Question 1

If adrenaline is used with local anesthetic in a finger block, which drug can be used to reverse vasospasm?
A)aramine
B)GTN
C)Hydrallazine
D)Phentolamine
E)Theophylline

Accepted Answer

Phentolamine is an alpha-adrenergic blocker that can be used to reverse vasospasm caused by adrenaline (epinephrine) in a local anesthetic solution. It works by dilating blood vessels and increasing blood flow to the affected area.

Question 2

the absorption from highest to lowest is
A)intercostals, peripheral nerve, subcutaneous
B)subcutaneous, peripheral nerve, intercostals
C)peripheral nerve, intercostals, subcutaneous
D)intercostals, subcutaneous, peripheral nerve
E)they are all the same

Accepted Answer

The absorption of local anesthetics from highest to lowest is intercostals, peripheral nerve, then subcutaneous. This is due to the differences in blood supply to these areas, with the intercostal area having a higher blood flow, leading to faster absorption, followed by peripheral nerves, and then the subcutaneous tissue having the lowest blood flow and thus the slowest absorption.

Question 3

The recommended local anesthetic dose for intercostals blocks is what percentage of maximum for peripheral blocks?
A)50
B)25
C)15
D)10
E)5

Accepted Answer

D

Question 4

For a median nerve block at the wrist the needle is inserted
A)lateral to flexor carpi radialis
B)directly lateral to palmaris longus
C)at the medial border of palamaris longus
D)through palmaris longus
E)none of the above

Accepted Answer

The median nerve at the wrist is located just lateral to the palmaris longus tendon, making option B the correct choice for the site of needle insertion for a median nerve block.

Question 5

Which statement is incorrect with regards to ulnar nerve blocks at the wrist
A)the ulnar nerve lies lateral to the artery
B)the ulnar nerve lies lateral to flexor carpi ulnaris
C)the site of needle insertion is directly lateral to flexor carpi ulnaris
D)lignocaine with adrenaline can be used safely
E)if lignocaine is used the block lasts for 1-2 hours

Accepted Answer

The answer of Which statement is incorrect with regards to...

Question 6

Which statement is incorrect?
A)the nail bed of the middle finger is supplied by the median nerve
B)the nail bed of the fifth finger is supplied by the ulnar nerve
C)the total anaesthetic agent which should be used in a finger block is 4 ml
D)the palmer and dorsal digital nerves are superficial to their arteries
E)the dorsum of the whole hand distal to the DIP is supplied by the radial nerve

Accepted Answer

The dorsum of the hand distal to the DIP joints is not entirely supplied by the radial nerve; the ulnar and median nerves also contribute to this area.

Question 7

Which statement is incorrect with regards to the plantar surface of the foot?
A)it is mostly supplied by the posterial tibial nerve
B)the saphenous nerve is blocked between the medial mallelous and tibialis anterior
C)often two nerves need to be anaesthatised for an adequate block
D)for a posterior tibial nerve block anaesthetic is injected lateral to the posterial tibial artery at the upper border of the medial mallelous
E)the sural nerve is blocked inferior to the lateral malleolus

Accepted Answer

The answer of Which statement is incorrect with regards to...

Question 8

With regards to local anesthesia of the oral region which is incorrect?
A)to anaesthasise the chin and lower lip a mental nerve block or an inferior alveolar nerve block can be done
B)an intra oral mental nerve block is done where the lip meets the gum at the level of the first pre molar
C)an external mental nerve block can be done in the same region
D)local anaesthetic with adrenaline should not be used
E)a midline laceration may need a bilateral block

Accepted Answer

Local anesthetic with adrenaline is often used in dental procedures to prolong the effect of the anesthesia and to control bleeding. The statement that it should not be used is incorrect.

Question 9

Which is false with regards to intra oral nerve blocks?
A)the technique is similar to that for a lingual nerve block
B)and inferior alveolar nerve block will anaesthatise the chin and lower lip
C)a lingual nerve block will anaesthatise the anterior two thirds of the tongue plus the floor of the mouth and the gums
D)in such block the needle is inserted two cm along the lateral border of the ramus of the mandible
E)the site of needle insertion is 1 cm above the third molar

Accepted Answer

The answer of Which is false with regards to intra...

Question 10

which is true with regard to a laceration of the pinna of the ear?
A)direct infiltration is a safe option
B)adequate regional block is achieved by injecting LA from both a superior and inferior direction anterior to the ear
C)adequate regional block is achieved by injecting LA from both superior and inferior directions posterior to the ear
D)adequate regional block requires both and anterior and posterior block
E)an intraoral approach provides the longest anaesthesia

Accepted Answer

Adequate regional block for the pinna requires both anterior and posterior blocks to cover the sensory innervation from the auriculotemporal nerve (anteriorly) and the greater auricular nerve (posteriorly).

Question 11

Which is not true with regional blockade of the infraorbital nerve?
A)it is found one cm inferior to the mid point of the lower margin of the orbit
B)anesthesia by an percutaneous route lasts longer than a intraoral route
C)it anaesthatises the upper lip
D)it anesthatises the lower eyelid
E)it anaesthatises the lateral side of the nose

Accepted Answer

Anesthesia by a percutaneous route does not necessarily last longer than an intraoral route; the duration of anesthesia depends on the anesthetic used and other factors, not the route of administration.

