A Practice Test On Anesthesia! Trivia Quiz

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A Practice Test On Anesthesia! Trivia Quiz - Quiz

A practice test on anaesthesia trivia quiz! There are different types of drugs given to a patient so that they can be unconscious or some parts of their body made numb of feeling. In some instances, not drugs but gasses are used. As an aspiring anaesthetic, how much do you know about different benzodiazepines, their effect as well as consumption in different types of patients? This quiz will help you find out!


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

    Correct Answer
    C. Retrograde Amnesia
    Explanation
    Retrograde amnesia is not one of the five principal pharmacological effects of benzodiazepines. The five principle effects are sedation, anxiolysis, anticonvulsant, spinal cord mediated skeletal muscle relaxation, and amnesia. Retrograde amnesia refers to the inability to recall past events, which is not a specific effect of benzodiazepines.

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  • 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

    Correct Answer
    A. Lorazepam- due to lower lipid solubility
    Explanation
    Lorazepam has the slowest onset of action because it has lower lipid solubility. Lipid solubility affects the rate at which a drug can cross cell membranes and enter the bloodstream. Lower lipid solubility means that the drug will have a harder time crossing cell membranes and will therefore take longer to reach its target site and produce its effects. In contrast, Midazolam, which has water solubility, can more easily cross cell membranes and therefore has a faster onset of action. Diazepam, on the other hand, has rapid redistribution, meaning it is quickly distributed throughout the body after administration, leading to a faster onset of action compared to lorazepam.

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  • 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

    Correct Answer
    B. Diazepam
    Explanation
    Cimetidine is known to inhibit the metabolism of certain drugs, including benzodiazepines, by blocking the enzyme responsible for their breakdown. Diazepam is specifically mentioned as a benzodiazepine to avoid because it has a long half-life and can accumulate to toxic levels when used concurrently with cimetidine. Therefore, it is important to avoid diazepam in this patient to prevent potential adverse effects.

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  • 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

    Correct Answer
    B. Modest decrease in initial dose and anticipate marked increase in duration of action
    Explanation
    As the elderly population is more susceptible to the effects of medications, including benzodiazepines, it is expected that the initial dose of benzodiazepines would be decreased in elderly patients. This is because their bodies may not metabolize the drug as efficiently as a younger individual, leading to a higher risk of adverse effects. Additionally, the duration of action of benzodiazepines is anticipated to increase in elderly patients due to slower clearance of the drug from their system. Therefore, a modest decrease in the initial dose and a marked increase in the duration of action would be expected in elderly patients.

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  • 5. 

    The dose of Benzodiazepines required to reach a desired clinical end point is increased in the elderly compared to the younger patient.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    The statement is false because the dose of Benzodiazepines required to reach a desired clinical end point is actually decreased in the elderly compared to younger patients. This is because the elderly population is more sensitive to the effects of Benzodiazepines due to age-related changes in metabolism and drug clearance. Therefore, a lower dose is needed to achieve the desired therapeutic effect in older patients.

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  • 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.

    Correct Answer
    B. Prolonged
    Explanation
    Benzodiazepines are highly protein bound, meaning they bind strongly to proteins in the blood. In the presence of renal failure, the elimination of drugs from the body can be impaired. Since benzodiazepines are bound to proteins, they may be less available for elimination in renal failure, leading to a prolonged clinical effect. Therefore, the clinical effect of benzodiazepines is likely to be prolonged in the presence of renal failure.

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  • 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

    Correct Answer
    C. The strength of binding between drug and receptor
    Explanation
    The correct answer is "the strength of binding between drug and receptor." Affinity refers to the degree of attraction or binding between a drug and its receptor. It indicates how strongly a drug binds to a specific receptor site, which can affect the drug's potency and efficacy. A higher affinity means a stronger binding, resulting in a more potent drug-receptor interaction.

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  • 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

    Correct Answer
    D. Agonist
    Explanation
    An agonist is a drug that binds to either the plasma membrane or intracellular receptors of a cell and alters its physiology. This binding activates the receptors, leading to a cellular response. Unlike antagonists, which block the receptors and inhibit the cellular response, agonists enhance the response by mimicking the action of endogenous substances. Therefore, an agonist can be considered a drug that activates and stimulates cellular processes.

