Chem II Quiz 2

68 Questions | Total Attempts: 67

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Chem II Quiz 2

Review of material for test 2. Local anesthetics, pKa, diffusion, mixtures.


Questions and Answers
  • 1. 
    A non-uniform mixture that has regions of different composition is known as what?
    • A. 

      Heterogeneous mixture

    • B. 

      Homogeneous mixture

    • C. 

      Colloid

    • D. 

      Solvent

  • 2. 
    Albumin is an example of a…
    • A. 

      Heterogeneous mixture

    • B. 

      Colloid

    • C. 

      Solution

    • D. 

      Solvent

  • 3. 
    Theoretically, what would happen if you added another drug to change the pH of Hespan?
    • A. 

      Nothing, Hespan is a solution

    • B. 

      Since Hespan is a solution, changing the pH may cause precipitation

    • C. 

      Since Hespan is a colloid changing the pH may cause precipitation

    • D. 

      Nothing, Hespan is a colloid

  • 4. 
    How would you classify blood?
    • A. 

      Homogeneous mixture

    • B. 

      Solution

    • C. 

      Colloid

    • D. 

      Heterogeneous mixture

  • 5. 
    How much will one mole of H2SO4 weigh?        
    • A. 

      98 grams

    • B. 

      49 grams

    • C. 

      60 grams

    • D. 

      25 grams

  • 6. 
    How much will one mole of Propofol (C12H18O) weigh?       
    • A. 

      15 grams

    • B. 

      178 grams

    • C. 

      98 grams

    • D. 

      29 grams

  • 7. 
    Which the following is not true regarding acids?
    • A. 

      Acids are proton donors

    • B. 

      Acids will have a low pKa

    • C. 

      After donating a proton, they will form conjugate acid

    • D. 

      Acids will have a low pH

  • 8. 
    Which of the following pH’s is classified as more neutral?
    • A. 

      5.3

    • B. 

      7.4

    • C. 

      11.9

    • D. 

      2.6

  • 9. 
    Which of the following pH’s would be classified as a strong base?
    • A. 

      5.3

    • B. 

      7.4

    • C. 

      11.9

    • D. 

      2.6

  • 10. 
    What is Henry’s law?
    • A. 

      States that the solubility of a gas (amount of gas that dissolves in a liquid) is directly proportional to the partial pressure of that gas in the gas phase and inverse to temperature.

    • B. 

      States that in a mixture of gases, the pressure exerted by each gas is the same as that which it would exert if it alone occupied the container

    • C. 

      States that if you had two different containers containing two different gases at the same temperature and pressure, then they contain the same number of molecules.

    • D. 

      States that volume is proportional to temperature, or V/T=constant.

  • 11. 
    If you increase the partial pressure of anesthetic agents in the lungs, according to Henry’s law what will happen to the gases solubility in the blood?
    • A. 

      Solubility does not change, it is constant

    • B. 

      Anesthetic solubility will increase

    • C. 

      Anesthetic solubility will decrease

  • 12. 
    How many milligrams of local anesthetic are in 12 cc of 0.25% Bupivicaine?
    • A. 

      2.5 mg

    • B. 

      250 mg

    • C. 

      48 mg

    • D. 

      30 mg

  • 13. 
    How many ml’s of local anesthetic 1% lidocaine could be given max to a patient who weighs 60 kg?
    • A. 

      24 ml

    • B. 

      42 ml

    • C. 

      15 ml

    • D. 

      19 ml

  • 14. 
    You are the SRNA for a patient undergoing  an arthroplasty on their left foot. The surgeon wants to know how many ml’s 0.5% bupivacaine with epi he can inject into the patient. This patient weighs 50 kg.
    • A. 

      32 ml

    • B. 

      25 ml

    • C. 

      40 ml

    • D. 

      70 ml

  • 15. 
    1:400,000 epinephrine  contains how much epi per cc?
    • A. 

      50 mcg

    • B. 

