Anesthesia Pharmacology Exam: Hardest Quiz

171 Questions | Total Attempts: 1025

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Anesthesia Quizzes & Trivia

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Questions and Answers
  • 1. 
    Define Pharmacokinetics.
    • A. 

      Describes the relationship between the drug concentration and the response.

    • B. 

      What the drug does to the body

    • C. 

      Is the relationship between the dose of the drug given and its observed plasma concentration and/or tissue concentration

    • D. 

      The time necessary for plasma drug concentration to fall by 50% or other % after a continuous infusion or specific duration.

  • 2. 
    Define Pharmacodynamics.
    • A. 

      The time necessary for plasma drug concentration to fall by 50% or other % after a continuous infusion or specific duration.

    • B. 

      Is the relationship between the dose of the drug given and its observed plasma concentration and/or tissue concentration

    • C. 

      What the body does to the drug

    • D. 

      Describes the relationship between the drug concentration and the response.

  • 3. 
    PK and PD can vary between patients.  Which of the following would be a reason for variation?
    • A. 

      AGE

    • B. 

      Concominant Medications

    • C. 

      Concurrent Illness

    • D. 

      All of the Above

  • 4. 
    What is assumed if the oral dose of a drug is the same as the IV dose of the same drug?
    • A. 

      The drug is liquid in oral form.

    • B. 

      The drug is bound to protein.

    • C. 

      There is little first dose metabolism

    • D. 

      The patient has a big mouth

  • 5. 
    The transfer of drug across a membrane is based on what?
    • A. 

      Molecular size

    • B. 

      Degree of ionization

    • C. 

      Lipid solublity

    • D. 

      Protein binding

    • E. 

      All of the above

  • 6. 
    What is the pKa of a drug?
    • A. 

      An estimate of the osmotic gradient of the drug

    • B. 

      Is the ph at which ionized vs nonionized form of the drug are the same.

    • C. 

      The kick after a touchdown worth one point.

    • D. 

      The amount of drug bound to protein.

  • 7. 
    Define pH.
    • A. 

      An estimate of the osmotic gradient of the drug

    • B. 

      The natural log [H+]

    • C. 

      The negative log [H+].

    • D. 

      A new application for the Iphone

  • 8. 
    Which anesthetic agent has analgesic effects?
    • A. 

      Desflurane

    • B. 

      Sevoflurane

    • C. 

      Isoflurane

    • D. 

      Nitrous oxide

  • 9. 
    What was the main problem with early anesthetic agents?
    • A. 

      Early agents needed CO2 to vaporize

    • B. 

      They caused coronay steal

    • C. 

      Early agents were toxic

    • D. 

      All of the above

  • 10. 
    When is a basic drug ionized.
    • A. 

      When it is eliminated by the body.

    • B. 

      When the pH is less than the pKa

    • C. 

      When the pH is more than the pKa

    • D. 

      When the pH is equal to the pKa

  • 11. 
    What helped decreased flammability of the anesthetic agents
    • A. 

      Elimintating the use of oxygen in the ventilator

    • B. 

      Combining carbon with fluorine

    • C. 

      The use of industrial gas cylinders

    • D. 

      The use of the positive pressure scavenging system

  • 12. 
    Which drug has the tendency to potentiate cardiac arrythmias when halothane is used?
    • A. 

      Lidocaine

    • B. 

      Atropine

    • C. 

      Epinepherine

    • D. 

      Adenosine

  • 13. 
    Which inhaled agent can cause renal failure?
    • A. 

      Methoxyflurane

    • B. 

      Enflurane

    • C. 

      Isoflurane

    • D. 

      Desflurane

  • 14. 
    The less soluble the agent....
    • A. 

      The slower the patient falls to sleep

    • B. 

      The more nephrotoxic the drug is

    • C. 

      The faster the drug goes to the brian

    • D. 

      The slower the drug goes to the brain

  • 15. 
    Why do babies and infants require more anesthetic agent?
    • A. 

      They have large heads compared to their chest

    • B. 

      Because they have less surface area than adults

    • C. 

      They have higher metabolic rates

    • D. 

      They don't, they require less

  • 16. 
    Which patient will require the least anesthetic
    • A. 

      A chronic alcoholic

    • B. 

      A heavily intoxicated high school student

    • C. 

      An infant

    • D. 

      An chronic heroin user

  • 17. 
    Why is isoflurane not the best choice for inhalation induction in children
    • A. 

      Agent is too powerful for a child

    • B. 

      Agent has pungent odor

    • C. 

      Isoflurane is the best choice for inhalation induction

    • D. 

      It requires higher peak pressures to deliver the agent to the patient

  • 18. 
    Which agent is least likely to form carbon monxide when introduced to co2 absorbers?
    • A. 

      N20

    • B. 

      Halothan

    • C. 

      Sevoflurane

    • D. 

      Desflurane

  • 19. 
    What is the blood-gas solubility coefficient an indicator of? 
    • A. 

      Which fluid compartment the anesthetic will occupy

    • B. 

      Speed of uptake and elimination

    • C. 

      If the anesthetic is a gas or liquid at room temperature

    • D. 

      The relative toxicity of the drug

  • 20. 
    What does the Oil-gas coefficient represent?
    • A. 

      The lower the coefficient the more potent the gas

    • B. 