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  • 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

    Correct Answer
    A. Inhibit or block responses caused by an agonist
    Explanation
    An antagonist is a substance that inhibits or blocks the responses caused by an agonist. Agonists are substances that activate receptors in the body, while antagonists work against these activations by binding to the receptors without activating them. This prevents the agonist from binding and activating the receptor, thus inhibiting or blocking its responses.

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  • 10. 

    What is the MOA of Benzos?

    • 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.

    Correct Answer
    D. Enhances the inhibitory effects of various neurotransmitter by facilitating GABA receptor binding. This opens chloride channels and causes hyperpolarization.
    Explanation
    Benzos enhance the inhibitory effects of various neurotransmitters by facilitating GABA receptor binding. This action opens chloride channels, causing hyperpolarization. This hyperpolarization inhibits the transmission of signals between neurons, resulting in a calming and sedating effect.

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  • 11. 

    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

    Correct Answer
    A. Midazolam has 2 times the affinity for benzo receptors
    Explanation
    Midazolam has a higher affinity for benzodiazepine receptors compared to diazepam. This means that midazolam has a stronger binding ability to these receptors, which are involved in the modulation of anxiety, sedation, and muscle relaxation. The higher affinity suggests that midazolam may have a more potent effect on these receptors compared to diazepam.

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  • 12. 

    All benzos 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

    Correct Answer
    B. Composed of a benzene ring fused to a seven-membered diazepine ring
    Explanation
    The correct answer states that all benzos share the similarity of being composed of a benzene ring fused to a seven-membered diazepine ring. This means that the chemical structure of all benzos includes these two components. This structural similarity is what classifies them as benzodiazepines and distinguishes them from other compounds.

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  • 13. 

    How is midazolam unique in comparison to other benzos?

    • 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.

    Correct Answer
    C. It is hydrophilic and becomes lipid soluble upon exposure to blood.
    Explanation
    Midazolam is unique in comparison to other benzos because it is hydrophilic and becomes lipid soluble upon exposure to blood. This means that it can easily cross the blood-brain barrier and have a rapid onset of action. Other benzos may not have the same ability to become lipid soluble, which can affect their pharmacokinetics and efficacy.

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  • 14. 

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

    • A.

      Lorazepam

    • B.

      Flumazenil

    • C.

      Midazolam

    • D.

      Diazepam

    Correct Answer
    D. Diazepam
    Explanation
    Diazepam is the correct answer because it is commonly formulated with propylene glycol as a solvent. When injected, propylene glycol can cause pain and irritation at the injection site, leading to discomfort for the patient.

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  • 15. 

    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

    Correct Answer
    A. 0.5 mg/kg
    Explanation
    An appropriate oral dose for pediatric pre-medication with midazolam is 0.5 mg/kg. This means that the dosage should be calculated based on the child's weight, with 0.5 mg of midazolam given for every kilogram of body weight. This dosage is commonly used to provide sedation and anxiety relief before medical procedures in children. It is important to calculate the dosage accurately to ensure the safety and effectiveness of the medication.

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  • 16. 

    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

    Correct Answer
    B. 0.1 mg/kg
    Explanation
    An appropriate adult IV induction dose for midazolam would be 0.1 mg/kg. This dosage is commonly used for sedation and anesthesia induction in adults. It is important to calculate the dosage based on the individual's weight to ensure safety and effectiveness. Higher doses may lead to excessive sedation or adverse effects, while lower doses may not achieve the desired level of sedation. Therefore, 0.1 mg/kg is a suitable dosage for midazolam induction in adults.

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  • 17. 

    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

    Correct Answer
    C. 30-60 seconds
    Explanation
    The correct answer is 30-60 seconds. This is because Midazolam is a fast-acting drug that is commonly used for sedation and anesthesia. It works by enhancing the effects of a neurotransmitter in the brain called gamma-aminobutyric acid (GABA), which helps to calm the central nervous system. Due to its rapid onset of action, patients typically start to feel the effects of Midazolam within 30-60 seconds after administration.

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  • 18. 

    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.

    Correct Answer
    C. You would decrease the amount of drug given since this pt may be at risk for overdose.
    Explanation
    Low albumin levels can affect the distribution and metabolism of drugs in the body. Albumin is a protein that binds to many drugs, including Midazolam, and helps transport them throughout the body. When albumin levels are low, there is less protein available to bind to the drug, leading to an increased concentration of free, unbound drug in the bloodstream. This can result in a higher drug effect and an increased risk of overdose. Therefore, to minimize the risk of overdose, the amount of Midazolam given to the patient for pre-medication should be decreased.

