Pharmacology Of Anesthesia Quiz: Exam!
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Pharmacology of anaesthesia quiz: exam! There are different ways that a medical practitioner can mess up while performing anaesthesia, and this is why one needs to know the different drugs that can be used and how. How conversant are you with the most common drugs and how they are used? This quiz is a perfect test and refresher. Do check it out and see how well you do!
Questions and Answers
- 1.
Which of the following is not at an increased risk for Malignant Hyperthermia?
- A.
Patient with Muscular Dystrophy
- B.
Patient who is immunosuppressed
- C.
Patient who had a heat stroke last year while playing outdoors
- D.
Patients whose mother has MH.
Correct Answer
B. Patient who is immunosuppressedExplanation
Malignant Hyperthermia (MH) is a potentially life-threatening reaction to certain medications used during general anesthesia. It is an inherited condition, usually passed down from a parent. Patients with Muscular Dystrophy and patients whose mother has MH are at an increased risk for MH because of the genetic component. A patient who had a heat stroke last year while playing outdoors may be at an increased risk for heat-related complications but not specifically for MH. Being immunosuppressed does not directly increase the risk for MH.Rate this question:
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- 2.
The non-barbituate agents have short duration of action mainly due to…
- A.
Redistribution
- B.
Metabolism
- C.
Low lipid solubility
- D.
Low potency
Correct Answer
A. RedistributionExplanation
The non-barbiturate agents have a short duration of action mainly due to redistribution. This means that after the drug is administered, it quickly moves from the bloodstream to other tissues in the body, such as muscle and fat. This redistribution reduces the concentration of the drug in the bloodstream, leading to a decrease in its effects. Redistribution is a key factor in the short duration of action of these agents, as it allows for a rapid decrease in drug concentration and a shorter overall duration of effect.Rate this question:
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- 3.
What is an appropriate intubating dose of Atracurium?
- A.
1-1.5 mg/kg
- B.
.08-0.1 mg/kg
- C.
0.6-1.2 mg/kg
- D.
0.15-0.2 mg/kg
- E.
0.4-0.5 mg/kg
Correct Answer
E. 0.4-0.5 mg/kgExplanation
An appropriate intubating dose of Atracurium is 0.4-0.5 mg/kg.Rate this question:
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- 4.
What would be an appropriate starting dose of dantrolene to give to a 2 yr old child weighing 14 kg?
- A.
14 mg
- B.
140 mg
- C.
35 mg
- D.
280 mg
Correct Answer
C. 35 mgExplanation
An appropriate starting dose of dantrolene for a 2-year-old child weighing 14 kg would be 35 mg. The dosage of dantrolene is typically based on the weight of the patient, and a common starting dose for children is 2-4 mg/kg. In this case, 2 mg/kg would be 28 mg (2 x 14 kg), and 4 mg/kg would be 56 mg (4 x 14 kg). The closest option to these calculations is 35 mg, which falls within the appropriate dosage range for a child of this weight.Rate this question:
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- 5.
Which of the non-barbituate agents is unique due to the fact it has no stereoisomers?
- A.
Etomidate
- B.
Propofol
- C.
Ketamine
- D.
Thiopental
Correct Answer
B. PropofolExplanation
Propofol is unique among the non-barbiturate agents because it has no stereoisomers. Stereoisomers are molecules that have the same chemical formula and connectivity but differ in the spatial arrangement of atoms. Propofol does not have any mirror-image forms or chiral centers, making it the only option in the given list without stereoisomers. This characteristic of propofol can have implications for its pharmacokinetics and pharmacodynamics.Rate this question:
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- 6.
You are the SRNA for a 12 yr old male who is 5’0” and weighs 45 kg. What would be an appropriate intubating dose of vecuronium?
- A.
45 mg
- B.
4.5 mg
- C.
54 mg
- D.
9 mg
- E.
22.5 mg
Correct Answer
B. 4.5 mgExplanation
An appropriate intubating dose of vecuronium for a 12-year-old male weighing 45 kg would be 4.5 mg. This dose is calculated based on the patient's weight and is within the appropriate range for intubation.Rate this question:
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- 7.
It is perfectly safe to use regional anesthetics on malignant hyperthermia susceptible patients.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
Malignant hyperthermia is a potentially life-threatening condition triggered by certain medications used during anesthesia. Regional anesthesia, which involves numbing only a specific region of the body, does not typically involve the use of the specific medications that can trigger malignant hyperthermia. Therefore, it is considered safe to use regional anesthesia on patients who are susceptible to malignant hyperthermia.Rate this question:
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- 8.
