C. 

      Isoflurane

    • D. 

      Halothane

    • E. 

      Thiopental

  • 2. 
    An 11 year old boy was severely burned after playing with fireworks and had to undergo a number of surgeries and multiple skin grafting procedures. To help him cope with the pain during the long recovery period he constantly received ketamine? Which of the following is an adverse reaction most associated “only” with this general anesthetic?
    • A. 

      Hypotension and apnea

    • B. 

      Nausea and vomiting

    • C. 

      Sensitize heart to catecholamines

    • D. 

      Malignant hyperthermia

    • E. 

      Hallucination and delirium

    • F. 

      Life threatening hepatitis

  • 3. 
    Inhaled and intravenous anesthetics depress spontaneous and evoked activity of the neurons in many regions of the brain. Which of the following is the primary molecular target for some inhaled anesthetics, benzodiazepines, etomidate, and propofol?
    • A. 

      NMDA receptor

    • B. 

      5NT-1 Dopamine receptor

    • C. 

      M2 receptor

    • D. 

      Alpha 1- receptor

    • E. 

      Site outside the Voltage-gated Na channels

    • F. 

      GABA-A receptor sites

  • 4. 
    Which of the following general anesthetics is associated with the development of threatening hepatitis that involves reactive metabolites form previous exposure to anesthetic initiating an immune-mediated response?
    • A. 

      Isoflurane

    • B. 

      Desfluorane

    • C. 

      Sevoflurane

    • D. 

      Nitrous oxide

    • E. 

      Halothane

  • 5. 
    Which of the following anesthetics produces: an increase coronary blood flow with decrease O2 consumption making it safe for use in patients with ischemic heart disease, causes less cerebral vasodilation making it ideal for neurosurgical procedures, but relaxes uterine muscle less ideal for labor or vaginal delivery. It is also less toxic to liver and has medium rate of onset and recovery.
    • A. 

      Desfluorane

    • B. 

      Sevoflurane

    • C. 

      Halothane

    • D. 

      Isoflurane

    • E. 

      Enflurane

  • 6. 
    In the manifestation of obstructed loop of vowel which general anesthetic should be avoided because it exchanges with nitrogen in any air-containing cavity in the body increasing the volume/pressure of cavity?
    • A. 

      Propofol

    • B. 

      Thiopental sodium

    • C. 

      Halothane

    • D. 

      Isoflurane

    • E. 

      Nitrous oxide

  • 7. 
    An autosomal dominant genetic disorder of skeletal muscle that occurs in susceptible individuals undergoing anesthesia with all halogenated anesthetics some of its characteristics are onset of tachycardia and hypertension with severe muscle rigidity, hyperthermia and hyperkalemia and hypercalcemia?
    • A. 

      Myasthenia gravis

    • B. 

      Halothane hepatitis

    • C. 

      Malignant hyperthermia

    • D. 

      Potential nephrotoxicity

    • E. 

      Coronary steal

  • 8. 
    A 32 year old man is taken to the emergency room after complaining that he is unable to walk. His symptoms begun 3 days earlier with “pins and needles” in both feet that gradually worsened and ascended to involve knees and the fingertips. He had difficulty maintaining proper control of the movements of his arms and feet. He reported the sensation of electric shocks through his legs and upon flexion of the neck, and has been unable to maintain an erection. The neurological examination showed hyperesthesia and hyperalgesia. He then confessed inhaling “two to three boxes of cartridges of it for the past three months.” The suspected drug most likely antagonizes the NMDA receptor also, which one is it?
    • A. 

      Nitrous oxide

    • B. 

      Ketamine

    • C. 

      Propofol

    • D. 

      Sevoflurane

    • E. 

      Isoflurane

    • F. 

      Nitric oxide

  • 9. 
    A 31 year old female presents with the following clinical manifestations which include fever, malaise, anorexia, nauseas, vomiting, jaundice, skin rash, liver tenderness. Fulminant hepatitis was present. Additional symptoms were elevated serum transaminases, alkaline phosphatase, bilirubin and eosinophilia. Liver transplantation was necessary due to the severity of the case. The manifestations begun 4 days after the patient had been exposed to an anesthetic. Which of the following is the most probable anesthetic that lead to this prognosis?
    • A. 

      Nitrous oxide

    • B. 

      Thiopental sodium

    • C. 

      Halothane

    • D. 

      Propofol

    • E. 

      Ketamine

  • 10. 
    A 65 year old man underwent open cholecystectomy. Anesthesia was induced with an intravenous anesthetic. He was then incubated and maintained with another anesthetic up to 1.5 % in a 1:1 mixture of nitrous oxide-oxygen. His blood pressure under the anesthesia was within normal limits and no respiratory complications were recorded. On the day postoperative he developed tachyapnea, tachycardia, and hypontesion. The second day he developed pain with fever and vomiting and a rise of liver enzymes transaminases and bilirubin to twice the normal limit. Patient tested negative for viral hepatitis. The most probable combination which caused these complications is?
    • A. 

      Thiopentone first, nitrous oxide with propofol second

    • B. 

      Thiopentone first, nitrous oxide with ketamine second

    • C. 

      Thiopentone first, nitrous oxide with halothane second

    • D. 