      The higer the coefficient the more potent the gas

    • C. 

      The proper placement of a hanger yoke

    • D. 

      The acceptable trace levels of oils in the vaporizers

  • 21. 
    Define general anesthesia.
    • A. 

      An altered physiologic state characterized by loss of consciousness analgesia of the entire body, amnesia, and to some degree muscle relaxation

    • B. 

      When 50 percent of the population between 33 and 55 years old has complete muscle relaxation

    • C. 

      When a patient is able to respond to commands during anesthesia however is able to make their own adjustments in regards to airway management

    • D. 

      Minimum alveolar concentration

  • 22. 
    What does MAC stand for.
    • A. 

      Maximum allowable hematocrit loss

    • B. 

      Minimum arterial capacity

    • C. 

      Minimum alveolar concentration

    • D. 

      Manageable airway contacts

  • 23. 
    P-450 sevoflurabe
    • A. 

      A

    • B. 

      B

  • 24. 
    Factors that influence the magnitude of carbon monoxide production from volatile anesthetics include:
    • A. 

      Dryness of the carbon dioxide absorbent with hydration preventing formation

    • B. 

      High temperatures of carbon dioxide absorbent as during low fresh gas flows and/or increased metabolic production of carbon dioxide.

    • C. 

      Prolonged high fresh gas flows that cause dryness.

    • D. 

      Type of carbon dioxide absorbent.

    • E. 

      All of the above

  • 25. 
    • A. 

      When Co2 absorbers have been left out of the anesthesia machine

    • B. 

      When CO2 absorbers have been exhausted over the weekend from lack of use and are no longer effective

    • C. 

      The phenomena of more accidents occuring on Mondays in the OR

    • D. 

      The phenomena of Miami Dolphins fans questioning the effectiveness of the "wildcat" offense

  • 26. 
    Which inhaled agent causes the largest increase in heart rate
    • A. 

      Desflurane

    • B. 

      Isoflurane

    • C. 

      N2O

    • D. 

      Halothane

  • 27. 
    Which inhalation agent has the least amount of effects on BP?
    • A. 

      N2O

    • B. 

      Isoflurane

    • C. 

      Desflurane

    • D. 

      Sevoflurane

  • 28. 
    Which agent's use has the highest incident of coronary steal?
    • A. 

      Isoflurane

    • B. 

      N2O

    • C. 

      Desflurane

    • D. 

      Sevoflurane

  • 29. 
    Which inhaled agent would be best for a patient with an ischemic CVA
    • A. 

      Sevoflurane

    • B. 

      Desflurane

    • C. 

      Isoflurane

    • D. 

      N2O

  • 30. 
    What is the meyer-overton theory?
    • A. 

      Explains the increasing oil-gas partition pressure coefficient that is correlated with anesthetic potency

    • B. 

      Explains the increasing blood-gas partition pressure coefficient that is correlated with anesthetic potency

  • 31. 
    Which of the following agents does not have any muscle relaxing properties?
    • A. 

      Isoflurane

    • B. 

      Sevoflurane

    • C. 

      N2O

    • D. 

      Desflurane

    • E. 

      Halothane

  • 32. 
    What is MAC?
    • A. 

      Minimum absorbed Carbon monoxie

    • B. 

      Minimum acceptable analgesia

    • C. 

      Maximum allowable Carbon dioxide

    • D. 

      Minimum alveolar concentration

  • 33. 
    Describe how MAC changes with age
    • A. 

      It increase 6% for every decade of life

    • B. 

      It increase 10% for every decade of life

    • C. 

      It decrease 6% for every decade of life

    • D. 

      It decrease 10% for every decade of life

  • 34. 
    At what age is a patients highest MAC levels?
    • A. 

      1 year

    • B. 

      21 years

    • C. 

      6 months

    • D. 

      1 month

  • 35. 
    What is the only inorganic agent used
    • A. 

      N2O

    • B. 

      Sevoflurane

    • C. 

      Isoflurane

    • D. 

      Desflurane

  • 36. 
    What are the cardiac effects of N20?
    • A. 

      Prolonger PR interval

    • B. 

      Peaked T waves

    • C. 

      Torsades de pointe

    • D. 

      Can cause myocardial ischemia in hypovolemic patients and in patients with CAD.

  • 37. 
    Which of the following is NOT a respiratory effect of N2O?
    • A. 

      Tachypnea

    • B. 

      Reddish skin discoloration

    • C. 

      Response to CO2 is depressed

    • D. 

      Increases the apneic threshold

  • 38. 
     Who is the best looking guy in FIU's CRNA program scheduled to graduate in December of 2011?
    • A. 

      Chris

    • B. 

      All of the above

  • 39. 
    All of these factors affect pharmacokinetics of a drug except?
    • A. 

      Extremes of age

    • B. 

      Hydration

    • C. 

      Renal or hepatic disease

    • D. 

      Skeletal muscle mass

    • E. 

      Skin pigmentation

  • 40. 
    The Pka of the drug delineates what % of a drug is in an ionized form?
    • A. 

      25%

    • B. 

      35%

    • C. 

      50%

    • D. 

      75%

  • 41. 
    Does a weak acid inserted into an alkaline medium manifest its desired effects faster?
    • A. 

      True

    • B. 

      False

  • 42. 
    A weak acid inserted into an acidic environment will be absorbed how?
    • A. 