What is the purpose of giving lidocaine prior to administration of propofol?
- A.
To make the propofol slightly more acidic
- B.
To prevent allergic reaction to egg lecithin
- C.
To prevent burning upon injection
- D.
To decrease ability of bacteria to grow in propofol
Correct Answer
C. To prevent burning upon injectionExplanation
Lidocaine is often used as a local anesthetic to numb the area before a procedure. In this case, lidocaine is given prior to the administration of propofol to prevent burning upon injection. Propofol is known to cause pain and burning sensation when injected, and lidocaine helps to alleviate this discomfort.Rate this question:
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- 9.
What is the maximum dose of Dantrolene which can be given to a 10 yr old child weighing 30 kg?
- A.
75 mg
- B.
300 mg
- C.
600 mg
- D.
30 mg
Correct Answer
B. 300 mgExplanation
The maximum dose of Dantrolene that can be given to a 10-year-old child weighing 30 kg is 300 mg. This dosage is determined based on the child's weight and age, as well as the recommended dosage guidelines for Dantrolene. It is important to adhere to the maximum dosage to ensure the safety and effectiveness of the medication.Rate this question:
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- 10.
You are the SRNA for a 58 yr old female having open heart surgery. She is 5’4” and 70 kg. What would be an appropriate intubating dose of pancuronium?
- A.
7 mg
- B.
105 mg
- C.
84 mg
- D.
14 mg
- E.
35 mg
Correct Answer
A. 7 mgExplanation
An appropriate intubating dose of pancuronium for a 58-year-old female undergoing open heart surgery would be 7 mg. This dose is determined based on the patient's weight, which is 70 kg. Pancuronium is a neuromuscular blocking agent used during surgery to induce muscle relaxation and facilitate intubation. The dosage is calculated based on the patient's weight to ensure optimal effect and minimize the risk of adverse effects.Rate this question:
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- 11.
Which of the following patients should NOT receive propofol? PICK TWO
- A.
72 yr old male, allergy to egg whites
- B.
89 yr old male, severe CV shock, EF 10%
- C.
45 yr old male, allergy to sulfites
- D.
8 yr old male with history of asthma
Correct Answer(s)
B. 89 yr old male, severe CV shock, EF 10%
C. 45 yr old male, allergy to sulfitesExplanation
allergy to egg yolks is contraindicated, not contraindicated in asthma patients M&M 201,Rate this question:
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- 12.
What test could be done on a patient suspected to have MH?
- A.
DNA Hyperthermia test
- B.
Succinylcholine challenge test
- C.
There are no tests available.
- D.
Caffeine Halothane Test
Correct Answer
D. Caffeine Halothane TestExplanation
The Caffeine Halothane Test is used to diagnose Malignant Hyperthermia (MH), a potentially life-threatening reaction to certain medications used during general anesthesia. This test involves exposing a muscle sample from the patient to caffeine and halothane in a laboratory setting and observing for abnormal muscle contractions. If the muscle sample contracts abnormally, it indicates a positive result for MH. This test is considered the gold standard for diagnosing MH and is crucial in identifying patients at risk before undergoing anesthesia.Rate this question:
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- 13.
You are caring for a 60 yr old male going in for removal of abdominal mass. He is 6’0” and 90 kg, what would be an appropriate intubating dose of succinylcholine?
- A.
135 mg
- B.
9 mg
- C.
81 mg
- D.
18 mg
- E.
45 mg
Correct Answer
A. 135 mg -
- 14.
You were a very good SRNA this morning and drew up all your drugs, including the propofol, at 6:15 am. At the last minute your first case of the day was cancelled and you did not get another case until 1:30 pm. Can you still use your propofol on this patient?
- A.
No, too much time has passed
- B.
Yes, but only if you remembered to refrigerate the propofol.
- C.
Yes, propofol is good for 12 hours after opening.
Correct Answer
A. No, too much time has passedExplanation
good for 6 hours in a syringe. good for 12 hours if gttRate this question:
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- 15.
Dantrolene should be continued for ____ Hours post MH episode.
- A.
24
- B.
12
- C.
48
- D.