      Isoflurane first, nitrous oxide with thiopentone second

    • E. 

      Halothane first, nitrous oxide with diazepam second

  • 11. 
    While in the operating room a 48 year old diabetic man is exposed to an anesthetic agent. He suddenly develops the following: sustained muscle contraction resulting in signs of hypermetabolism, acidosis, tachycardia, hypercarbia, hypoxemia and heat production. Which of the following choices most likely the condition:
    • A. 

      Halothane hepatitis

    • B. 

      Conscious sedation

    • C. 

      Malignant hyperthermia

    • D. 

      Hyperglycemic shock

    • E. 

      Metabolic syndrome

  • 12. 
    A 22-year old man is scheduled to undergo a laparoscopic hernia repair under general anesthesia. The patient seems very anxious in the preoperative area and a premedication administered parenterally is considered. Which of the following medications would be appropriate to prepare this patient for surgery?
    • A. 

      Sevoflurane

    • B. 

      Botulinum toxin

    • C. 

      Baclofen

    • D. 

      Naltrexone

    • E. 

      Midazolam

  • 13. 
    A 14-year-old girl is admitted to an ambulatory surgery center for strabismus surgery to correct misalignment of her extra ocular muscles. She is otherwise healthy and all her laboratory values are within normal range. The surgery is anticipated to last approximately 90 minutes. An induction agent given intravenously is selected for procedure requiring general anesthesia. Which drug is it?
    • A. 

      Desfluorane

    • B. 

      Gabapentin

    • C. 

      Cisatrocurium

    • D. 

      Tramadol

    • E. 

      Propofol

    • F. 

      Etomidate

  • 14. 
    A 72-year-old man is in need of repair of an abdominal aortic aneurism. Patient has a blood pressure of 165/100 mmHg, and his past medical history shows his hypertension has been poorly controlled with hydrochlorothiazide and propanolol taken daily. Patient also has angina that is occasionally treated with nitroglycerin. His EKG changes with moderate exercise. Patient arrives to the emergency department with complaints of serious back pain, two days before the scheduled surgery, and surgeon fears aneurism is leaking or expanding and decides to proceed with the surgery. Which of the following drugs would be best used for rapid anesthetic induction and maintenance?
    • A. 

      Thiopental

    • B. 

      Propofol

    • C. 

      Etomidate

    • D. 

      Ketamine

    • E. 

      Halothane

  • 15. 
    A 49-year-old woman underwent abdominal surgery to remove a colon cancer. The anesthesia was performed with thiopental, fentanyl and nitrous oxide. Which of the following adverse effects was the patient most likely to experience postoperatively?
    • A. 

      Watery diarrhea

    • B. 

      Malignant hyperthermia

    • C. 

      Nausea and vomiting

    • D. 

      Hallucinations

    • E. 

      Strong pain

  • 16. 
    A 10-year-old boy diagnosed to have strabismus, for surgical correction, was anesthetized with halothane. Succinyl choline was administered to facilitate endotracheal intubation. Twenty minutes later masseter muscle tone remains increased so that his teeth compress the endotracheal tube. Even other skeletal muscle tone was found to be increased. His body temperature is 39 C (102.2 F), pulse is 125/minute and respiration rate is 20.  In this situation which of the following skeletal muscle relaxant is used to treat this condition?
    • A. 

      Centrally acting muscle relaxant

    • B. 

      Non-depolarization blocker

    • C. 

      Depolarization blocker

    • D. 

      Raynodine receptor blocker

  • 17. 
    A 55 year old patient is seen in the ER having been found wandering around apparently lost in a shopping mall. His wife says that this problem has not happened before, although her husband has been having episodes where his memory fails. He seems well for a while then another episode happens. He never seems to recover completely and his condition is gradually worsening in almost a stepwise fashion. General neurological exam is normal. The most likely diagnosis is:
    • A. 

      Vascular dementia

    • B. 

      Frontotemporal dementia

    • C. 

      Alcoholism

    • D. 

      Alzheimer’s

    • E. 

      PCA (posterior cerebral artery) stroke

  • 18. 
    A 25-year-old College student noticed weakness while walking that developed over a couple of weeks. So he saw the doctor at the student health center. When asked by the doctor, he is not very clear when it started, but he thinks that the weakness is slowly getting worse and now he says the right arm is also getting weak. He says that the legs feel quite heavy and stiff all the time. He says he has no known illnesses. He smokes a packet of cigarettes a day and drinks about one or two beers a day. He does not use any other medications or recreational drugs. His father is a Hypertensive and his mother is a Diabetic. Both are healthy and on regular medication. So the doctor in the health center examined him and sent him to the City hospital. The Internist there examined him and found that he has a spastic paraparesis and there is wasting in the right hand. The student has no sensory loss anywhere and his bladder and bowel functions are good. So the Internist got a battery of Investigations done and found that all of them are normal, except an abnormal finding in the CSF analysis. What is the most probable CSF change that may be found in the disease he is suffering from?
    • A. 

      Elevated level of Protein

    • B. 

      Reduced level of Glucose

    • C. 

      Elevated level of Chlorides

    • D. 

      Elevated Leukocyte count

    • E. 

      Reduced level of VEGF