      2.5 mcg

    • C. 

      5 mcg

    • D. 

      10 mcg

  • 16. 
    If an acidic drug with a pKa of 3.5 is placed into the stomach (pH 2) what will happen to the drug?
    • A. 

      There will be more ionized then unionized drug and will not be well absorbed.

    • B. 

      There will be 50% ionized and 50% unionized drug

    • C. 

      There will be more unionized then ionized drug and it can be absorbed

    • D. 

      None of above

  • 17. 
    What would happen if an acidic drug with a pKa of 4 is placed into the intestines (pH 8)?
    • A. 

      There will be more ionized then unionized drug and the drug will not be well absorbed

    • B. 

      There will be 50% ionized and 50% unionized drug

    • C. 

      There will be more unionized then ionized drug and it can be absorbed

    • D. 

      None of above

  • 18. 
    How will metabolic acidosis affect the absorption of acidic drugs?
    • A. 

      There will be no effect

    • B. 

      Less drug will be absorbed since more of the drug will be unionized

    • C. 

      The drug will be eliminated from the body completely

    • D. 

      More drug will be absorbed since more of the drug will unionized

  • 19. 
    What will happen if a basic drug with a pkA of 11 is placed into a basic solution with a pH of 9?
    • A. 

      The ionized form will predominate

    • B. 

      There will be a 50/50 split of ionized vs unionized

    • C. 

      The unionized form will predominate

    • D. 

      None of above

  • 20. 
    Local anesthetics are considered to be weak bases.
    • A. 

      True

    • B. 

      False

  • 21. 
    What is the mechanism of action of local anesthetics?
    • A. 

      Mimics acetylcholinesterase to Cause sustained depolarization rendering the NMJ unable to conduct further impulses=Muscle relaxation

    • B. 

      Produces skeletal muscle relaxation by a direct action on excitation-contraction coupling, presumably by decreasing the amount of calcium released from the sarcoplasmic reticulum

    • C. 

      Dependent upon type of anesthetic as ester and amides have different MOA’s

    • D. 

      Prevents passage of sodium ions through ion selective channels in nerve membranes to block nerve conduction.

  • 22. 
    In regard to local anesthetics their _______ nature allows them pass through cell membranes, but once inside the cell membrane their ______ portion binds inside the cell.
    • A. 

      Lipophilic, hydrophilic

    • B. 

      Hydrophilic, lipophilic

    • C. 

      Ionized, unionized

    • D. 

      None of above

  • 23. 
    The _____   the pKa of a local anesthetic, the ______ the degree of ionization at physiologic pH
    • A. 

      Higher, Lower

    • B. 

      Higher, greater

    • C. 

      PKa has no effect on degree of ionization

  • 24. 
    Which form of the local anesthetic is most active at the intracellular receptor site?
    • A. 

      Anionic Form

    • B. 

      Lipophilic form

    • C. 

      Cationic form

    • D. 

      Polar form

  • 25. 
    The potency of local anesthetic is directly related to…
    • A. 

      Protein Binding

    • B. 

      Degree of Ionization

    • C. 

      Chirality of molecule

    • D. 

      Lipid Solubility

  • 26. 
    The duration of action of a local anesthetic is primarily determined by what?
    • A. 

      Protein Binding

    • B. 

      Degree of Ionization

    • C. 

      Chirality of molecule

    • D. 

      Lipid Solubility

  • 27. 
    Which of the following is an achiral molecule?
    • A. 

      Ropivacaine

    • B. 

      Lidocaine

    • C. 

      Procaine

    • D. 

      Bupivacaine

  • 28. 
    Addition of epinephrine to a local anesthetic will result in all of the following except what?
    • A. 

      Prolongation of block

    • B. 

      Increased intensity of block

    • C. 

      Faster onset of block

    • D. 

      Decreased systemic absorption

  • 29. 
    The below molecule is what type of local anesthetic?
    • A. 

      Amide

    • B. 

