Question 1

Which one of the following drugs is used in a balanced anesthesia?&#10;A)NSAIDs&#10;B)Opioids&#10;C)Respiratory stimulants&#10;D)Oral antidiabetic drugs

Accepted Answer

Opioids are often used in balanced anesthesia because they provide pain relief and sedation, which helps to reduce the amount of other anesthetic agents needed to achieve the desired level of anesthesia. NSAIDs, respiratory stimulants, and oral antidiabetic drugs are not typically used in balanced anesthesia.

Question 2

Which one of the following drugs does not have to be stopped before general surgery?&#10;A)Warfarin&#10;B)Oral hypoglycemics&#10;C)H2 receptor blockers&#10;D)Diuretics

Accepted Answer

They are sometimes used before surgery to reduce H⁺ formation in the stomach.Warfarin would promote bleeding,oral hypoglycemics promote hypoglycemia and diuretics promote hypovolemina and hypokalemia.

Question 3

Local anesthetics ____________.&#10;A)can be divided into ester and acid drugs&#10;B)are often combined with alpha antagonists&#10;C)if accidentally injected into a blood vessel cause paralysis and respiratory failure&#10;D)block Na&#8314; channels and prevent initiation of pain impulses

Accepted Answer

They are combined with alpha agonists which constrict blood vessels,reduce diffusion into blood vessels,keep the local anesthetic longer in place and reduce systemic adverse effects.They cause cardiac and CNS toxicity (arrhythmias,convulsions).

Question 4

The rate at which an inhaled anesthetic agent reaches the brain is least determined by ____________.&#10;A)solubility of the anesthetic in the blood&#10;B)concentration of the anesthetic in the inspired air&#10;C)rate and depth of respiration&#10;D)metabolism of the anesthetic

Accepted Answer

Most inhaled agents are not or some are only slightly metabolized and elimination occurs mostly through the lungs.Solubility and rate of onset of anesthesia show an inverse relationship; the more a gas is soluble the longer it remains in the blood and the slower it enters the brain.The anesthesiologist controls the concentration of the anesthetic and determines onset and duration and the deeper the patient breathes the more of the anesthetic is delivered into the body.

Question 5

A rare but possible event during general anesthesia is malignant hyperthermia.This condition ____________.&#10;A)is caused by increased Na&#8314; fluxes in the skeletal muscles&#10;B)also causes muscle paralysis, hypotension and heart block&#10;C)has no drug treatment except quickly cooling the patient&#10;D)can occur with all anesthetics but is more frequent with halothane

Accepted Answer

It is caused by increased Ca⁺⁺ fluxes in skeletal muscles.It causes,in addition,muscular rigidity,hypertension and tachycardia.It can be treated with dantrolene,which decreases Ca⁺⁺ fluxes.

Question 6

Patients being seen soon after a nerve block might ____________.&#10;A)be somewhat confused&#10;B)show slightly increased muscular strength&#10;C)show slightly decreased sensory function&#10;D)be treated aggressively

Accepted Answer

Sensory function is reduced and the patient might not be able to give accurate feedback during therapy.The advantage of a block is that the patient recovers quickly and shows no CNS after-effects.Muscle strength is reduced.Sensory and strength testing should be done and treatment should be done carefully.

Question 7

A patient seen post-op for therapy ____________.&#10;A)may still be confused&#10;B)should suppress coughing&#10;C)should be encouraged to breathe slowly&#10;D)may engage in strengthening activities

Accepted Answer

The patient should be encouraged to cough and breathe deeply to expel remaining inhaled anesthetic and bronchial secretions,and might still show some muscular weakness from the use of neuromuscular blocking agents.

Question 8

A patient with COPD should receive which of the following drugs prior to surgery?&#10;A)Bronchodilators&#10;B)Aspirin&#10;C)Anti-viral agents&#10;D)Opioids

Accepted Answer

Bronchodilators are recommended for patients with COPD prior to surgery to improve lung function and prevent bronchospasm. Aspirin and anti-viral agents are not specific to COPD and opioids may increase respiratory depression in these patients.

Question 9

Which of the following drug-effect combinations used before general surgery is mismatched?&#10;A)Monoamine oxidase inhibitors: to avoid severe hypotension&#10;B)Benzodiazepines: to sedate the patient&#10;C)Anticholinergics: to prevent bradycardia&#10;D)Antiemetics: to avoid nausea and vomiting

Accepted Answer

MAO inhibitors should be stopped because they can cause hyperpyrexia and hypertensive crisis.

Deck 10: Anesthetic Agents