6
Correct Answer
A. 24Explanation
Dantrolene should be continued for 24 hours post MH episode. This is because Malignant Hyperthermia (MH) is a life-threatening condition that can occur during anesthesia. Dantrolene is the drug of choice for treating and preventing MH. It works by inhibiting calcium release from the sarcoplasmic reticulum in skeletal muscle cells. Continuing Dantrolene for 24 hours after the episode helps to ensure that the patient remains stable and prevents any further complications or recurrence of MH symptoms.Rate this question:
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- 16.
Which of the following agents has the highest degree of protein binding?
- A.
Etomidate
- B.
Propofol
- C.
Ketamine
- D.
All have similar protein binding
Correct Answer
B. PropofolExplanation
propofol 95-99% protein boundRate this question:
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- 17.
You are the SRNA for a 75 yr old female going in for a bowel resection. She is 5’2” and 50 kg. What would be an appropriate intubating dose of Rocuronium?
- A.
75 mg
- B.
5 mg
- C.
30 mg
- D.
10 mg
- E.
90 mg
Correct Answer
C. 30 mgExplanation
An appropriate intubating dose of Rocuronium for a patient undergoing a bowel resection would be 30 mg. This dose is determined based on the patient's weight, which is 50 kg in this case. The dosage of Rocuronium is typically calculated at 0.6-1.2 mg/kg, depending on various factors such as the patient's age, medical condition, and the desired level of muscle relaxation. In this scenario, a dose of 30 mg falls within the recommended range for a patient of this weight, making it an appropriate choice.Rate this question:
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- 18.
What is the name of the receptor that is responsible for MH?
- A.
Ranitidine
- B.
Ryanodine
- C.
Cyanide
- D.
Muscarinic
Correct Answer
B. RyanodineExplanation
Ryanodine is the correct answer because it is the name of the receptor that is responsible for malignant hyperthermia (MH). Ryanodine receptors are located on the sarcoplasmic reticulum of skeletal muscle cells and play a crucial role in regulating calcium release during muscle contraction. Mutations in the ryanodine receptor gene can lead to abnormal calcium release, which can trigger MH, a potentially life-threatening condition characterized by muscle rigidity, high fever, and metabolic acidosis.Rate this question:
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- 19.
Propofol is metabolized extensively in the liver, as well as in the lungs and other sites. How will hepatic disease affect the half life of Propofol?
- A.
Effects can be prolonged
- B.
Decrease the half life
- C.
Contraindicated in liver disease
Correct Answer
A. Effects can be prolongedExplanation
N&P 132, effects can be prolonged but not contraindicatedRate this question:
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- 20.
What is an appropriate intubating dose of Nimbex for a 50 yr old 5’11” male weighing 110 kg?
- A.
165 mg
- B.
11 mg
- C.
100 mg
- D.
22 mg
- E.
55 mg
Correct Answer
D. 22 mgExplanation
An appropriate intubating dose of Nimbex for a 50 yr old 5’11” male weighing 110 kg is 22 mg. This is determined based on the patient's weight and the recommended dosage guidelines for Nimbex. The dosage may vary depending on the individual's specific needs and medical condition, but in this case, 22 mg is the appropriate dose.Rate this question:
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- 21.
Hyperthermia is an early sign of MH.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
Hyperthermia is not an early sign of MH. Malignant Hyperthermia (MH) is a rare but potentially life-threatening condition that can be triggered by certain medications used during anesthesia. Hyperthermia, or high body temperature, is a symptom that occurs later in the progression of MH, rather than being an early sign. Early signs of MH include muscle rigidity, increased heart rate, and increased carbon dioxide production. Therefore, the correct answer is False.Rate this question:
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- 22.
You are caring for a 82 yr old woman who is about to be induced for surgery. You plan to use propofol for your induction and would plan that….
- A.
You would reduce your dose by 25-50%
- B.
With no prior medical history you could use the standard dosage of propofol
- C.
You would increase your dose by 25-50%
Correct Answer
A. You would reduce your dose by 25-50%Explanation
When caring for an elderly patient, it is important to consider age-related changes in drug metabolism and elimination. As individuals age, their liver and kidney function may decline, leading to a decreased ability to process medications. Propofol, being a sedative-hypnotic agent, is metabolized in the liver and excreted by the kidneys. Therefore, in an 82-year-old woman, it is recommended to reduce the dose of propofol by 25-50% to account for potential age-related changes in pharmacokinetics and to minimize the risk of adverse effects or prolonged sedation.Rate this question:
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- 23.