      Faster

    • B. 

      Slower

    • C. 

      The same

    • D. 

      None of the above

  • 43. 
    A weak acid inserted into an alkaline medium will manifest its desired effect how?
    • A. 

      Faster

    • B. 

      Slower

    • C. 

      No change

  • 44. 
    A weak base injected into an alkaline medium will most likely exhibit which trait?(Choose all that apply)
    • A. 

      More in an unionized form

    • B. 

      Less lipid soluble

    • C. 

      More ionized form

    • D. 

      More lipid soluble

  • 45. 
    An ionized medication will be metabolized by the liver.
    • A. 

      True

    • B. 

      False

  • 46. 
    What happens to a drug when the Pka and the pH are the same?
    • A. 

      30% inoized & 70% unionized

    • B. 

      60% inoized & 40% unionized

    • C. 

      50% inoized & 50% unionized

    • D. 

      75% inoized & 25% unionized

  • 47. 
    When the pH and the Pka are equal how does a small change in pH effect the ionization
    • A. 

      Little difference

    • B. 

      Small changes in degree of ionization

    • C. 

      No notable therapeutic effect

    • D. 

      Large changes is degree of ionization

  • 48. 
    Propofol, a weak acid, has a Pka of 11, how will propofol behave in a body with a pH of 7.4
    • A. 

      More ionized

    • B. 

      Less Ionized

    • C. 

      No Change

    • D. 

      Less ionized

  • 49. 
    Isoflurane is a methyl esther what is halothane.
    • A. 

      Alkyne derivative

    • B. 

      Alkene derivative

    • C. 

      Alkane derivative

    • D. 

      Ethyl methyl terrible

  • 50. 
    What is the MAC of sevoflurane?
    • A. 

      1.7

    • B. 

      1.15

    • C. 

      6

    • D. 

      104

    • E. 

      0.77

  • 51. 
    What is the MAC of N2O?
    • A. 

      1.7

    • B. 

      1.15

    • C. 

      6

    • D. 

      104

    • E. 

      0.77

  • 52. 
    What is the MAC of Isoflurane
    • A. 

      1.7

    • B. 

      1.15

    • C. 

      6

    • D. 

      105

    • E. 

      0.77

  • 53. 
    What is the MAC of Halothane
    • A. 

      1.7

    • B. 

      1.15

    • C. 

      6

    • D. 

      104

    • E. 

      0.77

  • 54. 
    What is the MAC of desflurane
    • A. 

      1.7

    • B. 

      1.15

    • C. 

      6

    • D. 

      105

    • E. 

      0.77

  • 55. 
    How does age effect MAC?
    • A. 

      Older patient less MAC, younger patient more MAC

    • B. 

      Older patients More MAC, younger patients less MAC

    • C. 

      Older women less MAC older men more MAC

    • D. 

      Teenagers usually need th most MAC

  • 56. 
    Which gas causes the most coronary steal?
    • A. 

      Desflurane

    • B. 

      Isoflurane

    • C. 

      Sevoflurane

    • D. 

      N2O

  • 57. 
    What is coronary steal.
    • A. 

      When the heart become less compliant and there is an inotropic decrease

    • B. 

      When the heart slows down decreasing CO

    • C. 

      When O2 is stolen from ischemic areas of the heart and brought to non ischemic areas.

    • D. 

      Occurs in lateral decubiti position and placement of the kidney rest.

  • 58. 
    What is Compound A?
    • A. 

      A medicine that allows all CRNA student to get A's

    • B. 

      CO2 absorbents containing Na/K OH react with Sevo and form a by-product that may cause Nephrotoxicity

    • C. 

      A compound associated with increased MAC levels

    • D. 

      Only found with the use of epinepherine

  • 59. 
    What happens when you give an anesthetic agent and BP decreases what are your compensatory mechanisms?
    • A. 

      Bradycardia and chemoreceptors

    • B. 

      Bradycardia and baroreceptors

    • C. 

      Tachycardia and chemoreceptors

    • D. 

      Tachycardia and baroreceptors

  • 60. 
    What is a potential side effect of Halothane
    • A. 

      Halothane induced neuropathy

    • B. 

      Halothane induced hepatitis

    • C. 

      Halothane induced ESRD

    • D. 

      Halothane induced myopathy

  • 61. 
    Which best describes the blood-gas coefficient and its affects on induction rate choose all that apply
    • A. 

      The lower the coefficient the less soluble the gas

    • B. 

      The lower the coefficient the more soluble the gas

    • C. 

      The higher the coefficient the faster the induction

    • D. 

      The lower the coefficient the faster the induction

  • 62. 
    Where do inhaled anesthetics go first?
    • A. 

      Adipose tissue

    • B. 

      Bone

    • C. 

      The blood vessel rich group such as the lungs heart liver brain

    • D. 

      Scavenger system

  • 63. 
    Which of the following is true in regards to pediatric anesthesia (choose all that apply)
    • A. 

      Children have increase respiratory rates

    • B. 

      Children have increase alveolar ventilation

    • C. 

      Children have faster induction

    • D. 

      Children are more prone to malignant hyperthermia

  • 64. 
    What is T Beta ½ Calculation?
    • A. 

      The amount of T-killer cells present in the blood

    • B. 

