Pharmacology Of Anesthesia Quiz: Exam!

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  • 1/131 Questions

    What is the purpose of giving lidocaine prior to administration of propofol?

    • To make the propofol slightly more acidic
    • To prevent allergic reaction to egg lecithin
    • To prevent burning upon injection
    • To decrease ability of bacteria to grow in propofol
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About This Quiz

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!

Pharmacology Of Anesthesia Quiz: Exam! - Quiz

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  • 2. 

    Which of the following is a depolarizing muscle relaxant?

    • Rocuronium

    • Mivacurium

    • Succinylcholine

    • Vecuronium

    Correct Answer
    A. Succinylcholine
    Explanation
    Succinylcholine is a depolarizing muscle relaxant because it acts by initially depolarizing the motor end plate of the neuromuscular junction, causing muscle contraction, and then prolonging the depolarization, leading to muscle relaxation. This mechanism of action is different from non-depolarizing muscle relaxants like Rocuronium, Mivacurium, and Vecuronium, which block the action of acetylcholine at the neuromuscular junction without causing depolarization.

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  • 3. 

    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….

    • You would reduce your dose by 25-50%

    • With no prior medical history you could use the standard dosage of propofol

    • 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.

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  • 4. 

    It is perfectly safe to use regional anesthetics on malignant hyperthermia susceptible patients. 

    • True

    • False

    Correct Answer
    A. True
    Explanation
    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.

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  • 5. 

    Which of the non-barbituate agents has analgesic properties?

    • Ketamine

    • Etomidate

    • Propofol

    • Thiopental

    Correct Answer
    A. Ketamine
    Explanation
    Ketamine is a non-barbiturate agent that has analgesic properties. It works by blocking N-methyl-D-aspartate (NMDA) receptors in the brain, which reduces the perception of pain. Ketamine is commonly used as an anesthetic and analgesic in both human and veterinary medicine. It is known for its dissociative effects, causing a state of sedation, analgesia, and amnesia. Ketamine is often used in emergency settings and for procedures where pain control is necessary. It is also being studied for its potential use in treating depression and post-traumatic stress disorder.

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  • 6. 

    This non-barb has a high incidence of emergence delirium, 12%.

    • Etomidate

    • Propofol

    • Ketamine

    Correct Answer
    A. Ketamine
    Explanation
    Ketamine is known to have a high incidence of emergence delirium, which is a state of confusion and agitation that can occur as the patient wakes up from anesthesia. This side effect is more common with ketamine compared to other anesthesia options such as etomidate and propofol. Therefore, ketamine is the correct answer in this case.

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  • 7. 

    Which non-barb induction agent has analgesic and bronchodilator effects?

    • Ketamine

    • Propofol

    • Etomidate

    Correct Answer
    A. Ketamine
    Explanation
    Ketamine is the correct answer because it is a non-barbiturate induction agent that has analgesic and bronchodilator effects. Ketamine is known for its dissociative properties and is often used in anesthesia for its ability to provide both sedation and pain relief. It is also a bronchodilator, meaning it can help relax the muscles in the airways and improve breathing. Propofol is a barbiturate and does not have analgesic or bronchodilator effects. Etomidate is also a non-barbiturate induction agent, but it does not have analgesic or bronchodilator effects either.

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  • 8. 

    Hyperthermia is an early sign of MH.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    Hyperthermia is not an early sign of Malignant Hyperthermia (MH). In fact, hyperthermia is one of the main symptoms of MH and typically occurs later in the progression of the condition. Other early signs of MH include muscle rigidity, increased heart rate, and increased carbon dioxide production. Therefore, the correct answer is False.

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  • 9. 

    It is perfectly safe to use regional anesthetics on malignant hyperthermia susceptible patients. 

    • True

    • False

    Correct Answer
    A. True
    Explanation
    Regional anesthetics can be safely used on patients who are susceptible to malignant hyperthermia. Malignant hyperthermia is a rare but potentially life-threatening condition triggered by certain medications used during general anesthesia. Regional anesthesia, such as epidural or spinal anesthesia, does not involve the use of these triggering medications and therefore does not pose a risk to patients with malignant hyperthermia susceptibility. Therefore, it is safe to use regional anesthetics on such patients.