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  • 19. 

    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

    Correct Answer
    D. Midazolam < Lorazepam < Diazepam
    Explanation
    The elimination half-time of a medication refers to the time it takes for half of the drug to be eliminated from the body. In this case, the correct answer is Midazolam < Lorazepam < Diazepam. This means that Midazolam has the shortest elimination half-time, followed by Lorazepam, and then Diazepam.

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  • 20. 

    What is the elimination half time of Midazolam?

    • A.

      21-37 hours

    • B.

      1-4 hours

    • C.

      10-20 hours

    • D.

      5-10 hours

    Correct Answer
    B. 1-4 hours
    Explanation
    The elimination half-life of Midazolam is 1-4 hours. This means that it takes approximately 1-4 hours for the concentration of Midazolam in the body to decrease by half. After several half-lives, the drug is considered to be effectively eliminated from the body.

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  • 21. 

    What is the elimination half time of Lorazepam?

    • A.

      1-4 hours

    • B.

      21-37 hours

    • C.

      10-20 hours

    • D.

      5-10 hours

    Correct Answer
    C. 10-20 hours
    Explanation
    The elimination half-life of a drug refers to the time it takes for the concentration of the drug in the body to decrease by half. In the case of Lorazepam, the elimination half-life is 10-20 hours. This means that it takes between 10 and 20 hours for half of the drug to be eliminated from the body. This information is important for determining the dosing frequency and duration of action of the drug.

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  • 22. 

    What is the elimination half time of Diazepam?

    • A.

      5-10 hours

    • B.

      1-4 hours

    • C.

      10-20 hours

    • D.

      21-37 hours

    Correct Answer
    D. 21-37 hours
    Explanation
    The elimination half-life of Diazepam is the time it takes for half of the drug to be eliminated from the body. The given answer of 21-37 hours suggests that it takes between 21 and 37 hours for half of the Diazepam to be cleared from the system. This means that it takes a relatively long time for Diazepam to be eliminated from the body compared to the other options provided.

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  • 23. 

    Describe the metabolism and excretion of the benzodiazepines?

    • A.

      Metabolized by liver and excreted in the urine

    • B.

      Metabolized in kidneys and excreted in feces

    • C.

      Metabolized by liver and excreted in feces

    • D.

      Metabolized in kidneys and excreted by urine

    Correct Answer
    A. Metabolized by liver and excreted in the urine
    Explanation
    Benzodiazepines are metabolized by the liver, meaning that the liver breaks them down into different compounds. These metabolites are then eliminated from the body through the urine, indicating that they are excreted in the urine. This process allows the body to eliminate the benzodiazepines and their metabolites, ensuring that they do not accumulate in the body.

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  • 24. 

    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

    Correct Answer
    B. Decrease BP & PVR, especially in hypovolemic pt
    Explanation
    Benzodiazepines have a depressant effect on the cardiovascular system, leading to a decrease in blood pressure (BP) and peripheral vascular resistance (PVR). This effect is especially pronounced in hypovolemic patients. Additionally, benzodiazepines can decrease arterial blood pressure (ABP), cardiac output (CO), and heart rate (HR). However, they can also increase heart rate (HR) and decrease stroke volume (SV).

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  • 25. 

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

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    Benzodiazepines are not preferred as a pre-medication for anesthesia because they can cause respiratory depression in patients.

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  • 26. 

    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

    Correct Answer
    D. Direct Analgesic Effects
    Explanation
    Benzodiazepines are a class of drugs that are primarily used for their anxiolytic (anti-anxiety) and sedative effects. They work by enhancing the activity of a neurotransmitter called gamma-aminobutyric acid (GABA) in the brain, which leads to a decrease in neuronal excitability and a calming effect. Benzodiazepines can also increase the seizure threshold, making them useful in the treatment of seizures. However, they do not have direct analgesic effects, meaning they do not directly relieve pain. Therefore, the correct answer is "Direct Analgesic Effects".

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  • 27. 

    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.

