The Anesthesia Quiz: How Does It Work?

94 Questions | Total Attempts: 214

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Anesthesia Quizzes & Trivia

Questions and Answers
  • 1. 
    Which of the following is not one of the Five Principle pharmacological effects of Benzodiazepines?
    • A. 

      Sedation

    • B. 

      Anxiolysis

    • C. 

      Retrograde Amnesia

    • D. 

      Anticonvulsant

    • E. 

      Spinal Cord mediated skeletal muscle relaxation

  • 2. 
    Which of the Benzodiazepines reviewed has the slowest onset of action and why?
    • A. 

      Lorazepam- due to lower lipid solubility

    • B. 

      Midazolam- due to its water solubility

    • C. 

      Diazepam- due to rapid redistribution

  • 3. 
    While doing a pre-op assessment on an inpatient you find that the pt is currently taking Tagamet (cimetidine) and is on a Heparin regimen. With this knowledge you know to avoid which of the benzodiazepines?
    • A. 

      Lorazepam

    • B. 

      Diazepam

    • C. 

      Midazolam

    • D. 

      Thiopental

  • 4. 
    In regards to the adjustments of Benzodiazepines in respect to the elderly patient.  Would you expect to have:
    • A. 

      Significant increase in initial dose and anticipate marked decrease in duration of action

    • B. 

      Modest decrease in initial dose and anticipate marked increase in duration of action

    • C. 

      No change in dose or frequency or duration from that of an healthy 25 year old patient.

    • D. 

      None of above

  • 5. 
    The dose of Benzodiazepines required to reach a desired clinical endpoint is increased in the elderly compared to the younger patient.
    • A. 

      True

    • B. 

      False

  • 6. 
    Benzodiazepines are extensively protein bound.  Therefore, in the presence of renal failure their clinical effect will be:
    • A. 

      Shortened

    • B. 

      Prolonged

    • C. 

      No significant change.

  • 7. 
    Define Affinity:
    • A. 

      Inhibit or block responses caused by an agonist

    • B. 

      Drugs which alter the physiology of a cell by binding to plasma membrane or intracellular receptors

    • C. 

      The strength of binding between drug and receptor

    • D. 

      Binds to a site other than the agonist-binding domain

  • 8. 
    A drug that alters the physiology of a cell by binding to the plasma membrane or intracellular receptors is known as what?
    • A. 

      Antagonist

    • B. 

      Competitive Agonist

    • C. 

      Competitive Antagonist

    • D. 

      Agonist

  • 9. 
    What is an antagonist?
    • A. 

      Inhibit or block responses caused by an agonist

    • B. 

      A drug which alters the physiology of a cell by binding to plasma membrane or intracellular receptors

    • C. 

      Biochemical messengers, often called 2ndmessengers

    • D. 

      The strength of binding between drug and receptor

  • 10. 
    A Competitive antagonist binds to a site other than the agonist binding domain.
    • A. 

      True

    • B. 

      False

  • 11. 
    What is GABA?
    • A. 

      The major excitatory neurotransmitter and is important in agonizing the effects of amino acid transmitter.

    • B. 

      Proteins or glycoproteins that are present on the cell surface, on an organelle within the cell, or in the cytoplasm.

    • C. 

      The major inhibitory neurotransmitter and is important in antagonizing the effects of amino acid transmitter.

    • D. 

      Refers to the portion of the chemical structured composed of a benzene ring fused to a seven-membered diazepine ring

  • 12. 
    What is the MOA of Benzo's?
    • A. 

      Blockade of chloride channels leading to depolarization and inhibition of neurotransmitter

    • B. 

      Inhibition of cyclooxygenase activity

    • C. 

      Inhibition of GABA receptor binding which leads to degredation of GABA, preventing it from exerting it's effect.

    • D. 

      Enhances the inhibitory effects of various neurotransmitter by facilitating GABA receptor binding. This opens chloride channels and causes hyperpolarization.

  • 13. 
    How do midazolam and diazepam compare to one another?
    • A. 

      Midazolam has 2 times the affinity for benzo receptors

    • B. 

      Diazepam has 3 times the affinity for benzo receptors

    • C. 

      Diazepam is hydrophilic

    • D. 

      Midazolam has a much londer elimination half time

  • 14. 
    All benzo's share what similarities?
    • A. 