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  • 10. 

    which of the following has the shortest duration of action?

    • Vecuronium

    • Rocuronium

    • Pancuronium

    • Succinylcholine

    Correct Answer
    A. Succinylcholine
    Explanation
    Succinylcholine has the shortest duration of action among the given options. This is because succinylcholine is a depolarizing neuromuscular blocking agent that rapidly binds to the acetylcholine receptors at the neuromuscular junction and causes a brief period of muscle paralysis. Its effects are short-lived, typically lasting only a few minutes, making it suitable for short procedures or rapid sequence intubation. In contrast, Vecuronium, Rocuronium, and Pancuronium are non-depolarizing neuromuscular blocking agents that have longer durations of action.

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  • 11. 

    This non-barb will increase salivation, inclusion of a antisialagogue is recommended.

    • Etomidate

    • Ketamine

    • Propofol

    Correct Answer
    A. Ketamine
    Explanation
    Ketamine is the correct answer because it is a known antisialagogue, meaning it reduces salivation. The question states that a non-barb (non-barbiturate) will increase salivation, so in order to counteract this effect, an antisialagogue should be used. Ketamine fits this criteria and is commonly used in medical settings for its anesthetic properties and ability to reduce salivation.

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  • 12. 

    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?

    • No, too much time has passed

    • Yes, but only if you remembered to refrigerate the propofol.

    • Yes, propofol is good for 12 hours after opening.

    Correct Answer
    A. No, too much time has passed
    Explanation
    good for 6 hours in a syringe. good for 12 hours if gtt

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  • 13. 

    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?

    • Effects can be prolonged

    • Decrease the half life

    • Contraindicated in liver disease

    Correct Answer
    A. Effects can be prolonged
    Explanation
    N&P 132, effects can be prolonged but not contraindicated

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  • 14. 

    If you give your pt an intubating dose of succynocholine and they have a MH reaction, what type of muscle rigidity can you see prior to actually intubating the patient?

    • Masseter

    • Chest wall

    • Diaphragm

    • Bicep

    Correct Answer
    A. Masseter
    Explanation
    Prior to intubating a patient who is experiencing a malignant hyperthermia (MH) reaction after receiving an intubating dose of succinylcholine, you may observe muscle rigidity in the masseter muscles. This is because succinylcholine can trigger MH in susceptible individuals, leading to uncontrolled muscle contractions and rigidity. The masseter muscles, which are responsible for chewing and closing the jaw, may become rigid and tense in this situation.

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  • 15. 

    Whta is MOA of Ketamine?

    • Selective modulation of GABA receptors

    • Non-competitive antagonist binding to the phencyclidine recognition site on the NMDA receptor & acts on opioid receptors

    • Through binding to and activating alpha subunit receptors to cause sustained depolarization.

    • Inhibition of acetycholinesterase

    Correct Answer
    A. Non-competitive antagonist binding to the phencyclidine recognition site on the NMDA receptor & acts on opioid receptors
    Explanation
    Ketamine's mechanism of action involves non-competitive antagonist binding to the phencyclidine recognition site on the NMDA receptor and also acts on opioid receptors. This means that ketamine blocks the activity of the NMDA receptor, which is involved in pain perception, learning, and memory. Additionally, it interacts with opioid receptors, which are involved in pain modulation and can contribute to ketamine's analgesic effects. This dual action on both NMDA and opioid receptors contributes to ketamine's anesthetic and analgesic properties.

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  • 16. 

    Dantrolene should be continued for ____ Hours post MH episode.

    • 24

    • 12

    • 48

    • 6

    Correct Answer
    A. 24
    Explanation
    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.

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  • 17. 

    This non-barb hypnotic is good for patients with a history of PONV.

    • Etomidate

    • Propofol

    • Ketamine

    Correct Answer
    A. Propofol
    Explanation
    Etomidate and Ketamine increase the incidence of PONV, Propofol is an antiemetic.

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  • 18. 

    What is an appropriate intubating dose of Succinylcholine?