    Correct Answer
    A. Primarily on the postsynaptic nerve endings in the cerebral cortex
    Explanation
    Benzodiazepine receptors are primarily found on the postsynaptic nerve endings in the cerebral cortex. This means that these receptors are located on the receiving end of the synapse in the outer layer of the brain, known as the cerebral cortex. These receptors play a role in the regulation of anxiety, sleep, muscle relaxation, and memory. They are targeted by benzodiazepine drugs, which bind to these receptors and enhance their inhibitory effects on the central nervous system.

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  • 28. 

    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

    Correct Answer
    B. Binds to a site other than the agonist-binding domain
    Explanation
    A non-competitive antagonist is a drug that binds to a site other than the agonist-binding domain. This means that it does not directly compete with the agonist for binding to the receptor. Instead, it binds to a different site on the receptor and alters its function, inhibiting the normal cellular function that the agonist would activate. This type of antagonist does not interfere with the agonist's binding, but rather affects the receptor's ability to respond to the agonist.

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  • 29. 

    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

    Correct Answer
    D. You may severely reduce ABP
    Explanation
    When giving both an opioid and a benzo together, you should be cautious because it may severely reduce ABP (arterial blood pressure). Opioids and benzodiazepines both have sedative effects and can cause respiratory depression. When taken together, they can potentiate each other's effects, leading to a further decrease in respiratory drive and potentially causing the patient's blood pressure to drop significantly. This can result in hypotension and compromise the patient's perfusion. Therefore, it is important to monitor the patient closely and be prepared to intervene if their blood pressure drops too low.

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  • 30. 

    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.

    Correct Answer
    A. Flumazenil, slow titration of 0.2 mg doses IV
    Explanation
    Flumazenil is the correct choice for treating a benzodiazepine overdose. It is a selective antagonist of benzodiazepine receptors and can reverse the sedative effects of benzodiazepines. Slow titration of 0.2 mg doses intravenously is recommended to prevent rapid reversal and potential withdrawal symptoms. Narcan is used to reverse opioid overdose, not benzodiazepine overdose. Flurazepam is a benzodiazepine itself and would not be appropriate for treating an overdose. Waiting it out is not a safe or effective treatment option for a benzodiazepine overdose.

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  • 31. 

    Which benzo would be used to treat panic attacks?

    • A.

      Lorazepam

    • B.

      Alprazolam

    • C.

      Flurazepam

    • D.

      Diazepam

    Correct Answer
    B. Alprazolam
    Explanation
    Alprazolam is the correct answer because it is a benzodiazepine commonly used to treat panic attacks. It works by enhancing the effects of a neurotransmitter called GABA in the brain, which helps to reduce anxiety and induce a calming effect. Alprazolam has a rapid onset of action and is effective in managing the symptoms of panic disorder, including panic attacks. The other options, lorazepam, flurazepam, and diazepam, are also benzodiazepines, but they are not typically used as first-line treatments for panic attacks.

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  • 32. 

    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

    Correct Answer
    C. 20 mg
    Explanation
    The correct answer is 20 mg. The dosage of oral midazolam for a child weighing 40 kg is determined based on their weight. The recommended dosage is typically calculated as a certain amount of medication per kilogram of body weight. Without further information or specific guidelines, it is reasonable to assume that 20 mg is the appropriate dosage for a child weighing 40 kg.

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  • 33. 

    You are holding a room temperature bottle of thiopental that was mixed 5 days ago. Can you still use it?

    • A.

      Yes, still good!

    • B.

      Nope, it is only stable for 2 days

    • C.

      If it had been refrigerated it would be good, but now it is not. Don't use.

    Correct Answer
    A. Yes, still good!
    Explanation
    The correct answer is "Yes, still good!" because thiopental is a stable drug that can be stored at room temperature for up to 7 days after it has been mixed. Therefore, even though the bottle was mixed 5 days ago, it is still safe to use.

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  • 34. 

    How long can Methohexital be refrigerated and stable for after mixing?

    • A.

      2 weeks

    • B.

      6 weeks

    • C.

      6 days

    • D.

      1 month

    Correct Answer
    B. 6 weeks
    Explanation
    Methohexital can be refrigerated and remain stable for up to 6 weeks after mixing. This means that the medication can be prepared in advance and stored in a refrigerator for a relatively long period of time without losing its effectiveness. It is important to note that after 6 weeks, the stability of the medication may decrease, and it may not be safe or effective to use. Therefore, it is crucial to adhere to the recommended storage guidelines to ensure the medication's potency and safety.

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  • 35. 