      The temperature at which MAC needs to be cut in half

    • C. 

      The defensive play that kentucky called when Tebow was knocked out!

    • D. 

      The amount of time to eliminate half the drug concentration

  • 65. 
    What is First Order Kinetics?  
    • A. 

      Drug is eliminated at a constant rate regardless of amount

    • B. 

      The amount of time to eliminate half the drug concentration

    • C. 

      When the first reaction with the body/drug takes place

    • D. 

      A constant fraction is eliminated per unit time

  • 66. 
    Why are neither chloroform nor ether used in the United States?(choose all that apply)
    • A. 

      High toxicity

    • B. 

      The raw material to make these products not available in the united states

    • C. 

      Danger of flammability

    • D. 

      U.S. no longer carries vaporizers to handle these anesthetics

  • 67. 
    How is emergence determined?
    • A. 

      Brain elimination of the agent

    • B. 

      Cardiac elimination of the agent

    • C. 

      Pulmonary elimination of the agent

    • D. 

      Kidney elimination of the agent

  • 68. 
    Which inhalation agent is good for pediatric induction?
    • A. 

      Isoflurane

    • B. 

      Sevoflurane

    • C. 

      Desflurane

    • D. 

      Halothane

  • 69. 
    How is elimination of an agent accomplished
    • A. 

      Exhalation

    • B. 

      Bio-transformation

    • C. 

      Transcutaneous loss

    • D. 

      All of the above

  • 70. 
    What is the most important route of elimination for an anesthetic agent?
    • A. 

      Urine

    • B. 

      Insensible loss through the skin

    • C. 

      Bronchi

    • D. 

      Alveoli

  • 71. 
    True or false hyperventilation will decrease the rate of alveolar concentration?
    • A. 

      True

    • B. 

      False

  • 72. 
    True or false hypoventilation will decrease the rate of alveolar concentration?
    • A. 

      True

    • B. 

      False

  • 73. 
    Complete the following: "The higher the flow delivered....."
    • A. 

      The higher the inspiratory concentration

    • B. 

      The lower the inspiratory concentration

    • C. 

      The higher the solubility

    • D. 

      The lower the solubility

  • 74. 
    What is the first thing a CRNA can do with a patient who has mild inspiratory wheezes?
    • A. 

      Give subcutaneous epi

    • B. 

      Give Brethine SQ

    • C. 

      Increase rate of agent

    • D. 

      Hang 1-2 gram Magnesium IV

  • 75. 
    Both hypothermia and hyperthermia require decreases in MAC True or False 
    • A. 

      True

    • B. 

      False

    • C. 

      True unless the Patient temperature is greater than 42 degrees celcius then more MAC is required

  • 76. 
    What decrease in Hct would constitute less MAC?
    • A. 

      A 5% decrease

    • B. 

      A 10% decrease

    • C. 

      A 15% decrease

    • D. 

      A 20% decrease

  • 77. 
    At what PaO2 level is a decrease in MAC required?
    • A. 

      80

    • B. 

      60

    • C. 

      40

    • D. 

      30

  • 78. 
    If a patient has hypocalcemia what change is MAC would be required
    • A. 

      A decrease in MAC

    • B. 

      An increase in MAC

    • C. 

      No change in MAC

  • 79. 
    How many days postpartum must a patient be prior to returning to normal MAC level needs?
    • A. 

      1 day

    • B. 

      2 days

    • C. 

      3 days

    • D. 

      1 week

  • 80. 
    What is the CRNA's concerns with a patient who takes St. John's Wart
    • A. 

      Increased cytochrome p-450 activity

    • B. 

      Digoxin interference

    • C. 

      Fatigue

    • D. 

      Dizziness

    • E. 

      All of the above

  • 81. 
    What is the usual effects of sevoflurane on BP
    • A. 

      Increase

    • B. 

      Decrease

    • C. 

      No change

  • 82. 
    Isoflurane and Sevoflurane will have what type of effect on respiratory rate?
    • A. 

      Increase

    • B. 

      Decrease

    • C. 

      No change

  • 83. 
    Isoflurane and Sevoflurane will have what type of effect on tidal volume?
    • A. 

      Increase

    • B. 

      Decrease

    • C. 

      No change

  • 84. 
    Which agent is best for a patient with cerebral ischemia?
    • A. 

      Desflurane

    • B. 

      Sevoflurane

    • C. 

      Isoflurane

    • D. 

      N2O

  • 85. 
    FOr cerebral blood flow what range are you trying to keep
    • A. 

      20-120

    • B. 

      60-160

    • C. 

      90-140

    • D. 

      75-135

  • 86. 
    What are the factors that influence the magnitude of carbon monoxide production from volatile anesthetics?
    • A. 

      Dryness of the carbon dioxide absorbent with hydration preventing formation

    • B. 

      High temperatures of carbon dioxide absorbent as during fresh gas flow and/or increased metabolic production of carbon dioxide

    • C. 

      Prolonged high fresh gas flow that causes dryness

    • D. 

      Type of carbon dioxide absorbent

    • E. 

      All of the above

  • 87. 
    What does clinical pharmacokinetics describe?
    • A. 

      Absorption

    • B. 

      Distribution

    • C. 

      Metabolism

    • D. 

      Elimination

    • E. 