    • 1-1.5 mg/kg

    • .08-0.1 mg/kg

    • 0.6-1.2 mg/kg

    • 0.15-0.2 mg/kg

    • 0.4-0.5 mg/kg

    Correct Answer
    A. 1-1.5 mg/kg
    Explanation
    An appropriate intubating dose of Succinylcholine is 1-1.5 mg/kg.

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  • 19. 

    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?

    • 45 mg

    • 4.5 mg

    • 54 mg

    • 9 mg

    • 22.5 mg

    Correct Answer
    A. 4.5 mg
    Explanation
    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.

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  • 20. 

    Which non-barb can supress adrenal cortical function?

    • Etomidate

    • Ketamine

    • Propofol

    Correct Answer
    A. Etomidate
    Explanation
    Etomidate is a non-barbiturate anesthetic agent that can suppress adrenal cortical function. It works by inhibiting the production of cortisol, a hormone produced by the adrenal glands. This suppression of adrenal function can be beneficial in certain medical procedures or conditions where decreased cortisol production is desired. Etomidate is commonly used for induction of anesthesia and sedation in critically ill patients. It has a rapid onset of action and a short duration, making it an effective choice for these purposes.

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  • 21. 

    You are the SRNA for Mr. Joe, a 20 yr old male having repair of a torn ACL tendon.  You paralyzed the patient using succinylcholine to intubate, and currently have your Sevo going at 2%. Right as the makes his incision into the patients knee you notice your HR has jumped and the patient is tachycardic. His BP has also jumped up considerably. What does this mean?

    • He may be too light on anesthesia, give some fentanyl and go up on your sevo.

    • This may be the beginning stages of Malignant hyperthermia. Call for Help.

    • He is not paralyzed enough, give some vec.

    • Do nothing, the tachycardia will go away once the incision portion is over.

    Correct Answer
    A. He may be too light on anesthesia, give some fentanyl and go up on your sevo.
    Explanation
    The sudden increase in heart rate and blood pressure suggests that the patient may be experiencing inadequate anesthesia. Increasing the dose of anesthesia by administering fentanyl and increasing the sevo (sevoflurane) concentration can help deepen the anesthesia and ensure the patient remains adequately sedated throughout the procedure.

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  • 22. 

    Dantrolene should be continued for ____ Hours post MH episode.

    • 24

    • 12

    • 48

    • 6

    Correct Answer
    A. 24
    Explanation
    Dantrolene should be continued for 24 hours post MH episode. This is because malignant hyperthermia (MH) is a potentially life-threatening condition triggered by certain medications used during general anesthesia. Dantrolene is the specific treatment for MH, and it works by inhibiting the release of calcium from the sarcoplasmic reticulum in muscle cells. It is important to continue administering dantrolene for 24 hours after the episode to ensure that the muscles remain relaxed and prevent any recurrence of MH symptoms.

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  • 23. 

    Which of the non-barbituate agents has the lowest amount of protein binding & works on NMDA receptors?

    • Propofol

    • Ketamine

    • Etomidate

    • Thiopental

    Correct Answer
    A. Ketamine
    Explanation
    12% protein bound, crosses BBB readily

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  • 24. 

    When caring for children you should ALWAYS give the anticholinergic and the cholinesterase inhibitor together  in one syringe. 

    • True

    • False

    Correct Answer
    A. False
    Explanation
    It is not recommended to give the anticholinergic and the cholinesterase inhibitor together in one syringe when caring for children. These two medications have different mechanisms of action and should be administered separately to ensure their effectiveness and avoid any potential drug interactions or adverse effects.

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  • 25. 

    Pre-treatment with a non-depolarizer may help to lessen all side effects from succinylcholine except:

    • Arrythmias

    • Hyperkalemia

    • Myalgia

    • Elevated Intraocular Pressure

    Correct Answer
    A. Hyperkalemia
    Explanation
    Pre-treatment with a non-depolarizer muscle relaxant can help reduce the side effects caused by succinylcholine, such as arrhythmias, myalgia, and elevated intraocular pressure. However, it does not have an effect on hyperkalemia, which is an increased level of potassium in the blood. Therefore, pre-treatment with a non-depolarizer cannot lessen the side effect of hyperkalemia caused by succinylcholine.