    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

    Correct Answer
    C. Protein binding
    Explanation
    The substitutions on the carbon atoms of barbiturates do not determine protein binding. Protein binding refers to the extent to which a drug binds to proteins in the blood, affecting its distribution and elimination from the body. The substitutions on the carbon atoms of barbiturates, on the other hand, can affect factors such as hypnotic potency, anti-convulsant properties, and duration of action.

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  • 36. 

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

    • A.

      Thiobarbituates

    • B.

      Malobarbituates

    • C.

      Pentabarbituates

    • D.

      Oxybarbituate

    Correct Answer
    D. Oxybarbituate
    Explanation
    An oxybarbiturate is a barbiturate compound that contains an oxygen atom on the #2 carbon. The prefix "oxy-" indicates the presence of an oxygen atom. Barbiturates are a class of drugs that act as central nervous system depressants, and they are commonly used as sedatives, hypnotics, and anesthetics. The presence of an oxygen atom on the #2 carbon in a barbiturate molecule can affect its pharmacological properties, such as its potency and duration of action. Therefore, a barbiturate with an oxygen atom on the #2 carbon would be called an oxybarbiturate.

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  • 37. 

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

    • A.

      Thiobarbituates

    • B.

      Oxybarbituates

    • C.

      Pentabarbituate

    • D.

      Sulbarbituates

    Correct Answer
    A. Thiobarbituates
    Explanation
    A barbiturate with a sulfur atom on the #2 carbon is called a thiobarbiturate. The prefix "thio-" indicates the presence of a sulfur atom. Barbiturates are a class of drugs that act as central nervous system depressants, and the addition of a sulfur atom on the #2 carbon changes the chemical properties of the compound, resulting in a thiobarbiturate. Oxybarbituates, pentabarbituate, and sulbarbituates are not correct terms to describe a barbiturate with a sulfur atom on the #2 carbon.

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  • 38. 

    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.

    Correct Answer
    B. Depression of the reticulcar activating system, suppression of excitatory neurotranmitters and enhancement of inhibitory neurotransmitters.
    Explanation
    Barbituates act by depressing the reticular activating system, suppressing excitatory neurotransmitters, and enhancing inhibitory neurotransmitters. This leads to a decrease in brain activity and a calming effect on the central nervous system. Additionally, barbituates enhance the inhibitory effects of various neurotransmitters by facilitating GABA receptor binding. This causes hyperpolarization of post-synaptic cell membranes, making them less likely to be excited.

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  • 39. 

    Distribution of barbituates depends on all of the following except...

    • A.

      Lipid Solubility

    • B.

      Protein binding

    • C.

      Hepatic oxidation

    • D.

      Degree of ionization

    Correct Answer
    C. Hepatic oxidation
    Explanation
    The distribution of barbiturates depends on factors such as lipid solubility, protein binding, and degree of ionization. Hepatic oxidation, on the other hand, refers to the metabolism of barbiturates in the liver rather than their distribution. Therefore, hepatic oxidation is not a factor that affects the distribution of barbiturates.

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  • 40. 

    Duration of action of highly lipid soluble barbituates is determined by...

    • A.

      Hepatic Oxidation

    • B.

      Lipid Solubility

    • C.

      Renal Excretion

    • D.

      Redistribution

    Correct Answer
    D. Redistribution
    Explanation
    ppt slide 10

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  • 41. 

    How much methohexital would you expect to find excreted unchanged in the urine?

    • A.

      < 1%

    • B.

      1-3 %

    • C.

      5-10 %

    • D.

      95%

    Correct Answer
    A. < 1%
    Explanation
    Methohexital is a short-acting barbiturate used as an anesthetic. The given answer suggests that less than 1% of the administered dose is expected to be excreted unchanged in the urine. This indicates that a significant portion of the drug is likely to be metabolized or eliminated through other routes, such as hepatic metabolism or fecal excretion.

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  • 42. 

    The elimination half time of Methohexital is ~4 hours.

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    Methohexital has an elimination half-life of approximately 4 hours. This means that it takes around 4 hours for half of the drug to be eliminated from the body. Therefore, the statement "The elimination half-time of Methohexital is ~4 hours" is true.

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  • 43. 

    What is responsible for the quick awakening associated with a single dose of thiopental?

    • A.

      Rapid hepatic oxidation

    • B.

      Rapid renal excretion

    • C.