      All of the above

  • 88. 
    What does information about pharmacokinetis help us as CRNA's with
    • A. 

      It describes ADME of a drug within the body

    • B. 

      Describes the effects of the drug upon the body

    • C. 

      It allows the prediction of plasma concentration following different dosing regimens

    • D. 

      All of the above

  • 89. 
    What is ultimately responsible for undesired effects of a drug
    • A. 

      Pharmacokinetics

    • B. 

      Pharmacodynamics

    • C. 

      Plasma levels

    • D. 

      Metabolism

  • 90. 
    What factors are responsible for variability in both PK&PD of drugs among patients?
    • A. 

      Age

    • B. 

      Concurrent illnesses

    • C. 

      Concomitant medications

    • D. 

      All of the above

  • 91. 
    Transfer of drugs across membranes are dependent upon what?
    • A. 

      Molecular size

    • B. 

      Degree of ionization

    • C. 

      Lipid solubility

    • D. 

      Protein binding

    • E. 

      All of the above

  • 92. 
    True or false most electrolyte actions do not require energy
    • A. 

      True

    • B. 

      False

  • 93. 
    Where is a drug concentration greater?
    • A. 

      On the side of the membrane where the drug is more ionized

    • B. 

      On the side of the membrane where the drug is less ionized

  • 94. 
    What factors determine the ionization of a drug? (choose all that apply)
    • A. 

      PH of the environment

    • B. 

      Stabilty of the drug

    • C. 

      PKa

    • D. 

      Route of drug administration

  • 95. 
    True or false.  For a drug to be transported it must be ionized?
    • A. 

      True

    • B. 

      False

  • 96. 
    I could not figure a good question for this...I am not the smartest guy, but review slide 10 on the PK-PD power point slide.  Trivia question.  Who is the only defenseman in NHL history who did not have to wait the normal 5 year waiting period for induction to the hall of fame?
    • A. 

      Wayne Gretzky

    • B. 

      Phil Esposito

    • C. 

      Bobby Orr

    • D. 

      Ray Bourque

  • 97. 
    If a drug binds to a nonspecific sight what occurs?
    • A. 

      Pharmacologic response

    • B. 

      Toxic Response

    • C. 

      No response

    • D. 

      All of the above

  • 98. 
    If a drug binds to a receptor site what can occur (choose all that apply)
    • A. 

      Pharmacologic response

    • B. 

      Toxic Response

    • C. 

      No effect

    • D. 

      All of the above

  • 99. 
    Which organs have enzymes that can metabolize drugs resulting in metabolites that may be active or inactive?
    • A. 

      Liver

    • B. 

      GI tract

    • C. 

      Lungs

    • D. 

      All of the above

  • 100. 
    What part of the body has esterases (esterases are enzymes that cleave ester bonds and make the drug inactive)
    • A. 

      Neuro tissue

    • B. 

      Integumentary tissue

    • C. 

      Blood

    • D. 

      Catabolized muscle cells

  • 101. 
    What are pro-drugs?
    • A. 

      Drugs with a very short half life for example adenosine

    • B. 

      Drugs that are not active until the body itself activates them

    • C. 

      Drugs that can only be given by MD anesthesiologist because of their toxic effect

    • D. 

      I have no idea, but if I ask Barry Bonds, Roger Clemens, Sammy Sosa, A-Rod, or Manny Ramirez they would know.

  • 102. 
    What is a phase I reaction?
    • A. 

      The initial reaction to a drug prior to anaphylaxis

    • B. 

      When the drug is made more polar and water soluble

    • C. 

      Inactivation of the pharmacologic activity of the drug

    • D. 

      All of the above

  • 103. 
    What is a phase II reaction
    • A. 

      The initial reaction to a drug prior to anaphylaxis

    • B. 

      When the drug is made more polar and water soluble

    • C. 

      Inactivation of the pharmacologic activity of the drug

    • D. 

      All of the above

  • 104. 
    Which of the following statements best describes linear PK
    • A. 

      It is the pharmacokinetics in which most drugs follow

    • B. 

      Serum drug concentrations change proportionally to dosing

    • C. 

      It is a steady state, when given IV, between dosage rate and elimination

    • D. 

      All of the above

  • 105. 
    What is compartmental PK?
    • A. 

      Inactivation of the pharmacologic activity of the drug

    • B. 

      When the drug is made more polar and water soluble

    • C. 

      Describes the body as hypothetical compartments linked by transfer rate processes

    • D. 

      All of the above

  • 106. 
    Which compartment can a drug sample not be taken from
    • A. 

      Central Compartment

    • B. 

      Peripheral compartment

    • C. 

      One-compartment

    • D. 

      All of the above

  • 107. 
    What makes up the hypothetical central compartment 
    • A. 

      Brain

    • B. 

      Lungs

    • C. 

      Liver

    • D. 

      Heart

    • E. 

      All of the above

  • 108. 
    What makes up the peripheral compartment
    • A. 

      Muscle

    • B. 

      Skin

    • C. 

      Fat

    • D. 

      Bone

    • E. 

      All of the above

  • 109. 
    What are the two major water compartments in the body? Choose all that apply
    • A. 

      Extracellular

    • B. 

      Plasma

    • C. 

      Interstitial

    • D. 

      Intracellular

  • 110. 
    How is the volume of distribution of a drug calculated?
    • A. 