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  • 26. 

    Pre-treatment with a non-depolarizer may help to lessen all side effects from succinylcholine except:

    • Arrythmias

    • Hyperkalemia

    • Myalgia

    • Elevated Intraocular Pressure

    Correct Answer
    A. Hyperkalemia
    Explanation
    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.

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  • 27. 

    Which of the following has the longest duration of effect?

    • Nimbex

    • Vecuronium

    • Succinylcholine

    • Pancuronium

    Correct Answer
    A. Pancuronium
    Explanation
    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.

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  • 28. 

    The chemical structure of this drug is 2,6-diisopropylphenol.

    • Etomidate

    • Ketamine

    • Propofol

    Correct Answer
    A. Propofol
    Explanation
    Propofol is the correct answer because its chemical structure matches the given description of 2,6-diisopropylphenol. This means that propofol is composed of a phenol ring with two isopropyl groups attached at positions 2 and 6. Etomidate and ketamine do not have this specific chemical structure, so they are not the correct answer.

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  • 29. 

    The non-barbituate agents have short duration of action mainly due to…

    • Redistribution

    • Metabolism

    • Low lipid solubility

    • Low potency

    Correct Answer
    A. Redistribution
    Explanation
    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.

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  • 30. 

    Hyperthermia is an early sign of MH.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    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.

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  • 31. 

    Which of the following muscle relaxants allows you to skip use of a reversal agent?

    • Mivacurium

    • Vecuronium

    • Pancuronium

    • Rocuronium

    Correct Answer
    A. Mivacurium
    Explanation
    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”

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  • 32. 

    How much glycopyrolate should you give to a patient receiving 3 mg of neostigmine?

    • 0.6 mg

    • 0.32 mg

    • 0.021 mg

    • 3 mg

    Correct Answer
    A. 0.6 mg
    Explanation
    To reverse the effects of neostigmine, glycopyrolate is administered. The correct answer is 0.6 mg because the recommended dose of glycopyrolate is typically 0.2 mg for every 1 mg of neostigmine. Therefore, if the patient is receiving 3 mg of neostigmine, the appropriate dose of glycopyrolate would be 0.6 mg (3 mg x 0.2 mg).

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  • 33. 

    What is the mechanism of action of non-depolarizing muscle relaxants?

    • Works at spinal nerve roots to cause paralysis and NMJ

    • Bind to alpha subunit receptors but do not activate them, merely tie up the receptors to block acetylcholine.

    • By potentiating the inhibitory effects of GABA

    • Through binding to and activating alpha subunit receptors to cause sustained depolarization.

    Correct Answer
    A. Bind to alpha subunit receptors but do not activate them, merely tie up the receptors to block acetylcholine.
    Explanation
    Non-depolarizing muscle relaxants work by binding to alpha subunit receptors without activating them. Instead, they block the receptors and prevent acetylcholine from binding, leading to muscle paralysis. This mechanism of action differs from depolarizing muscle relaxants, which cause sustained depolarization by activating alpha subunit receptors.

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  • 34. 

    What is the name of the receptor that is responsible for MH?

    • Ranitidine

    • Ryanodine

    • Cyanide

    • Muscarinic

    Correct Answer
    A. Ryanodine
    Explanation
    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.

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  • 35. 

    http://www.youtube.com/watch?v=c1JzCDqt3BM

    • Love it

    • Now I have that song stuck in my head....

    • All of the above.

    Correct Answer
    A. All of the above.
    Explanation
    The given answer "All of the above" is correct because the statement "Love it" indicates that the person enjoyed the video, "Now I have that song stuck in my head" suggests that the person found the song memorable or catchy, and the phrase "All of the above" implies that both statements are true. Therefore, all three statements express positive sentiments towards the video.

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  • 36. 

    How do we prevent the muscarinic effects of cholinesterase inhibitors?