      Redistribution

    • D.

      Patient respiratory rate

    Correct Answer
    C. Redistribution
    Explanation
    The quick awakening associated with a single dose of thiopental is due to redistribution. Thiopental is a short-acting barbiturate that rapidly distributes from the central nervous system to other tissues in the body, such as muscle and fat. This redistribution decreases the concentration of thiopental in the brain, leading to a rapid awakening.

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  • 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

    Correct Answer
    D. Decrease Tv and RR
    Explanation
    Barbiturates are central nervous system depressants that can cause respiratory depression. Upon awakening from the effects of barbiturates, the respiratory pattern is expected to show a decrease in tidal volume (Tv) and respiratory rate (RR). This means that the amount of air inhaled and exhaled with each breath will be reduced, as well as the number of breaths taken per minute. This respiratory pattern is a result of the depressant effects of barbiturates on the respiratory centers in the brain.

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  • 45. 

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

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    Barbiturates are not known to increase CBF (cerebral blood flow) and ICP (intracranial pressure). In fact, they have the opposite effect by decreasing both CBF and ICP. This is one of the reasons why barbiturates are sometimes used in the management of increased intracranial pressure or cerebral edema. Therefore, the statement that barbiturates increase CBF and ICP is false.

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  • 46. 

    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

    Correct Answer
    D. > 1mg/kg IV
    Explanation
    The correct answer is "> 1mg/kg IV." This means that the recommended dosage of methohexital for a patient undergoing ECT is more than 1mg per kilogram of body weight, administered intravenously. This dosage is typically determined by the patient's weight and medical condition, and it is important to follow the appropriate guidelines to ensure the patient's safety and efficacy of the treatment.

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  • 47. 

    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.

    Correct Answer
    A. Act at stereospecific receptors at presynaptic and postsynaptic sites in the central nervous system. mimic the endogenous endorphines to inhibit pain transmission.
    Explanation
    Opioids act at stereospecific receptors at presynaptic and postsynaptic sites in the central nervous system. They mimic the endogenous endorphins to inhibit pain transmission. This means that opioids bind to specific receptors in the brain and spinal cord, which helps to reduce the transmission of pain signals. By mimicking the body's natural pain-relieving substances, opioids can effectively relieve pain.

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  • 48. 

    Which of the following is NOT an endogenous peptide?

    • A.

      Endorphin

    • B.

      Ekephalin

    • C.

      Dynorphine

    • D.

      Epinorphin

    Correct Answer
    D. Epinorphin
    Explanation
    Epinorphin is not an endogenous peptide because it is not naturally produced in the body. Endogenous peptides, such as endorphin, enkephalin, and dynorphin, are naturally occurring peptides that are synthesized and released within the body. Epinorphin, on the other hand, is not produced by the body and is typically synthesized in a laboratory setting.

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  • 49. 

    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?

    Correct Answer
    C. An excitatory neurotransmitter presumed to be released by terminals of pain fibers
    Explanation
    Substance P is an excitatory neurotransmitter that is believed to be released by the terminals of pain fibers. It is involved in the transmission of pain signals in the body. This neurotransmitter plays a role in the regulation of pain perception and is associated with the sensation of pain. It is not a major inhibitory neurotransmitter or an active metabolite of opioid metabolism. The last option, "a rapper," is not a valid explanation for Substance P.

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  • 50. 

    Which opioid receptor produces ONLY spinal analgesia.

    • A.

      Mu2

    • B.

      Kappa

    • C.

      Mu1

    • D.

      Delta

    Correct Answer
    A. Mu2
    Explanation
    Mu2 opioid receptors produce only spinal analgesia. These receptors are primarily located in the spinal cord and are responsible for mediating the analgesic effects of opioids in the spinal region. Activation of Mu2 receptors inhibits the transmission of pain signals in the spinal cord, resulting in pain relief. In contrast, Mu1 receptors are found in various regions of the brain and spinal cord, and their activation produces a range of effects including analgesia, respiratory depression, and euphoria. Kappa and delta opioid receptors also contribute to analgesia, but they are not specific to spinal regions.

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Our quizzes are rigorously reviewed, monitored and continuously updated by our expert board to maintain accuracy, relevance, and timeliness.

  • Current Version
  • Mar 22, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Oct 29, 2008
    Quiz Created by
    Scottishduffy
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