      Total dose of the drug divided by the plasma concentrationat time=0

    • B. 

      Theoretical volume of plasma that is completely cleared of a drug at a given tim

    • C. 

      TIme it takes the drug concentration to fall 1/2

    • D. 

      The time it takes for the total amount of drug to decrease by 1/2

  • 111. 
    What is clearance
    • A. 

      Total dose of the drug divided by the plasma concentrationat time=0

    • B. 

      Theoretical volume of plasma that is completely cleared of a drug at a given time

    • C. 

      TIme it takes the drug concentration to fall 1/2

    • D. 

      The time it takes for the total amount of drug to decrease by 1/2

  • 112. 
    What is elimination half time?
    • A. 

      The time it takes for the total amount of drug to decrease by 1/2

    • B. 

      Total dose of the drug divided by the plasma concentrationat time=0

    • C. 

      TIme it takes the drug concentration to fall 1/2

    • D. 

      Theoretical volume of plasma that is completely cleared of a drug at a given time

  • 113. 
    What is elimination half life?
    • A. 

      The time it takes for the total amount of drug to decrease by 1/2

    • B. 

      Total dose of the drug divided by the plasma concentrationat time=0

    • C. 

      TIme it takes the drug concentration to fall 1/2

    • D. 

      Theoretical volume of plasma that is completely cleared of a drug at a given time

  • 114. 
    What is context sensitive half time?
    • A. 

      Theoretical volume of plasma that is completely cleared of a drug at a given time

    • B. 

      The time necessary for plasma drug concentration to fall by 50% or other % after continuous infusion of specific duration

    • C. 

      TIme it takes the drug concentration to fall 1/2

    • D. 

      All of the above

  • 115. 
    Once again can not think of a question, or I do not know the math they will use but be familiar with the henderson-hasselbach equation.  Trivia question.  We all know Wilt Chamberlain played professional basketball.  What other sport did he play professionally?
    • A. 

      Track&field

    • B. 

      Volleyball

    • C. 

      Tennis

    • D. 

      MMA

  • 116. 
    Why are diuretic usually held prior to surgery?
    • A. 

      Volume depletion

    • B. 

      Rebound hypertension

    • C. 

      Intraoperative hypertension

    • D. 

      Intraoperative hyperglycemia

  • 117. 
    At what diastolic BP will surgery usually be held? 
    • A. 

      80

    • B. 

      90

    • C. 

      100

    • D. 

      110

  • 118. 
    What is the ASA recommendation in regards to herbal supplements?
    • A. 

      Stop taking 3 days prior to surgery

    • B. 

      Stop taking 1 week prior to surgery

    • C. 

      Stop 2 weeks prior to surgery

    • D. 

      Stop taking 3 weeks prior to surgery

  • 119. 
    What is the CRNA's concerns with a patient who takes echinacea (used to treat viral bacterial and fungal infections)
    • A. 

      Tachyphylaxis

    • B. 

      Barbituate toxicity

    • C. 

      Hepatotoxicity

    • D. 

      Activation of macrophages and killer T-Cells

    • E. 

      All of the above

  • 120. 
    What is the CRNA's concerns with a patient who takes Ephedra or Ma Huang (used for increased energy and appetite supression
    • A. 

      Acts on Alpha and Beta cells like ephedrine

    • B. 

      Increased HR

    • C. 

      Increased BP

    • D. 

      Relaxation of smooth muscles

    • E. 

      All of the above

  • 121. 
    What drug should be used for a patient who is currently taking ephedra and become hypotensive during surgery
    • A. 

      Dopamine

    • B. 

      Neosynephrine

    • C. 

      Dobutamine

    • D. 

      Calcium

  • 122. 
    What is the CRNA's concerns with a patient who takes Garlic
    • A. 

      Hypotension

    • B. 

      Increased bleeding times

    • C. 

      Increased risk for hypotension

    • D. 

      Impaired platelet aggregation

    • E. 

      All of the above

  • 123. 
    What is the CRNA's concerns with a patient who takes Ginkgo (choose all that apply)
    • A. 

      Increased bleeding times

    • B. 

      Tachycardia

    • C. 

      Decreased effectiveness of barbituates

    • D. 

      Hypotension

  • 124. 
    What is the CRNA's concerns with a patient who takes Ginseng
    • A. 

      Hypertension

    • B. 

      Insomnia

    • C. 

      Hemodynamic instability

    • D. 

      Prolonged bleeding time

    • E. 

      All of the above

  • 125. 
    What is the CRNA's concerns with a patient who takes Kava-Kava
    • A. 

      Interaction with levodopa

    • B. 

      Potentiation of barbituates

    • C. 

      Potentiation of benzodiazepines

    • D. 

      Decrease in MAC

    • E. 

      All of the above

  • 126. 
    What is the CRNA's concerns with a patient who takes Valerian
    • A. 

      Tremors

    • B. 

      Headache

    • C. 

      Dysrythmias

    • D. 

      Liver dysfunction

    • E. 

      All of the above

  • 127. 
    Higher Vd relates to elimination how?
    • A. 

      Longer elimination

    • B. 

      Shorter elimination

    • C. 

      No change in elimination time

  • 128. 
    Define zero order kinetics
    • A. 

      A constant fraction is eliminated per unit time

    • B. 