      Carboxyclic Acid

    • C. 

      Ether

    • D. 

      Ester

  • 30. 
    The below molecule is what type of local anesthetic?
    • A. 

      Amide

    • B. 

      Carboxyclic Acid

    • C. 

      Ether

    • D. 

      Ester

  • 31. 
    Which of the following local anesthetics are metabolized by plasma cholinesterases?
    • A. 

      Tetracaine

    • B. 

      Prilocaine

    • C. 

      Ropivacaine

    • D. 

      Benzocaine

    • E. 

      Cocaine

  • 32. 
    What is the pKa of Procaine?
    • A. 

      8.2

    • B. 

      9.0

    • C. 

      8.9

    • D. 

      7.7

  • 33. 
    What is the pKa of Mepivacaine?
    • A. 

      8.2

    • B. 

      9.0

    • C. 

      8.9

    • D. 

      7.6

  • 34. 
    Which of the following is known to be most toxic to the cardiovascular system?
    • A. 

      Bupivacaine

    • B. 

      Lidocaine

    • C. 

      Prilocaine

    • D. 

      Chloroprocaine

  • 35. 
    All Local anesthetics will contain all of the following except:
    • A. 

      Ester or amide group

    • B. 

      Hydroxyl Group

    • C. 

      Amine group

    • D. 

      Aromatic ring

  • 36. 
    Which portion of the local anesthetic is lipophilic?
    • A. 

      Ester or amide group

    • B. 

      Hydroxyl Group

    • C. 

      Amine group

    • D. 

      Aromatic ring

  • 37. 
    Which portion of the local anesthetic is hydrophilic?
    • A. 

      Ester or amide group

    • B. 

      Hydroxyl Group

    • C. 

      Amine group

    • D. 

      Aromatic ring

  • 38. 
    What occurs during Ester hydrolysis?
    • A. 

      Plasma cholinesterase breaks down H2O into one H and one OH, then uses the OH the replace the OR group.

    • B. 

      OH is introduced into the lipophilic benzene ring

    • C. 

      Enzyme plasma cholinesterase breaks down H2O into one H and one OH, then uses the OH the replace the N group.

    • D. 

      An enzyme detaches one or more carbon atoms from the amine group to make it into either a 2nd or 1st degree amine.

  • 39. 
    What occurs during aromatic hydroxylation?
    • A. 

      Plasma cholinesterase breaks down H2O into one H and one OH, then uses the OH the replace the OR group

    • B. 

      OH is introduced into the lipophilic benzene ring

    • C. 

      Enzyme plasma cholinesterase breaks down H2O into one H and one OH, then uses the OH the replace the N group.

    • D. 

      An enzyme detaches one or more carbon atoms from the amine group to make it into either a 2nd or 1st degree amine.

  • 40. 
    What occurs during amide hydrolysis?
    • A. 

      Enzymes breaks down H2O into one H and one OH, then uses the OH the replace the OR group.

    • B. 

      OH is introduced into the lipophilic benzene ring

    • C. 

      Enzymes breaks down H2O into one H and one OH, then uses the OH the replace the N group.

    • D. 

      An enzyme detaches one or more carbon atoms from the amine group to make it into either a 2nd or 1st degree amine.

  • 41. 
    What occurs during N-Dealkylation?
    • A. 

      Plasma cholinesterase breaks down H2O into one H and one OH, then uses the OH the replace the OR group.

    • B. 

      OH is introduced into the lipophilic benzene ring

    • C. 

      Enzyme plasma cholinesterase breaks down H2O into one H and one OH, then uses the OH the replace the N group.

    • D. 

      An enzyme detaches one or more carbon atoms from the amine group to make it into either a 2nd or 1st degree amine.

  • 42. 
    Allergic reactions to Bupivacaine are most likely to come from what substance?
    • A. 

      Methylparaben

    • B. 

      P-aminobenzoic Acid

    • C. 