    • By delivering small doses calculated on patient weight

    • By pre-medication with an opioid

    • Through inactivation of acetylcholinesterase

    • By concurrently administering an anticholinergic drug

    Correct Answer
    A. By concurrently administering an anticholinergic drug
    Explanation
    Concurrently administering an anticholinergic drug can help prevent the muscarinic effects of cholinesterase inhibitors. Anticholinergic drugs work by blocking the action of acetylcholine, the neurotransmitter responsible for the muscarinic effects. By blocking the action of acetylcholine, the anticholinergic drug can counteract the excessive stimulation caused by cholinesterase inhibitors, thereby preventing the muscarinic effects such as increased salivation, sweating, and gastrointestinal distress.

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  • 37. 

    Which of the following will increase your ICP?

    • Propofol

    • Etomidate

    • Ketamine

    • All of the above

    Correct Answer
    A. Ketamine
    Explanation
    Ketamine is a dissociative anesthetic that can increase intracranial pressure (ICP) due to its sympathomimetic effects. It stimulates the release of catecholamines, which can cause vasoconstriction and increase cerebral blood flow, leading to an increase in ICP. Propofol and etomidate, on the other hand, are both sedative-hypnotic agents that have minimal effects on ICP and may even decrease it. Therefore, the correct answer is Ketamine.

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  • 38. 

    All muscle relaxants are quaternary ammonium compounds that mimic the effects of…

    • Pseudocholinesterase

    • Acetylcholine

    • Monocholine

    • Muscarinic receptors

    Correct Answer
    A. Acetylcholine
    Explanation
    Muscle relaxants are quaternary ammonium compounds that mimic the effects of acetylcholine. Acetylcholine is a neurotransmitter that plays a crucial role in muscle contraction. By mimicking its effects, muscle relaxants can help reduce muscle spasms and promote muscle relaxation. Pseudocholinesterase is an enzyme that breaks down acetylcholine, while monocholine is not a known substance. Muscarinic receptors are the receptors that acetylcholine binds to in order to exert its effects. Therefore, the correct answer is acetylcholine.

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  • 39. 

    Regaining 4/4 twitches after administration of a non-depolarizing muscle relaxant means that you no longer need to administer a reversal agent. 

    • True

    • False

    Correct Answer
    A. False
    Explanation
    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.

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  • 40. 

    For a patient who is borderline tachycardic it is recommended to administer neostigmine without glycopyrolate. 

    • True

    • False

    Correct Answer
    A. False
    Explanation
    It is not recommended to administer neostigmine without glycopyrolate for a patient who is borderline tachycardic. The use of neostigmine can cause an increase in heart rate, and glycopyrolate is typically administered along with neostigmine to counteract this effect and prevent further tachycardia. Therefore, it is false to say that it is recommended to administer neostigmine without glycopyrolate in this situation.

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  • 41. 

    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?

    • Rocuronium 90 mg

    • Succinylcholine 120 mg

    • Mivacurium 20 mg

    • Rapid sequence can not be done on this patient without prolonged effect of muscle relaxant.

    Correct Answer
    A. Rocuronium 90 mg
    Explanation
    Rocuronium would be the medication of choice for this induction because the patient has a known pseudocholinesterase deficiency. Succinylcholine, which is commonly used for rapid sequence inductions, is contraindicated in patients with pseudocholinesterase deficiency as it can lead to prolonged paralysis. Mivacurium is also not recommended in this case because it is metabolized by pseudocholinesterase. Therefore, Rocuronium, a non-depolarizing muscle relaxant, would be the safest option for this patient.

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  • 42. 

    What is the mechanism of action of the cholinesterase inhibitors?

    • Attenuate the peripheral muscarinic effects of NMBA's.

    • Inhibition of the hydrolysis of acetylcholine resulting in greater availability at its sites of action

    • Through binding to and activating alpha subunit receptors to cause sustained depolarization.