      All are highly alkaline solutions

    • B. 

      Composed of a benzene ring fused to a seven-membered diazepine ring

    • C. 

      They are safe to be given during pregnancy

    • D. 

      Composed of malonic acid and urea

  • 15. 
    How is midazolam unique in comparison to other benzo's?
    • A. 

      It is the only benzo safe to give to pregnant women.

    • B. 

      Is known to cause pain upon injection, but has minimal respiratory depression

    • C. 

      It is hydrophilic and becomes lipid soluble upon exposure to blood.

    • D. 

      It is not highly protein bound like the other benzo's and thus more is available for use by the body.

  • 16. 
    Which of the following drugs will cause pain upon injection due to the solvent propylene glycol?
    • A. 

      Lorazepam

    • B. 

      Flumazenil

    • C. 

      Midazolam

    • D. 

      Diazepam

  • 17. 
    What is an appropriate oral dose for pediatric pre-medication with midazolam?
    • A. 

      0.5 mg/kg

    • B. 

      1 mg/kg

    • C. 

      2-3 mg

    • D. 

      10 - 20 mcg/ kg

  • 18. 
    What would be an appropirate Adult IV induction dose for midazolam?
    • A. 

      0.5 mg/kg

    • B. 

      0.1 mg/kg

    • C. 

      2-3 mg

    • D. 

      4 mg/kg

  • 19. 
    You have just given you pt Midazolam, how long would you expect to wait to see onset of the drug?
    • A. 

      3-5 minutes

    • B. 

      20-25 minutes

    • C. 

      30-60 seconds

    • D. 

      2 minutes

  • 20. 
    When doing a pre-op evaluation for a pt you notice the pt has low albumin levels. How would this effect the amount of Midazolam given to the pt for pre-medication?
    • A. 

      You would need to increase the amount given in order to reach the desired effect

    • B. 

      You would not change the dose at all.

    • C. 

      You would decrease the amount of drug given since this pt may be at risk for overdose.

  • 21. 
    Put these medications in order of shortest elimination half time to longest: Midazolam, Diazepam, Lorazepam
    • A. 

      Midazolam < Diazepam < Lorazepam

    • B. 

      Diazepam < Lorazepam < Midazolam

    • C. 

      Lorazepam < Midazolam < Diazepam

    • D. 

      Midazolam < Lorazepam < Diazepam

  • 22. 
    What is the elimination half time of Midazolam?
    • A. 

      21-37 hours

    • B. 

      1-4 hours

    • C. 

      10-20 hours

    • D. 

      5-10 hours

  • 23. 
    What is the elimination half time of Lorazepam?
    • A. 

      1-4 hours

    • B. 

      21-37 hours

    • C. 

      10-20 hours

    • D. 

      5-10 hours

  • 24. 
    What is the elimination half time of Diazepam?
    • A. 

      5-10 hours

    • B. 

      1-4 hours

    • C. 

      10-20 hours

    • D. 

      21-37 hours

  • 25. 
    What effects do benzodiazepines exert upon the cardiovascular system?
    • A. 

      No effect on cardiovascular system, even at high doses.

    • B. 

      Decrease BP & PVR, especially in hypovolemic pt

    • C. 

      Decrease ABP, CO & HR

    • D. 

      Increase HR and decrease SV

  • 26. 
    Benzodiazepines are preferred as a pre-medication for anesthesia because they do not cause any respiratory depression in patients.
    • A. 

      True

    • B. 

      False

  • 27. 
    Which of the following is not a cerebral effect of benzodiazepines?
    • A. 

      Reduce CMRO2 & CBF

    • B. 

      Increase the seizure threshold to prevent seizure

    • C. 

      Anti-anxiety & sedative effects

    • D. 

      Direct Analgesic Effects

  • 28. 
    Where would you find benzodiazepine receptors?
    • A. 

      Primarily on the postsynaptic nerve endings in the cerebral cortex

    • B. 

      Pre-synaptic nerve endings in the brain stem and spinal cord.

    • C. 

      Brain, spinal cord and peripheral tissue: pre-synaptic and post synaptic.

  • 29. 
    What is a non-competitive antagonist?
    • A. 

      A drug which alters the physiology of a cell by binding to plasma membrane or intracellular receptors

    • B. 