      Benzene ring

    • D. 

      All the above

  • 43. 
    Allergic reactions to Procaine are most likely to come from what substance?
    • A. 

      Methylparaben

    • B. 

      P-aminobenzoic Acid

    • C. 

      Benzene ring

    • D. 

      All the above

  • 44. 
    Where in the body would you find diffusion across a permeable membrane?
    • A. 

      At the alveolar membrane

    • B. 

      In the blood as water moves in and out of cells

    • C. 

      Blood Brain Barrier

    • D. 

      All the above

  • 45. 
    Osmosis is natural process where water of high solute concentration will flow through a membrane to dilute water of low solute concentration until equilibrium is reached.
    • A. 

      True

    • B. 

      False

  • 46. 
    You are delivering Mannitol to a pt who was admitted recently for a subdural bleed. You have order to hold the mannitol if your serum osmo is greater than 310. Is it safe to give the mannitol now?                 Na -145   K -5.0  BUN-  17   Cr- 0.9   Glucose- 90  Cl- 105
    • A. 

      Yes, safe to give

    • B. 

      Unable to calculate serum osmo from information given

    • C. 

      No, do not give

  • 47. 
    Calculate the serum osmolality for this pt.                 Na- 138    K- 4.5    BUN- 14   Cr- 0.9  Glucose- 108  Cl- 103
    • A. 

      312

    • B. 

      296

    • C. 

      291

    • D. 

      153

  • 48. 
    What is Osmolality?
    • A. 

      The pressure that must be applied to a solution to prevent the flow of a solvent (pressure required to stop osmosis).

    • B. 

      Net movement of one type of molecule through space as a result of random motion

    • C. 

      Concentration of solute in terms of osmoles per liter of solution (solute + solvent)

    • D. 

      Concentration of solute in terms of osmoles (or mOsm) per kilogram of solvent (e.g. water)

  • 49. 
    What is Osmolarity?
    • A. 

      The pressure that must be applied to a solution to prevent the flow of a solvent (pressure required to stop osmosis).

    • B. 

      Net movement of one type of molecule through space as a result of random motion

    • C. 

      Concentration of solute in terms of osmoles per liter of solution (solute + solvent)

    • D. 

      Concentration of solute in terms of osmoles (or mOsm) per kilogram of solvent (e.g. water)

  • 50. 
    Which of the gas laws would be used to explain diffusion hypoxia?
    • A. 

      Henry’s Law

    • B. 

      Graham’s Law

    • C. 

      Charle’s Law

    • D. 

      Fick’s Law

  • 51. 
    According to fick’s law diffusion of gas is directly proportional to all of the following except….
    • A. 

      Membrane thickness

    • B. 

      Partial pressure gradient

    • C. 

      Membrane surface area

    • D. 

      Solubility of gas

  • 52. 
    In what situation would it be safe to use N2O?
    • A. 

      COPD pt with pulm HTN

    • B. 

      VP shunt placement in infant

    • C. 

      Bowel resection

    • D. 

      Craniotomy

  • 53. 
    What equation could you use to calculate the resting membrane potential of a cell?
    • A. 

      Fick’s equation

    • B. 

      Graham’s Equation

    • C. 

      Nernst Equation

    • D. 

      Paerm equation

  • 54. 
    How will cardiogenic pulmonary edema effect rates of diffusion across the alveolar membrane?
    • A. 

      Increase diffusion

    • B. 

      Decrease diffusion

    • C. 

      No change on diffusion

    • D. 

      What does it matter? They are probably gonna die anyway.

  • 55. 
    Which of the following ions contributes the most to resting membrane potential?                           
    • A. 

      K

    • B. 

      Na

    • C. 

      Cl

    • D. 

      Mg

  • 56. 
    You have just intubated a pt and are about to start a case. Your preceptor tells you to crank the sevo up to ~4 for a few minutes. What effect will this have?
    • A. 