    • Selective inhibition of GABA

    Correct Answer
    A. Inhibition of the hydrolysis of acetylcholine resulting in greater availability at its sites of action
    Explanation
    The mechanism of action of cholinesterase inhibitors is the inhibition of the hydrolysis of acetylcholine, which leads to increased availability of acetylcholine at its sites of action. This allows for enhanced cholinergic neurotransmission and can be beneficial in conditions such as Alzheimer's disease, where there is a deficiency of acetylcholine. By inhibiting the breakdown of acetylcholine, cholinesterase inhibitors help to maintain higher levels of this neurotransmitter in the brain, improving cognitive function.

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  • 43. 

    Which of the following agents is eliminated via Hoffman Elimination?

    • Mivacurium

    • Pancuronium

    • Atracurium

    • Rocuronium

    Correct Answer
    A. Atracurium
    Explanation
    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.

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  • 44. 

    You can safely administer glycopyrolate without a cholinesterase inhibitor.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    Glycopyrrolate is an anticholinergic medication that works by blocking the action of acetylcholine, a neurotransmitter that is involved in various bodily functions. Cholinesterase inhibitors, on the other hand, work by inhibiting the breakdown of acetylcholine, thereby increasing its levels in the body. Since glycopyrrolate works by blocking acetylcholine, it can be safely administered without a cholinesterase inhibitor.

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  • 45. 

    When can your reversal agents be administered?

    • When you have 0/4 twitches

    • When you have at least 1 /4 twitches

    • You must have 4/4 twitches prior to administration

    • After your anesthetic agent has been turned off.

    Correct Answer
    A. When you have at least 1 /4 twitches
    Explanation
    The reversal agents can be administered when you have at least 1 out of 4 twitches. This means that there should be some muscle movement present before the reversal agents are given. It implies that the patient is not fully paralyzed and there is still some level of muscle function. Administering the reversal agents in this scenario can help to reverse the effects of the anesthesia and restore muscle movement.

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  • 46. 

    The mixing of Lidocaine w/ Propofol may result in coalescence of oil droplets which may pose risk of pulmonary embolism.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    S&H 155

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  • 47. 

    Acetylcholine is rapidly metabolized by acetylcholinesterase to…. (Two answers)

    • Acetic Acid

    • Choline

    • Succinylmonocholine

    • Cholinesterase

    Correct Answer(s)
    A. Acetic Acid
    A. Choline
    Explanation
    Acetylcholine is a neurotransmitter that is involved in the transmission of signals between nerve cells. It is rapidly metabolized by an enzyme called acetylcholinesterase. This enzyme breaks down acetylcholine into its two components: acetic acid and choline. Acetic acid is a simple organic acid, while choline is an essential nutrient that is important for various functions in the body, including the synthesis of acetylcholine itself. Therefore, the correct answers are acetic acid and choline.

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  • 48. 

    What is the mechanism of action of succinylcholine?

    • Works at spinal nerve roots to cause paralysis and NMJ

    • Bind to alpha subunit receptors but do not activate them, merely tie up the receptors to block acetylcholine.

    • By potentiating the inhibitory effects of GABA

    • Through binding to and activating alpha subunit receptors to cause sustained depolarization.

    Correct Answer
    A. Through binding to and activating alpha subunit receptors to cause sustained depolarization.
    Explanation
    Succinylcholine works by binding to and activating alpha subunit receptors, which leads to sustained depolarization. This sustained depolarization prevents the muscle from repolarizing, causing paralysis.

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  • 49. 

    This non-barb has a chemical structure of carboxylated imidazole-containing compound that (like versed) is water solule at acidic pH and lipid soluble at physiologic pH.

    • Etomidate

    • Ketamine

    • Propofol

    Correct Answer
    A. Etomidate
    Explanation
    Etomidate is the correct answer because it is a carboxylated imidazole-containing compound that exhibits water solubility at acidic pH and lipid solubility at physiologic pH. This property allows it to easily cross cell membranes and distribute throughout the body. Etomidate is commonly used as an intravenous anesthetic due to its rapid onset and short duration of action. It works by enhancing the inhibitory effects of GABA, a neurotransmitter that reduces neuronal activity and produces sedation and anesthesia.

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  • Current Version
  • Mar 19, 2023
    Quiz Edited by
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  • Dec 03, 2008
    Quiz Created by
    Scottishduffy

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