      Binds to a site other than the agonist-binding domain

    • C. 

      A drug which really hates playing sports, and instead takes a bunch of art classes.

    • D. 

      A drug which inhibits a normal cellular function by competing with agonists for receptors

  • 30. 
    Why should you be cautious when giving both an opioid and a benzo together?
    • A. 

      You increase risk for arrythmias

    • B. 

      Patient may lose respiratory drive

    • C. 

      You may increase ICP & SVR

    • D. 

      You may severely reduce ABP

  • 31. 
    What drug would you choose to treat a pt with a benzodiazepine overdose?
    • A. 

      Flumazenil, slow titration of 0.2 mg doses IV

    • B. 

      Narcan, slow titration of 1-4mcg/kg

    • C. 

      Flurazepam 15-30 mg

    • D. 

      Just wait it out.

  • 32. 
    Which benzo would be used to treat panic attacks?
    • A. 

      Lorazepam

    • B. 

      Alprazolam

    • C. 

      Flurazepam

    • D. 

      Diazepam

  • 33. 
    How much oral midazolam would you give to a child weighing 40 kg?
    • A. 

      40 mg

    • B. 

      4 mg

    • C. 

      20 mg

    • D. 

      60 mg

  • 34. 
    Which of the following is true regarding Barbituates?
    • A. 

      Composed of a benzene ring fused to a seven-membered diazepine ring, and highly acidic

    • B. 

      Composed of malonic acid & urea and highly acidic

    • C. 

      Derived from poppy and highly alkaline

    • D. 

      Composed of malonic acid & urea and highly alkaline

  • 35. 
    How long can Methohexital be refrigerated and stable for after mixing?
    • A. 

      2 weeks

    • B. 

      6 weeks

    • C. 

      6 days

    • D. 

      1 month

  • 36. 
    Substitutions on the carbon atoms of barbituates determine all of the following except:
    • A. 

      Hypnotic potency

    • B. 

      Anti-convulsant properties

    • C. 

      Protein binding

    • D. 

      Duration of action

  • 37. 
    A  barbituate with an oxygen atom on the #2 carbon would be called a...
    • A. 

      Thiobarbituates

    • B. 

      Malobarbituates

    • C. 

      Pentabarbituates

    • D. 

      Oxybarbituate

  • 38. 
    A Barbituate with a sulfur atom on the #2 carbon is called a...
    • A. 

      Thiobarbituates

    • B. 

      Oxybarbituates

    • C. 

      Pentabarbituate

    • D. 

      Sulbarbituates

  • 39. 
    What is the MOA of barbituates?
    • A. 

      Act at stereospecific receptors at presynaptic and postsynaptic sites in the central nervous system– brain(periaqueductal gray, amygdala, corpus striam, and hypothalmus) and spinal cord(substanstantia geltinosa) and in the peripheral tissues.

    • B. 

      Depression of the reticulcar activating system, suppression of excitatory neurotranmitters and enhancement of inhibitory neurotransmitters.

    • C. 

      Receptor binding enhances the inhibitory effects of various neurotransmitter by facilitating GABA receptor binding. This opens chloride gating channels, producing hyperpolarization of post synaptic cell membranes and rendering post synaptic neurons more resistant to excitation.

  • 40. 
    Distribution of barbituates depends on all of the following except...
    • A. 

      Lipid Solubility

    • B. 

      Protein binding

    • C. 

      Hepatic oxidation

    • D. 

      Degree of ionization

  • 41. 
    Duration of action of highly lipid soluble barbituates is determined by...
    • A. 

      Hepatic Oxidation

    • B. 

      Lipid Solubility

    • C. 

      Renal Excretion

    • D. 

      Redistribution

  • 42. 
    How much methohexital would you expect to find excreted unchanged in the urine?
    • A. 

      < 1%

    • B. 

      1-3 %

    • C. 

      5-10 %

    • D. 

      95%

  • 43. 
    The elimination half time of Methohexital is ~4 hours.
    • A. 

      True

    • B. 

      False

  • 44. 
    What is the respiratory pattern associated with barbituates upon awakening?
    • A. 

      Decrease Tv and Increase RR

    • B. 

      Increase Tv and RR

    • C. 

      Increase Tv and decrease RR

    • D. 