How much can your temperature increase every 5 minutes in MH? (pick best answer)
- A.
1 degree C
- B.
1-2 degrees C
- C.
0.5-1 degree C
- D.
0.1 degree C
Correct Answer
B. 1-2 degrees CExplanation
In MH, the temperature can increase by 1-2 degrees Celsius every 5 minutes. This means that the temperature can rise by a significant amount in a short period of time.Rate this question:
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- 24.
What would be an appropriate intubating dose of Atracurium for a 5’1” 48 yr old female weight 60 kg?
- A.
90 mg
- B.
6 mg
- C.
70 mg
- D.
12 mg
- E.
30 mg
Correct Answer
E. 30 mgExplanation
An appropriate intubating dose of Atracurium for a patient is typically calculated based on their weight. In this case, the patient weighs 60 kg. The recommended dose of Atracurium is usually around 0.5-0.6 mg/kg. Therefore, for a 60 kg patient, the appropriate dose would be around 30-36 mg. The closest option to this range is 30 mg, which makes it the correct answer.Rate this question:
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- 25.
What is an appropriate induction dose of propofol for a 50 yr old male who is 5’10” and weighs 80 kg?
- A.
80 mg
- B.
160 mg
- C.
16 mg
- D.
400 mg
Correct Answer
B. 160 mgExplanation
1.5-2.5mg/kgRate this question:
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- 26.
What class of medications is contraindicated in MH?
- A.
Calcium Channel blockers
- B.
Beta Blockers
- C.
Calcium gluconate
- D.
NSAIDS
Correct Answer
A. Calcium Channel blockersExplanation
Calcium Channel blockers are contraindicated in Malignant Hyperthermia (MH). MH is a potentially life-threatening condition triggered by certain medications used during anesthesia. Calcium Channel blockers can exacerbate the symptoms of MH by further increasing muscle contractions and elevating body temperature. Therefore, they should be avoided in individuals with MH susceptibility to prevent severe complications.Rate this question:
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- 27.
You are the SRNA for a patient with a known pseudocholinesterase deficiency who needs a rapid sequence induction due to past medical history of GERD which is poorly controlled. The patient weighs 80 kg. What medication would you choose for this induction?
- A.
Rocuronium 90 mg
- B.
Succinylcholine 120 mg
- C.
Mivacurium 20 mg
- D.
Rapid sequence can not be done on this patient without prolonged effect of muscle relaxant.
Correct Answer
A. Rocuronium 90 mgExplanation
The patient has a known pseudocholinesterase deficiency, which means they have a decreased ability to metabolize succinylcholine. Succinylcholine is typically used for rapid sequence induction, but in this case, it would lead to prolonged muscle relaxation due to the patient's deficiency. Therefore, an alternative medication should be chosen. Rocuronium is a non-depolarizing muscle relaxant that does not rely on pseudocholinesterase for metabolism. It is a suitable choice for rapid sequence induction in this patient.Rate this question:
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- 28.
What be an appropriate induction dose of propofol for a 75 yr old female who is 5’4” and weighs 75 kg? (Be careful here…)
- A.
150 mg
- B.
225 mg
- C.
75 mg
- D.
15 mg
Correct Answer
C. 75 mgExplanation
Non-barbituate notes- dose of propofol must be reduced 25-50% in people over the age of 60.Rate this question:
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- 29.
You suspect your patient has MH, what do you expect to see on their ABG?
- A.
CO2 42, BE +3, Ph 7.34
- B.
CO2 62, BE 0, Ph 7.60
- C.
CO2 65, BE -10, Ph 7.43
- D.
CO2 32, BE -9, Ph 7.18
- E.
CO2 61, BE -11, Ph 7.20
Correct Answer
E. CO2 61, BE -11, Ph 7.20Explanation
The correct answer is CO2 61, BE -11, Ph 7.20. In a patient with MH (malignant hyperthermia), there is an increased production of carbon dioxide (CO2) due to increased muscle metabolism. This leads to respiratory acidosis, which is reflected by an elevated CO2 level. The base excess (BE) is negative, indicating metabolic acidosis. The pH is decreased, indicating acidemia. Therefore, the ABG values in the given answer are consistent with the expected findings in a patient with MH.Rate this question:
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- 30.
What is the recommended dose of propofol for maintenance of anesthesia?