Question 12

Which is false with regards to a Biers Block?
A)If regional block lasts for 40 - 60 mins
B)the minimal duration of cuff inflation is 20 mins
C)bupivicaine can be used at a smaller dose of 1/mg/kg, but the cuff must remain up for at least 40 mins
D)lignocaine can be used safely
E)it is contraindicated in patients with sickle cell disease and Raynauds disease

Accepted Answer

The answer of Which is false with regards to a...

Question 13

Which is false of methoxyflourane?
A)it is found in the green sticks used for pain control in the ambulance
B)its is an ether like substance
C)it produces good analgesia with no anaesthesia
D)adverse effects include delerium, hypotension, arythmias, and respiratory depression
E)it is flammable

Accepted Answer

Methoxyflurane is not flammable, which is one of the reasons it can be used safely in various settings, including in the pre-hospital environment. Its chemical properties and the way it is administered do not present a fire hazard, distinguishing it from some other anesthetic agents that are flammable.

Question 14

Which is a false statement with regards to nitrous oxide?
A)when supplied as Entonox, it is 30% oxygen and 70% nitrous oxide
B)it does not cause hypoxia when used as entonox
C)it does not cause significant depression or loss of airway reflexes
D)it is a clear, odourless gas
E)it supports combustion but is not explosive

Accepted Answer

Entonox is a 50% mixture of oxygen and 50% nitrous oxide, not 30% oxygen and 70% nitrous oxide.

Question 15

which of these induction agents increases ICP?
A)ketamine
B)thiopentone
C)propofol
D)fentanyl
E)midazolam

Accepted Answer

Ketamine is known to potentially increase intracranial pressure (ICP), making it a less favorable choice for induction in patients with concerns about elevated ICP.

Question 16

Which is not a complication of succinylcholine?
A)increased intragastric pressure
B)histamine release
C)masseter spasm
D)malignant hyperthermia
E)hypotension

Accepted Answer

Hypotension is not a typical complication of succinylcholine. Succinylcholine can cause increased intragastric pressure, histamine release, masseter spasm, and trigger malignant hyperthermia.

Question 17

Which is not a feature of the non-depolarising neuromuscular relaxant mentioned?
A)pancuronium - tachycardia, long half life
B)atracurium - short half life
C)rocuronium - short duration of onset (1-3 mins)
D)vecuronium - brief increase ICP
E)vecuronium - lack of haemodynamic alterations

Accepted Answer

Vecuronium does not typically cause a brief increase in intracranial pressure (ICP), making this statement incorrect in the context of features of non-depolarising neuromuscular relaxants.

Question 18

Which statement is false?
A)lignocaine 1mg/kg may blunt the increase in ICP with instrumentation of the larynx.
B)In this setting lignocaine should be given no more than 20 secs prior to other agents
C)The standard adult blade for intubation is called the Macintosh blade
D)The straight blade for paediatric intubation is the Miller blade
E)The adult blade with a hinged tip that lifts the epiglottis is the McCoy blade

Accepted Answer

Lignocaine, when used to blunt the increase in intracranial pressure (ICP) associated with laryngeal instrumentation, should be administered 1-5 minutes prior to the procedure, not within 20 seconds as stated. This allows adequate time for the drug to take effect.

Question 19

Which is an incorrect statement with regards to TAC?
A)it is nuch more effective on scalp and facial wounds than extremities
B)application is for 1 hour minutes to achieve sufficient local anaesthesia
C)It must be kept in a locked cupboard
D)It should not be used in wounds where adrenaline is contraindicated
E)Significant toxicity throught mucous membranes occurs, though low dose application on mucous membranes can occur safely

Accepted Answer

TAC is applied for 10-15 minutes to achieve sufficient local anaesthesia.

Question 20

With regards to non invasive ventilation, CPAP, which is false?
A)it recruits collapsed alveoli
B)it prevents alveoli collapse
C)it increases FEV1
D)it improves FRC
E)it improves alveolar fluid distribution

Accepted Answer

CPAP (Continuous Positive Airway Pressure) does not directly increase FEV1 (Forced Expiratory Volume in 1 second), which is a measure of how much air a person can forcefully exhale in one second. It is primarily used to keep the airways open, recruit collapsed alveoli, prevent alveolar collapse, improve functional residual capacity (FRC), and can help in improving alveolar fluid distribution, but it does not directly affect the FEV1, which is more related to airway obstruction and airflow limitation.

Quiz 1: Anesthesia and Pain Management

If adrenaline is used with local anesthetic in a finger block, which drug can be used to reverse vasospasm?

the absorption from highest to lowest is

The recommended local anesthetic dose for intercostals blocks is what percentage of maximum for peripheral blocks?

For a median nerve block at the wrist the needle is inserted

Which statement is incorrect with regards to ulnar nerve blocks at the wrist

Which statement is incorrect?

Which statement is incorrect with regards to the plantar surface of the foot?

With regards to local anesthesia of the oral region which is incorrect?

Which is false with regards to intra oral nerve blocks?

which is true with regard to a laceration of the pinna of the ear?

Which is not true with regional blockade of the infraorbital nerve?

Which is false with regards to a Biers Block?

Which is false of methoxyflourane?

Which is a false statement with regards to nitrous oxide?

which of these induction agents increases ICP?

Which is not a complication of succinylcholine?

Which is not a feature of the non-depolarising neuromuscular relaxant mentioned?

Which statement is false?

Which is an incorrect statement with regards to TAC?

With regards to non invasive ventilation, CPAP, which is false?