      Decrease Tv and RR

  • 45. 
    How are barbituate metabolized?
    • A. 

      Hepatic Oxidation

    • B. 

      Renal oxidation

    • C. 

      Glomerular filtration

    • D. 

      Broken down in small intestines and excreted in feces

  • 46. 
    Is Thiopental safe to give during pregnancy?
    • A. 

      No!

    • B. 

      Up to 4mg/kg, yes

    • C. 

      Yes, it does not cross the placental barrier and even a high dose will not effect the fetus

    • D. 

      Only minimal dose of 0.5 mg/kg.

  • 47. 
    Unlike the benzo's, Barbituates are known to increase CBF and ICP.
    • A. 

      True

    • B. 

      False

  • 48. 
    How much methohexital should be given to a pt undergoing ECT?
    • A. 

      0.5 mg/kg IV

    • B. 

      20 mg/kg via rectal suppository

    • C. 

      5 mg/kg PO

    • D. 

      > 1mg/kg IV

  • 49. 
    What is the MOA of opioids?
    • A. 

      Act at stereospecific receptors at presynaptic and postsynaptic sites in the central nervous system. mimic the endogenous endorphines to inhibit pain transmission.

    • B. 

      Receptor binding enhances the inhibitory effects of various neurotransmitter by facilitating GABA receptor binding.

    • C. 

      Depression of the reticulcar activating system, suppression of excitatory neurotranmitters and enhancement of inhibitory neurotransmitters.

  • 50. 
    Which of the following is NOT an endogenous peptide?
    • A. 

      Endorphin

    • B. 

      Ekephalin

    • C. 

      Dynorphine

    • D. 

      Epinorphin

  • 51. 
    What is Substance P?
    • A. 

      The major inhibitory neurotransmitter.

    • B. 

      An active metabolite of opioid metabolism which relieves pain

    • C. 

      An excitatory neurotransmitter presumed to be released by terminals of pain fibers

    • D. 

      A rapper?

  • 52. 
    Which of the opioid receptors causes Euphoria, Miosis, Bradycardia, Urinary retention & Hypothermia?
    • A. 

      Delta

    • B. 

      Mu1

    • C. 

      Mu2

    • D. 

      Kappa

  • 53. 
    Which opioid receptor causes dysphoria, miosis, diuresis & sedation?
    • A. 

      Mu1

    • B. 

      Mu2

    • C. 

      Kappa

    • D. 

      Delta

  • 54. 
    Which opioid receptor causes depression of ventilation, physical dependence, minimal constipation & urinary retention?
    • A. 

      Mu1

    • B. 

      Mu2

    • C. 

      Kappa

    • D. 

      Delta

  • 55. 
    Enkephalin is responsible for stimulating which opioid receptor?
    • A. 

      Mu

    • B. 

      Kappa

    • C. 

      Delta

  • 56. 
    Dynorphin is responsible for stimulating which opioid receptor?
    • A. 

      Mu

    • B. 

      Kappa

    • C. 

      Delta

  • 57. 
    Endorphin stimulates which opioid receptor?
    • A. 

      Mu

    • B. 

      Kappa

    • C. 

      Delta

  • 58. 
    Which opioid receptors are responsible for physical dependence?
    • A. 

      Mu1 & Mu2

    • B. 

      Mu2 & Delta

    • C. 

      Mu1 & Kappa

    • D. 

      Kappa & Delta

  • 59. 
    What respiratory effects are associated with opioid?
    • A. 

      Chest wall flaccidity

    • B. 

      Increase RR with decrease Tv

    • C. 

      Decrease RR and increase Tv

    • D. 

      Increased response to CO2

  • 60. 
    Which class of drug would to NOT give to a pt undergoing a cholangiogram?
    • A. 

      Benzo's

    • B. 

      Barbituates

    • C. 

      Opioids

  • 61. 
    You are caring for Mr. X who is currently having a Left BKA. You notice his HR increasing and take a quick glance at his pupils to see they are normal size. His train of four is currently 0/4. What does this tell you?
    • A. 

      He is too light, Increase the sevo.

    • B. 

      Maybe he could use some more opioids, to relieve pain.

    • C. 

      Maybe he could use some more paralytic.

    • D. 

      He needs a little more midazolam, to calm him.

  • 62. 
    Which of the following is not an effect of opiods?
    • A. 