- A.
1.5-2.5 mg/kg
- B.
3-5 mg/kg
- C.
25-100 mcg/kg/min
- D.
100-300 mcg/kg/min
Correct Answer
D. 100-300 mcg/kg/minExplanation
The recommended dose of propofol for maintenance of anesthesia is 100-300 mcg/kg/min. This dosage range ensures a continuous and steady level of anesthesia throughout the procedure. Using a lower dose may result in inadequate anesthesia, while a higher dose may increase the risk of side effects and complications. Therefore, it is important to administer propofol within the recommended dosage range to ensure optimal patient safety and comfort during anesthesia.Rate this question:
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- 31.
Pre-treatment with a non-depolarizer may help to lessen all side effects from succinylcholine except:
- A.
Arrythmias
- B.
Hyperkalemia
- C.
Myalgia
- D.
Elevated Intraocular Pressure
Correct Answer
B. HyperkalemiaExplanation
Pre-treatment with a non-depolarizer drug before succinylcholine administration can help reduce the occurrence of side effects such as arrhythmias, myalgia, and elevated intraocular pressure. However, it does not have a significant impact on preventing hyperkalemia, which is an increase in potassium levels in the blood. Therefore, the correct answer is hyperkalemia.Rate this question:
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- 32.
The MH gene is passed via:
- A.
Autosomal dominant gene
- B.
Autosomal recessive gene
Correct Answer
A. Autosomal dominant geneExplanation
The MH gene is passed via an autosomal dominant gene, meaning that only one copy of the gene is needed for the trait to be expressed. This means that if a person inherits the MH gene from one parent, they will have the condition. Autosomal dominant inheritance patterns are characterized by the presence of affected individuals in each generation of a family, as each affected individual has a 50% chance of passing on the gene to their offspring.Rate this question:
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- 33.
What is an appropriate dose of propofol sedation during a MAC case?
- A.
25-100 mcg/kg/min
- B.
1.5-2.5 mg/kg
- C.
100-300 mcg/kg/min
- D.
3-5 mg/kg
Correct Answer
A. 25-100 mcg/kg/minExplanation
An appropriate dose of propofol sedation during a MAC case is 25-100 mcg/kg/min. This range ensures that the patient receives a sufficient level of sedation without causing excessive sedation or respiratory depression. It allows for individualized dosing based on the patient's weight and response to the medication. This dosage range is commonly used in MAC cases to provide effective sedation while maintaining patient safety.Rate this question:
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- 34.
Regaining 4/4 twitches after administration of a non-depolarizing muscle relaxant means that you no longer need to administer a reversal agent.
- A.
True
- B.
False
Correct Answer
B. FalseExplanation
Regaining 4/4 twitches after administration of a non-depolarizing muscle relaxant does not necessarily mean that you no longer need to administer a reversal agent. The reversal agent is still required to fully reverse the effects of the muscle relaxant and restore normal muscle function.Rate this question:
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- 35.
In a patient with MH, what would you expect their serum myoglobin to be?
- A.
> 100 mg
- B.
> 170 mcg
- C.
> 180 mg
- D.
>2200 mcg
Correct Answer
B. > 170 mcgExplanation
In a patient with Malignant Hyperthermia (MH), their serum myoglobin levels would be expected to be greater than 170 mcg. This is because MH is a condition characterized by a rapid and severe increase in body temperature, which can lead to muscle breakdown and release of myoglobin into the bloodstream. Elevated levels of serum myoglobin indicate muscle damage, which is a common feature of MH. Therefore, a myoglobin level higher than 170 mcg would be expected in patients with MH.Rate this question:
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- 36.
At what percentage of blockade by non-depolarizing muscle relaxants would you achieve surgical relaxation?
- A.
99%
- B.
75%
- C.
90%
- D.
60%
Correct Answer
C. 90%Explanation
Surgical relaxation is achieved when the muscles are completely relaxed, allowing for easy manipulation during surgery. Non-depolarizing muscle relaxants work by blocking the action of acetylcholine at the neuromuscular junction, leading to muscle relaxation. The percentage of blockade refers to the degree of inhibition of muscle contraction. Therefore, to achieve surgical relaxation, a high percentage of blockade is required. Among the given options, 90% blockade by non-depolarizing muscle relaxants would provide the necessary level of muscle relaxation for surgery.Rate this question:
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- 37.