      Will decrease diffusion across alveolar membrane, don’t want too much gas since pt was just induced and may be hypotensive

    • B. 

      Will increase diffusion across alveolar capillary membrane by increasing that partial pressure gradieant across the membrane

    • C. 

      Will have no effect on diffusion, it is just an old habit and old practice that people still do solely out of habit

    • D. 

      Because the preceptor wants to start huffing the sevo and she needs to make sure there is enough for both her and the patient to share.

  • 57. 
    What is the second gas effect and how will it effect your anesthesia?
    • A. 

      By adding another gas you decrease the rate of diffusion of both gases since now two gases, as opposed to one, must diffuse across the alveolar membrane

    • B. 

      Adding a second gas is considered dangerous and puts pt at risk for overdose, this is why our machines prevent you from administering more than one VAA at once.

    • C. 

      By using a gas like N2O which diffuses quickly, you can also speed up the rate of diffusion of your VAA.

    • D. 

      If you fart more than once, it probably smells much worse than the first time due to the second time gas effect.

  • 58. 
    What is Osmotic pressure?
    • A. 

      The pressure that must be applied to a solution to prevent the flow of a solvent, related to number of non-permeable molecules

    • B. 

      The amount of pressure exerted by plasma proteins

    • C. 

      The intermingling of molecules in gases and liquids as a result of random thermal agitation

    • D. 

      Reflects the total number of ions or molecules in a solution regardless of size or weight

  • 59. 
    You are SRNA for a pt who is having a removal of gangrenous toes. The surgeon injects local anesthetic into the toes, yet when he begins to make the incision the patient complains of pain. What went wrong here?
    • A. 

      The toes are now a more basic environment, causing less availability of the LA

    • B. 

      The toes are now a more acidic environment, causing less availability of the LA

    • C. 

      The surgeon gave too small a dose, he needs to give more

    • D. 

      The antibiotics this pt takes for the infection have cross reacted with the LA’s and deactivated them.

  • 60. 
    What happens to the components of a mixture, such as blood, when all the components are separated?               
    • A. 

      Chemical properties of components will be changed

    • B. 

      You can not separate components of a mixture since molecules have bonded

    • C. 

      Chemical properties of individual components will not be changed at all

    • D. 

      You will end up making colloids

  • 61. 
    What is the difference between a solution and a colloid?
    • A. 

      Colloids components can be separated and still maintain chemical properties, while the solution can not

    • B. 

      Colloids contain smaller molecules, 0.1-2nm in diameter

    • C. 

      Solutions components can be separated and still maintain chemical properties, while the colloid can not

    • D. 

      Colloids contain larger molecules, 2-500 nm in diameter

  • 62. 
    How will hypothermia effect solubility of the Volatile anesthetic agents?
    • A. 

      Solubility will increase

    • B. 

      Solubility will decrease

    • C. 

      No change in solubility

  • 63. 
    How will a patient running a fever affect the solubility of your anesthetic agents?
    • A. 

      Solubility will increase

    • B. 

      Solubility will decrease

    • C. 

      No change in solubility

  • 64. 
    Identify the aromatic group in the below molecule:
    • A. 

      A

    • B. 

      B

    • C. 

      C

    • D. 

      None of above

  • 65. 
    Identify intermediate linkage in the molecule below.
    • A. 

      A

    • B. 

      B

    • C. 

      C

    • D. 

      None of above

  • 66. 
    Identify Amine group in the molecule below.
    • A. 

      A

    • B. 

      B

    • C. 

      C

    • D. 

      None of above

  • 67. 
    Identify carboxylic acid group in the molecule below.
    • A. 

      A

    • B. 

      B

    • C. 

      C

    • D. 

      None of above

  • 68. 
    Comic Relief:  Commercial fail 1982
    • A. 

      I want to enjoy AYDS!!!

    • B. 

      Ha ha ha ha!!

    • C. 

      Awe c'mon, the Aids epidemic had barely begun.

    • D. 

      All the Above