      Chest wall rigidity

    • B. 

      Fetal respiratory depression

    • C. 

      Anterograde Amnesia

    • D. 

      Constipation

  • 63. 
    What is the onset of action for Morphine?
    • A. 

      2 hours

    • B. 

      30-60 seconds

    • C. 

      15-30 minutes

    • D. 

      5-10 minutes

  • 64. 
    What are the metabolites of morphine?
    • A. 

      Morphine 3-gluconiride which is active and induces analgesia and resp depression, & Mophine 6-gluconiride which is inactive

    • B. 

      Morphine 3-gluconiride & Mophine 6-gluconiride both of which are inactive.

    • C. 

      Morphine 3-gluconiride which is inactive, & Mophine 6-gluconiride which is active and induces analgesia and resp depression

    • D. 

      Morphine 3-gluconiride & Mophine 6-gluconiride both of which are active and cause respiratory depression and analgesia

  • 65. 
    Which of the opioids will NOT cause miosis?
    • A. 

      Morphine

    • B. 

      Fentanyl

    • C. 

      Meperidine

    • D. 

      Narcan

  • 66. 
    You are the SRNA for Mr. Chaviano who is just our of surgery. He has a past medical histort of HTN, palpitations, schizophrenia, & GERD. He is shivering in the PACU and the nurse requests something to help. What do you do?
    • A. 

      Give some Narcan to reverse your opioids.

    • B. 

      Give Meperidine to treat the shivering

    • C. 

      Give Fentanyl to treat shivering

    • D. 

      Find some warm blankets and cover him up.

  • 67. 
    How does meperidine compare to morphine?
    • A. 

      1/10 as potent

    • B. 

      10 times as potent

    • C. 

      100 time as potent

    • D. 

      1,000 times as potent

  • 68. 
    How does fentanyl compare to morphine?
    • A. 

      1/10 as potent

    • B. 

      10 times as potent

    • C. 

      100 times as potent

    • D. 

      1000 times as potent

  • 69. 
    Which opioid has the highest degree of lipid solubility?
    • A. 

      Sufentanil

    • B. 

      Remifentanil

    • C. 

      Fentanyl

    • D. 

      Morphine

  • 70. 
    You are caring for Mrs. Tica who has a past history of A-fib, DM, pancreatitis & asthma. Which drug would you choose to relieve her pain?
    • A. 

      Toradol

    • B. 

      Morphine

    • C. 

      Ethanol

    • D. 

      Fentanyl

  • 71. 
    How does Sufentanil compare to Morphine?
    • A. 

      1/10 as potent

    • B. 

      10 times as potent

    • C. 

      100 times as potent

    • D. 

      1,000 as potent

  • 72. 
    How is remifentanil metabolized?
    • A. 

      90% metabolized to normeperidine,1/2 as active as a analgesic

    • B. 

      By nonspecific plasma esterase inactive metabolites

    • C. 

      Metabolized via conjugation with glucuronic acid

    • D. 

      Metabolized via hepatic oxidation

  • 73. 
    Why is remifentanil unique among the opioids?
    • A. 

      Can be safely given to asthmatics and those on MAOI's

    • B. 

      Does not cause miosis

    • C. 

      Context sensitive half time independent of infusion time.

    • D. 

      Most rapid onset with large Vd.

  • 74. 
    Meperidine acts on which opioid receptors?
    • A. 

      Mu & Delta

    • B. 

      Only the Mu receptors

    • C. 

      Delta & Kappa

    • D. 

      Mu & Kappa

  • 75. 
    Fentanyl has a much more rapid onset but a longer elimination half time than Morphine. Why?
    • A. 

      Because of fentanyl high lipid solubility

    • B. 

      Because fentanyl is highly protein bound

    • C. 

      Because Morphine has a much high lipid solubility and thus is excreted more rapidly

    • D. 

      Because morphine has a much larger Vd.

  • 76. 
    Which medication would you give to reverse post-op ventilatory depression of Fentanyl while maintaining analgesia?
    • A. 

      Nalbuphine

    • B. 

      Narcan, carefully titrated

    • C. 

      Flumazenil

    • D. 

      Switch to Meperidine

  • 77. 
    Which medication would you give to reliev post-op itching caused by Morphine?
    • A. 