You have a patient in the PACU who has been receiving morphine and is now itching from the pain medications. What might you give to help relieve the itching?
- A.
Ketamine 0.2 mg/kg
- B.
Propofol 10 mg
- C.
Etomidate 0.1 mg/kg
- D.
Propofol 50 mg
Correct Answer
B. Propofol 10 mgExplanation
Propofol is a sedative-hypnotic medication that can be used to relieve itching caused by pain medications such as morphine. It has antihistamine properties and can help alleviate itching in the patient. Ketamine and etomidate are not typically used for itching relief, and the higher dose of propofol (50 mg) may be excessive for this purpose. Therefore, the most appropriate option is to administer a lower dose of propofol (10 mg) to help relieve the itching.Rate this question:
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- 38.
What is the most important clinical s/s that would lead you to suspect MH?
- A.
Increased temperature
- B.
Increased ETCO2
- C.
Hypoxia
- D.
Muscle rigidity
- E.
Increased HR
Correct Answer
B. Increased ETCO2Explanation
An increased end-tidal carbon dioxide (ETCO2) level is the most important clinical sign/symptom that would lead to a suspicion of malignant hyperthermia (MH). MH is a rare but potentially life-threatening condition that can occur as a reaction to certain medications used during anesthesia. It is characterized by a rapid increase in body temperature, muscle rigidity, and increased heart rate. However, an increased ETCO2 level is specific to MH and is considered a hallmark sign, as it indicates an abnormal increase in carbon dioxide production due to increased muscle activity. This can help alert healthcare providers to the possibility of MH and prompt immediate intervention.Rate this question:
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- 39.
Which of the following muscle relaxants would you choose to give to a patient having cardiac surgery in order to counteract the bradycardia caused by narcotics?
- A.
Succinylcholine
- B.
Rocuronium
- C.
Mivacurium
- D.
Pancuronium
Correct Answer
D. PancuroniumExplanation
Pancuronium would be the muscle relaxant of choice to counteract the bradycardia caused by narcotics during cardiac surgery. This is because pancuronium has a sympathomimetic effect, meaning it stimulates the sympathetic nervous system, which can help increase heart rate. Succinylcholine, rocuronium, and mivacurium do not have this sympathomimetic effect and would not be as effective in counteracting bradycardia.Rate this question:
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- 40.
How is Etomidate metabolized?
- A.
By pseudocholinesterase
- B.
By the kidneys
- C.
By hepatic microsomal enzymes
- D.
Via exhalation through the lungs
Correct Answer
C. By hepatic microsomal enzymesExplanation
Etomidate is metabolized by hepatic microsomal enzymes. Hepatic microsomal enzymes are responsible for the metabolism of various drugs in the liver. They break down the drug into smaller molecules that can be easily eliminated from the body. In the case of etomidate, these enzymes play a crucial role in its metabolism, ensuring its elimination from the body. This information is important for understanding the pharmacokinetics and clearance of etomidate in patients.Rate this question:
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- 41.
What are the common side effects of Dantrolene?
- A.
Muscle weakness including difficulty swallowing or choking
- B.
Pulmonary edema
- C.
Anaphylaxis
- D.
Rhabdomyolysis
- E.
All of the above
Correct Answer
E. All of the aboveExplanation
The common side effects of Dantrolene include muscle weakness, difficulty swallowing or choking, pulmonary edema, anaphylaxis, and rhabdomyolysis. Therefore, the correct answer is "All of the above." These side effects can occur when taking Dantrolene, and it is important to be aware of them and seek medical attention if any of these symptoms occur.Rate this question:
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- 42.
Which of the following muscle relaxants allows you to skip use of a reversal agent?
- A.
Mivacurium
- B.
Vecuronium
- C.
Pancuronium
- D.
Rocuronium
Correct Answer
A. MivacuriumExplanation
may be skipped to prevent PONV, but not really recommended per lecture, metabolized mostly by plasma cholinesterase, “unlike sux, antagonism w/ cholinesterase inhib will quicken reversal once some response to nerve stimulation becomes apparent, Spontaneous recovery is rapid, neostig profoundly decreases plasma cholinesterase, but moderate levels of miv induced blockade are antagonized readily, edrophonium provides more rapid antag of deep miv induced blockade”Rate this question:
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- 43.
For which patient would it be inappropriate to use Etomidate? PICK TWO
- A.
20 yr old asthmatic
- B.