      A constant amount of drug is eliminated per unit time

    • C. 

      The time necessary for plasma drug concentration to fall by 50% or other % after a continuous infusion or specific duration.

    • D. 

      All of the above

  • 129. 
    Where can elimination of a drug from the body occur
    • A. 

      Central compartment

    • B. 

      Peripheral compartment

    • C. 

      All of the above

  • 130. 
    Once again not sure how to write the question but refer to slide 11 in the Pk-Pd pt 2 lecture.  Be able to set up the chart for calculation of half life.  Trivia (yeah!)  Who was the last MLB pitcher to win the Cy Young and MVP awards in the same year.
    • A. 

      Roger Clemens

    • B. 

      CC Sabathia

    • C. 

      Dennis Eckersley

    • D. 

      Catfish Hunter

  • 131. 
    Which two anesthetics are no longer in use because of their toxicity and flammability (choose two)
    • A. 

      Ether

    • B. 

      Sevoflurane

    • C. 

      Isoflurane

    • D. 

      Chloroform

    • E. 

      Desflurane

  • 132. 
    Emergence is mainly dependent on what?
    • A. 

      Fresh gas flow

    • B. 

      Pulmonary elimination

    • C. 

      Kidney elimination

    • D. 

      Nephrotoxicity

  • 133. 
    No question need to know from week 3 uptake and distribution of volatile anesthetics slide #5 and #7 #9 Key point inhalation agents pass through many barriers from the machine to the brain. Important-FD-flow delivered.  Determined by vaporizer and flowmeter.  Eventually goes through the circuit FI-inspired concentration. 3-fresh gas flow rate. Determined by breathing circuit volume, and finally circuit absorption. FA-alveolar gas concentration determined by IMPORTANT 1. uptake, ventilation, concentration effect and second gas effect Ratio between inspired and alveolar concentration.  Several barriers between machine and patient.  Partial pressures my differ, inflow to the circuit form blood to brain.  PHARMACOKINETICS nFactors affecting alveolar concentration (FA): nAlveolar gas concentration (FA) would approach inspired gas concentration (FI) without uptake of anesthetic agent by the body nAnesthetic agent is taken up by pulmonary circulation during induction, therefore alveolar concentrations lag behind inspired concentrations (FA/FI < 1.0) nGreater the uptake, slower the rate of rise of the alveolar concentration and the lower the FA:FI ratio
    • A. 

      Yes

    • B. 

      No

  • 134. 
    What is MAC?(choose all that apply)
    • A. 

      The partial pressure of an inhaled anasthetic at 1 atm the prevents skeletal muscle moveement to noxious stimuli in 50% of patients

    • B. 

      Maximim alveolar concentration

    • C. 

      Minimum alveolar concentration

    • D. 

      All of the above

  • 135. 
    What is the MAC of sevoflurane
    • A. 

      1

    • B. 

      2

    • C. 

      3

    • D. 

      4

  • 136. 
    Complete the following.... "The higher the flow delivered....."(choose all that apply)
    • A. 

      The higher the inspiratory concentration

    • B. 

      The lower the inspiratory concentration

    • C. 

      The higher the alveolar concentration

    • D. 

      The lower the alveolar concentration

  • 137. 
    Which type of agent is taken up by the blood more readily soluble or insoluble?
    • A. 

      Soluble

    • B. 

      Insoluble

  • 138. 
    How is the blood gas coefficient related to solubilty?
    • A. 

      The lower the coefficient the more soluble the agent

    • B. 

      The lower the coefficient the less soluble the agent

    • C. 

      The higher the concentration the less soluble the agent

  • 139. 
    What is dead space?
    • A. 

      Perfusion no ventilation

    • B. 

      Perfusion with ventilation

    • C. 

      Ventilation with perfusion

    • D. 

      Ventilation but no perfusion

  • 140. 
    What is shunting
    • A. 

      Perfusion no ventilation

    • B. 

      Perfusion with ventilation

    • C. 

      Ventilation with perfusion

    • D. 

      Ventilation but no perfusion

  • 141. 
    What effect does ventilation have on FA (choose all that apply)
    • A. 

      Hyperventilation increases rate of rise of FA

    • B. 

      Hyperventilation decreases the rate of rise of FA

    • C. 

      Hypoventilation increases rate of rise of FA

    • D. 

      Hypoventilation decreases rate of rise of FA

    • E. 

      All of the above

  • 142. 
    How is elimination accomplishes?
    • A. 

      Exhalation

    • B. 

      Biotransformation

    • C. 

      Transcutaneous loss

    • D. 

      All of the above

  • 143. 
    Which of the following agents are no longer in use (choose all that apply)
    • A. 

      Sevoflurane

    • B. 

      Halothane

    • C. 

      Isoflurane

    • D. 

      Desflurane

    • E. 

      Enflurane

  • 144. 
    What is the ED50 of an agent? (choose all that apply)
    • A. 

      Same as MAC of an agent

    • B. 

      Effective dose in 50% of patients

    • C. 

      End-tidal differential

    • D. 

      Expired dose

  • 145. 
    What is MAC-BAR
    • A. 

      When there is a bromide attachment to the agent

    • B. 

      When there is a barium attachment to the agent

    • C. 

      Block adrenergic response

    • D. 