      Narcan 1-4 mcg/kg IV

    • B. 

      Flumazenil, titrate by doses of 0.2 mg

    • C. 

      Nubain 10-20 mg IV

    • D. 

      Meperidine

  • 78. 
    What medication would you give to treat an opioid overdose?
    • A. 

      Flumazenil, slow titration of 0.2 mg doses

    • B. 

      Nubain 10-20 mg

    • C. 

      Lithium

    • D. 

      Narcan 1-4 mcg/kg

  • 79. 
    What is the half life of Narcan?
    • A. 

      60-90 minutes

    • B. 

      30-45 minutes

    • C. 

      3 hours

    • D. 

      4-6 hours

  • 80. 
    Epidural or subarachnoid placement of opioids is based on activation of which receptors?
    • A. 

      Kappa

    • B. 

      Mu

    • C. 

      Delta

    • D. 

      All the above

  • 81. 
    Which of the following is not a factor which increases risk of respiratory depression with opioids?
    • A. 

      High opioid dose

    • B. 

      High lipid solubility

    • C. 

      Administration of other sedatives

    • D. 

      Lack of tolerance

    • E. 

      Advanced age

  • 82. 
    30mg of Ketorolac would be equivalent to how much morphine?
    • A. 

      1 mg

    • B. 

      30 mg

    • C. 

      15 mg

    • D. 

      10 mg

  • 83. 
    Which of the following is not one of the Top 4 side effects of neuraxial opioids?
    • A. 

      Sedation

    • B. 

      Pruritis

    • C. 

      Nausea/Vomitting

    • D. 

      Urinary retention

    • E. 

      Depressed ventilation

  • 84. 
    What would be an appropriate loading dose for remifentanil?
    • A. 

      5-20 microgram

    • B. 

      1 mcg/kg

    • C. 

      0.5 mg/kg

    • D. 

      5 mcg/kg

  • 85. 
    Which of the following benzodiazepines is most commonly used during the preoperative period and for IV conscious sedation?
    • A. 

      Diazepam

    • B. 

      Lorazepam

    • C. 

      Midazolam

    • D. 

      Alprazolam

  • 86. 
    Which of the following is NOT a pharmacological effect of benzodiazepines?
    • A. 

      Amnesia

    • B. 

      Anxiolysis

    • C. 

      Analgesia

    • D. 

      Anticonvulsant

  • 87. 
    Which of the following is true regarding benzodiazepines?
    • A. 

      Amnesitic effects are greater than sedative effects

    • B. 

      Produce sufficient skeletal muscle relaxation for surgery

    • C. 

      Have a high tendency of tolerance compared to barbiturates

    • D. 

      Longer duration of sedation than amnesia

  • 88. 
    Which adverse reaction is a patient most likely to experience after receiving general anesthesia?
    • A. 

      Nauseau & Vomiting

    • B. 

      Seizures

    • C. 

      Cyanosis

    • D. 

      Increased HR

  • 89. 
    The drug most commonly prescribed to treat opioid overdose is?
    • A. 

      Flumazenil

    • B. 

      Nalbuphine

    • C. 

      Naloxone

    • D. 

      Butorphanol

  • 90. 
    Which benzodiazepine is primarily used to treat anxiety?
    • A. 

      Lorazepam

    • B. 

      Midazolam

    • C. 

      Diazepam

    • D. 

      Temazepam

  • 91. 
    Which benzodiazepine is primarily used for induction of anesthesia?
    • A. 

      Midazolam

    • B. 

      Propofol

    • C. 

      Thiopental

    • D. 

      Etomidate

  • 92. 
    How is remifentanil different than other opioids?
    • A. 

      Shortest acting opioid

    • B. 

      Stronger acting than Fentanyl

    • C. 

      Structurally unique due to ester linkage

    • D. 

      Few side effects

  • 93. 
    What is responsible for the pain reaction elicited when diazepam is given IM?
    • A. 

      Any IM injection is painful

    • B. 

      Ethyl alcohol component

    • C. 

      Propylene glycol component

    • D. 

      Solubility component

  • 94. 
    Sodium Thiopental is a contraindication in which patients?
    • A. 

      History of neurologic distrubances

    • B. 

      History of hemolytic amenia

    • C. 

      Acute intermittent porphyria

    • D. 

      Immunosuppression