Exam 2 Stoetling's Book Etomidate questions

Question 1

What is etomidate?
A. A barbiturate
B. A carboxylated imidazole–containing compound
C. A steroid
D. A benzodiazepine

Answer 1

Answer: B

Question 2

What is the original formulation of etomidate?
A. A fat emulsion
B. Water soluble at an acidic pH
C. A single isomer
D. 35% propylene glycol (pH 6.9)

Answer 2

Answer: D

Question 3

What is the mechanism of action of etomidate?
A. It binds directly to opioid receptors
B. It enhances the affinity of the excitatory neurotransmitter for GABAA receptors
C. It modulates other ligand-gated ion channels in the brain
D. It enhances the affinity of the inhibitory neurotransmitter for GABAA receptors

Answer 3

Answer: D

Question 4

What is the volume of distribution (Vd) of etomidate?
A. Small, suggesting little tissue uptake
B. Large, suggesting considerable tissue uptake
C. Moderate, suggesting moderate tissue uptake
D. None of the above

Answer 4

Answer: B

Question 5

How is etomidate metabolized?
A. By hepatic microsomal enzymes and plasma esterases
B. By hydrolysis of the ethyl ester side chain to its carboxylic acid ester
C. By recovery of unchanged drug in urine
D. Both A and B

Answer 5

Answer: D

Question 6

How does cardiopulmonary bypass affect the plasma etomidate concentration?
A. It has no effect
B. It increases the plasma etomidate concentration
C. It decreases the plasma etomidate concentration
D. It causes a fluctuation in the plasma etomidate concentration

Answer 6

Answer: C

Question 7

Etomidate is commonly used for:
A) inducing anesthesia
B) treating pain
C) treating anxiety
D) reducing inflammation

Answer 7

Answer: A) inducing anesthesia

Question 8

What is the recommended standard induction dose of etomidate?
A) 0.2 to 0.4 mg/kg IV
B) 1 to 2 mg/kg IV
C) 0.5 to 1 mg/kg IV
D) 0.1 to 0.2 mg/kg IV

Answer 8

Answer: A) 0.2 to 0.4 mg/kg IV

Question 9

What is a common side effect of etomidate during the induction period?
A) Hallucinations
B) Nausea and vomiting
C) Involuntary myoclonic movements
D) Respiratory depression

Answer 9

Answer: C) Involuntary myoclonic movements

Question 10

How does prior administration of an opioid affect myoclonic-like activity during the induction period with etomidate?
A) It has no effect
B) It increases the frequency of myoclonic-like activity
C) It decreases the frequency of myoclonic-like activity
D) It causes respiratory depression

Answer 10

Answer: C) It decreases the frequency of myoclonic-like activity

Question 11

How does the duration of action of etomidate change with increasing dose or continuous infusion?
A) It becomes shorter
B) It becomes longer
C) It stays the same
D) It becomes unpredictable

Answer 11

Answer: B) It becomes longer

Question 12

Does etomidate provide analgesia?
A) Yes
B) No
C) Only in high doses
D) Only in combination with an opioid

Answer 12

Answer: B) No

Question 13

What is the principal limiting factor in the clinical use of etomidate for induction of anesthesia?
A) Nausea and vomiting
B) Respiratory depression
C) Adrenocortical suppression
D) Allergic reactions

Answer 13

Answer: C) Adrenocortical suppression

Question 14

Is postoperative nausea and vomiting more common in patients receiving etomidate compared to propofol?
A) Yes
B) No
C) It depends on the patient’s age
D) It depends on the type of surgery performed

Answer 14

Answer: B) No

Question 15

What is the primary effect of etomidate on the Central Nervous System?
A. Increases cerebral blood flow and CMRO2
B. Suppresses adrenocortical function
C. Decreases cerebral blood flow and CMRO2
D. Activates seizure foci

Answer 15

Answer: C

Question 16

What is the cardiovascular effect of induction of anesthesia with 0.3 mg/kg IV of etomidate?
A. Minimal changes in heart rate, stroke volume, and cardiac output
B. Significant decrease in systemic blood pressure and cardiac output
C. Significant decrease in heart rate, stroke volume, and cardiac output
D. Significant increase in systemic vascular resistance

Answer 16

Answer: A

Question 17

What is the effect of etomidate on myocardial contractility?

A. Etomidate has no effect on myocardial contractility
B. Etomidate causes dose-dependent increases in developed tension in isolated cardiac muscle
C. Etomidate causes dose-dependent decreases in developed tension in isolated cardiac muscle
D. Etomidate causes irreversible depression in developed tension in isolated cardiac muscle

Answer 17

Answer: C

Question 18

What is the effect of etomidate on ventilation?

A. Etomidate causes significant apnea
B. Etomidate has no effect on ventilation
C. Etomidate may stimulate ventilation independently of the medullar centers that normally respond to carbon dioxide
D. Etomidate causes transient decreases in tidal volume and frequency of breathing

Answer 18

Answer: D

Question 19

What is the common excitatory effect of etomidate?

A. Dystonia
B. Tremor
C. Myoclonus
D. Seizures

Answer 19

Answer: C