60 yr old SZ disorder
- C.
30 yr old having eye globe surgery
- D.
40 yr old who requires long term infusion.
Correct Answer(s)
B. 60 yr old SZ disorder
D. 40 yr old who requires long term infusion.Explanation
increases evoked potentials, may precipitate sz's, can cause adrenocortical suppression w/ longterm use. decreases IOP, no histamine productionRate this question:
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- 44.
Which of the following muscle relaxing agents would be BEST to give to a patient in multi-system organ failure?
- A.
Succinylcholine
- B.
Mivacurium
- C.
Vecuronium
- D.
Rocuronium
Correct Answer
B. MivacuriumExplanation
Mivacurium is metabolized by plasma cholinesterase, independent of direct organ metabolism. Sux is too, but you don't want to give Sux to renal fl.Rate this question:
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- 45.
What is the half life of Dantrolene?
- A.
1 hour
- B.
6 hours
- C.
30 minutes
- D.
2 hours
Correct Answer
B. 6 hoursExplanation
The half-life of a drug refers to the time it takes for half of the drug to be eliminated from the body. In the case of Dantrolene, the correct answer is 6 hours, which means that it takes approximately 6 hours for half of the drug to be eliminated from the body. This information is important for determining the dosing frequency and duration of action of the drug.Rate this question:
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- 46.
What would be an appropriate induction dose of etomidate for a 58 yr old female who is 5’6” and weighs 90 kg?
- A.
18 mg
- B.
180 mg
- C.
45 mg
- D.
90 mg
Correct Answer
A. 18 mgExplanation
0.2-0.5mg/kgRate this question:
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- 47.
Which of the following agents is eliminated via Hoffman Elimination?
- A.
Mivacurium
- B.
Pancuronium
- C.
Atracurium
- D.
Rocuronium
Correct Answer
C. AtracuriumExplanation
Atracurium is eliminated via Hoffman elimination. Hoffman elimination is a chemical reaction that occurs in the body and is responsible for the breakdown and elimination of certain drugs. Atracurium is a neuromuscular blocking agent that is commonly used during surgery to relax muscles. It undergoes Hoffman elimination, which involves the breaking of a specific chemical bond in the drug molecule, leading to its breakdown and elimination from the body. This is different from the other agents listed, such as Mivacurium, Pancuronium, and Rocuronium, which are eliminated through different mechanisms.Rate this question:
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- 48.
Which drugs are potentiated by dantrolene?
- A.
Neuromuscular blockers like vecuronium
- B.
NSAIDS like ketoralac
- C.
Steroids like prednisone
- D.
Beta blockers like esmolol
Correct Answer
A. Neuromuscular blockers like vecuroniumExplanation
Dantrolene is a muscle relaxant that works by inhibiting calcium release from the sarcoplasmic reticulum in skeletal muscle, leading to muscle relaxation. It is specifically used to treat malignant hyperthermia and muscle spasticity. Dantrolene has been found to potentiate the effects of neuromuscular blockers like vecuronium. This means that when dantrolene is administered along with vecuronium, the muscle relaxant effect of vecuronium is enhanced, leading to a greater degree of muscle relaxation. This can be beneficial in certain medical situations where a stronger muscle relaxant effect is desired.Rate this question:
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- 49.
What is the half life of etomidate?
- A.
2-5 hours
- B.
30-90 minutes
- C.
5-10 hours
- D.
10-20 minutes
Correct Answer
A. 2-5 hoursExplanation
The half-life of etomidate is the time it takes for half of the drug to be eliminated from the body. In this case, the correct answer is 2-5 hours, which means that after 2-5 hours, half of the etomidate will be eliminated from the body. This information is important for determining the dosing frequency and duration of action of etomidate in medical settings.Rate this question:
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- 50.
Which of the following has the longest duration of effect?
- A.
Nimbex
- B.
Vecuronium
- C.
Succinylcholine
- D.
Pancuronium
Correct Answer
D. PancuroniumExplanation
Pancuronium has the longest duration of effect compared to the other options. It is a long-acting nondepolarizing neuromuscular blocking agent that is used during surgery to relax muscles and facilitate intubation. Its effects can last for several hours, making it suitable for procedures that require prolonged muscle relaxation. Nimbex, Vecuronium, and Succinylcholine are also neuromuscular blocking agents, but they have shorter durations of action compared to Pancuronium.Rate this question:
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