      Where all Irish guys go after class

  • 146. 
    What is MAC- awake?
    • A. 

      This is the MAC at time=0

    • B. 

      50% of patients will be able to follow a a simple command at this level

    • C. 

      This is MAC when patient arrises from anesthesia

    • D. 

      All of the above

  • 147. 
    What do you have to be concerned with when a patient is hypovolemic and receive N20 
    • A. 

      Pulmonary vascular resistance

    • B. 

      Myocardium depression

    • C. 

      Myocardium ischemia

    • D. 

      Catecholamine release

    • E. 

      All of the above

  • 148. 
    When giving N2O what respiratory concerns will you have as a CRNA?
    • A. 

      Increased Apneic threshold

    • B. 

      Tachypnea

    • C. 

      Increased respiratory rate

    • D. 

      Decreased tidal volume

    • E. 

      All of the above

  • 149. 
    In which of the following surgeries will N2O be contraindicated?
    • A. 

      Craniotomy

    • B. 

      Eye globe

    • C. 

      Pneumothorax

    • D. 

      All of the above

  • 150. 
    What is the MAC of desflurane?
    • A. 

      1

    • B. 

      2

    • C. 

      4

    • D. 

      6

    • E. 

      7

  • 151. 
    I have in my notes know what % of agent is metabolized by body, but have not looked it up.  SO you guessed it trivia time!  In 1986 the Boston Celtics won the NBA championship.  They had three players in the NBA's 50 greatest players of all time.  Their nickname was the big three. name them (choose all that apply  
    • A. 

      Larry "Joe" Bird

    • B. 

      Robert "Chief" Parrish

    • C. 

      Kevin McHale

    • D. 

      Bill Walton

    • E. 

      Bob Cousy

  • 152. 
    Which of the following vaporizers is heated?
    • A. 

      Isoflurane

    • B. 

      Halothane

    • C. 

      Sevoflurane

    • D. 

      Desflurane

  • 153. 
    True or false minute volume is (RR*V)/minutes
    • A. 

      True

    • B. 

      False

  • 154. 
    Which gas is the most irritating to the airway?
    • A. 

      Sevoflurane

    • B. 

      Isoflurane

    • C. 

      Desflurane

    • D. 

      Halothane

  • 155. 
    Which gas is the Least irritating to the airway
    • A. 

      Sevoflurane

    • B. 

      Desflurane

    • C. 

      Isoflurane

    • D. 

      Halothane

  • 156. 
    What is the vapor pressure of sevoflurane
    • A. 

      660

    • B. 

      240

    • C. 

      160

  • 157. 
    What is the vapor pressure of Desflurane
    • A. 

      160

    • B. 

      660

    • C. 

      240

  • 158. 
    What is the vapor pressure of isoflurane
    • A. 

      240

    • B. 

      660

    • C. 

      160

    • D. 

      406

  • 159. 
    What factors affect flow inspired
    • A. 

      FGF rate

    • B. 

      Absorption in circuit

    • C. 

      Volume in circuit

    • D. 

      All of the above

  • 160. 
    What factors affect flow alveolar
    • A. 

      Concentration

    • B. 

      Uptake

    • C. 

      Ventilation

    • D. 

      All of the above

  • 161. 
    What factors affect uptake
    • A. 

      Solubility

    • B. 

      Partial pressure difference

    • C. 

      Flow

    • D. 

      All of the above

  • 162. 
    What is the blood:gas coefficient of Isoflurane?
    • A. 

      0.47

    • B. 

      0.69

    • C. 

      0.42

    • D. 

      1.43

  • 163. 
    What is the blood:gas coefficient of sevoflurane?
    • A. 

      0.47

    • B. 

      0.69

    • C. 

      0.42

    • D. 

      1.43

  • 164. 
    What is the gas coefficient of desflurane?
    • A. 

      1.43

    • B. 

      0.69

    • C. 

      0.47

    • D. 

      0.42

  • 165. 
    What is the blood:gas coefficient of N2O
    • A. 

      0.42

    • B. 

      0.69

    • C. 

      0.47

    • D. 

      1.43

  • 166. 
    What is the MAC of Isoflurane?
    • A. 

      1.15

    • B. 

      2

    • C. 

      6

    • D. 

      104

  • 167. 
    What is the MAC of N2O
    • A. 

      1.15

    • B. 

      2

    • C. 

      6

    • D. 

      104

  • 168. 
    What is the MAC of Desflurane?
    • A. 

      1.15

    • B. 

      2

    • C. 

      6

    • D. 

      104

  • 169. 
    What is the MAC of sevoflurane?
    • A. 

      1.15

    • B. 

      2

    • C. 

      6

    • D. 

      106

  • 170. 
    What factors increase the production of CO
    • A. 

      High temperatures

    • B. 

      Dryness

    • C. 

      Type of absorbent

    • D. 

      All of the above

  • 171. 
    OK I am very tired so that is it.  One last trivia question.  The ABA was actually the first professional basketball league to adopt the 3 point field goal (they also used a red, white, and blue ball like the Harlem globe trotters) who was the first player in NBA player in history to make a 3 point field goal in a regular season NBA game?
    • A. 

      Larry "Joe" Bird

    • B. 

      Chris Ford

    • C. 

      Pistol pete Maravich

    • D. 

      Michael Jordan

    • E. 

      Bob Cousy